bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of gear-manufacturing quality on the mechanical and thermal responses of a polymer-gear pair
Authors: Zorko Damijan , Wei Peitang , Vukašinović Nikola
Published: January 2024

Gear-manufacturing quality affects the load sharing between the meshing gears as well as the load distribution along the width of the tooth. This study aims to investigate the effect of gear-manufacturing quality on the mechanical and thermal states of polymer-gear pairs and consequently on their lifetime. The deviations of the geometric quality parameters, i.e., the lead profile and pitch, were found to have a substantial effect on the stress (root and flank) state of the gear. The effect of the lead deviation was found to be most pronounced for the quality grades Q12 to Q10, where depending on the load, a 30–80% stress reduction was observed when improving the gear quality from Q12 to Q10. Improving the quality from Q10 to Q8 did not lead to a substantial improvement in the load distribution and the observed stress reduction was in range of 5–20%. Similar trends were found for the pitch deviation, where again the most pronounced stress reduction was seen when improving the quality grade from Q12 to Q10. The study reveals where the most effective changes, leading to an increased gear-life, can be achieved. Improving the gear quality grade from Q12 to Q11 proved to have a much more substantial effect than improving the gear quality from Q9 to Q8. Considering that improving the gear quality from Q12 to Q11 or even Q10 can be achieved by a proper tool design and corrective iterations with the right process parameters, while improving the quality from Q9 to Q8 is by far more challenging. A novel methodology is proposed to assess the effect of the gear’s quality on the generation of heat and the resulting operational temperature. The proposed methodology enables more accurate prediction of the gear pair’s operating temperature.
Internet-based cognitive rehabilitation for working cancer survivors: results of a multicenter randomized controlled trial
Authors: Klaver Kete M , Duijts Saskia F A , Geusgens Chantal A V , Kieffer Jacobien M , Agelink van Rentergem Joost , Hendriks Mathijs P , Nuver Janine , Marsman Hendrik A , Poppema Boelo J , Oostergo Tanja , Doeksen Annemiek , Aarts Maureen J B , Ponds Rudolf W H M , van der Beek Allard J , Schagen Sanne B
Published: January 2024

Background

Cognitive problems contribute to decline in work performance. We evaluated (1) the effectiveness of basic self-management and extensive therapist-guided online cognitive rehabilitation on attainment of individually predetermined work-related goals among occupationally active cancer survivors, and (2) whether effectiveness of the programs differed for survivors with and without formal cognitive impairment.

Methods

In a 3-arm randomized controlled trial (NCT03900806), 279 non–central nervous system cancer survivors with cognitive complaints were assigned to the basic program (n = 93), the extensive program (n = 93), or a waiting-list control group (n = 93). Participants completed measurements pre-randomization (T0), 12 weeks post-randomization upon program completion (T1), and 26 weeks post-randomization (T2). Mixed-effects modeling was used to compare intervention groups with the control group on goal attainment, and on self-perceived cognitive problems, work ability, and health-related quality of life.

Results

Participants in the extensive program achieved their predetermined goals better than those in the control group, at short- and long-term follow-up (effect size [ES] = .49; P < .001; ES = .34; P = .014). They also had fewer recovery needs after work (ES = -.21; P = .011), more vitality (ES = .20; P = .018), and better physical role functioning (ES = .0.43 P = .015) than controls. At long-term follow-up, this finding persisted for physical role functioning (ES = .42; P = .034). The basic program elicited a small positive nonsignificant short-term (not long-term) effect on goal attainment for those with adequate adherence (ES = .28, P = .053). Effectiveness of the programs did not differ for patients with or without cognitive impairment.

Conclusions

Internet-based therapist-guided extensive cognitive rehabilitation improves work-related goal attainment. Considering the prevalence of cognitive problems in survivors, it is desirable to implement this program.
Trajectories and predictors of high-occurrence pain flares in ambulatory cancer patients on opioids
Authors: Meghani Salimah H , Quinn Ryan , Robinson Andrew , Chittams Jesse , Vapiwala Neha , Naylor Mary , Cheatle Martin , Knafl George J
Published: January 2024

Background

Pain flares have a substantive impact on the quality of life and well-being of patients with cancer. We identified longitudinal trajectories (clusters) of cancer pain flares in ambulatory patients and sociodemographic and clinical predictors of these trajectories.

Methods

In a prospective cohort study using ecological momentary assessment (mEMA), we collected patient-reported daily pain flare ratings data over 5 months and identified predictors and correlates using validated measures.

Results

The mean age of the sample (N = 270) was 60.9 years (SD = 11.2), 64.8% were female, and 32.6% self-identified as African American. Four pain flare clusters were identified. The “high-occurrence” cluster (23% of patients) experienced 5.5 (SD = 5.47) daily flares, whereas low-moderate clusters (77%) reported 2.4 (SD = 2.74) daily flares (P < .000). Those in the high-occurrence cluster reported higher pain scores (P = .000), increased pain-related interference (P = .000), depressive symptoms (P = .023), lower quality of life (P = .001), and reduced pain self-efficacy (P = .006). Notably, 67.2% of those prescribed opioids as needed (PRN only) were in the high-occurrence pain flare cluster, compared with 27.9% with PRN and around-the-clock opioid prescriptions (P = .024). Individual predictors of high-occurrence pain flares were income below $30 000, unemployment, being African American, lower education level, Medicaid insurance, current opioid misuse (COMM), baseline inpatient hospital stay duration, and PRN-only opioid regimen. In the multiple predictor model, lower education level, unemployment, COMM score, extended inpatient duration, and PRN-only opioid regimen remained significant.

Conclusion

In ambulatory patients with cancer, high occurrence of pain flares may be mitigated by attention to opioid prescription factors and addressing social determinants of health needs of underserved patients.
Fatigue life and fatigue reliability mechanism of ball bearings
Authors: Cheng Hongchuan , Li Xinhai , Ma Guohui , Shi Xiafei , Yang Zhou
Published: January 2024

As the main supporting parts of rotating machinery, the fatigue life and fatigue reliability of ball bearings directly affect the accuracy, stability and reliability of equipment. Based on the quasi-static model of bearing and the fatigue life theory, this paper analyzes the effect of the external loads on the mechanical properties and fatigue life of bearing, and studies the action mechanism of bearing working conditions and other parameters. In addition, based on the stress–strength model and the fatigue life model of bearing, the fatigue reliability and sensitivity of bearings are analyzed by means of perturbation method, Edgeworth series and fourth moment technique, and the correctness is verified by the Monte Carlo simulation. Results have important theoretical and practical value, and can provide theoretical support for the research of reliability optimization design, fault mechanism and fault diagnosis method of ball bearings.
ω Centauri: a MUSE discovery of a counter-rotating core
Authors: Pechetti Renuka , Kamann Sebastian , Krajnović Davor , Seth Anil , van de Ven Glenn , Neumayer Nadine , Dreizler Stefan , Weilbacher Peter M , Martens Sven , Wragg Florence
Published: January 2024

ω Centauri is considered the most massive globular cluster of the Milky Way and likely the former nuclear star cluster of a Galaxy accreted by the Milky Way. It is speculated to contain an intermediate-mass black hole (IMBH) from several dynamical models. However, uncertainties regarding the location of the cluster centre or the retention of stellar remnants limit the robustness of the IMBH detections reported so far. In this paper, we derive and study the stellar kinematics from the highest-resolution spectroscopic data yet, using the Multi Unit Spectroscopic Explorer (MUSE) in the narrow field mode and wide field mode. Our exceptional data near the centre reveal for the first time that stars within the inner 20 arcsec (∼0.5 pc) counter-rotate relative to the bulk rotation of the cluster. Using this data set, we measure the rotation and line-of-sight velocity dispersion profile out to 120 arcsec with different centres proposed in the literature. We find that the velocity dispersion profiles using different centres match well with those previously published. Based on the counter–rotation, we determine a kinematic centre and look for any signs of an IMBH using the high-velocity stars close to the centre. We do not find any significant outliers >60 km s−1 within the central 20 arcsec, consistent with no IMBH being present at the centre of ω Centauri. A detailed analysis of Jeans’ modelling of the putative IMBH will be presented in the next paper of the series.
Multiwavelength detection of an ongoing FUOr-type outburst on a low-mass YSO
Authors: Guo Zhen , Lucas P W , Kurtev R G , Borissova J , Elbakyan Vardan , Morris C , Bayo A , Smith L , Caratti o Garatti A , Contreras Peña C , Minniti D , Jose J , Ashraf M , Alonso-García J , Miller N , Muthu H D S
Published: January 2024

During the pre-main-sequence evolution, Young Stellar Objects (YSOs) assemble most of their mass during the episodic accretion process. The rarely seen FUOr-type events are valuable laboratories to investigate the outbursting nature of YSOs. Here, we present multiwavelength detection of a high-amplitude eruptive source in the young open cluster VdBH 221 with an ongoing outburst, including optical to mid-infrared time series and near-infrared spectra. The initial outburst has an exceptional amplitude of >6.3 mag in Gaia and 4.6 mag in Ks, with a peak luminosity up to 16 L⊙ and a peak mass accretion rate of 1.4 × 10−5 M⊙ yr−1. The optical to infrared spectral energy distribution of this object is consistent with a low-mass star (0.2 M⊙) with a modest extinction (AV < 2 mag). A 100-d delay between optical and infrared rising stages is detected, suggesting an outside-in origin of the instability. The spectroscopic features of this object reveal a self-luminous accretion disc, very similar to FU Orionis, with a low line-of-sight extinction. Most recently, there has been a gradual increase in brightness throughout the wavelength range, possibly suggesting an enhancement of the mass accretion rate.
Neuroinvasive Bacillus cereus Infection in Immunocompromised Hosts: Epidemiologic Investigation of 5 Patients With Acute Myeloid Leukemia
Authors: Little Jessica S , Coughlin Cassie , Hsieh Candace , Lanza Meaghan , Huang Wan Yi , Kumar Aishwarya , Dandawate Tanvi , Tucker Robert , Gable Paige , Vazquez Deida Axel A , Moulton-Meissner Heather , Stevens Valerie , McAllister Gillian , Ewing Thomas , Diaz Maria , Glowicz Janet , Winkler Marisa L , Pecora Nicole , Kubiak David W , Pearson Jeffrey C , Luskin Marlise R , Sherman Amy C , Woolley Ann E , Brandeburg Christina , Bolstorff Barbara , McHale Eileen , Fortes Esther , Doucette Matthew , Smole Sandra , Bunnell Craig , Gross Anne , Platt Dana , Desai Sonali , Fiumara Karen , Issa Nicolas C , Baden Lindsey R , Rhee Chanu , Klompas Michael , Baker Meghan A
Published: January 2024

Background

Bacillus cereus is a ubiquitous gram-positive rod-shaped bacterium that can cause sepsis and neuroinvasive disease in patients with acute leukemia or neutropenia.

