Normal Population Research Articles

Impact of etiology, sex, diabetes mellitus and remission status on erythrocytic profile in patients with cushing's syndrome: a large population database study.

The study aimed to characterize the erythrocytic profile in patients with cushing's syndrome (CS) versus controls from the normal population according to etiology, sex, presence of diabetes mellitus (DM) and hypercortisolemia remission status. This retrospective cohort analysis compared erythrocytic parameters between patients with CS of pituitary (CD) and adrenal (aCS) etiology and age, sex, body mass index (BMI) and socioeconomic status-matched controls in a 1:5 ratio. Laboratory values at baseline were calculated as mean values during the year preceding CS diagnosis, and over one year thereafter. The cohort included 397 CS patients (68.26% female; mean age 51.11 ± 16.85years) and 1970 controls. Patients with CS had significantly higher baseline median levels of hemoglobin (Hgb) (13.70g/dL vs. 13.12g/dL [p < 0.0001]) and hematocrit (Hct) (41.64% vs. 39.80% [p < 0.0001]) compared to controls. These differences were observed for both CD and aCS and for both sexes. Patients who attained remission had Hgb and Hct levels comparable to controls (13.20g/dL and 40.08% in patients with CD and aCS vs. 13.20g/dL and 39.98% in controls). Meanwhile, those with persistent/recurrent disease maintained elevated levels. Patients with comorbid DM had similar Hgb but higher Hct (p = 0.0419), while patients without DM showed elevated erythrocytic values compared to controls (p < 0.0001). Our data illustrates that erythrocytic parameters are directly influenced by glucocorticoid excess as Hgb and Hct are higher in patients with CS, and normalize after remission. We have identified the influence of DM on erythrocytic parameters in patients with CS for the first time.

Refined Aircraft Positioning Based on Stochastic Hybrid Estimation with Adaptive Square-Root Unscented Particle Filtering

The positioning of civil aviation aircraft relative to a geographic reference point on Earth in a Cartesian frame is significant to detect the deviations from the desired path, especially for high-altitude airports or special airports based on performance-based navigation (PBN). To obtain these critical deviations during aircraft approach and landing, it is fundamental to estimate the continuous flight variables and discrete flight modes simultaneously with enough accuracy. With the coordinate conversion between the North, East, and Down (NED) frame and the geographic coordinate system based on World Geodetic System 1984 (WGS-84) considered, this study proposed a non-linear stochastic hybrid estimation algorithm with adaptive square-root unscented particle filtering (ASR-UPF) to estimate the true path. The probabilities of mode transition, represented by the normal cumulative density function of continuous states, determine whether to proceed with mode transitions. In addition, the adaptive update characterized by tracking variable noise and the importance sampling distributions based on the results of square-root unscented Kalman filtering (SR-UKF), as a comparative study of continuous system filtering, were used. The experiments illustrated the ASR-UPF is able to reduce the state estimation error more effectively, and more promptly track the error caused by incorrect mode estimation with adaptability compared to the SR-UKF. A further test with real flight data indicates that the proposed method gives the refined estimation of position and azimuth in NED frame.

Evaluating the effectiveness of two wavelengths of 810 and 980 nm Diode laser with two different beam profiles on tooth discoloration in bleaching: an experimental study

Teeth color has a significant impact on facial aesthetics. Tooth bleaching is the safest way to lighten the color of your teeth. Today, hydrogen peroxide is the most commonly used bleaching agent. The diode laser is one of the light sources that speeds up the bleaching process. One of the laser beam features is the laser beam profile, which depicts the distribution of laser intensity across the beam section. The goal of this study is to look into the effectiveness of Gaussian and Flat top beam profiles on tooth shade using two diode laser wavelengths of 810 and 980 nm in the tooth bleaching process. Fifty human anterior and premolar teeth were extracted and placed in a tea and coffee solution for three weeks before being divided into five groups. The first group did not receive laser radiation because 40% hydrogen peroxide was used; in the second and third groups, the profile of the flat top beam and the wavelength were 810 and 980 nm, respectively; and in the fourth and fifth groups, the wavelength of the Gaussian beam profile was 810 and 980 nm. The shade of the samples before and after bleaching was measured with a CIELab-based spectrophotometer, and the results were analyzed using one-way ANOVA and Tukey’s multiple comparison test. All bleaching methods resulted in a significant change in tooth color (ΔE&gt;3.3). There was a significant difference in average shade changes across groups (P&lt;0.001). The highest degree of shade change was observed in two groups of lasers with a wavelength of 980 nm and profiles of Flat top beam (ΔE=5.35) and Gaussian (ΔE=5.02). There were no differences between the remaining groups. We conclude that the 980 nm wavelength produces a greater shade change than the 810 nm wavelength and chemical method. The diode laser’s 810 nm wavelength has no effect on the shade of teeth.

