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Skin cancer mortality rates continue to rise, and survival analysis is increasingly needed to understand who is at risk and what interventions improve outcomes. However, current statistical methods are limited by inability to synthesize multiple data types, such as patient genetics, clinical history, demographics, and pathology and reveal significant multimodal relationships through predictive algorithms. Advances in computing power and data science enabled the rise of artificial intelligence (AI), which synthesizes vast amounts of data and applies algorithms that enable personalized diagnostic approaches. Here, we analyze AI methods used in skin cancer survival analysis, focusing on supervised learning, unsupervised learning, deep learning, and natural language processing. We illustrate strengths and weaknesses of these approaches with examples. Our PubMed search yielded 14 publications meeting inclusion criteria for this scoping review. Most publications focused on melanoma, particularly histopathologic interpretation with deep learning. Such concentration on a single type of skin cancer amid increasing focus on deep learning highlight growing areas for innovation; however, it also demonstrates opportunity for additional analysis that addresses other types of cutaneous malignancies and expands the scope of prognostication to combine both genetic, histopathologic, and clinical data. Moreover, researchers may leverage multiple AI methods for enhanced benefit in analyses. Expanding AI to this arena may enable improved survival analysis, targeted treatments, and outcomes.

Abstract Introduction Upadacitinib (UPA) is an oral, selective Janus kinase inhibitor that has demonstrated favorable efficacy with an acceptable safety profile across a global, phase 3 program in rheumatoid arthritis (RA). This phase 2 open-label extension investigated the efficacy and safety of UPA through 6 years of treatment. Methods Patients from two phase 2b trials (BALANCE-1 and -2) enrolled in BALANCE-EXTEND (NCT02049138) and received open-label UPA 6 mg twice daily (BID). Dose increases to 12 mg BID were required for patients with

Background: Metabolic bone diseases (MBD) are typically diagnosed by non-invasive imaging and clinical biomarkers. However, imaging does not provide structural information, and biomarkers can be transiently affected by many systemic factors. Bone biopsy and pathologic evaluation is the gold standard for diagnosis of MBD, however, it is rarely utilized. We describe our technique for iliac crest tetracycline-labelled bone using a cannulated drill and assess the utility of bone biopsies to provide diagnostic and therapeutic guidance. Methods: In the 25-year period between March 1998 and January 2023, a total of 95 bone biopsies were performed on 94 patients for an osteological indication at Vanderbilt University Medical Center (VUMC). Patient demographics, bone biopsy indications, complications, diagnostic utility, and subsequent therapeutic guidance were retrospectively reviewed and analyzed. Results: The procedure had minimal complications and was well tolerated by patients. This technique provided good quality specimens for pathology, which helped establish a diagnosis and treatment change in most patients. Patients that had biopsy-guided treatment alterations showed significant increases in Dual-Energy X-ray Absorptiometry (DEXA) bone mineral density (BMD) scores post-biopsy and subsequent treatment. Conclusion: Despite scientific and technological progress in non-invasive diagnostic imaging, clinical biomarkers, and procedures for MBD, there remains a small but significant subset of patients who may benefit from inclusion of tetracycline-labelled bone biopsy into the diagnostic and therapeutic picture. Future prospective comparison studies are warranted. Mini abstract: Tetracycline-labelled bone biopsies are under-utilized. Biopsy led to a histological diagnosis and ensuing treatment alteration in most patients with significant increases in bone mineral density. The biopsy procedure used herein provided good specimens with low pain/adverse events. Bone biopsy remains a valuable tool in a small, though significant, subset of patients.

Rice is the most important crop grown in the Philippines since it is an essential food and a source of income for many Filipinos. The study’s purpose is to determine the various influencing factors affecting the rice production of small-scale farmers in Albuera, Leyte, Philippines. Using Slovin’s formula, a total of 73 rice farmers were randomly selected as respondents to the survey. Some descriptive techniques were employed to summarize the different variables. A categorical relationship analysis using a Chi-square test was used to analyze the significant factors of rice production. Results showed that about 57.53% and 42.47% of the farmers are experiencing low and high production levels, respectively. On average, rice farmers are "moderately affected" (M=23.00, SD=4.55) by the different constraints in the rice production process from planting to harvesting. In addition, farmers are "uncertain" (M=19.67, SD=3.01) about the effectiveness and usefulness of extension agents' role in their production process. Moreover, it is revealed that the demographic profile, constraints in rice farming, and extension agents' role does not affect the farmers' rice production level. On the other hand, other sources of income (p=0.034), monthly income in farming (p=0.13), and farm size (p

Does serial learning result in specific associations between pairs of items, or does it result in a cognitive map based on relations of all items? In 2 experiments, we trained human participants to learn various lists of photographic images. We then tested the participants on new lists of photographic images. These new lists were constructed by selecting only 1 image from each list learned during training. In Experiment 1, participants were trained to choose the earlier (experimenter defined) item when presented with adjacent pairs of items on each of 5 different 5-item lists. Participants were then tested on derived lists, in which each item retained its original ordinal position, even though each of the presented pairs was novel. Participants performed above chance on all of the derived lists. In Experiment 2, a different group of participants received the same training as those of Experiment 1, but the ordinal positions of items were systematically changed on each derived list. The response accuracy for Experiment 2 varied inversely with the degree to which an item's original ordinal position was changed. These results can be explained by a model in which participants learned to make both positional inferences about the absolute rank of each stimulus, and transitive inferences about the relative ranks of pairs of stimuli. These inferences enhanced response accuracy when ordinal position was maintained, but not when it was changed. Our results demonstrate quantitatively that, in addition to item-item associations that participants acquire while learning a list of arbitrary items, they form a cognitive map that represents both experienced and inferred relationships.

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Copyright of Historia Agraria is the property of Historia Agraria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Time to treatment initiation (TTI) is a quality metric in cancer care. The purpose of this study is to determine the accuracy of TTI data from a single cancer center registry that reports to the National Cancer Database (NCDB) for sarcoma diagnoses. Methods. A retrospective analysis of a single Commission on Cancer (CoC)-accredited cancer center’s tumor registry between 2006 and 2016 identified 402 patients who underwent treatment of a musculoskeletal soft tissue sarcoma and had TTI data available. Registry-reported TTI was extracted from the tumor registry. Effective TTI was manually calculated by medical record review as the number of days from the date of tissue diagnosis to initiation of first effective treatment. Effective treatment was defined as oncologic surgical excision or initiation of radiation therapy or chemotherapy. Registry-reported TTI and effective TTI values were compared for concordance in all patients. Results. In the entire cohort, 25% (99/402) of patients had TTI data discordance, all related to surgical treatment definition. For patients with a registry-reported value of TTI = 0 days, 74% (87/118) had a diagnostic surgical procedure coded as their first treatment event, with 73 unplanned incomplete excision procedures and 14 incisional biopsies. In these patients, effective TTI was on average 59 days (P0 days, only 4% (12/284) had discordant TTI values. Conclusions. Nearly three-fourths of patients with a registry-reported value of TTI = 0 days in a large, CoC-accredited cancer center registry had a diagnostic procedure coded as their first treatment event, though their effective treatment had not yet started. These data suggest that TTI is likely longer than what is reported to the NCDB. Redefinition of what constitutes surgical treatment should be considered to improve the accuracy of data used in measuring TTI in sarcoma.