Methods

A single-center retrospective review was conducted to evaluate patients with acute leukemia, positive blood or cerebrospinal fluid test results for B cereus, and abnormal neuroradiographic findings between January 2018 and October 2022. Infection control practices were observed, environmental samples obtained, a dietary case-control study completed, and whole genome sequencing performed on environmental and clinical Bacillus isolates.

Results

Five patients with B cereus neuroinvasive disease were identified. All patients had acute myeloid leukemia (AML), were receiving induction chemotherapy, and were neutropenic. Neurologic involvement included subarachnoid or intraparenchymal hemorrhage or brain abscess. All patients were treated with ciprofloxacin and survived with limited or no neurologic sequelae. B cereus was identified in 7 of 61 environmental samples and 1 of 19 dietary protein samples—these were unrelated to clinical isolates via sequencing. No point source was identified. Ciprofloxacin was added to the empiric antimicrobial regimen for patients with AML and prolonged or recurrent neutropenic fevers; no new cases were identified in the ensuing year.

Conclusions

B cereus is ubiquitous in the hospital environment, at times leading to clusters with unrelated isolates. Fastidious infection control practices addressing a range of possible exposures are warranted, but their efficacy is unknown and they may not be sufficient to prevent all infections. Thus, including B cereus coverage in empiric regimens for patients with AML and persistent neutropenic fever may limit the morbidity of this pathogen.
PRDM16 co-operates with LHX2 to shape the human brain
Authors: Suresh Varun , Bhattacharya Bidisha , Tshuva Rami Yair , Danan Gotthold Miri , Olender Tsviya , Bose Mahima , Pradhan Saurabh J , Zeev Bruria Ben , Smith Richard Scott , Tole Shubha , Galande Sanjeev , Harwell Corey C , Baizabal José-Manuel , Reiner Orly
Published: January 2024

PRDM16 is a dynamic transcriptional regulator of various stem cell niches, including adipocytic, hematopoietic, cardiac progenitors, and neural stem cells. PRDM16 has been suggested to contribute to 1p36 deletion syndrome, one of the most prevalent subtelomeric microdeletion syndromes. We report a patient with a de novo nonsense mutation in the PRDM16 coding sequence, accompanied by lissencephaly and microcephaly features. Human stem cells were genetically modified to mimic this mutation, generating cortical organoids that exhibited altered cell cycle dynamics. RNA sequencing of cortical organoids at day 32 unveiled changes in cell adhesion and WNT-signaling pathways. ChIP-seq of PRDM16 identified binding sites in postmortem human fetal cortex, indicating the conservation of PRDM16 binding to developmental genes in mice and humans, potentially at enhancer sites. A shared motif between PRDM16 and LHX2 was identified and further examined through comparison with LHX2 ChIP-seq data from mice. These results suggested a collaborative partnership between PRDM16 and LHX2 in regulating a common set of genes and pathways in cortical radial glia cells, possibly via their synergistic involvement in cortical development.
Absolute properties of the oscillating eclipsing Algol XZ Ursae Majoris
Authors: Lee Jae Woo , Hong Kyeongsoo , Kim Hye-Young , Wolf Marek , Park Jang-Ho , Rittipruk Pakakaew
Published: January 2024

It is known from archival TESS data that the semi-detached Algol system XZ Ursae Majoris (UMa) is one of the candidate binary stars exhibiting short-period oscillations. We secured new high-resolution spectroscopic observations for the program target to better understand its binary and pulsation properties. From the echelle spectra, the radial velocities (RVs) of the eclipsing pair were derived, and the atmosphere parameters of the primary component were measured to be vAsin i = 80 ± 7 km s−1, Teff, A = 7940 ± 120 K, and [M/H] = −0.15 ± 0.20. The combined solution of our double-lined RVs and the TESS data provides robust physical parameters for XZ UMa with mass and radius measurement precision of better than 2%. The outside-eclipse residuals from a mean light curve in the 0.002 phase bin were used for multifrequency analyses, and we extracted 32 significant frequencies (22 in <5.0 d−1 and 10 in 39–52 d−1). The low frequencies may be mostly aliasing sidelobes, while six of the high frequencies may be pulsation signals arising from the detached primary located inside the δ Sct domain. Their periods, pulsation constants, and pulsational–orbital-period ratios indicate that the mass-accreting primary star is a δ Sct pulsator and, hence, XZ UMa is an oscillating eclipsing Algol.
Search for Dark Energy with Neutron Interferometry
Authors: Fischer Hauke , Käding Christian , Lemmel Hartmut , Sponar Stephan , Pitschmann Mario
Published: January 2024