Point-of-care viscoelastic coagulation monitor parameters in Amazon parrots (Amazona spp.).

To evaluate the feasibility of the point-of-care viscoelastic coagulation monitor (VCM) in Amazon parrots (Amazona spp.) and describe the parameters with fresh whole-blood samples in healthy Amazon parrots. A total of 18 Amazon parrots were enrolled. Physical examinations, a CBC, and a biochemistry profile, including bile acids, were performed on all parrots. VCM tracings were obtained at the time of venipuncture for baseline laboratory work. The median clot time was 2102seconds (range: 38.6-3599s), median clot formation time was 929seconds (range: 21.4-1711s), median alpha angle was 20 (range: 6-67), and the median maximum clot formation was 8.5 (range: 0-36). The median lysis index at 30minutes (LI30) was 100 (range: 98-100), and the median lysis index at 45minutes (LI45) was 100 (range: 90-100). Of 18 samples, alpha angles were not reported in 7 samples, LI30 was not reported in 10 samples, and LI45 was not reported in 12 samples. Of the qualitative curves, 6 reflected normal mammalian curves, and the remainder were consistent with a hypocoaguable state. The results were markedly variable, with the majority of VCM tracings being hypocoagulable in comparison with reference intervals established for dogs and cats. Using these protocols, the VCM is not reliable in Amazon parrots. Future areas of investigation include altering the temperature during sample analysis, the use of activators, or an exchange of clotting reagents for an extrinsic pathway activator, which may contribute to the success of this device in avian species.

Surface relief VCSELs at 670 nm with integrated polymer microlens for highly collimated fundamental-mode emission

We demonstrate the integration of a wet-chemically etched surface relief on a vertical-cavity surface-emitting laser (VCSEL) emitting in the red spectral range for higher-order mode suppression. With this relief, fundamental-mode emission is achieved over the entire power range from threshold beyond thermal rollover. For collimation of the emitted beam, we implement polymer microlenses fabricated on-chip by a thermal reflow technique. We reduce the angle of divergence for all injected currents to a maximum of 2∘. By measuring high-resolution spectra, we show that Gaussian beam profiles correspond to pure fundamental-mode emission which is preserved after implementation of the polymer microlens onto the etched relief, proving the compatibility of the two processes.

Development and application of a machine learning-based predictive model for obstructive sleep apnea screening

ObjectiveTo develop a robust machine learning prediction model for the automatic screening and diagnosis of obstructive sleep apnea (OSA) using five advanced algorithms, namely Extreme Gradient Boosting (XGBoost), Logistic Regression (LR), Support Vector Machine (SVM), Light Gradient Boosting Machine (LightGBM), and Random Forest (RF) to provide substantial support for early clinical diagnosis and intervention.MethodsWe conducted a retrospective analysis of clinical data from 439 patients who underwent polysomnography at the Affiliated Hospital of Xuzhou Medical University between October 2019 and October 2022. Predictor variables such as demographic information [age, sex, height, weight, body mass index (BMI)], medical history, and Epworth Sleepiness Scale (ESS) were used. Univariate analysis was used to identify variables with significant differences, and the dataset was then divided into training and validation sets in a 4:1 ratio. The training set was established to predict OSA severity grading. The validation set was used to assess model performance using the area under the curve (AUC). Additionally, a separate analysis was conducted, categorizing the normal population as one group and patients with moderate-to-severe OSA as another. The same univariate analysis was applied, and the dataset was divided into training and validation sets in a 4:1 ratio. The training set was used to build a prediction model for screening moderate-to-severe OSA, while the validation set was used to verify the model's performance.ResultsAmong the four groups, the LightGBM model outperformed others, with the top five feature importance rankings of ESS total score, BMI, sex, hypertension, and gastroesophageal reflux (GERD), where Age, ESS total score and BMI played the most significant roles. In the dichotomous model, RF is the best performer of the five models respectively. The top five ranked feature importance of the best-performing RF models were ESS total score, BMI, GERD, age and Dry mouth, with ESS total score and BMI being particularly pivotal.ConclusionMachine learning-based prediction models for OSA disease grading and screening prove instrumental in the early identification of patients with moderate-to-severe OSA, revealing pertinent risk factors and facilitating timely interventions to counter pathological changes induced by OSA. Notably, ESS total score and BMI emerge as the most critical features for predicting OSA, emphasizing their significance in clinical assessments. The dataset will be publicly available on my Github.