Abstract Background It has been hypothesized that polypharmacy may increase the frequency of multidrug interactions (MDIs) where one drug interacts with two or more other drugs, amplifying the risk of associated adverse drug events (ADEs). The main objective of this study was to determine the prevalence of MDIs in medication lists of elderly ambulatory patients and to identify the medications most commonly involved in MDIs that amplify the risk of ADEs. Methods Medication lists stored in the electronic health record (EHR) of 6,545 outpatients ≥60 years old were extracted from the enterprise data warehouse. Network analysis identified patients with three or more interacting medications from their medication lists. Potentially harmful interactions were identified from the enterprise drug-drug interaction alerting system. MDIs were considered to amplify the risk if interactions could increase the probability of ADEs. Results MDIs were identified in 1.3 % of the medication lists, the majority of which involved three interacting drugs (75.6 %) while the remainder involved four (15.6 %) or five or more (8.9 %) interacting drugs. The average number of medications on the lists was 3.1 ± 2.3 in patients with no drug interactions and 8.6 ± 3.4 in patients with MDIs. The prevalence of MDIs on medication lists was greater than 10 % in patients prescribed bupropion, tramadol, trazodone, cyclobenzaprine, fluoxetine, ondansetron, or quetiapine and greater than 20 % in patients prescribed amiodarone or methotrexate. All MDIs were potentially risk-amplifying due to pharmacodynamic interactions, where three or more medications were associated with the same ADE, or pharmacokinetic, where two or more drugs reduced the metabolism of a third drug. The most common drugs involved in MDIs were psychotropic, comprising 35.1 % of all drugs involved. The most common serious potential ADEs associated with the interactions were serotonin syndrome, seizures, prolonged QT interval and bleeding. Conclusions An identifiable number of medications, the majority of which are psychotropic, may be involved in MDIs in elderly ambulatory patients which may amplify the risk of serious ADEs. To mitigate the risk, providers will need to pay special attention to the overlapping drug-drug interactions which result in MDIs.

We investigated the biochemical profile of greater rheas (Rhea americana) in captivity and correlated these values according to the birds’ sex. A total of 69 serum samples were collected from a breeding site in Mossoró, northeastern Brazil, and analyzed to quantify serum biochemical parameters (total protein, albumin, cholesterol, calcium, phosphorus, uric acid, urea, creatinine, ALP, AST, and CK). The birds had levels of urea, creatinine, total cholesterol, aspartate aminotransferase, calcium, and phosphorus similar to the values reported for ratite and ostrich species. By sex, females showed higher values (p < 0.05) of calcium (3.5 mmol/L), total cholesterol (7.5 mmol/L), and uric acid (435.3 μmol/L) than males, which had 3.1 mmol/L, 3.8 mmol/L, and 390.7 μmol/L, respectively. This can be attributed to the difference in diet, the productive phase of females, or stress at the time of sampling. The data present a wide spectrum of biochemical results regarding the health of greater rheas, contributing to the veterinary clinical practice of this species.

Intersubjectivity refers to two non-verbal intersubjective relations infants experience during their first year that are precursors to the emergence of words. Trevarthen, a pioneer in the study of intersubjectivity, referred to those relations as primary and secondary intersubjectivity. The former, a dyadic coordination between the infant and her caregiver, begins at birth. The latter, a triadic coordination that develops around 9 months, allows the infant and a caregiver to share attention to particular features of the environment. Secondary intersubjectivity is crucial for an infant’s ability to begin to produce words, at around 12 months. Much research on the social and cognitive origins of language has focused on secondary intersubjectivity. That is unfortunate because it neglects the fact that secondary intersubjectivity and the emergence of words are built on a foundation of primary intersubjectivity. It also ignores the evolutionary origins of intersubjectivity and its uniquely human status. That unique status explains why only humans learn words. This article seeks to address these issues by relating the literature on primary intersubjectivity, particularly research on bi-directional and contingent communication between infants and mothers, to joint attention and ultimately to words. In that context, we also discuss Hrdy’s hypothesis about the influence of alloparents on the evolution of intersubjectivity.

Abstract Monkeys can learn the implied ranking of pairs of images drawn from an ordered set, despite never seeing all of the images simultaneously and without explicit spatial or temporal cues. We recorded the activity of posterior parietal cortex (including lateral intraparietal area LIP) neurons while monkeys learned 7-item transitive inference (TI) lists with 2 items presented on each trial. Behavior and neuronal activity were significantly influenced by the ordinal relationship of the stimulus pairs, specifically symbolic distance (the difference in rank) and joint rank (the sum of the ranks). Symbolic distance strongly predicted decision accuracy and learning rate. An effect of joint rank on performance was found nested within the symbolic distance effect. Across the population of neurons, there was significant modulation of firing correlated with the relative ranks of the two stimuli presented on each trial. Neurons exhibited selectivity for stimulus rank during learning, but not before or after. The observed behavior is poorly explained by associative or reward mechanisms, and appears more consistent with a mental workspace model in which implied serial order is mapped within a spatial framework. The neural data suggest that posterior parietal cortex supports serial learning by representing information about the ordinal relationship of the stimuli presented during a given trial.