We use previously obtained experimental results by neutron interferometry to effectively constrain the parameter space of several prominent dark energy models. This investigation encompasses the environment-dependent dilaton field, a compelling contender for dark energy that emerges naturally within the strong coupling limit of string theory, alongside symmetron and chameleon fields. Our study presents substantial improvements over previous constraints of the dilaton and symmetron fields, improving parameter constraints by several orders of magnitude. However, the analysis does not yield any new constraints on the chameleon field. Furthermore, we establish constraints for the projected neutron split interferometer, which has recently concluded a decisive proof-of-principle demonstration. Our symmetron simulations reveal that, depending on the parameter values, there are multiple static solutions with an increasing number of nodes and increasing energy inside a cylindrical vacuum chamber. This agrees with results obtained earlier in the literature for infinitely extended parallel plates. Interestingly, while these multiple solutions can correspond to domain walls forming inside the vacuum chamber, we also find solutions that do not reach their vacuum expectation value inside the vacuum chamber, but display multiple nodes nonetheless.
Casimir Effect of Lorentz-Violating Charged Dirac Field in Background Magnetic Field
Authors: Rohim Ar , Romadani Arista , Adam Apriadi Salim
Published: January 2024

We study the effect of the Lorentz violation on the Casimir energy and pressure of a charged Dirac field in a background uniform magnetic field. In the model, the Lorentz violation is parameterized not only by the intensity but also by its direction. We investigate two cases of the direction of violation, namely, time-like and space-like vector cases. We use the boundary condition of the MIT bag model to represent the property of the plates. We show how the Lorentz violation and the magnetic field affect the structure of the Casimir energy and its pressure. We also investigate the weak and strong magnetic field cases with two different limits, heavy and light masses. In addition, we compute the ratio of the influence of the strong magnetic field to that of the weak one for the Casimir energy and its pressure. We find that the strong magnetic field enhances the magnitude of the Casimir energy and its pressure, where the parameter of the intensity of Lorentz violation could scale the plate’s distance.
The Work-From-Home Technology Boon and its Consequences
Authors: Davis Morris A , Ghent Andra C , Gregory Jesse
Published: January 2024

We study the impact of widespread adoption of work-from-home (WFH) technology using an equilibrium model where people choose where to live, how to allocate their time between working at home and at the office, and how much space to use in production. Motivated by cross-sectional evidence on WFH, we model WFH as a complement to work at the office. Simulations of the model indicate that the pandemic induced a large change to the relative productivity of WFH that substantially increased home prices and will permanently affect incomes, income inequality, and city structure.
Apigenin promotes apoptosis of 4T1 cells through PI3K/AKT/Nrf2 pathway and improves tumor immune microenvironment in vivo
Authors: Zhang Chu , Liao Yupei , Li Tangjia , Zhong Haijing , Shan Luchen , Yu Pei , Xia Chenglai , Xu Lipeng
Published: January 2024

The 2022 US Cancer Statistics show that breast cancer is one of the most common cancers in women. Epidemiology has shown that adding flavonoids to the diet inhibits cancers that arise in particular women, such as cervical cancer, ovarian cancer, and breast cancer. Although there have been research reports on apigenin (API) and breast cancer, its anti-tumor effect and potential mechanism on breast cancer have not yet been clarified. Therefore, in this study, we used 4T1 cells and a 4T1 xenograft tumor mouse model to investigate the antitumor effect of API on breast cancer and its underlying mechanism. In vitro, we used MTT, transwell, staining, and western blotting to investigate the inhibitory effect of apigenin on 4T1 and the underlying molecular mechanism. In vivo by establishing a xenograft tumor model, using immunohistochemistry, and flow cytometry to study the inhibitory effect of apigenin on solid breast tumors and its effect on the tumor immune microenvironment. The results showed that API can induce breast cancer cell apoptosis through the PI3K/AKT/Nrf2 pathway and can improve the tumor immune microenvironment in mice with breast tumors, thereby inhibiting the growth of breast cancer. Thus, API may be a promising agent for breast cancer treatment.
Developmental toxicity of pyriproxyfen induces changes in the ultrastructure of neural cells and in the process of skull ossification
Authors: Luckmann Maico Roberto , Ferreira Méllanie Amanda Silva , da Silva Norma Machado , Nazari Evelise Maria
Published: January 2024

Some studies relate the use of pyriproxyfen (PPF) in drinking water with damage to embryonic neurodevelopment, including a supposed association with cases of microcephaly. However, the effects on neural cells and skull ossification in embryos remain unclear. This study aims to investigate the effects of PPF on the structure and ultrastructure of brain cells and its influence on the skull ossification process during embryonic development. Chicken embryos, used as an experimental model, were exposed to concentrations of 0.01 and 10 mg/l PPF at E1. The findings demonstrated that PPF led to notable ultrastructural alterations such as reduced cilia and microvilli of ependymal cells and damage to mitochondria, endoplasmic reticulum, Golgi bodies, and cell membranes in neural cells. The frequency of changes and the degree of these cell damage between the forebrain and midbrain were similar. PPF induced a reduction in fox3 transcript levels, specific for differentiation of neurons, and a reduction in the NeuN protein content related to mature neurons and dendritic branches. PPF impacted the ossification process of the skull, as evidenced by the increase in the ossified area and the decrease in inter-bone spacing. In conclusion, this study highlights the ability of PPF to affect neurodevelopmental processes by inducing ultrastructural damage to neural cells, concomitant with a reduction in NeuN and fox3 expression. This detrimental impact coupled with deficiencies in skull ossification can prevent the proper growth and development of the brain.
STK214947, a novel indole alkaloids, inhibits HeLa and SK-HEP-1 cells survival and EMT process by bloking the Notch3 and Akt signals
Authors: Xu Zihan , Yuan Yuxin , Liu Jiaqi , Li Caijing , Chen Kejin , Wang Fang , Li Ganpeng
Published: January 2024

