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Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of cancer treatment, significantly affecting patients’ quality of life. Current pharmacological treatments are often ineffective or poorly tolerated, necessitating alternative therapeutic approaches. Scrambler Therapy (ST), a non-invasive neuromodulation technique, has shown potential for reducing neuropathic pain, but optimal dosing regimens remain undefined.
Objective
This case study aims to evaluate the effectiveness of Scrambler Therapy in reducing pain levels and improving functional status in a patient with chemotherapy-induced peripheral neuropathy.
Methods
A single patient diagnosed with CIPN was treated with Scrambler Therapy over a series of sessions. Pain levels and functional status were measured using standardized assessment tools before, during, and after the therapy to evaluate the impact of ST on symptom relief and daily functioning.
Results
After completing the Scrambler Therapy sessions, the patient reported significant reductions in pain intensity and notable improvements in functional status. These improvements were sustained several weeks and months following the therapy, indicating the potential long-term benefits of ST for managing CIPN.
Conclusion
This case study demonstrates the potential of Scrambler Therapy as an effective treatment option for reducing pain and improving functional status in patients with chemotherapy-induced peripheral neuropathy. These findings suggest that ST may provide a promising non-invasive alternative to current treatments for managing neuropathic pain in cancer patients.
Determining whether cryptic remnant animal populations survive within specific landscapes is a conservation challenge and may require multiple types of information. Hainan Island, China, has lost most of its large mammal fauna, with no recent evidence for persistence of large carnivores. We conducted a survey of local ecological knowledge in communities around seven protected areas in 2015, collecting sighting reports of the Asiatic black bear Ursus thibetanus. Respondents living near Wuzhishan National Nature Reserve reported the highest number of dated sightings as well as the most recent sightings. In follow-up interviews, wildlife rangers at Wuzhishan reported recent signs of bears and local hunting, and a possible bear photograph was taken inside the Reserve in 2017. Characteristic bear signs, including fresh diagnostic claw marks on trees, were detected at Wuzhishan in 2021, confirming bear presence. Wuzhishan is the last area in Hainan where large herbivores and carnivores survive, and where local conservation efforts still have the potential to maintain functional forest ecosystems that support megafaunal assemblages.
In Wisconsin, herbicide resistance in waterhemp [Amaranthus tuberculatus (Moq.) Sauer] has been confirmed to five herbicide sites of action, including protoporphyrinogen oxidase (PPO) inhibitors. Following a report of a suspected PPO inhibitor–resistant A. tuberculatus population (A92 accession), our objective was to characterize resistance to PPO inhibitors applied preemergence or preemergence to this accession, along with two PPO inhibitor–susceptible control accessions (A66 and A82). We hypothesized that PPO-inhibitor resistance in A92 was driven by target site–resistance mechanisms. According to our results, the A92 accession is resistant to sulfentrazone (3.1-fold; P-value = 0.0278) and fomesafen (3.1-fold; P-value = 0.0745) preemergence and to lactofen (18.6-fold; P-value = 0.0003) and fomesafen (5.9-fold; P-value= < 0.0001) preemergence. Resistance to PPO inhibitors was not explained by the presence of any known target-site mutations in PPX1 or PPX2 genes. Our study represents the first confirmed case of an A. tuberculatus accession resistant to PPO inhibitors applied preemergence in Wisconsin. Consistent with previous research, our results demonstrate that the A92 accession, compared with control accessions, is less sensitive to fomesafen regardless of the application timing. Further research is necessary to identify other potential PPO-inhibitor resistance mechanisms in the A92 accession, including potential non–target site resistance mechanisms associated with cytochrome P450 monooxygenases or glutathione S-transferases.
The current study probes Mandarin-learning toddlers’ sensitivity to two grammatical noun phrase orders differing in typological markedness. With three visual fixation experiments, we find that by age 2;6, children distinguish the cross-linguistically common order – but not the typologically rare one – from an ungrammatical order; however, their sensitivity to the two grammatical orders does not differ significantly. Further, we conduct a corpus analysis and demonstrate that for early acquisition, both grammatical orders are neither sufficiently nor consistently supported in the linguistic input. The sensitivity patterns and input profile outlined in our study constitute the first step of testing, in a natural language setting, a bias for typologically common ordering discussed in the artificial language learning literature. Although the findings remain inconclusive, they underscore the potential for future investigations in this direction.
In this paper, we consider an approach introduced in term rewriting for the automatic detection of non-looping non-termination from patterns of rules. We adapt it to logic programing by defining a new unfolding technique that produces patterns describing possibly infinite sets of finite rewrite sequences. We present an experimental evaluation of our contributions that we implemented in our tool NTI (Non-Termination Inference).
The influence of compressibility on shear flow turbulence is investigated within a self-preservation framework. This study focuses on the axisymmetric jet to examine compressibility effects in a slowly spatially evolving flow, unlike mixing layers, where the convective Mach number remains constant. Revisiting self-preservation, an a priori description of the compressible scaling for Reynolds stresses and higher-order velocity moments is developed. Turbulence moments are found to scale with powers of the spreading rate, suggesting Reynolds stress anisotropy results from compressibility effects consistent with self-preservation of the governing equations. Particle image velocimetry measurements for Mach 0.3 and perfectly expanded Mach 1.25 jets confirm the scaling predictions. The attenuation function, $\varPhi (M_c)$, describing the relationship between the convective Mach number, $M_c$, and the spreading rate, follows a similar trend in jets and mixing layers, where a higher $M_c$ results in reduced spreading rates. In the jet where $M_c$ decays, the relationship between the local $M_c$ and turbulence attenuation remains captured through $\varPhi (M_c)$, which scales proportionally with the spreading rate. A new scale is introduced, where the pressure in the mean momentum equation is substituted. The difference between the streamwise and radial-Reynolds-normal stresses was found to be a scale which is independent of Mach number and spreading rate. Further analysis of the Reynolds-stress-transport budget shows that internal redistribution of energy occurs within the Reynolds-normal stresses, and the role of pressure modification in turbulence attenuation supports previous observations. These findings confirm that the compressible axisymmetric jet exhibits self-preservation, with scaling extending into supersonic regimes.
This study examines the interplay between psychological contract fulfillment, distributive justice, and leader–member exchange (LMX) in shaping affective organizational commitment among university academics. Drawing on social exchange theory, and using simple random sampling, we propose a moderated mediation model to explore how these variables interact. To test the hypotheses, we used the linear moderated mediation test, applying PROCESS for SPSS. Specifically, on a sample of 465 academics, the study tests the hypothesis that distributive justice mediates the relationship between psychological contract fulfillment and affective commitment, with LMX acting as a moderator. Findings reveal that distributive justice is not always necessary for fostering affective commitment when psychological contracts are fulfilled, unless the quality of LMX is low. In low-quality leader–member relationships, perceptions of distributive justice become crucial when it comes to translating contract fulfillment into affective commitment. These results highlight the importance of relational dynamics in academic settings, especially when resources are limited. The study concludes with a discussion of its theoretical and practical implications, as well as limitations and avenues for future research.
This article contributes to the literature on religious soft power by considering how non-Muslim-majority great powers – China, Russia, and the US – use Islam as a foreign policy resource in their soft power strategies. We argue that these states have deployed Islam to present positive self-images on the international stage, at the same time as using negative-other strategies via soft disempowerment to construct competitor states as unfriendly and/or dangerous to Muslims. We conclude by arguing that the use of Islam by non-Muslim great powers is a potentially dangerous game. While instrumentalising Islam may provide immediate benefits, it also opens the possibility for critique, particularly around perceived inconsistencies between domestic religious practices of a state and its internationally promoted narratives. These tensions can invite accusations of illegitimacy and hypocrisy, especially when leveraged by competitors or transnational religious actors.
