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Refractory cancer pain affects 10–20% of patients with advanced malignancies and is not adequately controlled by opioids. The intrathecal therapy is an effective interventional procedure for referral, but the implanted infusion pumps are costly and the refilling requires technical expertise. Hypophysectomy, in its three stages—surgical, chemical, and radiosurgical—has emerged as an alternative for managing this pain. However, the underlying mechanism remains elusive, with existing hypotheses unable to comprehensively account for both the initial and long-term analgesic effects. This literature review explores the historical evolution, clinical outcomes, and hypothesized mechanisms of hypophysectomy for pain relief. Surgical hypophysectomy initially demonstrated an 85.5% success rate but carried significant risks like diabetes insipidus and hypopituitarism. Chemical hypophysectomy reduced invasiveness, achieving 75.1% pain relief with fewer complications. Modern pituitary radiosurgery has improved safety while maintaining high efficacy (initial relief: 95.9%, long-term: 73.5%). The mechanisms underlying pain relief remain unclear but include tumor regression, increased β -endorphins, neuroendocrine modulation, and hypothalamic involvement. A new hypothesis suggests that radiosurgery induces hormone redistribution (e.g., oxytocin, vasopressin) through hypothalamic–pituitary modulation, contributing to both immediate and long-term analgesia. Despite its potential, unresolved issues such as optimal radiation dose, pain assessment standardization, and precise mechanisms limit widespread adoption. This review underscores the need for larger, homogenous studies to validate the safety and efficacy of hypophysectomy in treating refractory cancer pain. These findings offer a promising avenue for improving palliative care in oncology. [ABSTRACT FROM AUTHOR]

Context: Antral follicle count (AFC) is reflective of ovarian reserve and linked to reproductive performance in mammalian females. We previously demonstrated earlier upregulation of endometrial oxytocin receptor transcription in heifers with low AFC, indicating an earlier onset of luteolysis. Aims: We aimed to support the earlier onset of luteolysis in non-pregnant heifers with a low number of antral ovarian follicles (Open Low AFC) and hypothesized a reduced abundance of luteinizing hormone/choriogonadotropin receptor (LH/CG-R) and increased abundance of thrombospondin-1 (THBS1) in luteal tissue of those heifers. We further investigated if classical interferon stimulated genes (ISGs) are already upregulated in response to conceptus-derived interferon tau. Methods: For 4 years, 10 heifers with the highest (High AFC) and 10 heifers with the lowest AFC (Low AFC) of the population (n = 120/year) were selected, synchronized and inseminated. On day 15 or 16 after insemination, reproductive tracts were collected, and pregnancy status was determined. Corpora lutea were isolated, weighed and underwent transcriptomic analysis. Key results: Transcript abundance of LH/CG-R was lower in Open Low AFC heifers compared to all other subgroups. Transcript abundance of THBS1 was upregulated in Open vs Pregnant heifers and showed greater abundance in Low vs High AFC heifers. Luteal weights and abundance of ISGs did not differ between heifers of differing AFC groups or pregnancy status. Conclusions: The patterns of luteal LH / CG-R and THBS1 abundance support the concept of earlier onset of luteolysis in Open heifers with diminished AFC. Implications: This may result in a shorter window for maternal recognition of pregnancy and contribute to inferior reproductive performance. Livestock production systems rely on efficient reproduction. Selection of heifers with a high number of antral ovarian follicles can be applied with the aim of improving reproductive efficiency. The herein presented results support an earlier onset of luteolysis in non-pregnant heifers with a low number of antral follicles. This indicates a shorter time period for the recognition of pregnancy by the dam, which might contribute to inferior reproductive performance in heifers with a low number of antral ovarian follicles. Image by MK, created with biorender.com. This article belongs to the collection: The biology of the ovary – Honouring the contributions of Ken P McNatty and Rex J Scaramuzzi. [ABSTRACT FROM AUTHOR]

Background: Breast thermography originated in the 1950s but was later abandoned due to the contradictory results obtained in the following decades. However, advances in infrared technology and image processing algorithms in the twenty-first century led to a renewed interest in thermography. This work aims to provide an updated and objective picture of the recent scientific evidence on its effectiveness, both as a screening and as a diagnostic tool. Methods: We searched for clinical studies published between 2001 and May 31, 2023, in the databases PubMed and Scopus, that aimed to evaluate the effectiveness of digital, long-wave infrared imaging for detecting breast cancer. Additional documents were retrieved from the studies included in the systematic reviews that resulted from the search and by searching for the names of commercial systems. We limited our selection to studies that reported the sensitivity and specificity of breast thermography (or the data needed to calculate them) using images collected by themselves, with at least five breast cancer cases. Studies that considered breast diseases other than cancer to be positive or that did not use standard tests to set the ground truth diagnosis were excluded, as well as articles written in a language other than English and documents we could not access. We also conducted meta-analyses of proportions of the sensitivity and specificity values reported in the selected studies and a bivariate meta-analysis to account for the correlation between these metrics. Results: Our systematic search resulted in 22 studies, with an average pooled sensitivity and specificity of 88.5% and 71.8%, respectively. However, the differences in patient recruitment, sample size, imaging protocol, equipment, and interpretation criteria yielded a high heterogeneity measure (79.3% and 99.1% I 2 value, respectively). Conclusions: Overall, thermography showed a high sensitivity in the selected studies, whereas specificity started off lower and increased over time. The most recent studies reported a combination of sensitivity and specificity comparable to standard diagnostic tests. Most of the selected studies were small and tend to include only patients with a suspicious mass that requires biopsy. However, larger studies with a wider variety of patient types (asymptomatic, women with dense breasts, etc.) have been published in the latest years. [ABSTRACT FROM AUTHOR]

Organizational agility is the ability of an organization to swiftly and efficiently respond to changes in the organization's environment. However, the literature demonstrates the interchangeability of agility, flexibility, adaptability, and versatility. Therefore, confusion and conceptual overlap persist. As a result, this study aimed to provide further conceptual clarity about organizational agility by synthesizing organizational agility, flexibility, adaptability, and versatility. A systematic review of 40 articles published in business and management-related journals between 1991 and 2022 in ABI/INFORMS, Since Direct, Emerald databases are employed. Findings from thematic analysis and content analysis using Leximancer text mining analysis show that versatility, adaptability, and flexibility are closely connected with their focus on coping with change in the business environment. However, agility is distinct due to its emphasis on organizational ability, capability, and changeability, as well as how it conceptualizes these attributes. This review contributes to developing organizational agility theory and practice by disentangling organizational agility from related concepts. Specifically, it contributes to scientific communication by referring to the same phenomena as organizational agility. Finally, the study concludes by highlighting future research directions. [ABSTRACT FROM AUTHOR]

Background: To determine whether, when primary breast cancer is treated by local excision supported by systemic therapy appropriate to the oestrogen receptor status (ER) of the tumour, local radiotherapy can be avoided.Methods: We carried out a randomised controlled trial in 585 patients aged less than 70 years with primary breast cancers of 4 cm or less in size in four specialist units and seven other hospitals in Scotland. After local excision of the tumour (1 cm margin) and an axillary lymph-node clearance or sample, all patients received systemic therapy with oral tamoxifen 20 mg daily or six 3-weekly intravenous bolus injections of cyclophosphamide 600 mg, methotrexate 50 mg, and fluorouracil 600 mg per m2, depending upon the ER concentration in the primary tumour. Patients were then randomly allocated to postoperative radical radiotherapy (50 Gy to breast with boost to the tumour bed) or to no further local treatment. The median follow-up of living patients was 5.7 years. The primary analysis was by intention to treat but since some patients did not receive systemic therapy appropriate to their ER status, a subsidiary analysis was restricted to 464 patients in whom all details of the protocol had been observed.Findings: In the primary analysis survival was equal in the radiotherapy and non-radiotherapy groups (hazard ratio [HR] 0.98, 95% CI 0.67-1.44). Event-free survival showed an advantage in the irradiated patients (HR 0.54, 95% CI 0.39-0.74), largely due to fewer loco-regional relapses (HR 0.20, 95% CI 0.12-0.33). The relapse rate in the ipsilateral breast was 24.5% in the non-irradiated group and 5.8% following breast irradiation. The subsidiary analysis confirmed these findings and indicated the advantage of radiotherapy irrespective of ER concentration. There was a non-significant trend towards fewer distant metastases in the irradiated group.Interpretation: After local excision of a primary breast cancer, we conclude that radiotherapy to the residual breast tissue is advisable even when selective adjuvant systemic therapy is given. [ABSTRACT FROM AUTHOR]

Background: Auditory processing disorder (APD) in school children can affect the academic, language, and social abilities of the children. Screening for APD in schools can help in identification of children with APD and suitable measures can be taken to help children who may have APD. A majority of the tests used for identifying or screening APD are verbal tests. Hence, in a multilingual country like India, there is a need to develop and validate test battery in many languages. Aims and Objectives: The present study was designed to investigate the validity of Auditory Processing Screening Tests in Marathi (APST-M) and its with Screening Checklist for Auditory Processing (SCAP). Methods: A total of 81 children aged 9–12 years participated in the study. SCAP, APST-M, and diagnostic test battery which included the auditory memory and sequencing test (AMST), perception of speech in noise (PSIN) test, dichotic digit test (DDT), and pitch pattern test (PPT) were administered. Results: The performance on the APST-M and scores of SCAP showed a significant association. The subtests, AMST and DDT showed a significant association between screening and diagnostic version of the tests. However, no significant association was observed between the screening and diagnostic version of PSIN and PPT. It was observed that auditory memory and binaural integration are affected in a majority of children with listening difficulties. Conclusions: APST-M, a performance based screening tool, can be used for screening APD in Marathi speaking school children. However, PPT maybe a difficult test for screening in school children. [ABSTRACT FROM AUTHOR]

Background: The 'FAST‐forward', study published in April 2020, demonstrated the effectiveness of an extremely hypofractionated radiotherapy schedule, delivering the total radiation dose in five sessions over the course of 1 week. We share our department's experience regarding patients treated with this regimen in real‐world clinical settings, detailing outcomes related to short‐term toxicity and efficacy. Methods: A descriptive observational study was conducted on 160 patients diagnosed with breast cancer. Between July 2020 and December 2021, patients underwent conservative surgery followed by a regimen of 26 Gy administered in five daily fractions. Results: The median age was 64 years (range: 43–83), with 82 patients (51.3%) treated for left‐sided breast cancer, 77 patients (48.1%) for right‐sided breast cancer, and 1 instance (0.6%) of bilateral breast cancer. Of these, 66 patients had pT1c (41.3%), 70.6% were infiltrative ductal carcinomas, and 11.3% were ductal carcinoma in situ. Most tumours exhibited intermediate grade (41.9%), were hormone receptor positive (81.3%), had low Ki‐67 (Ki‐67 < 20%; 51.9%) and were Her 2 negative (85%). The majority of surgical margins were negative (99.4%). Among the patients, 72.5% received hormonotherapy, and 23.8% received chemotherapy. Additionally, 26 patients (16.3%) received an additional tumour boost following whole breast irradiation (WHBI) of 10 Gy administered in five sessions of 2 Gy over a week. The median planning target volume (PTV) was 899 cm3 (range: 110–2509 cm3). Early toxicity was primarily grade I radiodermatitis, affecting 117 patients (73.1%). During a median follow‐up of 15 months (range: 3.9–28.77), only one patient experienced a local relapse, which required mastectomy. Conclusions: The implementation of this highly hypofractionated regimen in early‐stage breast cancer appears feasible and demonstrates minimal early toxicity. However, a more extended follow‐up duration would be required to evaluate long‐term toxicity and efficacy accurately. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review highlights contemporary clinical trials of locoregional therapies in the treatment of invasive breast cancer, focusing on pre-operative radiotherapy, omission of surgery, and omission of radiotherapy. Recent Findings: Emerging research has challenged the current standard of care regarding treatment sequences and evaluated the de-escalation of locoregional therapies. Pre-operative RT has garnered particular interest due to the ability to perform immediate reconstruction at the time of surgery. Likewise, for older patients with low-risk disease or those with exceptional response after neoadjuvant systemic therapy, omission of surgery and omission of radiotherapy, respectively, represent alternative treatment pathways that can both improve quality of life and decrease morbidity without compromising patient outcomes. Summary: Pre-operative radiotherapy, omission of surgery, and omission of radiotherapy represent contemporary issues with growing interest in the breast surgery community. Results from pivotal clinical trials will provide more concrete answers regarding feasibility and efficacy in the coming years. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Invasive cribriform carcinoma (ICC) is a rare form of invasive breast carcinoma with good prognosis. To date, case reports considering skin manifestations of ICC are scarce. We herein report a case of pure ICC presenting as an erythematous papule on the nipple with mammary Paget's disease in the epidermis. We aim to bring awareness to skin manifestation of ICC. [ABSTRACT FROM AUTHOR]

Previous research on cool-hot executive function (EF) interactions has examined the effects of motivation and emotional distraction on cool EF separately, focusing on one EF component at a time. Although both incentives and emotional distractors have been shown to modulate attention, how they interact and affect cool EF processes is still unclear. Here, we used an experimental paradigm that manipulated updating, inhibition, and shifting demands to determine the interactions of motivation and emotional distraction in the context of cool EF. Forty-five young adults (16 males, 29 females) completed the go/no-go (inhibition), two-back (updating), and task-switching (shifting) tasks. Monetary incentives were implemented to manipulate motivation, and task-irrelevant threatening or neutral faces were presented before the target stimulus to manipulate emotional distraction. We found that incentives significantly improved no-go accuracy, two-back accuracy, and reaction time (RT) switch cost. While emotional distractors had no significant effects on overall task performance, they abolished the incentive effects on no-go accuracy and RT switch cost. Altogether, these findings suggest that motivation and emotional distraction interact in the context of cool EF. Specifically, transient emotional distraction disrupts the upregulation of control activated by incentives. The present investigation has advanced knowledge about the relationship between cool and hot EF and highlights the importance of considering motivation–emotion interactions for a fuller understanding of control. Highlights: We examined how motivation and emotional distraction affected executive functions. Monetary incentives enhanced performance across executive function tasks. Emotional distractors abolished the incentive effects on inhibition and shifting. Motivation and emotion interact in the context of specific executive functions. Transient emotional distraction disrupts the upregulation of control by incentives. [ABSTRACT FROM AUTHOR]

In this narrative review, we aim to explore the ability of radiation therapy to eradicate breast cancer regional node metastasis. It is a journey through data of older trials without systemic therapy showing the magnitude of axillary therapy (surgery versus radiation) on cancer control. Considering that both systemic and loco-regional therapies were shown to reduce any recurrence with a complex interaction, our review includes surgical, radiation, and radiobiology consideration for breast cancer, and provide our view of future practise. The aim is to provide information optimise radiation therapy in the era of primary systemic therapy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the prevalence of hyperacusis and auditory processing (listening) difficulties (APDiff) in normal-hearing young adults and to explore the relationship between these two conditions. Methods: A total of 333 participants aged 18–24 underwent pure-tone audiometry tests and completed the Khalfa Hyperacusis Questionnaire (KHQ) and the University of Cincinnati Auditory Processing Inventory (UCAPI) online. Results: Hyperacusis was identified in 26.43% of participants, and APDiff in 36.04%. A strong, positive correlation was found between KHQ and UCAPI scores (r = 0.603, p < 0.001). Logistic regression models indicated that hyperacusis significantly increased the likelihood of having APDiff (OR 7.688, p < 0.001). Conclusion: Despite the high prevalence of hyperacusis and APDiff in young adults, few seek help from audiology clinics. Our findings highlight a significant link between hyperacusis and APDiff, emphasizing the need for screening protocols for auditory processing skills in young adults due to these conditions' potential social and academic impacts. [ABSTRACT FROM AUTHOR]