Apoptosis and epithelial-to-mesenchymal transition (EMT) are closely associated with tumor survival and metastasis. These are the basic events in tumor occurrence and progression. STK214947 is an indole alkaloid with a skeleton that is similar to that of indirubin. Indole alkaloids have attracted considerable attention because of their antitumor activity. However, the relationship between STK214947 and these basic events remains unknown. In this study, the effects of STK214947 on inducing apoptosis and reversing the EMT process in tumor cells were confirmed. Mild concentrations of STK214947 inhibited tumor cell migration by reversing EMT and significantly regulated the expression of EMT-related proteins, including Notch3, E-cadherin, N-cadherin and vimentin. In addition, STK214947 in high concentration could induce apoptosis by down-regulating Notch3, p-Akt/Akt, and NF-κB, and upregulating Caspase 3. These findings support the further development of STK214947 as a potential antitumor small molecule that targets Notch3 and Akt signal transduction in cancer.
Experience with pembrolizumab in a renal transplant patient with advanced lung cancer: a case report and review
Authors: Fernández Madrigal Laura , García Samblásand Victoria , Sánchez Escudero Laura
Published: January 2024

The treatment of non-small cell lung cancer (NSCLC) has undergone a change due to the advancement of new therapies, like immune checkpoint inhibitors (ICIs), including pembrolizumab. A 64-year-old woman received a kidney transplant in 2012 due to chronic kidney disease secondary to glomerulosclerosis, diagnosed in 2020 with stage IV NSCLC due to metastasis in the contralateral lung, with PD-L1 expression of 98%, starting treatment with ICIs, despite presenting a graft rejection risk around 40%. After 3 ICI cycles, the patient presented a partial response, with good tolerance to treatment and no signs of graft failure. ICIs were maintained for 19 cycles, until disease progression was observed on a reassessment computed tomography, with a progression-free interval of 18 months, with no evidence of treatment rejection. In transplant patients diagnosed with some type of tumor, antineoplastic therapies may be less effective than in the general population. The current evidence derives from observational studies and case series, since this patient population was excluded from clinical trials, suggesting that the use of ICIs in patients with kidney transplants can lead to acute graft rejection. This is still a controversial issue, it is necessary to improve the quality of the data, with the implementation of clinical trials or prospective studies.
Development of an Artificial Intelligence Teaching Assistant System for Undergraduate Nursing Students
Authors: Kowitlawakul Yanika , Tan Jocelyn Jie Min , Suebnukarn Siriwan , Nguyen Hoang D. , Poo Danny Chiang Choon , Chai Joseph , Kamala Devi M. , Wang Wenru
Published: January 2024

Keeping students engaged and motivated during online or class discussion may be challenging. Artificial intelligence has potential to facilitate active learning by enhancing student engagement, motivation, and learning outcomes. The purpose of this study was to develop, test usability of, and explore undergraduate nursing students' perceptions toward the Artificial Intelligence–Teaching Assistant System. The system was developed based on three main components: machine tutor intelligence, a graphical user interface, and a communication connector. They were included in the system to support contextual machine tutoring. A field-testing study design, a mixed-method approach, was utilized with questionnaires and focus group interview. Twenty-one undergraduate nursing students participated in this study, and they interacted with the system for 2 hours following the required activity checklist. The students completed the validated usability questionnaires and then participated in the focus group interview. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data from the focus group interviews. The results showed that the Artificial Intelligence–Teaching Assistant System was user-friendly. Four main themes emerged, namely, functionality, feasibility, artificial unintelligence, and suggested learning modality. However, Artificial Intelligence–Teaching Assistant System functions, user interface, and content can be improved before full implementation.
Effect of Huaier granule on prognosis of breast cancer: A single-center propensity score matching retrospective study
Authors: Guo Qianqian , Peng Yuting , Zhang Ge , Lin Huan , Chen Qianjun
Published: January 2024

Background:

Huaier granule is an important medicinal fungus extract widely used in cancer treatment. Previous retrospective studies have reported its effectiveness in breast cancer patients, but the imbalanced baseline characteristics of participants could have biased the results. Therefore, this retrospective study aimed to examine the efficacy of Huaier granule on the prognosis of breast cancer patients.

Methods:

In this single-center cohort study, breast cancer patients diagnosed and treated at the Guangdong Provincial Hospital of Chinese Medicine between 2009 and 2017 were selected. The data were retrospectively analyzed and divided into two groups according to whether the patients received Huaier granules. The propensity score matching (PSM) method was used to eliminate selection bias. The disease-free survival (DFS) and overall survival (OS) for these groups were compared using the Kaplan–Meier method and the Cox regression.

Results:

This study included 214 early invasive breast cancer patients, 107 in the Huaier group and 107 in the control group. In the Kaplan–Meier analysis, the 2-year and 5-year DFS rates were significantly different in the Huaier group and control group (hazard ratio [HR], 0.495; 95% confidence interval [CI], 0.257–0.953; P = 0.023). The 2-year and 5-year OS rates were also significantly different (HR, 0.308; 95% CI, 0.148–0.644; P = 0.001). On multivariable Cox regression, Huaier granule was associated with improved DFS (HR, 0.440; 95% CI, 0.223–0.868; P = 0.018) and OS (HR, 0.236; 95% CI, 0.103–0.540; P = 0.001).

Conclusion:

In this retrospective study, Huaier granules improved the DFS and OS of early invasive breast cancer patients, providing real-world evidence for further prospective studies on treating breast cancer with Huaier granules.
Assessment of the Oral Health Status of Patients Admitted to Pediatric Intensive Care Units
Authors: Bozkurt Ramazan , Eşer İsmet
Published: January 2024

Background

It is important to detect oral health problems early among patients admitted to pediatric intensive care units to establish the diagnosis and consequently allow nurses to plan appropriate oral care practices.

Objectives

The study aimed to assess the oral health status of patients admitted to pediatric intensive care units.

Methods

This descriptive cross-sectional study was conducted from June to September 2021 in the pediatric intensive care units of 3 hospitals. A total of 88 children were included in the study. An intraoral assessment was performed using a tongue depressor and a flashlight, and data were collected using a patient information form and the Oral Assessment Guide (OAG).

Results

The mean OAG score was 8.45 ± 2.876 points. A significant difference was found in the OAG score between the patients 60 months or younger and those 61 months or older (P < .05). The OAG score was significantly associated with the use of diuretics (P < .05) and the frequency of oral care (P < .05). A negative relationship was found between the OAG score and the Glasgow Coma Scale score (P < .05).

Conclusions

The oral health status of the patients worsened as their age increased, and their state of consciousness decreased. Oral care was more frequently applied to the patients who received artificial respiration. The study provides evidence-based data regarding the early detection of the factors threatening oral health and the necessary precautions.
The Arteria Lymphatica and Lymphatic Microperforators: A Dedicated Blood Supply to Collecting Lymphatics and Their Potential Implications in Lymphedema: Anatomical Description
Authors: Bendon Charlotte L. , Hanssen Eric , Nowell Cameron , Karnezis Tara , Shayan Ramin
Published: January 2024

Background:

Lymphedema is common after lymphatic damage in cancer treatment, with negative impacts on function and quality of life. Evidence suggests that blood vessel microvasculature is sensitive to irradiation and trauma; however, despite knowledge regarding dedicated mural blood supply to arteries and veins (vasa vasorum), equivalent blood vessels supplying lymphatics have not been characterized. We studied collecting lymphatics for dedicated mural blood vessels in our series of 500 lymphaticovenous anastomosis procedures for lymphedema, and equivalent controls.

Methods:

Microscopic images of lymphatics from lymphedema and control patients were analyzed for lymphatic wall vascular density. Collecting lymphatics from 20 patients with lymphedema and 10 control patients were sampled for more detailed analysis (podoplanin immunostaining, light/confocal microscopy, microcomputed tomography, and transmission electron microscopy) to assess lymphatic wall ultrastructure and blood supply.

Results:

Analysis revealed elaborate, dense blood microvessel networks associating with lymphatic walls in lymphedema patients and smaller equivalent vessels in controls. These vasa vasora or “arteria lymphatica” were supplied by regular axial blood vessels, parallel to lymphatic microperforators linking dermal and collecting lymphatics. Lymphatic walls were thicker in lymphedema patients than controls, with immunohistochemistry, computed tomography, transmission electron microscopy, and confocal microscopy characterizing abnormal blood vessels (altered appearance, thickened walls, elastin loss, narrow lumina, and fewer red blood cells) on these lymphatic walls.

Conclusions:

Dedicated blood vessels on lymphatics are significantly altered in lymphedema. A better understanding of the role of these vessels may reveal mechanistic clues into lymphedema pathophysiology and technical aspects of lymphedema microsurgery, and suggest potential novel therapeutic targets.
Tomographic Predictors of Ectasia Development After Keratorefractive Surgery
Authors: Masarwa Dua , Mimouni Michael , Aloni Eyal , Kaiserman Igor
Published: January 2024

Purpose:

The aim of this study was to identify the risk factors for postkeratorefractive surgery ectasia in unsuspicious tomographies and to report a new index coined diameter of peak locations (DPLs).

Methods:

All patients who underwent keratorefractive surgery between 2011 and 2018 at Care-Vision Laser Centers, Israel, and later developed ectasia were included. For each ectasia case, 3 matched controls were selected. Demographic and preoperative, intraoperative, and postoperative data were collected. Multivariate analysis was performed to evaluate the interdependence of the variables.

Results:

The retrospective study included 19 ectasia and 58 control eyes. There were no significant differences between the groups in ablation depth (P = 0.73), preoperative spherical equivalent (P = 0.12), percent tissue altered (P = 0.71), residual stromal bed (P = 0.73), and Ectasia Risk Score System (P = 0.60). The anterior and the posterior symmetry index were significantly higher (P < 0.001), and DPL was significantly tighter in the ectasia group (P = 0.01). Binary multiple logistic regression found the symmetry index of the posterior cornea and DPL to be better predictors than age, percent tissue altered, Ectasia Risk Score System, residual stromal bed, and ablation depth.