Superoxide Dismutase Modified the Association of Serum Malondialdehyde Levels with Cognitive Decline Among Older Adults: Findings from the Chinese Longitudinal Healthy Longevity Survey.

Numerous studies have investigated the correlation between malondialdehyde (MDA) and cognitive decline. However, limited research has explored the interplay between superoxide dismutase (SOD), C-reactive protein (CRP), and MDA. This study aims to scrutinize the association between MDA and cognitive function in older adults, while also elucidating the roles of SOD and CRP within this relationship. Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning 2008-2009, 2011-2012, and 2014, this study included 2,696 eligible subjects. Cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination (MMSE). Linear mixed-effects models were employed to examine the links between MDA, SOD, CRP, and their interactions with cognitive function. Elevated serum levels of MDA and CRP, as well as decreased serum SOD levels, were related to decreased cognitive function (β= -0.220 and -0.346, 95% CI: -0.399, -0.041 and -0.526, -0.167 for MDA and CRP; β= 0.384, 95% CI: 0.204, 0.564 for SOD). Notably, a significant interaction between MDA and SOD was detected (p = 0.001). An increase per standard deviation in serum MDA levels was significantly associated with a 0.347-point lower MMSE score only in participants with normal cognitive function and high SOD levels (β= -0.347, 95% CI: -0.497, -0.197; p < 0.001). Elevated serum MDA levels in the normal population with high SOD levels suggested diminished cognitive performance. Combining MDA with SOD could be pivotal in identifying older adults at risk of cognitive decline in clinical settings.

Age-related morphological change in bony segment and cartilage segment of Eustachian tube.

Eustachian tube dysfunction (ETD) is the predominant cause of otitis media with effusion in children and adults. Balloon dilatation of the Eustachian tube (BDET) provides a new method for restoring the ventilatory function of Eustachian tube (ET). However, the differences in age-related morphological changes in the dimensions and positions of ET in children and adults are unclear. This study aimed to examine age-related morphological changes in bony and cartilage segments of the ET in a three-dimensional space in normal population. A total of 71 randomly selected computed tomography (CT) images of the temporal bones of 46 people were retrospectively studied in four age groups: A (0-3 years old); B (4-8 years old), C (9-18 years old), and D (19-65 years old). Space analytic geometry was assessed to calculate the dimensions and positions of ET. The bony segment of ET lengthened from infancy to adulthood with age in groups A, B and C (r = 0.562**/0.000). The cartilage segment of ET mostly extended with age from infancy to 8 years old in children (r = 0.633**/0.000), but with bending close to the sagittal plane and away from the horizontal plane with age in groups A, B and C (P < .05), and with a constant angle to the coronal plane among the four groups (P > .05). The bony and cartilaginous segments of ET exhibit distinct morphological changes in space with age. The bony segment of ET extends in a constant position from infancy to adulthood. In contrast, the cartilaginous segment of the ET indicates multidimensional positional changes until adulthood, in addition to the elongation from infancy to children. This may provide an accurate morphological basis for comparing the differences in ETD pathogenesis and surgical treatment between children and adults.

Molecular mechanism of MLCK1 inducing 5-Fu resistance in colorectal cancer cells through activation of TNFR2/NF-κB pathway

Background and aimsChemotherapy resistance in colorectal cancer have been faced with significant challenges in recent years. Particular interest is directed to tumor microenvironment function. Recent work has, identified a small molecule named Divertin that prevents myosin light chain kinase 1(MLCK1) recruitment to the perijunctional actomyosin ring(PAMR), restores barrier function after tumor necrosis factor(TNF)-induced barrier loss and prevents disease progression in experimental inflammatory bowel disease. Studies have shown that MLCK is a potential target for affecting intestinal barrier function, as well as for tumor therapy. However, the relative contributions of MLCK expression and chemotherapy resistance in colorectal cancers have not been defined.MethodsStatistical analysis of MYLK gene expression differences in colorectal cancer patients and normal population and prognosis results from The Cancer Genome Atlas(TCGA) data. Cell activity was detected by Cell counting Kit-8. Cell proliferation was detected by monoclonal plate. The apoptosis was detected by flow cytometry and western blot. Determine the role of MLCK1 in inducing 5-Fluorouracil(5-Fu) resistance in colorectal cancer cells was detected by overexpression of MLCK1 and knock-down expression of MLCK1.ResultsMLCK1 is expressed at different levels in different colorectal cancer cells, high MLCK1 expressing cell lines are less sensitive to 5-Fu, and low MLCK1 expressing cell lines are more sensitive to 5-Fu. MLCK1 high expression enhances resistance to 5-Fu in colorectal cancer cells and the sensitivity to 5-Fu was increased after knocking down the expression of MLCK1, that might be closely correlated to TNFR2/NF-κB pathway.ConclusionsMLCK1 high expression can enhance resistance to 5-Fu in colorectal cancer cells and the sensitivity to 5-Fu was increased after knocking down the expression of MLCK1, that might be closely correlated to TNFR2/NF-κB pathway, which will provide a new method for the treatment of colorectal cancer patients who are resistant to 5-Fu chemotherapy.

Geometric morphometric anatomy of the lacrimal punctum in normal population: Punctum update (PUP) study – Paper 5

BackgroundTo investigate the geometric morphological differences of the lacrimal punctum by analyzing its shape in relation to age and sex in a normal population. Methods960 high-magnification slit-lamp images were obtained from 320 puncta of normal asymptomatic Indian individuals across eight decades of life. Using advanced geometric morphometric techniques, including Elliptic Fourier Analysis and Principal Component Analysis, the intricate details of the lacrimal punctum's shape in a diverse population sample were categorized by age and sex. High-resolution images of the lacrimal punctum underwent standardization for scale and orientation, followed by precise landmark identification and coordinate data extraction. ResultsThe geometric morphometry of the lacrimal punctum shows significant changes as one ages. However, the gender differences, in isolation, without consideration of age, remain subtle and are not pronounced. Interestingly, detailed Principal Component scores analysis revealed potential sex- and age-related variations specifically for the left and right lower puncta, which warrant further investigation. These changes could reflect unique aging changes in the proximal lacrimal drainage system. ConclusionThe study is a starting point for geometric morphometric analysis of the lacrimal punctum and provides valuable insights into the punctal changes in size, orientation, and overall morphology across different age groups and between sexes. These findings highlight the significance of considering individual age-wise anatomical variations to better understand the lacrimal punctum.

Folding Kinetics and Volume Variation of the β-Hairpin Peptide Chignolin upon Ultrafast pH-Jumps.

In-depth characterization of fundamental folding steps of small model peptides is crucial for a better understanding of the folding mechanisms of more complex biomacromolecules. We have previously reported on the folding/unfolding kinetics of a model α-helix. Here, we study folding transitions in chignolin (GYDPETGTWG), a short β-hairpin peptide previously used as a model to study conformational changes in β-sheet proteins. Although previously suggested, until now, the role of the Tyr2-Trp9 interaction in the folding mechanism of chignolin was not clear. In the present work, pH-dependent conformational changes of chignolin were characterized by circular dichroism (CD), nuclear magnetic resonance (NMR), ultrafast pH-jump coupled with time-resolved photoacoustic calorimetry (TR-PAC), and molecular dynamics (MD) simulations. Taken together, our results present a comprehensive view of chignolin's folding kinetics upon local pH changes and the role of the Tyr2-Trp9 interaction in the folding process. CD data show that chignolin's β-hairpin formation displays a pH-dependent skew bell-shaped curve, with a maximum close to pH 6, and a large decrease in β-sheet content at alkaline pH. The β-hairpin structure is mainly stabilized by aromatic interactions between Tyr2 and Trp9 and CH-π interactions between Tyr2 and Pro4. Unfolding of chignolin at high pH demonstrates that protonation of Tyr2 is essential for the stability of the β-hairpin. Refolding studies were triggered by laser-induced pH-jumps and detected by TR-PAC. The refolding of chignolin from high pH, mainly due to the protonation of Tyr2, is characterized by a volume expansion (10.4 mL mol-1), independent of peptide concentration, in the microsecond time range (lifetime of 1.15 μs). At high pH, the presence of the deprotonated hydroxyl (tyrosinate) hinders the formation of the aromatic interaction between Tyr2 and Trp9 resulting in a more disorganized and dynamic tridimensional structure of the peptide. This was also confirmed by comparing MD simulations of chignolin under conditions mimicking neutral and high pH.

Six-gene prognostic signature for non-alcoholic fatty liver disease susceptibility using machine learning.

nonalcoholic fatty liver disease (NAFLD) is a common liver disease affecting the global population and its impact on human health will continue to increase. Genetic susceptibility is an important factor influencing its onset and progression, and there is a lack of reliable methods to predict the susceptibility of normal populations to NAFLD using appropriate genes. RNA sequencing data relating to nonalcoholic fatty liver disease was analyzed using the "limma" package within the R software. Differentially expressed genes were obtained through preliminary intersection screening. Core genes were analyzed and obtained by establishing and comparing 4 machine learning models, then a prediction model for NAFLD was constructed. The effectiveness of the model was then evaluated, and its applicability and reliability verified. Finally, we conducted further gene correlation analysis, analysis of biological function and analysis of immune infiltration. By comparing 4 machine learning algorithms, we identified SVM as the optimal model, with the first 6 genes (CD247, S100A9, CSF3R, DIP2C, OXCT 2 and PRAMEF16) as predictive genes. The nomogram was found to have good reliability and effectiveness. Six genes' receiver operating characteristic curves (ROC) suggest an essential role in NAFLD pathogenesis, and they exhibit a high predictive value. Further analysis of immunology demonstrated that these 6 genes were closely connected to various immune cells and pathways. This study has successfully constructed an advanced and reliable prediction model based on 6 diagnostic gene markers to predict the susceptibility of normal populations to NAFLD, while also providing insights for potential targeted therapies.

Low-intensity vestibular noise stimulation improves postural symptoms in progressive supranuclear palsy.

Postural imbalance and falls are an early disabling symptom in patients with progressive supranuclear palsy (PSP) of multifactorial origin that may involve abnormal vestibulospinal reflexes. Low-intensity noisy galvanic vestibular stimulation (nGVS) is a non-invasive treatment to normalize deficient vestibular function and attenuate imbalance in Parkinson's disease. The presumed therapeutic mode of nGVS is stochastic resonance (SR), a mechanism by which weak sensory noise stimulation can enhance sensory information processing. To examine potential treatment effects of nGVS on postural instability in 16 patients with PSP with a clinically probable and [18F]PI-2620 tau-PET-positive PSP. Effects of nGVS of varying intensity (0-0.7mA) on body sway were examined, while patients were standing with eyes closed on a posturographic force plate. We assumed a bell-shaped response curve with maximal sway reductions at intermediate nGVS intensities to be indicative of SR. An established SR-curve model was fitted on individual patient outcomes and three experienced human raters had to judge whether responses to nGVS were consistent with the exhibition of SR. We found nGVS-induced reductions of body sway compatible with SR in 9 patients (56%) with optimal improvements of 31 ± 10%. In eight patients (50%), nGVS-induced sway reductions exceeded the minimal clinically important difference (improvement: 34 ± 5%), indicative of strong SR. nGVS yielded clinically relevant reductions in body sway compatible with the exhibition of SR in vestibular sensorimotor pathways in at least half of the assessed patients. Non-invasive vestibular noise stimulation may be thus a well-tolerated treatment strategy to ameliorate postural symptoms in PSP.

Soliton transformation in a cold Rydberg atomic system

This work presents a method for achieving soliton transformation in a cold Rydberg atomic system to enable the realization of diverse optical potentials. Our investigation demonstrates that this system can generate various solitons, including Gaussian, elliptical, ring, and necklace structures, based on different optical lattice potentials. Additionally, stable transitions from Gaussian profile to three other profiles can be achieved either abruptly or gradually by adjusting the centers and modulation depths of potentials along the direction of light propagation. These findings highlight the versatility of this system for generating and manipulating solitons. The ability to control soliton transformation offers prospects for various applications, including all-optical switching, optical information processing, and other areas.