Background: Early embryonic mortality is one of the major intriguing factors of reproductive failure that causes considerable challenge to the mammalian cell biologists. Heat stress is the major factor responsible for reduced fertility in farm animals. The present study aimed to investigate the influence of heat stress on prostaglandin production and the expression of key genes, including COX-2, PGES, PGFS, ITGAV and LGALS15, in buffalo endometrial epithelial cells. Methods and results: Buffalo genitalia containing ovaries with corpus luteum (CL) were collected immediately post-slaughter. The stages of the estrous cycle were determined based on macroscopic observations of the ovaries. Uterine lumens of the mid-luteal phase (days 6–10 of the estrous cycle) were washed and treated with trypsin to isolate epithelial cells, which were then cultured at control temperature (38.5 °C for 24 h) or exposed to elevated temperatures [38.5 °C for 6 h, 40.5 °C for 18 h; Heat Stressed (HS)]. The supernatant and endometrial epithelial cells were collected at various time points (0, 3, 6, 12, and 24 h) from both the control and treatment groups. Although heat stress (40.5 °C) significantly (P < 0.05) increased COX-2, PGES, and PGFS transcripts in epithelial cells but it did not affect the in vitro production of PGF2α and PGE2. The expression of ITGAV and LGALS15 mRNAs in endometrial epithelial cells remained unaltered under elevated temperature conditions. Conclusion: It can be concluded that elevated temperature did not directly modulate prostaglandin production but, it promoted the expression of COX-2, PGES and PGFS mRNA in buffalo endometrial epithelial cells. [ABSTRACT FROM AUTHOR]

Introduction: Partial breast irradiation (PBI) has increased in utilization, with the postoperative lumpectomy cavity and clips used to guide target volumes. The ideal timing to perform computed tomography (CT)-based treatment planning for this technique is unclear. Prior studies have examined change in volume over time from surgery but not the effect of patient characteristics on lumpectomy cavity volume. We sought to investigate patient and clinical factors that may contribute to larger postsurgical lumpectomy cavities and therefore predict for larger PBI volumes. Methods: A total of 351 consecutive women with invasive or in situ breast cancer underwent planning CT after breast-conserving surgery at a single institution during 2019 and 2020. Lumpectomy cavities were contoured, and volume was retrospectively computed using the treatment planning system. Univariate and multivariate analyses were performed to evaluate the associations between lumpectomy cavity volume and patient and clinical factors. Results: Median age was 61.0 years (range, 30-91), 23.9% of patients were Black people, 52.1% had hypertension, the median body mass index (BMI) was 30.4 kg/m², 11.4% received neoadjuvant chemotherapy, 32.5% were treated prone, mean interval from surgery to CT simulation was 54.1 days ± 45.9, and mean lumpectomy cavity volume was 42.2 cm3 ± 52.0. Longer interval from surgery was significantly associated with smaller lumpectomy cavity volume on univariate analysis, p = 0.048. Race, hypertension, BMI, the receipt of neoadjuvant chemotherapy, and prone position remained significant on multivariate analysis (p < 0.05 for all). Prone position vs. supine, higher BMI, the receipt of neoadjuvant chemotherapy, the presence of hypertension, and race (Black people vs. White people) were associated with larger mean lumpectomy cavity volume. Discussion: These data may be used to select patients for which longer time to simulation may result in smaller lumpectomy cavity volumes and therefore smaller PBI target volumes. Racial disparity in cavity size is not explained by known confounders and may reflect unmeasured systemic determinants of health. Larger datasets and prospective evaluation would be ideal to confirm these hypotheses. [ABSTRACT FROM AUTHOR]

Objective: Hearing loss (HL) has been linked to commonly studied detrimental mood states, such as loneliness and depression. However, its relationship with other negative emotions remained largely unstudied. We explore the association between HL and anxiety, anger, hostility, poor self‐esteem, and pessimism in a national cohort of US Hispanic adults. Study Design: Cross‐sectional study. Setting: Multicentered US national epidemiologic study (Hispanic Community Health Study). Methods: Subjects were ages 18 to 75 with completed audiometric and emotional survey data. Multivariable regressions controlling for age, gender, and education were conducted to analyze the association between HL, measured by 4‐frequency pure‐tone average (PTA), and emotional states. States included anxiety (Spielberger Trait Anxiety Scale‐10), anger (Spielberger Trait Anger Scale), hostility (Cook Medley Cynicism Scale‐13), poor self‐esteem (Self‐Esteem Scale‐10), and pessimism (Revised Life Orientation Test). Results: A total of 4120 to 4341 participants met inclusion criteria, depending on the specific survey; the average age was 46.7 years (standard deviation [SD] = 13.7), and the average PTA was 13.8 dB (SD = 10.1). Controlling for age, gender, and education, HL was associated with all outcomes. Specifically, for every 10 dB worsening in HL, the anxiety score worsened by 0.41 (0.23‐0.60), the anger score worsened by 0.40 (0.22‐0.58), the hostility score worsened by 0.16 (0.04‐0.27), the self‐esteem score worsened by 0.25 (0.12‐0.38), and the pessimism score worsened by 0.17 (0.04‐0.30) (all p <.01). Conclusion: HL is related to numerous negative mood states beyond loneliness and depression. This includes worse anxiety, anger, hostility, self‐esteem, and pessimism. Future studies should investigate whether treating HL improves negative emotional states. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies have reported poor cognition, such as attention and working memory, in adults with listening difficulties (LiD). However, they do not adequately describe the actual state of poor attention ability in adults with LiD. We examined the state of auditory attention in adults with and without LiD in tasks requiring multiple attention controls. Methods: Twenty-one adults who had normal hearing but complained about LiD encountered during everyday life and 22 healthy controls were included. We presented a target detection task using an odd-ball format for one ear and a sentence repetition task for the other ear. In the target detection task, participants listened to the 1,000-Hz tone served as the standard stimulus, while they had to accept a 2,000-Hz tone presented as the deviant stimulus. In the sentence repetition task, short sentences were presented. The stimuli presented to them were played on a personal computer at the most comfortable level. The participants heard these stimuli through headphones. They were required to press a key for standard stimuli in the target detection task and repeat what they heard immediately in the repetition task. We compared the response accuracy for each ear task between adults with and without LiD. Results: Our results showed that there were significant differences between the participant groups in the auditory dual-task under the dichotic listening situation. When examined individually, four adults with LiD had decreased scores in both the sentence repetition and target detection task, while the other nine participants showed a bias toward either task. Furthermore, the analysis of reaction time for pressing button revealed that the standard deviation of reaction time was extended in participants who scored poorly in either of the ear tasks. On the other hand, all adults without LiD were able to conduct the auditory dual-task exactly and promptly. Conclusion: The results suggest that adults with LiD have difficulties in appropriately allocating various cognitive abilities required for each task. We concluded that auditory attention is an important ability to conduct the auditory dual-task, and this is applicable for adults with LiD. Therefore, we believe that it is necessary to use auditory tests that require complex attentional abilities in listening, such as those required in daily life, to assess adults with LiD. [ABSTRACT FROM AUTHOR]

