Hyperthermia as an Antineoplastic Treatment Modality

Preclinical evaluation of hyperthermia for treating tumerous cancers is discussed

Older Adults Embracing Technology: Leave No One Behind

The goal of this exploratory study, conducted throughout 2005 - 2006, was to examine effective ways to provide both initial computer training and ongoing technical support for elders with little or no computer experience, and to explore whether the accomplishment of acquiring computer skills had an impact on the elders’ quality of life. The computer training and follow-up technical support were provided by student volunteers trained specifically for this study. Following the computer training, all participants were offered 12 weeks of ongoing technical support (phone, email or in person) by the same student tech tutors and additional student volunteers. Questionnaires measuring computer comfort and proficiency were administered pre and post training and again at 6 weeks and 12 weeks after the training. Participants kept logs of their computer use and recorded their goals, successes, and challenges throughout the study. The trained and volunteer tech tutors kept field notes of the elders’ learning, and recorded the nature of the technical help requested by the participants. A number of common themes were revealed in the narrative data of both the elders and the student tech tutors. These were clustered into four categories: social inclusion; the teaching and learning experience; expanding horizons; and expressions of self-efficacy. Specific challenges encountered by tech tutors and participants are presented and innovative teaching strategies are proposed. Findings point to the need for further studies to explore the psychosocial factors that motivate and hinder elder requests for ongoing technical help as well as the need for outreach to convey the unexpected benefits of going online to nonusers. A number of recommendations and implications for policy, education and further research were highlighted by the study

Padimedical: Medical Image Sharing Portal with DICOM Viewer – User Experience

Digital Imaging and Communication in Medicine (DICOM) is a standard medical imaging format for medical imaging information and data. Availability to access DICOM files remotely using smartphones has shown to improve healthcare systems especially for communication between doctors fromdifferent centres. Most of DICOM files need to be viewed using conventional institutional DICOM viewer. We developed software which allows medical personnel to access DICOM images remotely from their smartphone. This newly created software platform is named Padimedical. This pilot study aims to evaluate users’ satisfaction and usability. Practising medical doctors from a radiology department in a tertiary referral centre were chosen as correspondents in this study. The survey form was sent to over 30 doctors via email. A total of 24 out of 30 respondents completed the survey. The survey showed that Padimedical DICOM viewer was easily accessible (100%), compatible with OS operating system (100%), user-friendly (87.1%), and high signal to noise ratio (100%). All respondents (100%) agreed that the image viewing was smooth and responsive. All respondents would recommend to their peers (n=24). A total of 18 respondents suggested that the quality of images was high (76%) and 23 respondents suggested that the contents in this newly created platform were easy to share (96.15%). All the participants were able to make the correct diagnosis using Padimedical. Overall, the rating of our platform is 4.3 out of 5. Conclusion: Based on this pilot survey, Padimedical software was easily accessible remotely using smartphones, compatible with OS operating system, viewing images were smooth and responsive, produce high-quality image, and easy to share DICOM contents.Keywords—DICOM, images, software

Biomarkers of response to ibrutinib plus nivolumab in relapsed diffuse large B-cell lymphoma, follicular lymphoma, or Richter's transformation

We analyzed potential biomarkers of response to ibrutinib plus nivolumab in biopsies from patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), and Richter's transformation (RT) from the LYM1002 phase I/IIa study, using programmed death ligand 1 (PD-L1) immunohistochemistry, whole exome sequencing (WES), and gene expression profiling (GEP). In DLBCL, PD-L1 elevation was more frequent in responders versus nonresponders (5/8 [62.5%] vs. 3/16 [18.8%]; p = 0.065; complete response 37.5% vs. 0%; p = 0.028). Overall response rates for patients with WES and GEP data, respectively, were: DLBCL (38.5% and 29.6%); FL (46.2% and 43.5%); RT (76.5% and 81.3%). In DLBCL, WES analyses demonstrated that mutations in RNF213 (40.0% vs. 6.2%; p = 0.055), KLHL14 (30.0% vs. 0%; p = 0.046), and LRP1B (30.0% vs. 6.2%; p = 0.264) were more frequent in responders. No responders had mutations in EBF1, ADAMTS20, AKAP9, TP53, MYD88, or TNFRSF14, while the frequency of these mutations in nonresponders ranged from 12.5% to 18.8%. In FL and RT, genes with different mutation frequencies in responders versus nonresponders were: BCL2 (75.0% vs. 28.6%; p = 0.047) and ROS1 (0% vs. 50.0%; p = 0.044), respectively. Per GEP, the most upregulated genes in responders were LEF1 and BTLA (overall), and CRTAM (germinal center B-cell-like DLBCL). Enriched pathways were related to immune activation in responders and resistance-associated proliferation/replication in nonresponders. This preliminary work may help to generate hypotheses regarding genetically defined subsets of DLBCL, FL, and RT patients most likely to benefit from ibrutinib plus nivoluma

Effects Of V/III Ratio Of InGaN Quantum Well On The Properties Of Near Ultraviolet Light Emitting Diodes

- In this work, indium gallium nitride (InGaN) based near ultraviolet light emitting diode (NUV-LED) has been grown on a 2-inch c-plane patterned sapphire substrate at atmospheric pressure using metal organic chemical vapor deposition (MOCVD). The attention was paid to the effects of the V/III ratio of InGaN quantum wells (QWs) on the structural, optical, and electrical properties of NUV-LED. High resolution X-ray diffraction (HRXRD) results revealed that the indium composition and InGaN QWs’ thickness was increased as the V/III ratio changes from 20871 to 11824. In addition, it was found that V/III ratio has a significant impact on the surface morphology of the InGaN QWs and hence the surface morphology of the subsequent layers. The surface roughness of the top p-GaN layer slightly changed and will further be discussed in this work. Apart from that, the electroluminescence results show that the light output power (LOP) and the emission peak wavelength of the NUV-LED were significantly affected by the V/III ratio. It is discovered that the LOP was increased up to 45% and the emission peak wavelength of the NUV-LED was shifted to red as the V/III ratio decreases from 20871 to 11824. Through this study, a correlation was found between V/III ratio and the properties of QWs that resulted in the LOP enhancement of the NUV-LED

Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Author Correction: Federated learning enables big data for rare cancer boundary detection.

10.1038/s41467-023-36188-7NATURE COMMUNICATIONS14

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely