Sleep quality with WHO Step III opioid use for cancer pain

Peer reviewedPostprin

Mechanical behaviour of additively manufactured lunar regolith simulant components

Additive manufacturing and its related techniques have frequently been put forward as a promising candidate for planetary in-situ manufacturing, from building life-sustaining habitats on the Moon to fabricating various replacements parts, aiming to support future extra-terrestrial human activity. This paper investigates the mechanical behaviour of lunar regolith simulant material components, which is a potential future space engineering material, manufactured by a laser-based powder bed fusion additive manufacturing system. The influence of laser energy input during processing was associated with the evolution of component porosity, measured via optical and scanning electron microscopy in combination with gas expansion pycnometry. The compressive strength performance and Vickers microhardness of the components were analysed and related back to the processing history and resultant microstructure of the lunar regolith simulant build material. Fabricated structures exhibited a relative porosity of 44 – 49% and densities ranging from 1.76 – 2.3 g cm-3 , with a maximum compressive strength of 4.2 ± 0.1 MPa and elastic modulus of 287.3 ± 6.6 MPa, the former is comparable to a typical masonry clay brick (3.5 MPa). The 2 AM parts also had an average hardness value of 657 ± 14 HV0.05/15, better than borosilicate glass (580 HV). This study has shed significant insight into realizing the potential of a laser-based powder bed fusion AM process to deliver functional engineering assets via in-situ and abundant material sources that can be potentially used for future engineering applications in aerospace and astronautics

Molecular subtypes, histopathological grade and survival in a historic cohort of breast cancer patients

Molecular subtyping of breast cancer may provide additional prognostic information regarding patient outcome. However, its clinical significance remains to be established. In this study, the main aims were to discover whether reclassification of breast cancer into molecular subtypes provides more precise information regarding outcome compared to conventional histopathological grading and to study breast cancer-specific survival in the different molecular subtypes. Cases of breast cancer occurring in a cohort of women born between 1886 and 1928 with long-term follow-up were included in the study. Tissue microarrays were constructed from archival formalin-fixed, paraffin-embedded tissue from 909 cases. Using immunohistochemistry and in situ hybridisation as surrogates for gene expression analyses, all cases were reclassified into the following molecular subtypes: Luminal A; Luminal B (HER2−); Luminal B (HER2+); HER2 subtype; Basal phenotype; and five negative phenotype. Kaplan–Meier survival curves and Cox proportional hazards models were used in the analyses. During the first 5 years after diagnosis, there were significant differences in prognosis according to molecular subtypes with the best survival for the Luminal A subtype and the worst for HER2 and five negative phenotype. In this historic cohort of women with breast cancer, differences in breast cancer-specific survival according to subtype occur almost exclusively amongst the histopathological grade 2 tumours. From 5 years after time of diagnosis until the end of follow-up, there appears to be no difference in survival according to molecular subtype or histopathological grade.publishedVersio

Indium tin oxide nanowires manufactured via printing and laser irradiation

Metallic and semiconductor nanowires can provide dramatically increased electrical and optical properties in a wide range of fields, ranging from photovoltaics to sensors and catalysts. In this research, a rapid manufacturing process has been developed for printing indium tin oxide microparticles and converting them into nanowires. Microparticle indium tin oxide (ITO) inks were formulated and printed. These were then converted into hierarchical nanowire films via laser irradiation (980 nm, NIR) with raster speeds of 40 mm s−1 in air, much faster compared to traditional manufacturing processes. For a 4 cm2 film, only 40 s of processing were required. A full materials characterization was performed on the materials pre and post laser processing with the most probable conversion mechanism found to be a laser induced carbothermal reduction process. Microstructural, chemical, and crystallographic evidence of the laser induced carbothermal reduction process were derived from SEM, XRD, XPS and TEM analysis. Compared to conventionally heat-treated printed samples, laser processing was found to increase the conductivity of the printed ITO from 0.88% to 40.47% bulk conductivity. This research demonstrates the ability of printing and laser processing to form nanowires in a high-speed manufacturing context, thereby enabling the development of printed non-transparent ITO nanowire electronics and devices

Molecular Subtypes of Breast Cancer: Long-term Incidence Trends and Prognostic Differences

Background: Secular trends in incidence and prognosis of molecular breast cancer subtypes are poorly described. We studied long-term trends in a population of Norwegian women born 1886–1977. Methods: A total of 52,949 women were followed for breast cancer incidence, and 1,423 tumors were reclassified into molecular subtypes using IHC and in situ hybridization. We compared incidence rates among women born 1886–1928 and 1929–1977, estimated age-specific incidence rate ratios (IRR), and performed multiple imputations to account for unknown subtype. Prognosis was compared for women diagnosed before 1995 and in 1995 or later, estimating cumulative risk of death and HRs. Results: Between 50 and 69 years of age, incidence rates of Luminal A and Luminal B (HER2−) were higher among women born in 1929 or later, compared with before 1929 [IRRs 50–54 years; after imputations: 3.5; 95% confidence interval (CI), 1.8–6.9 and 2.5; 95% CI, 1.2–5.2, respectively], with no clear differences for other subtypes. Rates of death were lower in women diagnosed in 1995 or later, compared to before 1995, for Luminal A (HR 0.4; 95% CI, 0.3–0.5), Luminal B (HER2−; HR 0.5; 95% CI, 0.3–0.7), and Basal phenotype (HR 0.4; 95% CI, 0.2–0.9). Conclusions: We found a strong secular incidence increase restricted to Luminal A and Luminal B (HER2−) subtypes, combined with a markedly improved prognosis for these subtypes and for the Basal phenotype.acceptedVersio

Effect of remote ischaemic conditioning on infarct size and remodelling in ST-segment elevation myocardial infarction patients: the CONDI-2/ERIC-PPCI CMR substudy

The effect of limb remote ischaemic conditioning (RIC) on myocardial infarct (MI) size and left ventricular ejection fraction (LVEF) was investigated in a pre-planned cardiovascular magnetic resonance (CMR) substudy of the CONDI-2/ERIC-PPCI trial. This single-blind multi-centre trial (7 sites in UK and Denmark) included 169 ST-segment elevation myocardial infarction (STEMI) patients who were already randomised to either control (n = 89) or limb RIC (n = 80) (4 × 5 min cycles of arm cuff inflations/deflations) prior to primary percutaneous coronary intervention. CMR was performed acutely and at 6 months. The primary endpoint was MI size on the 6 month CMR scan, expressed as median and interquartile range. In 110 patients with 6-month CMR data, limb RIC did not reduce MI size [RIC: 13.0 (5.1–17.1)% of LV mass; control: 11.1 (7.0–17.8)% of LV mass, P = 0.39], or LVEF, when compared to control. In 162 patients with acute CMR data, limb RIC had no effect on acute MI size, microvascular obstruction and LVEF when compared to control. In a subgroup of anterior STEMI patients, RIC was associated with lower incidence of microvascular obstruction and higher LVEF on the acute scan when compared with control, but this was not associated with an improvement in LVEF at 6 months. In summary, in this pre-planned CMR substudy of the CONDI-2/ERIC-PPCI trial, there was no evidence that limb RIC reduced MI size or improved LVEF at 6 months by CMR, findings which are consistent with the neutral effects of limb RIC on clinical outcomes reported in the main CONDI-2/ERIC-PPCI trial

Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial

In the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study, fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) improved outcome compared with angiography-guided PCI for up to 2 years of follow-up. The aim in this study was to investigate whether the favourable clinical outcome with the FFR-guided PCI in the FAME study persisted over a 5-year follow-up