Beyond the Bell curve

One of the most important, and neglected, aspects of the school assessment process is the feedback phase. The purpose of this exploratory study was to examine the extent to which feedback is being conducted, training in feedback, and the types of feedback practices used in school settings. One hundred thirty-two school assessment professionals were surveyed, and results suggest that most believe in the importance of test feedback and are utilizing it. Results of this study also indicate that test feedback practices are lacking with most practitioners simply plotting scores on a bell curve. Recommendations for more culturally responsive, meaningful, and ethical feedback practices are discussed, including how to incorporate therapeutic assessment values and techniques in school settings.

Estimation of population mean using ranked set sampling in the presence of measurement errors

Ranked set sampling is widely acknowledged for its superior efficiency compared with simple random sampling. Only a small amount of work has been conducted using ranked set sampling when measurement errors are present. This study introduces innovative estimators utilizing ranked set sampling to assess the population mean when faced with both correlated and uncorrelated measurement errors. The expressions for the bias and mean squared error of the proposed estimators are derived up to the first-order approximation, revealing their superior performance compared to the other examined estimators. The efficacy of the suggested estimators in handling measurement errors was demonstrated through numerical illustration and simulation study investigations. The recommended estimators are further compared to the existing ones using the percentage relative efficiency and mean squared error, and the impact of measurement errors on the results is highlighted through the percentage computation of measurement errors. The innovative estimators suggested were formulated by judiciously incorporating ratio, exponential, and log estimators. Numerical examples involving expenditure and income, as well as simulated data generated from a normal population using R software, affirm the superior performance of the proposed estimators over existing ones such as the usual mean estimator and those proposed by Vishwakarma and Singh (2022), as evidenced by the higher percent relative efficiency and lower mean squared error. The evaluation of the percentage contribution of measurement error values confirms the impact of measurement errors on the properties of the estimators.

Effect of a hypertensive response during exercise on growth rates of aortic diameters.

Aortic diameters are related to age, sex, and body size. There are a scarcity of data on the long-term sequelae of a hypertensive response to exercise (HRE) on aortic diameters. In this retrospective cohort study, we aimed to evaluate the relationship between the growth rates of the aorta in individuals with a HRE. Our analysis included follow-up data of 649 patients recruited between January 2009 and December 2014 with a HRE. Participants with known connective tissue disease or a history of acute aortic syndrome were excluded. Sinus of Valsalva (SoV) and ascending aorta (AscAo) diameters were measured by transthoracic echocardiography using leading edge to leading edge convention at end-diastole. At baseline, median age, maximum systolic blood pressure (BP), body mass index (BMI), diameter of the SoV, and AscAo were 62 years, 208 mmHg, 26.9kg/m2, 35mm, and 35mm respectively. 32% of patients were female and 67% had hypertension. After a median follow-up of 7.1 years, mean yearly growth rates (±SD) of the SoV and AscAo were 0.09 (0.41) mm and 0.13 (0.56) mm respectively. No significant associations were observed between growth rates of aortic diameters and maximum systolic and diastolic BP or when considering only individuals with a baseline diameter > 40mm. In this large cohort study, maximum systolic and diastolic BP during exercise showed no association with growth rates of aortic diameters. Furthermore, the mean growth rates of aortic diameters in this population were in line with growth rates in a normal population.

Abstract PO1-11-10: Use of a standardized tool for the evaluation and treatment of cancer related cognitive impairment (chemo-brain) among breast cancer patients

Abstract There is a steep linear increase in patients surviving a cancer diagnosis. Clinical solutions that address the high prevalence of cancer-related treatment effects (CRTE) are urgently needed. A stark example of this need is the dearth of screening and treatment programs for cancer related cognitive impairment (CRCI) (colloquially called “chemo-brain”). Up to 75% of cancer patients report neurocognitive changes that leave patients unable to cope with the expectations of employers, colleagues, families, and friends. The prevalence of neurological disorders is 275% higher among adult cancer patients, when compared to an adult cancer-free population. For many adolescent and young adult cancer patients, the onset of CRCI occurs during "cognitive prime time"; a time when individuals are pursuing education, careers, and raising families. To address a gap in CRTE we have implemented a virtual multi-disciplinary intervention to measure and treat CRCI. Our CRCI intervention follows National Comprehensive Cancer Network and American Society of Clinical Oncology (ASCO) guidelines for CRCI. These guidelines indicate a multi-disciplinary approach with emphasis on increasing physical activity levels, cognitive-behavioral therapy, memory adaptive training, mood management, and sleep optimization. Our approach also follows recent ASCO guidelines for nutrition counseling. Our CRCI program utilizes medical oncologists, physician assistants, mental health therapists, registered dietitians, and occupational therapists. A nationally validated patient reported outcome (PRO) measurement, analysis, and reporting platform informs clinical treatment pathways, monitors patient progress, guides clinical decision making, and improves patient/provider communication. Using health status measures for CRCI, and following American Cancer Society and ASCO guidelines, patients are risk-stratified into three personalized cancer survivor care pathways: 1) low-complexity patients; 2) medium-complexity patients; and 3) high-complexity patients. Low-complexity patients baseline PROs score in the normal range, medium-complexity patients are those who score below the norm (moderate to large effect size difference from normal), and high-complexity patients are those who score well below the norm (greater than larger effect size difference from normal). Low-complexity patients are enrolled into a self-management and continuation of care program. Medium-complexity patients are enrolled into a shared care program. High-complexity patients are enrolled into an acute care program. All three clinical pathways include continued risk-factor vital-sign surveillance. Nearly 100% (99%) of patients who enroll in our primary cancer survivor care program complete our PRO baseline (N=80). From a convenient sample of breast cancer patients (N=42), provisional results of patient-specific segmentation analyses reveal a nearly perfect bell-shaped curve, with 51% of the population classified within the definition of medium-complexity and even split of outliers (high-complexity 24% and low-complexity 24%). Additionally, of all patients in our primary cancer survivor care program who completed at least three measurement time points for health status measures of cognitive impartment (N=38), 92% had a positive experience, 71% had a clinically significant improvement in cognitive health, 21% had a no change in cognitive status, and only 8% had a decline in cognitive health. If these data, and PRO implementation approach hold true, this program could be scaled to national and international cancer survivor population suffering from CRCI. Citation Format: John Librett, Mark Kosinski, Gregory Litton. Use of a standardized tool for the evaluation and treatment of cancer related cognitive impairment (chemo-brain) among breast cancer patients [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-10.

Photovoltaic Cell Defect Detection by Lock-In Thermography Using 2-D Gaussian Profile

Photovoltaic Cell Defect Detection by Lock-In Thermography Using 2-D Gaussian Profile

Decreased femoral trochlea axial orientation corrected by derotational distal femur osteotomy in patients with patellar dislocation yields satisfactory outcomes.

The femoral trochlea axial orientation has been shown to be a better predictor of patellar dislocation than the femoral anteversion angle. However, no study has investigated the importance of the femoral trochlea axial orientation in the surgical treatment of patellar dislocation. It is aimed to explore the pathological threshold of the femoral trochlea axial orientation and its guiding implications for surgical interventions in the study. Sixty-four patients with patellar dislocation and 64 controls were included for measurement of the femoral trochlea axial orientation. The ability to predict the patellar dislocation and the pathologic threshold of the femoral trochlea axial orientation were evaluated using the receiver operating characteristic curve. One hundred patients with medial patellofemoral ligament reconstruction and 25 patients with derotational distal femur osteotomy were divided into two groups based on the femoral trochlea axial orientation cut-off value and their postoperative knee functions, and patellar tilt angles were compared. There were significant differences in the femoral trochlea axial orientation (60.8 ± 7.9 vs. 67.8 ± 4.6, p < 0.05) between patients with patellar dislocation and the normal population. The sensitivity and specificity of the femoral trochlea axial orientation were 0.641 and 0.813, respectively, at the femoral trochlea axial orientation smaller than 63.8°. Amongst patients having had isolated medial patellofemoral ligament reconstruction with decreased femoral trochlea axial orientation, knee function was poorer after surgery. The prognosis of patients with the femoral trochlea axial orientation correction in derotational distal femur osteotomy was better than that for patients without correction. The femoral trochlea axial orientation had good predictive efficiency for patellar dislocation. Isolated medial patellofemoral ligament reconstruction is not sufficiently effective for patients with patellar dislocation and decreased femoral trochlea axial orientation. Patients with a decreased femoral trochlea axial orientation can have better surgical outcomes after correction by derotational distal femur osteotomy. Level III.