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TOPLINE: Women who continue breast cancer screening after age 70 face a considerable risk for overdiagnosis. METHODOLOGY: * Overdiagnosis--the risk of detecting and treating cancers that would never have caused [...]

RESEARCHERS ARE CALLING for the extent of skin erythema to be considered as an outcome measure in patients who develop chronic cutaneous graft-versus-host disease (ccGVHD) after allogeneic stem cell transplants [...]

An international panel of 49 melanoma specialists has come out against routine gene expression profile (GEP) testing for cutaneous melanoma, pending solid proof of clinical benefit. 'The currently published evidence [...]

'Anytime you have a maternal death, it sticks with you for life,' said Elliott Main, MD, a maternal fetal medicine specialist at Stanford (Calif.) University and one of the nation [...]

The organic anion uptake and efflux transporters [organic anion-transporting polypeptide (OATP)1B1, OATP1B3 and multidrug resistance-associated protein (MRP)2 and MRP3] that mediate the transport of the hepatobiliary-specific contrast agent gadoxetate (Gd-EOB-DTPA) are direct or indirect targets of the farnesoid X receptor (FXR), a key regulator of bile acid and lipid homeostasis. In benign liver tumors, FXR expression and activation is not yet characterized. We investigated the expression and activation of FXR and its targets in hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH) and their correlation with Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI). Gd-EOB-DTPA MRI patterns were assessed by an expert radiologist. The intensity of the lesions on the hepatobiliary phase was correlated to mRNA expression levels of OATP1B1, OATP1B3, MRP2, MRP3, FXR, and small heterodimer partner (SHP) in fresh surgical specimens of patients with FNH or HCA subtypes. Normal and tumor sample pairs of 43 HCA and 14 FNH were included. All FNH (14/14) were hyperintense. Of the 34 HCA with available Gd-EOB-DTPA-enhanced MRI, 6 were hyperintense and 28 HCA were hypointense. OATP1B3 was downregulated in the hypointense tumors compared with normal surrounding liver tissue (2.77±3.59 vs. 12.9±15.6, P< 0.001). A significant positive correlation between FXR expression and activation and OATP1B3 expression level was found in the HCA cohort. SHP showed a trend toward downregulation in hypointense HCA. In conclusion, this study suggests that the MRI relative signal in HCA may reflect expression level and/or activity of SHP and FXR. Moreover, our data confirms the pivotal role of OATP1B3 in Gd-EOB-DTPA uptake in HCA.SIGNIFICANCE STATEMENTFXR represents a valuable target for the treatment of liver disease and metabolic syndrome. Currently, two molecules, ursodeoxycholate and obeticholate, are approved for the treatment of primary biliary cirrhosis and cholestasis, with several compounds in clinical trials for the treatment of metabolic dysfunction-associated fatty liver disease. Because FXR expression and activation is associated with gadoxetate accumulation in HCA, an atypical gadoxetate-enhanced MRI pattern might arise in patients under FXR-targeted therapy, thereby complicating the differential diagnosis.

In gearboxes, rolling bearing power losses often make up a large amount of the total gearbox power losses. Therefore, an exact calculation of rolling bearing power losses is very important for resource and energy efficient gearbox design. The state of the art offers numerous friction calculation methods with different levels of detail to calculate power losses of rolling bearings. Bearing manufacturers like SKF and Schaeffler offer popular bearing-based/global calculation methods for standard rolling bearings. Contact-based/local calculation methods can consider a wider application field by generalization of tribological relations, which enables its application to e.g. hybrid bearings or non-standard bearings. The different methods may yield widely differing results. For its validation, measurement results are required. In this study, a broad comparison of calculation results with substantial measurement results is shown. Based on the validation a classification of the calculation methods is derived, which provides guidance for the design engineer to choose the appropriate method for the respective application. Contact-based/local calculation methods have the potential to predict friction in rolling bearings precisely.

In this paper a variant of eccentric drives will be described, which uses rolling elements instead of an eccentric gear. These rolling elements are constrained by a concentric carrier allowing for radial movement and are moved by an eccentric crank. They mesh with a gear geometry that translates their radial movement into tangential movement and constrains their position. Multiple offset eccentricities may be used with the same gear to reduce occurring forces. Such a drive may prove easier to manufacture than currently used eccentric drives, but the characteristics are not yet fully researched.

VACCINES AGAINST HUMAN papillomavirus have been hailed as a success: They have been shown to decrease the incidence of cervical lesions associated with the HPV types that are in the [...]

Only 8.5% of endometrial cancer recurrences were caught by routine pelvic exams in asymptomatic women in a review of 234 cases at the University of Wisconsin-Madison. It was a much [...]

THE FOOD AND DRUG ADMINISTRATION has granted accelerated approval to mirvetuximab soravtansine (Elahere) for use in pretreated patients with folate receptor (FR) alpha-positive, platinum-resistant epithelial ovarian, fallopian tube, and primary [...]

EXPERT ANALYSIS FROM ADA 2019 SAN FRANCISCO -- Type 2 diabetes is much more aggressive in adolescents than in adults, and by the time those with youth-onset diabetes reach their [...]

Women with breast cancer who are taking adjuvant endocrine therapy to reduce the risk for recurrence often report the side effects of dampening down estrogen, such as hot flashes and [...]

ANNUAL PROSTATE CANCER screening may be particularly important for Black men, new data suggest. The data come from a review of 45,834 veterans (aged 55-69 years) who had been diagnosed [...]

Given the low rates of metastasis and mortality associated with basal cell carcinomas (BCCs), which are generally slow-growing tumors that occur in older people, some patients do not require treatment. [...]

Vaccines against human papillomavirus have been hailed as a success: They have been shown to decrease the incidence of cervical lesions associated with the HPV types that are in the [...]

THE INFLUENZA VACCINE is only about 36% effective this year, preventing infections in just over a third of people who receive it, according to the Feb. 16 issue of Morbidity [...]

Not too long ago at the Dana-Farber/ Brigham and Women's Cancer Center in Boston, a woman with widely metastatic melanoma, who had been planning her own funeral, was surprised when [...]

THERE WERE NO LOCAL RECURRENCES when Mohs surgery was used to treat early-stage Merkel cell carcinomas in 53 patients at the Zitelli and Brodland Skin Cancer Center, Pittsburgh. The results [...]

Only 8.5% of endometrial cancer recurrences were caught by routine pelvic exams in asymptomatic women in a review of 234 cases at the University of Wisconsin-Madison. It was a much [...]

FROM JAMA NETWORK OPEN The incidence of metastatic prostate cancer shot up in the United States after the U.S. Preventive Services Task Force recommended against routinely screening men with the [...]

A 2021 update to the U.S. Preventive Services Task Force lung cancer screening guidelines eliminated racial disparities that were prevalent in the group's 2013 guidance, according to a report in [...]

A DROP-OFF in cancer screening during the first year of the COVID-19 pandemic has led to a marked increase in people presenting with advanced breast and colon cancer at Moores [...]

A 2021 update to the U.S. Preventive Services Task Force lung cancer screening guidelines eliminated racial disparities that were prevalent in the group's 2013 guidance, according to a report in [...]

VOXELOTOR FOR HEMOLYTIC ANEMIA in sickle cell disease can now be used in children as young as 4 years and is also available as a child-friendly, grape-flavored tablet for oral [...]

COMBINATION TORIPALIMAB and axitinib produced promising early results in patients with metastatic mucosal melanoma, according to a presentation made as part of the American Society of Clinical Oncology virtual scientific [...]

When Stephen Tyring, MD, PhD, an infectious disease dermatologist, started his career in the early 1980s, he said 'we were diagnosing Kaposi's sarcoma right and left We would see a [...]

AT THE END OF 6 MONTHS of low-dose pomalidomide (Pomalyst), more than half of men who have sex with men had partial or complete clearance of long-standing, grade 3 anal [...]

The take-home message from a growing number of recent COVID-19 case reports is that the infection might be far more than a respiratory disease. Although a cause-and-effect relationship is unknown, [...]