Light emitters integrated with Si platform are highly desirable for photonic integrated circuits, however, manufacturing them remains difficult. In this work, BGaAs/GaP quantum well (QW) structures are proposed as a promising solution of the challenge. These QWs can be grown on GaP/Si templates, which are intensively developed for recent years. An 8-band k·p model, envelope function approximation, self-consistency in solving of Schrödinger and Poisson equations with parabolic approximations of the indirect valleys and Fermi golden rule are used to calculate and analyze the material optical gain spectra of the QWs. A positive material gain is found for the QWs with 10-35% BAs mole fraction, with zinc-blende BGaAs epilayers grown on the GaP(001) substrates as direct gap semiconductors. It is predicted that such structures emit red light with wavelengths from the range of 730-690 nm. Optimal QWs widths for maximal TE and TM gain polarizations are below the critical thickness of BGaAs grown on the GaP(001). Presented results clearly indicate that BGaAs/GaP QW system is a very promising gain medium for Si-compatible photonic integrated circuits.

Background. Radiation after resection of an atypical lipomatous tumor (ALT) is controversial. This study evaluates local control and complications after the first resection of ALTs of the extremity with or without adjuvant radiation. Methods. A dual institution, retrospective review of patients treated from 1995 to 2020 with first-time resection of an ALT in the extremity was performed. In total, 102 patients underwent adjuvant radiation (XRT group) and 68 patients were treated with surgery alone (no-XRT group). The median follow-up time was 4.6 years (interquartile range (IQR) 2.0–7.3 years). The median radiation dose was 60 Gy (IQR 55–66 Gy). Univariable and multivariable analyses evaluated the association of patient, tumor, and treatment variables with recurrence and complications. Kaplan–Meier analysis evaluated local recurrence-free survival (LRFS) and time to complication. Results. The overall incidence of local recurrence was 1% (1/102) in the XRT group and 24% (16/68) in the no-XRT group p

Abstract Introduction The aim of this work is to evaluate the impact of the timing of pre-infusion serum uric acid (sUA) test results for use in applying stopping rules for pegloticase to identify patients at risk for infusion reactions (IRs) while on therapy. Methods Data from the phase 3 clinical trials of pegloticase were reviewed and individual uric acid levels of the 85 patients who received the approved regimen of biweekly infusions were examined in relation to the occurrence of IRs. Results Of the 22 patients (26%) who experienced an IR on pegloticase therapy without uric acid stopping rules, only seven (8%) would have had IRs if pegloticase therapy had been discontinued after two consecutive pre-infusion sUA levels above 6 mg/dl. If pegloticase therapy was stopped after a single pre-infusion sUA above 6 mg/dl, only two patients (2%) would have experienced IRs during the clinical studies. Conclusions A pre-infusion sUA level functions as a highly accurate biomarker for identification of patients who are at risk of IRs while on pegloticase therapy. Stopping pegloticase in patients who have a rise in pre-infusion uric acid levels to above 6 mg/dl while on therapy would result in most IRs being avoided. Funding Horizon Pharma.

Amblyomma aureolatum ticks are vectors of Rickettsia rickettsii, the etiologic agent of Rocky Mountain spotted fever in Brazil. Maintenance of R. rickettsii in nature depends on horizontal transmission along tick generations. Although such transmission is known to occur when uninfected and infected ticks feed simultaneously on susceptible animals (co-feeding systemic transmission), we investigated co-feeding nonsystemic transmission, which was based on R. rickettsii–infected and –uninfected A. aureolatum ticks feeding simultaneously on guinea pigs immune to R. rickettsii. Our acquisition and transmission infestations demonstrated that horizontal transmission of R. rickettsii by co-feeding ticks on immune hosts with no systemic infection did not occur when uninfected larvae fed distantly from infected nymphs but did occur in a few cases when uninfected larvae fed side-by-side with infected nymphs, suggesting that they shared the same feeding site. The co-feeding nonsystemic transmission type might have no epidemiologic importance for Rocky Mountain spotted fever.