Conclusions:

A higher posterior symmetry index and a tighter DPL are predictors of ectasia in patients with otherwise normal tomographies. A tight DPL implies a weak area in the cornea, which is thin and slightly bulging, increasing the risk of this area becoming ectatic.
Applications of artificial intelligence-enabled robots and chatbots in ophthalmology: recent advances and future trends
Authors: Madadi Yeganeh , Delsoz Mohammad , Khouri Albert S. , Boland Michael , Grzybowski Andrzej , Yousefi Siamak
Published: January 2024

Purpose of review

Recent advances in artificial intelligence (AI), robotics, and chatbots have brought these technologies to the forefront of medicine, particularly ophthalmology. These technologies have been applied in diagnosis, prognosis, surgical operations, and patient-specific care in ophthalmology. It is thus both timely and pertinent to assess the existing landscape, recent advances, and trajectory of trends of AI, AI-enabled robots, and chatbots in ophthalmology.

Recent findings

Some recent developments have integrated AI enabled robotics with diagnosis, and surgical procedures in ophthalmology. More recently, large language models (LLMs) like ChatGPT have shown promise in augmenting research capabilities and diagnosing ophthalmic diseases. These developments may portend a new era of doctor-patient-machine collaboration.

Ophthalmology is undergoing a revolutionary change in research, clinical practice, and surgical interventions. Ophthalmic AI-enabled robotics and chatbot technologies based on LLMs are converging to create a new era of digital ophthalmology. Collectively, these developments portend a future in which conventional ophthalmic knowledge will be seamlessly integrated with AI to improve the patient experience and enhance therapeutic outcomes.
In situ tissue profile of rat trigeminal nerve in trigeminal neuralgia using spatial transcriptome sequencing
Authors: Wei Wenbin , Liu Yuemin , Shen Yifen , Yang Tao , Dong Yabing , Han Zixiang , Wang Yiwen , Liu Zhiyang , Chai Ying , Zhang Mengjie , Wang Hanshao , Shen Hao , Shen Yihang , Chen Minjie
Published: January 2024

Background:

Trigeminal neuralgia (TN) is the most common neuropathic disorder in the maxillofacial region. The etiology and pathogenesis of TN have not been clearly determined to date, although there are many hypotheses.

Objective:

The goal of this study was to investigate the interactions between different types of cells in TN, particularly the impact and intrinsic mechanism of demyelination on the trigeminal ganglion, and to identify new important target genes and regulatory pathways in TN.

Methods:

TN rat models were prepared by trigeminal root compression, and trigeminal nerve tissues were isolated for spatial transcriptome sequencing. The gene expression matrix was reduced dimensionally by PCA and presented by UMAP. Gene function annotation was analyzed by Metascape. The progression of certain clusters and the developmental pseudotime were analyzed using the Monocle package. Modules of the gene coexpression network between different groups were analyzed based on weighted gene coexpression network analysis and assigned AddModuleScore values. The intercellular communication of genes in these networks via ligand–receptor interactions was analyzed using CellPhoneDB analysis.

Results:

The results suggested that the trigeminal ganglion could affect Schwann cell demyelination and remyelination responses through many ligand–receptor interactions, while the effect of Schwann cells on the trigeminal ganglion was much weaker. Additionally, ferroptosis may be involved in the demyelination of Schwann cells.

Conclusions:

This study provides spatial transcriptomics sequencing data on TN, reveals new markers, and redefines the relationship between the ganglion and myelin sheath, providing a theoretical basis and supporting data for future mechanistic research and drug development.
Reduced Compared With Traditional Schedules for Routine Antenatal Visits: A Systematic Review
Authors: Balk Ethan M. , Danilack Valery A. , Bhuma Monika Reddy , Cao Wangnan , Adam Gaelen P. , Konnyu Kristin J. , Peahl Alex Friedman
Published: January 2024

(Abstracted from Obstet Gynecol 2023;142:8–18)

Preventive care during pregnancy generally involves screening and monitoring of both mother and fetus to minimize negative outcomes for both during pregnancy and childbirth. Previous research has demonstrated improved outcomes associated with high-quality antenatal care but has not established optimal timing or frequency of visits for routine care.
The Impact of the COVID-19 Pandemic on Real-world Functioning in Adult Cochlear-implant Users
Authors: Young Tyler J. , Schneider Kara J. , Moberly Aaron , Tamati Terrin
Published: January 2024

Hypothesis:

As a result of COVID-19 lockdowns and the associated effects on the auditory-social environments of cochlear-implant (CI) users, we expected that adult CI users would report a decrease in real-world communication abilities, a decrease in social isolation, and a decrease in quality of life (QOL) from pre- to post-pandemic.

Background:

The COVID-19 pandemic brought many changes to the environments in which adults with CIs interact and communicate. However, the impact of these changes on CI users’ real-world functioning is not well understood. This study investigated the impact of the COVID-19 pandemic on real-world communication abilities, social isolation, and CI-related QOL in adult CI users.

Methods:

Fourteen adult CI users completed self-report questionnaires assessing communication abilities, social isolation, and CI-related QOL at time points before and after the onset of the COVID-19 pandemic. Responses at the 2 time points were compared to evaluate changes in CI users’ real-world functioning.

Results:

Adult CI users showed a significant decrease in self-reported communication ability and a nonsignificant decline in CI-related QOL from before to during COVID-19. However, a nonsignificant trend of a decline in social isolation was also observed in adult CI users.