As the 2019 novel coronavirus story unfolds, the most important thing for clinicians in the United States to do is ask patients who appear to have the flu if they, [...]

As the 2019 Novel Coronavirus story unfolds, the most important thing for clinicians in the United States to do is ask patients who appear to have the flu if they, [...]

Almost 14% of transected invasive melanoma biopsies at the University of Alabama at Birmingham were up-staged on final surgical pathology, in a review of cases at the university. Had their [...]

AbstractObjectiveThe impact of the coronavirus disease 2019 (COVID-19) on hepatocellular carcinoma (HCC) care is unclear. This study reports on HCC patterns during the COVID-19 pandemic in the Netherlands.MethodsPatients diagnosed with HCC between 2017 and 2020 were identified from the Netherlands Cancer Registration. Monthly incidence rates were compared between 2020 and 2017–2019. Patient, tumor, process, and treatment characteristics and survival were compared between 2020 and 2017–2019, and between COVID-high (April and May 2020) and COVID-low (June and July 2020) months.ResultsThe incidence of HCC was lower in May 2020 (IRR 0.56, P= 0.001) and higher in June 2020 (IRR 1.32, P= 0.05) compared to the same months in 2017–2019. In 2017–2019, 2134 patients presented with HCC, compared to 660 in 2020. Time-to-treatment was shorter in 2020 (median 60 vs. 70 days, P< 0.001). The percentage of patients undergoing any treatment did not differ, yet if treatment was not performed this was more commonly due to comorbidity in 2020 (52 vs. 39%, P< 0.001). No other differences were found in patient, tumor, process and treatment characteristics and survival between COVID-high and COVID-low months.ConclusionsThis study demonstrated no impact of the COVID-19 pandemic on HCC patients, despite a decrease in HCC diagnoses.

Debulking large exophytic basal cell carcinomas prior to hedgehog-inhibitor therapy might improve outcomes, according to Allison Vidimos, MD, a Mohs surgeon and chair of the department of dermatology at the [...]

Five years of treatment with bisphosphonates after chemotherapy for high-risk early breast cancer is too much, say researchers reporting new results from a phase 3 trial with almost 3,000 women. [...]

Clinicians should be on the lookout for immune-related adverse events (irAEs) even after patients have been receiving anti-PD-1 immunotherapy for a year or longer, according to team of international investigators. [...]

Women had about a twofold higher risk than that of men of developing dermatologic adverse events while taking immune checkpoint inhibitors for metastatic melanoma in a review of 235 patients [...]

The remarkable efficacy of biologics for moderate to severe psoriasis has led some to ask if biologics should be used for milder cases. The issue was tackled in a debate [...]

Hintergrund: Medikamentenvernebler im Rettungsdienst sollten eine hohe Vernebelungsleistung haben, um schnell eine therapeutische Wirkstoffkonzentration des vernebelten Medikaments zu erreichen. Eine Umfrage im süddeutschen Rettungsdienst zeigte allerdings, dass fast ausschließlich die wenig effizienten Jet-Vernebler zum Einsatz kommen. Ziel der Arbeit: Ziel der vorliegenden In-vitro-Studie war es herauszufinden, ob der Einsatz von Mesh-Verneblern die prähospitale Aerosoltherapie verbessern könnte. Material und Methoden: Die Vernebelungsleistung eines Jet-Verneblers (Cirrus™ 2, Fa. Intersurgical®) und 2 mobil einsatzbarer Mesh-Vernebler (Aerogen Solo®, Fa. Aerogen Limited, M‑Neb® mobile, NEBU-TEC International med. Produkte Eike Kern GmbH) wurde in einem In-vitro-Modell spontan atmender Notfallpatient*innen mit 4 unterschiedlichen Atemmustern bei verschiedenen Sauerstoffflussraten getestet. Ergebnisse: Die Mesh-Vernebler zeigten im Vergleich zum Jet-Vernebler eine signifikant höhere Verneblungsleistung und Salbutamol-Filterdeposition, wobei der M‑Neb® mobile die höchsten Werte für Leistung und Deposition erreichte. Der Sauerstofffluss hatte den größten Einfluss auf die Leistung des Jet-Verneblers, wirkte sich aber kaum auf die Mesh-Vernebler aus. Die Deposition wurde zudem stark vom Atemmuster beeinflusst. Diskussion: Der Einsatz von Mesh-Verneblern mit hoher Verneblungsleistung konnte in einem In-vitro-Modell die Aerosoltherapie von prähospitalen Notfallpatient*innen verbessern. Sie waren dem Jet-Vernebler in Bezug auf die Verneblungsleistung und die Lungendeposition überlegen und ermöglichten zudem eine bedarfsangepasste Sauerstofftherapie. Die höchste Medikamentendeposition wurde bei den tachypnoischen Patient*innen erreicht, welche in der praktischen Anwendung auch am meisten von einem erhöhten Medikamentenspiegel profitieren würden.

Due to their compactness and power density, planetary gearboxes are used for a wide range of high-performance applications in the automotive, aviation and marine sector. Aerospace applications in particular benefit from a full use of the load capacity potential to meet the requirements for lightweight construction and efficiency. Against this background, the load sharing between the individual planetary gears plays a decisive role. A uniform load sharing enables the design of the single tooth meshes without load increases and oversizing. However, due to manufacturing and assembly deviations, a perfect load sharing is technically not feasible. These load increases are taken into account in the standard calculation of the load capacity of planetary gearboxes by the mesh load factor Kγ. The load sharing in planetary gearboxes is influenced by a number of factors, such as the rigidity of shafts, housing and bearings, the number of planets, the quality of the gear wheels and the operating conditions. Detailed simulations or extensive experimental measurements are required to determine the exact load sharing. For new designs of planetary gearboxes, there are only simplified assumptions available, based on the number of planets and a rough estimation of the operating range. Especially additional dynamic forces, due to operation in high-speed ranges or near resonance frequencies, can lead to a considerable change of the dynamic load sharing compared to the static load sharing and cause an uncertainty in the design. Thus, in this paper the dynamic load sharing behaviour is investigated from 0 to 6800 rpm sun speed for different loads. Based on the experimental data recommendations for the design of planetary gearboxes under consideration of the operating conditions are derived.

THE FOOD AND DRUG Ad ministration has approved cemiplimab-rwlc (Libtayo) as the first immunotherapy to treat patients with locally advanced or metastatic basal cell carcinoma (BCC) previously treated with a [...]

SAN FRANCISCO -- Patients with alcohol use disorder reported a substantial decrease in drinking days, drinks per drinking day, and cravings in an ongoing trial of psilocybin at New York [...]

Background. High-intensity resistance training plays an essential role in the prevention and rehabilitation of musculoskeletal injuries and disorders. Although resistance exercises with heavy weights yield high levels of muscle activation, the efficacy of more user-friendly forms of exercise needs to be examined. Objective. The aim of this study was to investigate muscle activation and perceived loading during upper-extremity resistance exercises with dumbbells compared with elastic tubing. Design. A single-group, repeated-measures study design was used. Setting. Exercise evaluation was conducted in a laboratory setting. Participants. Sixteen female workers (aged 26-55 years) without serious musculoskeletal diseases and with a mean neck and shoulder pain intensity of 7.8 on a 100-mm visual analog scale participated in the study. Measurements. Electromyographic (EMG) activity was measured in 5 selected muscles during the exercises of lateral raise, wrist extension, and shoulder external rotation during graded loadings with dumbbells (2-7.5 kg) and elastic tubing (Thera-Band, red to silver resistance). The order of exercises and loadings was randomized for each individual. Electromyographic amplitude was normalized to the absolute maximum EMG amplitude obtained during maximal voluntary isometric contraction and exercise testing. Immediately after each set of exercise, the Borg CRIO scale was used to rate perceived loading during the exercise. Results. Resistance exercise with dumbbells as well as elastic tubing showed increasing EMG amplitude and perceived loading with increasing resistance. At the individually maximal level of resistance for each exercise--defined as the 3 repetitions maximum-normalized EMG activity of the prime muscles was not significantly different between dumbbells (59%-87%) and elastic tubing (64%-86%). Perceived loading was moderately to very strongly related to normalized EMG activity (r=.59-.92). Limitations. The results of this study apply only for exercises performed in a controlled manner (ie, without sudden jerks or high acceleration). Conclusions. Comparably high levels of muscle activation were obtained during resistance exercises with dumbbells and elastic tubing, indicating that therapists can choose either type in clinical practice. The Borg CR10 can be a useful aid in estimating intensity of individual rehabilitation protocols., More than half a century ago DeLorme (1) recommended progressive resistance training for rehabilitation of injured servicemen. Today, high:intensity resistance training has become an essential part of various rehabilitation protocols. [...]