Heart failure is the most common complication of congenital heart disease (CHD), characterized by high morbidity and mortality. Early recognition and intervention are crucial for improving outcomes in pediatric patients with CHD and heart failure. This study aimed to analyze the clinical value of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients with CHD and heart failure.
Methods:
Ninety-eight pediatric patients with CHD complicated by heart failure were included in the Case Group, and 61 pediatric patients with CHD were included in the Control Group. The Case Group was categorized into subgroups based on the cardiac function of patients: grade I (n = 35), grade II (n = 40), and grade III (n = 23). Left ventricular ejection fraction was collected from pediatric patients in the case group. The correlation of the cardiac functional indicators with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I levels was assessed using Pearson correlation analysis.
Results:
The serum levels of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients at grade III of cardiac function were significantly elevated compared to those at grade II, and these levels in patients at grade II were higher than those at grade I (P < 0.05). The left ventricular ejection fraction of pediatric patients in the Case Group were markedly negatively correlated with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I (r = − 0.6807, r = −0.3013, r = −0.5412, P < 0.0001).
Conclusions:
N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I have a certain diagnostic value in determining concurrent heart failure in pediatric patients with CHD.
The capabilities of large language models (LLMs) have advanced to the point where entire textbooks can be queried using retrieval-augmented generation (RAG), enabling AI to integrate external, up-to-date information into its responses. This study evaluates the ability of two OpenAI models, GPT-3.5 Turbo and GPT-4 Turbo, to create and answer exam questions based on an undergraduate textbook. 14 exams were created with four true-false, four multiple-choice, and two short-answer questions derived from an open-source Pacific Studies textbook. Model performance was evaluated with and without access to the source material using text-similarity metrics such as ROUGE-1, cosine similarity, and word embeddings. Fifty-six exam scores were analyzed, revealing that RAG-assisted models significantly outperformed those relying solely on pre-trained knowledge. GPT-4 Turbo also consistently outperformed GPT-3.5 Turbo in accuracy and coherence, especially in short-answer responses. These findings demonstrate the potential of LLMs in automating exam generation while maintaining assessment quality. However, they also underscore the need for policy frameworks that promote fairness, transparency, and accessibility. Given regulatory considerations outlined in the European Union AI Act and the NIST AI Risk Management Framework, institutions using AI in education must establish governance protocols, bias mitigation strategies, and human oversight measures. The results of this study contribute to ongoing discussions on responsibly integrating AI in education, advocating for institutional policies that support AI-assisted assessment while preserving academic integrity. The empirical results suggest not only performance benefits but also actionable governance mechanisms, such as verifiable retrieval pipelines and oversight protocols, that can guide institutional policies.
This study aimed to compare red meat, white meat and vegetable consumption before, during and after COVID-19 pandemic among older adults in regional China. Data were collected from individuals aged 60+ years in urban areas of Nanjing, China, in 2018, 2021 and 2023. Differences in food intake frequencies between participants and survey years were examined. Multivariate logistic regression models were employed to identify influencing factors of red plus white meat, and vegetable consumption. Totally, 13792 participants were analyzed, with 4355, 4622 and 4815 from 2018, 2021 and 2023 survey, respectively. The mean weekly intake frequency (± standard deviation) among participants in 2018, 2021 and 2023 was, separately, 3.85±2.83, 3.21±2.90 and 4.71±3.94 for red meat, 1.38±1.21, 2.08±1.90 and 2.73±2.55 for white meat, and 10.98±4.84, 10.00±5.04 and 10.34±5.04 for vegetable. Moreover, 23.2%, 32.6% and 52.3% of participants met recommendation for red plus white meat intake, while 53.7%, 46.8% and 49.6% reached recommendation for vegetable consumption before, during and after COVID-19 pandemic, respectively. Red plus white meat intake was positively associated with education, marital status and drinking, but negatively associated with age. Additionally, education and marital status were in negative relation to vegetable consumption, while smoking and drinking were positively associated with vegetable intake. The older residents consumed less red meat and vegetable but more white meat during COVID-19 pandemic, and their consumption levels of red plus white meat and vegetable went up after the pandemic. These findings highlight the need for targeted interventions to support older adults’ dietary habits during emergency events.
