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Tool wear management and real-time machining quality monitoring are pivotal components of realizing smart manufacturing objectives, as they directly influence machining precision and productivity. Traditionally, measuring and analyzing cutting force fluctuations in the time domain has been employed to diagnose tool wear effects. This study introduces a novel, indirect approach that leverages spindle-load current variations as a proxy for cutting force analysis. Compared to conventional methods relying on machining vibration or direct cutting force measurement, this technique provides a safer, simpler, and more cost-effective means of data aquisition, with reduced computational demands. Consequently, it is ideally suited for real-time monitoring and long-term analyses such as tool-life prediction and surface-roughness evolution induced by tool wear. An intelligent tool wear monitoring system was developed based on spindle-load current data. The system employs extensive cutting experiments to identify and analyze the correlation between tool wear and spindle-load current signal patterns. By establishing a tool wear near-end-of-life threshold, the system enables intelligent monitoring using C#. Experimental validation under both roughing and finishing conditions demonstrated the system's exceptional diagnostic accuracy and reliability. The results demonstrate that the current ratio threshold value has good universality in different materials, indicating that monitoring the machining current ratio to estimate the degree of tool wear is a feasible research direction, and that the average error between the experimental surface-roughness measurement value and the predicted value was 10%. [ABSTRACT FROM AUTHOR]

Background: Studies on the correlation between high body mass index (BMI) and extended survival among patients receiving immune checkpoint inhibitors (ICIs) have been made, although findings have shown variability. Our research explored the phenomenon of the "obesity paradox" in patients with metastatic urothelial carcinoma (mUC) undergoing treatment with ICIs. Materials and Methods: We conducted a retrospective analysis of patients diagnosed with mUC who received a minimum of one cycle of ICI treatment at two medical centers in Taiwan from September 2015 to January 2023. Features of patients' clinicopathologic factors, including age, sex, primary or metastatic location, treatment line, and BMI were examined. The primary outcome were overall survival (OS) and progression‐free survival (PFS), which were assessed utilizing the Kaplan–Meier method. We employed the Cox‐regression model to adjust for multiple covariates. Results: A total of 215 patients were included, with 128 (59.5%) being male, and the median age was 70 years. In the obese group (BMI ≥25 kg/m2), patients demonstrated significantly better median OS compared to the non‐obese group (BMI <25 kg/m2) (21.9 vs. 8.3 months; p = 0.021). However, there was no significant difference in median PFS between the high and low BMI groups (4.7 vs. 2.8 months; p = 0.16). Post‐hoc subgroup revealed a survival benefit from ICI treatment in male patients within the BMI ≥25 kg/m2 group (HR 0.49, 95% CI 0.30–0.81, p = 0.005). Conclusion: Based on real‐world data from the Asia‐Pacific region, there appears to be a correlation between obesity and prolonged OS in patients receiving ICI treatment for mUC. [ABSTRACT FROM AUTHOR]

Objectives: Platinum-based chemotherapy is the standard treatment for metastatic urothelial carcinoma (mUC). However, considering elderly patients often experience comorbidities and frailty, the utility of cisplatin-based chemotherapy for elderly patients is still debatable. We conducted this study to compare the safety and efficacy of carboplatin and cisplatin in elderly patients with mUC. Methods: This retrospective study enrolled elderly patients with mUC (defined as aged ≥70 years) who underwent first-line platinum-based chemotherapy between September 2001 and October 2018. The primary endpoints were chemotherapy-related adverse events (AEs), including treatment-related hospitalization or death. The secondary outcomes were overall survival (OS) and progression-free survival calculated by Kaplan-Meier analysis. Results: In total, 108 elderly patients with mUC were enrolled and allocated into the cisplatin or carboplatin group. Patients treated with carboplatin-based chemotherapy had a significantly higher incidence of all grade ≥3 AEs (78.8 vs. 50.0%, p = 0.008) than those on cisplatin. AE-related hospitalization (47.5 vs. 19.1%, p = 0.002) and treatment-related death (17.5 vs. 4.4%, p = 0.02) were significantly increased in the carboplatin group. In the univariate analysis, the median OS in the cisplatin group was significantly increased compared with the carboplatin group (13.6 vs. 7.2 months, p = 0.045). The Cox multivariate regression model indicated that leukocytosis (HR 3.17, 95% CI 1.84–5.46, p < 0.001) and anemia (HR 2.02, 95% CI 1.11–3.65, p = 0.02) were independent prognostic factors. Conclusion: Elderly patients with mUC treated with cisplatin-based chemotherapy had better survival and safety profiles than those treated with carboplatin. Age itself was not a crucial factor in determining cisplatin eligibility. [ABSTRACT FROM AUTHOR]