SANOFI HASN'T GIVEN UP on its sodium-glucose cotransporter (SGLT) 1/2 inhibitor sotagliflozin (Zynquista) for type 1 diabetes mellitus (T1DM) despite a recent 8-to-8 split decision on recommendation for approval from [...]

USE OF LINKED-COLOR IMAGING for upper-gastrointestinal tract endoscopy improves the detection of neoplasms in comparison with conventional white-light imaging, according to results from a randomized trial involving more than 1,500 [...]

Pregnancy after treatment for breast cancer with BRCA mutations is safe, with 'favorable' fetal outcomes and no increase in cancer recurrence, said researchers reporting a review of more than 1,000 [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2008.05.029 Byline: Beat H. Walpoth (a), Markus Schmid (b), Anna Schwab (b), Andreas Bosshard (b), Friedrich Eckstein (b), Thierry Carrel (b), Otto M. Hess (b) Abbreviations: CABG, coronary artery bypass grafting; CFR, coronary flow reserve; EDHF, endothelium-derived hyperpolarizing factor; ITA, internal thoracic artery; LAD, left anterior descending coronary artery; LV, left ventricular; NO, nitric oxide; SVG, saphenous vein graft Abstract: Flow mismatch between the supplying artery and the myocardial perfusion region has been observed in patients with internal thoracic artery grafts. Thus coronary flow changes of arterial (internal thoracic artery grafts) and saphenous (saphenous vein grafts) bypass grafts were studied early and late after coronary artery bypass grafting. Author Affiliation: (a) Cardiovascular Surgery, University Hospital, Geneva, Switzerland (b) Swiss Cardiovascular Center, University Hospital Bern, Bern, Switzerland Article History: Received 26 September 2007; Revised 18 April 2008; Accepted 19 May 2008 Article Note: (footnote) The study was partly funded by the Swiss Heart Foundation and the University Hospital of Bern.

Increasing the speed of the electric motor can significantly improve the power density of the powertrain of EVs (Electric Vehicles), resulting in a smaller size and thus weight and cost advantages. Achieving acceptable NVH behavior becomes more difficult at higher speeds, partly because the excitation frequencies of the gears cover a wider frequency range and therefore higher natural frequencies can also be directly excited. In the Speed4E joint research project, a high-speed electromechanical powertrain was developed, manufactured, and tested to investigate the main challenges on the NVH- and efficiency-behavior of high-speed powertrains. The high-speed design of the Speed4E drivetrain results in maximum electric motor speeds of up to 50,000 rpm, combined with a torque of up to 45 Nm at the transmission input shafts. This study presents the experimental results on the vibration behavior of the high-speed planetary gearbox, a comparison with the corresponding results of a highly efficient calculation method of the gearbox vibration excitation, and the theoretical background of the calculation method is presented. The results indicate the potential to improve the vibration behavior of high-speed drives in EVs and provide a deep understanding of the challenges associated with high speeds.

Immunotherapy after resection of the primary tumor improved survival in some patients with stage III melanoma in an analysis presented at the AACR virtual meeting II. Among patients with stage [...]

Concerns about potential risks about the use of spironolactone for acne during the COVID-19 pandemic were raised on social media last month, but spironolactone and other androgen blockers might actually [...]