Conclusion:

Findings showed a decrease in self-reported communication abilities and, to a lesser extent, CI-related QOL, suggesting that changes to the auditory-social environment brought on by the COVID-19 pandemic may have negatively impacted communication abilities in real-world, challenging environments. Yet, the potential decrease in social isolation suggests that these changes may have had an overall positive effect on social interaction, potentially with close family and friends in well-controlled environments. Assessing changes in real-world functioning in the same CI users from both before and during the COVID-19 pandemic provided a unique glimpse into how changes in the auditory-social environment may impact outcomes in adult CI users.
Contribution of 68Ga-DOTA-FAPI-04 PET/CT to Prostate Cancer Imaging
Authors: Ergül Nurhan , Çermik Tevfik Fikret , Alçın Göksel , Arslan Esra , Erol Fenercioğlu Özge , Beyhan Ediz , Şahin Rahime , Baloğlu Mehmnet Can , Baykal Koca Sevim , Türkay Rüştü , Yücetaş Uğur
Published: January 2024

Purpose

Prostate-specific membrane antigen (PSMA)–targeted PET/CT is a well-established imaging method in prostate cancer (PC) for both staging and restaging, and also for theranostic applications. An alternative imaging method is crucial for 15% PSMA-negative cases. We aimed to investigate the contribution of 68Ga-DOTA-FAPI-04 PET/CT to PC imaging.

Patients and Methods

Thirty-six patients diagnosed with PC were included. Patients underwent both 68Ga-PSMA PET/CT and 68Ga-DOTA-FAPI-04 PET/CT imaging within 1 week. In staging group, primary tumor uptake values were compared, and also correlations were done with histopathological findings, MRI findings, and total PSA levels. In biochemical recurrence group, the uptake values in prostatic region and metastases were evaluated to define the local recurrence or metastatic disease.

Results

In staging group, PSMA PET showed increased uptake in the primary lesion area in 14/27 (52%) patients, whereas 20/27 (74%) patients were positive in FAPI-04 PET. FAPI-04 positivity was found to be quite high, such as 54%, in PSMA-negative patients. A significant difference was observed between ISUP grade 1–3 patients and ISUP grade 4–5 patients in FAPI-04 PET (P = 0.03). Local recurrence was detected in 3 patients, pelvic lymph node metastasis in 1 patient, and sacrum metastasis in 1 patient in biochemical recurrence group, and all of the lesions had more intense uptake in PSMA PET than FAPI-04 PET.

Conclusions

FAPI PET imaging seems to have a potential to contribute PSMA PET imaging with FAPI positivity in more than half of PSMA-negative cases. Also, FAPI-targeted radionuclide therapy may be a promising method in patients resistant to PSMA-targeted therapy.
Multiparametric Cardiovascular Magnetic Resonance in Nonhospitalized COVID-19 Infection Subjects
Authors: Zhang Jun , Luo Song , Cai Jun , Kong Xiang , Zhang Lingyan , Qi Li , Zhang Long Jiang
Published: January 2024

Purpose:

To investigate intraindividual cardiac structural and functional changes before and after COVID-19 infection in a previously healthy population with a 3T cardiac magnetic resonance (CMR).

Materials and Methods:

A total of 39 unhospitalized patients with COVID-19 were recruited. They participated in our previous study as non-COVID-19 healthy volunteers undergoing baseline CMR examination and were recruited to perform a repeated CMR examination after confirmed COVID-19 infection in December 2022. The CMR parameters were measured and compared between before and after COVID-19 infection with paired t tests. The laboratory measures including myocardial enzymes and inflammatory indicators were also collected when performing repeated CMR.

Results:

The median duration was 393 days from the first to second CMR and 26 days from clinical symptoms onset to the second CMR. Four patients (10.3%, 4/39) had the same late gadolinium enhancement pattern at baseline and repeated CMR and 5 female patients (12.8%, 5/39) had myocardial T2 ratio >2 (2.07 to 2.27) but with normal T2 value in post-COVID-19 CMR. All other CMR parameters were in normal ranges before and after COVID-19 infection. Between before and after the COVID-19 infection, there were no significant differences in cardiac structure, function, and tissue characterization, no matter with or without symptoms (fatigue, chest discomfort, palpitations, shortness of breath, and insomnia/sleep disorders) (all P>0.05). The laboratory measures at repeated CMR were in normal ranges in all participants.

Conclusions:

These intraindividual CMR studies showed unhospitalized patients with COVID-19 with normal myocardial enzymes had no measurable CMR abnormalities, which can help alleviate wide social concerns about COVID-19–related myocarditis.
Reconstruction of Skin Defects in the Medial Canthal Region Using the Novel Hug Flap
Authors: Kashimura Tsutomu , Horigome Michio , Soejima Kazutaka
Published: January 2024

Various methods of reconstructing skin defects in the medial canthal region have been reported. We report 2 skin flaps for the upper and lower eyelids designed to reconstruct soft tissue defects in the medial canthal region based on the approach used for the orbit during surgeries for facial bone fractures. The skin flap was elevated without tension until it reached the defect. The skin flaps of the upper and lower eyelids were moved around the defect as rotational flaps and sutured. Two patients with skin defects in the medial canthal region after basal cell carcinoma resection were treated with this technique. No complications occurred, and good cosmetic and functional outcomes were obtained. This method can be used to reconstruct the eyelid with an elevated skin flap and is considered useful for repairing defects in the medial canthal region.