Assess the feasibility and effect of Enhanced Barrier Precautions (EBP) on the transmission of Staphylococcus aureus (SA) and carbapenem-resistant organisms (CRO) among residents in nursing home chronic ventilator units (NH-CVU).
Design:
Pre-post interventional study.
Setting:
Two community-based nursing homes with CVUs in Maryland. A total of 56 residents were enrolled in the baseline period and 64 residents were enrolled in the intervention period.
Methods:
During a 3-month baseline and intervention period, residents were swabbed monthly to estimate SA and CRO acquisition. During a 2-month training period, EBP was implemented for residents with chronic wounds, medical devices, or history of multidrug-resistant organism (MDRO) colonization. During the subsequent 3-month intervention period, healthcare personnel (HCP) wore gowns and gloves for high-contact care activities when residents were on EBP. Whole genome sequencing assessed resident-to-resident transmission.
Results:
At baseline, NH-CVU1 used gowns and gloves for all direct contact, while NH-CVU2 used EBP only for residents with a history of MDRO colonization. After training, the proportion of NH-CVU2 residents on EBP increased from 65% in the baseline period to 87% in the intervention period. Glove use was high (93–98%) in both NH-CVUs. Gown use increased from 39% to 77% in NH-CVU1 and from 26% to 72% in NH-CVU2. Resident-to-resident transmission of SA or CRO decreased by 25% in NH-CVU1 (p = 0.60) and by 67% in NH-CVU2 (p = 0.05). CRO transmission decreased by 33% in NH-CVU1 (p = 0.54) and by 83% in NH-CVU2 (p = 0.02).
Conclusions:
EBP is feasible and potentially decreases overall and CRO transmission in nursing home CVUs.
The Stages of Objective Memory Impairment (SOMI) system, based on the Free and Cued Selective Reminding Test (FCSRT), is a potential marker of subtle cognitive impairment in cognitively normal persons defined by a Clinical Dementia Rating (CDR) = 0. We investigated SOMI’s ability to predict incident cognitive impairment (CDR >0) in combination with demographic features and neuroimaging biomarkers.
Methods:
Cognitively unimpaired participants (CDR = 0) from the Harvard Aging Brain Study had baseline FCSRT scores, MRI, FDG-PET, and PiB-PET as well as follow-up CDRs for 5 years. Cox proportional hazards models with correction for multiple testing assessed the predictive validity of SOMI and neuroimaging biomarkers for progression (CDR >0). Comprehensive sensitivity analyses examined alternative outcomes and stricter screening criteria.
Results:
Participants (N = 231) were 73.7 years (SD = 6.0), 60.2% were female, 29.0% were APOE4 positive, and 54 (23.4%) progressed to CDR >0. At baseline, 67% were SOMI-0, 22% were SOMI-1, 4% were SOMI-2, and 7% were SOMI-3/4. After multiple testing correction, hazard ratios (HRs) using SOMI-0 as reference were: SOMI-1 = 2.06 (CI: 1.09 – 3.88), SOMI-2 = 2.85 (CI: 1.08 – 7.54), and SOMI-3/4 = 3.73 (CI: 1.58 – 8.79, p = 0.016). SOMI-3/4 remained significant across most biomarker models. Entorhinal thickness emerged as the most robust biomarker predictor (HR = 0.57 – 0.65, p ≤ 0.015). Sensitivity analyses confirmed robustness across alternative outcomes and stricter screening criteria.
Conclusions:
SOMI stages predict progression to incident cognitive impairment with SOMI-3/4 maintaining significance after rigorous multiple testing correction. Entorhinal thickness provides the strongest biomarker enhancement to prediction models. SOMI demonstrates substantial incremental predictive value beyond standard demographic and biomarker predictors.