Background: The phenotype of peripheral neuropathy (PN) associated with glial fibrillary acidic protein-immunoglobulin G (GFAP-IgG) has not been well described. Objectives: The aim of this study was to report the frequency, clinical, and electrophysiological characteristics of PN in GFAP-IgG-positive patients. Design: This study is a single-center retrospective observational study. Data Sources and methods: GFAP-IgG-positive patients with PN were retrospectively identified from the Huashan Hospital Autoimmune Encephalitis Cohort between 2017 and 2021. Eight patients who presented with PN from other published studies were also included in the analysis. The clinical and electrophysiological characteristics of GFAP-IgG-related PN were described. Results: A total of 21 (31%) patients (7 females, 14 males; M age: 42 ± 16 years) from a cohort of 68 GFAP-IgG-positive patients presented with PN. Twenty of 21 patients had symmetrical weakness. Sensory and autonomic symptoms were present in 16 and 15 patients, respectively. Lower extremities were the most frequently involved regions for both motor (20/21) and sensory (15/21) symptoms. Moreover, 13 patients (4 females, 9 males; M age: 43 ± 13 years) had electrodiagnostic study data, and 12 of 13 patients had abnormal findings. Regarding clinical features, motor nerve fibers were predominantly involved (12/13), and symmetric lower extremities (12/13) were the most commonly affected regions. Axonal neuropathy is the typical underlying pathophysiologic process of PN. All 21 patients responded to immunotherapy. However, four patients with tetraplegia had poor outcomes, and PN was the major determinant of their long-term disability. Most cases (6/8) from the literature presented with similar clinical and electrophysiological features to those from our cohort. Conclusion: Peripheral nerves could be involved in autoimmune GFAP astrocytopathy. Predominant motor axonal neuropathy mainly involving the lower extremities is the most common PN phenotype in this disorder. GFAP-IgG-related PN is responsive to immunotherapy. Registration: Chinese Clinical Trial Registry: ChiCTR2000029115 (http://www.chictr.org). [ABSTRACT FROM AUTHOR]

Optical flow provides an opportunity to elevate the resolution and sensitivity of deflection sensing in background-oriented schlieren (BOS). Despite extensive relevant literature within the field of computer vision, there is a lack of proper quantification of its abilities and limitations with regard to the state-of-the-art BOS experiments. Thus, this study performs an assessment of accuracy and resolution limits in different flow field scenarios utilizing background patterns generated with random dot and wavelet noise distributions. Accordingly, a synthetic assessment over a theoretically generated Prandtl–Meyer expansion fan is conducted with variations introduced in the background patterns and operational parameters of optical flow. A clear superiority of accuracy and resolvable range of density gradient amplitudes over cross-correlation is demonstrated. Moreover, an experimental assessment of supersonic flow features over multiple wind tunnel models is performed. The influence of experimental constraints, limitations and uncertainties related to the application of optical flow in BOS and its comparative performance against the block-matching counterpart is characterized. [ABSTRACT FROM AUTHOR]

Background: Breast-conserving surgery with radiotherapy is one of standard treatments for early breast cancer. However, it is regarded as an option to treat elderly patients with small hormone receptor-positive breast cancer with breast-conserving surgery and hormone therapy without radiotherapy. We conducted two sequential prospective studies to examine the feasibility of breast-conserving surgery without radiotherapy since 2002 and present the results. Patients and methods: Primary female breast cancer patients who fulfilled the strict eligibility criteria were prospectively enrolled in two sequential studies named WORTH 1 and 2. The surgical materials were sliced in 5-mm intervals and all slices were examined microscopically. Postoperative radiotherapy was not allowed, but tamoxifen or anastrozole was administered for 5 years. Ipsilateral breast tumor recurrence (IBTR)-free survival was the primary outcome. Results: The data of the two studies were combined (N = 321). The median follow-up period for IBTR was 94 months (4–192 months). Only three patients were treated with adjuvant chemotherapy. The 5- and 10-year IBTR-free rates were 97.0% and 90.5%, respectively. The age at operation and PR status affected IBTR rates independently. When we calculated IBTR-free rates of patients who were 65 years of age or older at the time of surgery and had PR-positive tumors, the 5- and 10-year IBTR rates were both 98.4%. Conclusions: Our "5-mm-thick slice and 5-mm free-margin" method may be effective to select patients who can be treated by breast-conserving surgery and hormone therapy without radiotherapy. [ABSTRACT FROM AUTHOR]

Background: The phenotype of peripheral neuropathy (PN) associated with glial fibrillary acidic protein-immunoglobulin G (GFAP-IgG) has not been well described. Objectives: The aim of this study was to report the frequency, clinical, and electrophysiological characteristics of PN in GFAP-IgG-positive patients. Design: This study is a single-center retrospective observational study. Data Sources and methods: GFAP-IgG-positive patients with PN were retrospectively identified from the Huashan Hospital Autoimmune Encephalitis Cohort between 2017 and 2021. Eight patients who presented with PN from other published studies were also included in the analysis. The clinical and electrophysiological characteristics of GFAP-IgG-related PN were described. Results: A total of 21 (31%) patients (7 females, 14 males; Mage: 42 ± 16 years) from a cohort of 68 GFAP-IgG-positive patients presented with PN. Twenty of 21 patients had symmetrical weakness. Sensory and autonomic symptoms were present in 16 and 15 patients, respectively. Lower extremities were the most frequently involved regions for both motor (20/21) and sensory (15/21) symptoms. Moreover, 13 patients (4 females, 9 males; Mage: 43 ± 13 years) had electrodiagnostic study data, and 12 of 13 patients had abnormal findings. Regarding clinical features, motor nerve fibers were predominantly involved (12/13), and symmetric lower extremities (12/13) were the most commonly affected regions. Axonal neuropathy is the typical underlying pathophysiologic process of PN. All 21 patients responded to immunotherapy. However, four patients with tetraplegia had poor outcomes, and PN was the major determinant of their long-term disability. Most cases (6/8) from the literature presented with similar clinical and electrophysiological features to those from our cohort. Conclusion: Peripheral nerves could be involved in autoimmune GFAP astrocytopathy. Predominant motor axonal neuropathy mainly involving the lower extremities is the most common PN phenotype in this disorder. GFAP-IgG-related PN is responsive to immunotherapy. Registration: Chinese Clinical Trial Registry: ChiCTR2000029115 (http://www.chictr.org). [ABSTRACT FROM AUTHOR]

Background: Intraoperative electron radiotherapy (IOERT) can be used to treat early breast cancer during the conservative surgery thus enabling shorter overall treatment times and reduced irradiation of organs at risk. We report on our first 996 patients enrolled prospectively in a registry trial.Methods: At Jules Bordet Institute, from February 2010 onwards, patients underwent partial IOERT of the breast. Women with unifocal invasive ductal carcinoma, aged 40 years or older, with a clinical tumour size ≤ 20 mm and tumour-free sentinel lymph node (on frozen section and immunohistochemical analysis). A 21 Gy dose was prescribed on the 90% isodose line in the tumour bed with the energy of 6 to 12 MeV (Mobetron®-IntraOp Medical).Results: Thirty-seven ipsilateral tumour relapses occurred. Sixteen of those were in the same breast quadrant. Sixty patients died, and among those, 12 deaths were due to breast cancer. With 71.9 months of median follow-up, the 5-year Kaplan-Meier estimate of local recurrence was 2.7%.Conclusions: The rate of breast cancer local recurrence after IOERT is low and comparable to published results for IORT and APBI. IOERT is highly operator-dependent, and appropriate applicator sizing according to tumour size is critical. When used in a selected patient population, IOERT achieves a good balance between tumour control and late radiotherapy-mediated toxicity morbidity and mortality thanks to insignificant irradiation of organs at risk. [ABSTRACT FROM AUTHOR]

Our tetracycline-off-inducible CD44 expression system previously established in mouse model, revealed that activation of CD44 with its major ligand hyaluronan (HA) promoted breast cancer (BC) metastasis to the liver. To identify the mechanisms that underpin CD44-promoted BC cell invasion, microarray gene expression profiling using RNA samples from (Tet)-Off-regulated expression system of CD44s in MCF7 cells, revealed a set of upregulated genes including, nuclear sirtuin-1 (SIRT1 also known as NAD-dependent deacetylase), an enzyme that requires NAD+ as a cofactor to deacetylate several histones and transcription factors. It stimulates various oncogenic pathways promoting tumorigenesis. This data suggests that SIRT1 is a potential novel transcriptional target of CD44- downstream signaling that promote BC cell invasion/metastasis. This review will discuss the evidence supporting this hypothesis as well as the mechanisms linking SIRT1 to cell proliferation and invasion. [ABSTRACT FROM AUTHOR]

Background: For decades, the postoperative wearing of abdominal binders has been suggested to reduce dead space and prevent mobilization of the musculoaponeurotic layer in an attempt to decrease the risk of seroma formation and recurrent diastasis.Objectives: This study sought to evaluate whether the postoperative wearing of an abdominal binder provides any additional contribution to the reduction of either seroma formation or recurrent diastasis recti when abdominoplasty is performed with quilting sutures.Methods: Thirty-four women undergoing abdominoplasty were randomized into 2 groups: the binder group (n = 16) wore abdominal binders during the postoperative period, whereas the control group (n = 18) did not. Ultrasound examination was performed on postoperative days 7 and 14 to assess seroma formation and at 6 months postoperatively to assess recurrence of diastasis recti. A t test for independent samples was applied to compare means between 2 numeric variables. Generalized estimation equation models were used to evaluate seroma volume at different time points for the 2 groups.Results: No significant differences in seroma volume were found between groups on postoperative days 7 (P = 0.830) and 14 (P = 0.882). Seven cases of subclinical recurrent diastasis were observed by ultrasound examination in the supraumbilical (4 cases) and infraumbilical regions (3 cases), but without significant differences (P = 1.000) between the 2 groups. Recurrent diastasis was not detected during physical examinations.Conclusions: The postoperative wearing of abdominal binders was not effective in preventing either seroma formation or recurrent diastasis following abdominoplasty with quilting sutures.Level Of Evidence:2: [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current study is to explore the association between extended adjuvant endocrine treatment and prognosis of women with hormone receptor-positive (HR+) early breast cancer. Methods: Databases including PubMed, Web of Science, Embase and the Cochrane Library databases were electronically searched to identify randomized controlled trials (RCTs) that reported extended endocrine therapy for women with HR+ early breast cancer. The retrieval time was limited from inception to September 2022. Two reviewers independently screened literature, extracted data, and assessed risk bias of included studies. Meta-analysis was performed by using R software Version 4.1.2 and STATA Version 12.0. Results: A total of 15 RCTs involving 29497 cases were included. The overall analysis showed that compared with the control, extended adjuvant endocrine therapy increased disease-free survival (DFS) (HR=0.814, 95% CI: 0.720-0.922, 95% PI: 0.556-1.194), overall survival (OS) (HR=0.885, 95% CI: 0.822-0.953, 95% PI: 0.771-1.035), relapse-free survival (RFS) (HR=0.833, 95% CI: 0.747-0.927, 95% PI: 0.575-1.159), distant metastatic-free survival (DMFS) (HR=0.824, 95% CI: 0.694-0.979, 95% PI: 0.300-2.089) and reduced new breast cancer cumulative incidence (NBCCI) (HR=0.484, 95% CI: 0.403-0.583, 95% PI: 0.359-0.654). For adverse events, extended adjuvant endocrine treatment was associated with a significantly higher risk of bone fracture (RR=1.446, 95% CI: 1.208-1.730, 95% PI: 1.154-1.854) and osteoporosis (RR=1.377, 95% CI: 1.018-1.862, 95% PI: 0.347-5.456). Conclusion: Our study showed that extended adjuvant endocrine therapy increased DFS, OS, RFS, DMFS, the incidence of bone fracture and osteoporosis, and reduced NBCCI. [ABSTRACT FROM AUTHOR]

This study explores the ecotourism service experience framework by analysing ecotourists' motivations and expectations, as well as the dimensions of ecotourism experiences. A total of 51 ecotourists were interviewed in person at ecotourist lodges in Lower Kinabatangan, Malaysia. Interview responses were analysed using thematic analysis, and a multi-data triangulation was carried out to identify key service experience dimensions guided by the co-creation concept. Findings reveal that motivations and expectations of ecotourists are connected to the dimensions of ecotourism experiences. Several findings reveal that key dimensions include 'wildlife', 'nature/environment' and 'experiences driven from ecotourism activities' (such as riverboat cruises and jungle trekking). Based on the interviews, these dimensions can be further interpreted and conceptualised as 'education', 'aesthetic', 'escape' and 'entertainment', similar to the four realms of experience in the experience economy model by Pine and Gilmore (1998 , 1999). Hence, an ecotourism service experience framework, comprising both tangible and intangible elements, is proposed as a sound and practical approach to understanding ecotourism service experiences. This study offers empirical evidence and an innovative approach by identifying the ecotourism service experience dimensions and exploring a relevant framework, which was previously neglected. Ecotourism operators should utilise the four identified service experience dimensions to stage unique ecotourism experiences and enhance destination attractiveness and competitiveness. Experiential marketing can capitalise on these dimensions as innovative selling points and attract ecotourists, thus providing practical value in marketing ecotourism destinations. [ABSTRACT FROM AUTHOR]

Mammary epithelial cells (MECs) are the only cells capable of synthesizing lactose. During lactation, alveolar MECs secrete lactose through the apical membrane into the alveolar lumen, whereas alveolar tight junctions (TJs) block the leakage of lactose into the basolateral sides of the MECs. However, lactose leaks from the alveolar lumen into the blood plasma in the mastitis and after weaning. This exposes the basolateral membrane of MECs to lactose. The relationship between lactose in blood plasma and milk production has been suggested. The present study determined whether lactose exposure on the basolateral membrane of mouse MECs adversely affects milk production in vitro. Restricted exposure to lactose on the basolateral side of the MECs was performed using a culture model, in which MECs on the cell culture insert exhibit milk production and less-permeable TJs. The results indicated that lactose exposure on the basolateral side inhibited casein and lipid production in the MECs. Interestingly, lactose exposure on the apical side did not show detectable effects on milk production in the MECs. Basolateral lactose exposure also caused the inactivation of STAT5, a primary transcriptional factor for milk production. Furthermore, p38 and JNK were activated by basolateral lactose exposure. The activation of p38 and JNK following anisomycin treatment reduced phosphorylated STAT5, and inhibitors of p38 blocked the reduction of phosphorylated STAT5 by basolateral lactose exposure. These findings suggest that lactose functions as a partial inhibitor for milk production but only when it directly makes contact with the basolateral membrane of MECs. [ABSTRACT FROM AUTHOR]

Since the discovery of interferon-tau (IFNT) over 30 years ago as the trophectodermal cytokine responsible for the maintenance of the maternal corpus luteum (CL) in ruminants, exhaustive studies have been conducted to identify genes and gene products related to CL maintenance. Recent studies have provided evidence that although CL maintenance, with the up- and down-regulation of IFNT, is important, its regulatory role in the endometrial expression of interferon-stimulated genes (ISGs) is far more important for conditioning the uterine environment for successful conceptus implantation and thereafter. This review initially describes the mammalian implantation process, briefly but focuses on recent findings, as there appears to be a common phenomenon during early to midpregnancy among mammalian species. [ABSTRACT FROM AUTHOR]

Video game research predominantly uses a "one game-one function" approach—researchers deploy a constellation of task-like minigames to span multiple domains or consider a complex video game to essentially represent one cognitive construct. To profile cognitive functioning in a more ecologically valid setting, we developed a novel 3-D action shooter video game explicitly designed to engage multiple cognitive domains. We compared gameplay data with results from a web-based cognitive battery (WebCNP) for 158 participants (aged 18–74). There were significant negative main effects on game performance from age and gender, even when controlling for prior video game exposure. Among younger players, game mechanics displayed significant and unique correlations to cognitive constructs such as aim accuracy with attention and stealth with abstract thinking within the same session. Among older players the relation between game components and cognitive domains was unclear. Findings suggest that while game mechanics within a single game can be deconstructed to correspond to existing cognitive metrics, how game mechanics are understood and utilized likely differs between the young and old. We argue that while complex games can be utilized to measure distinct cognitive functions, the translation scheme of gameplay to cognitive function should not be one-size-fits-all across all demographics. [ABSTRACT FROM AUTHOR]

The progressive motor neuropathy (PMN) mouse is a model of an inherited motor neuropathy disease with progressive neurodegeneration. Axon degeneration associates with homozygous mutations of the TBCE gene encoding the tubulin chaperone E protein. TBCE is responsible for the correct dimerization of alpha and beta-tubulin. Strikingly, the PMN mouse also develops a progressive hearing loss after normal hearing onset, characterized by degeneration of the auditory nerve and outer hair cell (OHC) loss. However, the development of this neuronal and cochlear pathology is not fully understood yet. Previous studies with pegylated insulin-like growth factor 1 (peg-IGF-1) treatment in this mouse model have been shown to expand lifespan, weight, muscle strength, and motor coordination. Accordingly, peg-IGF-1 was evaluated for an otoprotective effect. We investigated the effect of peg-IGF-1 on the auditory system by treatment starting at postnatal day 15 (p15). Histological analysis revealed positive effects on OHC synapses of medial olivocochlear (MOC) neuronal fibers and a short-term attenuation of OHC loss. Peg-IGF-1 was able to conditionally restore the disorganization of OHC synapses and maintain the provision of cholinergic acetyltransferase in presynapses. To assess auditory function, frequency-specific auditory brainstem responses and distortion product otoacoustic emissions were recorded in animals on p21 and p28. However, despite the positive effect on MOC fibers and OHC, no restoration of hearing could be achieved. The present work demonstrates that the synaptic pathology of efferent MOC fibers in PMN mice represents a particular form of "efferent auditory neuropathy." Peg-IGF-1 showed an otoprotective effect by preventing the degeneration of OHCs and efferent synapses. However, enhanced efforts are needed to optimize the treatment to obtain detectable improvements in hearing performances. [ABSTRACT FROM AUTHOR]

Individuals are increasingly relying on GPS devices to orient and find their way in their environment and research has pointed to a negative impact of navigational systems on spatial memory. We used immersive virtual reality to examine whether an audio–visual navigational aid can counteract the negative impact of visual only or auditory only GPS systems. We also examined the effect of spatial representation preferences and abilities when using different GPS systems. Thirty-four participants completed an IVR driving game including 4 GPS conditions (No GPS; audio GPS; visual GPS; audio–visual GPS). After driving one of the routes in one of the 4 GPS conditions, participants were asked to drive to a target landmark they had previously encountered. The audio–visual GPS condition returned more accurate performance than the visual and no GPS condition. General orientation ability predicted the distance to the target landmark for the visual and the audio–visual GPS conditions, while landmark preference predicted performance in the audio GPS condition. Finally, the variability in end distance to the target landmark was significantly reduced in the audio–visual GPS condition when compared to the visual and audio GPS conditions. These findings support theories of spatial cognition and inform the optimisation of GPS designs. [ABSTRACT FROM AUTHOR]

Growth-associated protein 43 (GAP43) is found in skeletal muscle, localized near the calcium release units. In interaction with calmodulin (CaM), it indirectly modulates the activity of dihydropyridine and ryanodine Ca2+ channels. GAP43–CaM interaction plays a key role in intracellular Ca2+ homeostasis and, consequently, in skeletal muscle activity. The control of intracellular Ca2+ signaling is also an important functional requisite in cardiac physiology. The aim of this study is to define the impact of GAP43 on cardiac tissue at macroscopic and cellular levels, using GAP43 knockout (GAP43−/−) newborn C57/BL6 mice. Hearts from newborn GAP43−/− mice were heavier than hearts from wild-type (WT) ones. In these GAP43−/− hearts, histological section analyses revealed a thicker ventricular wall and interventricular septum with a reduced ventricular chamber area. In addition, increased collagen deposits between fibers and increased expression levels of myosin were observed in hearts from GAP43−/− mice. Cardiac tropism and rhythm are controlled by multiple intrinsic and extrinsic factors, including cellular events such those linked to intracellular Ca2+ dynamics, in which GAP43 plays a role. Our data revealed that, in the absence of GAP43, there were cardiac morphological alterations and signs of hypertrophy, suggesting that GAP43 could play a role in the functional processes of the whole cardiac muscle. This paves the way for further studies investigating GAP43 involvement in signaling dynamics at the cellular level. [ABSTRACT FROM AUTHOR]