Biphasic Synovial Sarcoma of the Extremity: Quadruple Approach of Isolated Limb Perfusion, Surgical Ablation, Adipofascial Perforator Flap and Radiation to Avoid Amputation

Synovial sarcoma is a rare type of soft tissue sarcoma that occurs mostly in young adults, and it is always regarded as a high-grade tumor. Here, we report the case of a 31-year-old German Caucasian male with synovial sarcoma of the wrist who was offered amputation at his local hospital. After referral to our Reference Centre for Soft Tissue Sarcoma, the quadruple approach of isolated limb perfusion, surgical ablation, adipofascial perforator flap and radiation avoided amputation and enabled preservation of good hand function with no evidence of recurrence or metastasis after 1 year

Master Cleaner Robot

Is cleaning only the responsibility of the karamcharis? Do citizens have no role in this? We have to change this mindset.” – Narendra ModiThis article represents the mechanism of how will robot climb the stairs while cleaning with aid of the vacuum cleaner. This Robot will climb along the stair after being guided by some rigid mechanical structure. Its mechanical design consists of combination of tri wheels at its front and back being driven by DC motor for climbing stairs. In this paper we have discussed how this master cleaner robot would replace human effort to carry out mundane tasks in places like offices, hospitals, industrial and military automation, security systems and hazardous environments. Detailing regarding the vacuum cleaner is also mentioned briefly in the paper. There is a lot of scope for improvement and this model can be further modified and used in various other applications such as carrying heavy loads and thus further reducing human effort. In this paper we present the structure, design and implementation application of a climbing robot.The main application of this robot is to clean the surface with aid of the vacuum cleaner

Initial Public Offerings and the Firm Location

The firm geographic location matters in IPOs because investors have a strong preference for newly issued local stocks and provide abnormal demand in local offerings. Using equity holdings data for more than 53,000 households, we show the probability to participate to the stock market and the proportion of the equity wealth is abnormally increasing with the volume of the IPOs inside the investor region. Upon nearly the universe of the 167,515 going public and private domestic manufacturing firms, we provide consistent evidence that the isolated private firms have higher probability to go public, larger IPO underpricing cross-sectional average and volatility, and less pronounced long-run under-performance. Similar but opposite evidence holds for the local concentration of the investor wealth. These effects are economically relevant and robust to local delistings, IPO market timing, agglomeration economies, firm location endogeneity, self-selection bias, and information asymmetries, among others. Findings suggest IPO waves have a strong geographic component, highlight that underwriters significantly under-estimate the local demand component thus leaving unexpected money on the table, and support state-contingent but constant investor propensity for risk

SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion

Abstract: The B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in the state of Maharashtra in late 2020 and spread throughout India, outcompeting pre-existing lineages including B.1.617.1 (Kappa) and B.1.1.7 (Alpha)1. In vitro, B.1.617.2 is sixfold less sensitive to serum neutralizing antibodies from recovered individuals, and eightfold less sensitive to vaccine-elicited antibodies, compared with wild-type Wuhan-1 bearing D614G. Serum neutralizing titres against B.1.617.2 were lower in ChAdOx1 vaccinees than in BNT162b2 vaccinees. B.1.617.2 spike pseudotyped viruses exhibited compromised sensitivity to monoclonal antibodies to the receptor-binding domain and the amino-terminal domain. B.1.617.2 demonstrated higher replication efficiency than B.1.1.7 in both airway organoid and human airway epithelial systems, associated with B.1.617.2 spike being in a predominantly cleaved state compared with B.1.1.7 spike. The B.1.617.2 spike protein was able to mediate highly efficient syncytium formation that was less sensitive to inhibition by neutralizing antibody, compared with that of wild-type spike. We also observed that B.1.617.2 had higher replication and spike-mediated entry than B.1.617.1, potentially explaining the B.1.617.2 dominance. In an analysis of more than 130 SARS-CoV-2-infected health care workers across three centres in India during a period of mixed lineage circulation, we observed reduced ChAdOx1 vaccine effectiveness against B.1.617.2 relative to non-B.1.617.2, with the caveat of possible residual confounding. Compromised vaccine efficacy against the highly fit and immune-evasive B.1.617.2 Delta variant warrants continued infection control measures in the post-vaccination era

Degradation of polymers in chemical mechanical polishing

M.S.Dennis W. Hes

Polymorphous low grade adenocarcinoma of lip clinically mimicking squamous cell carcinoma: An unusual presentation

Polymorphous low grade adenocarcinoma (PLGA) is a malignant neoplasm that frequently occurs in the minor salivary glands in palate and oral cavity. We present a case of upper lip swelling with ulceroproliferative growth, clinically mimicking squamous cell carcinoma (SCC). Fine-needle aspiration cytology smears suggested PLGA, which was later confirmed on histopathology. Clinical presentation of PLGA may simulate SCC

A single centre experience of squamous cell carcinoma of the upper limb requiring digital or hand amputation and review of literature

Squamous cell carcinoma (SCC) is one of the most common primary malignancies affecting the upper limb. A range of treatment options exist for its management; amputation being indicated under certain instances. This is the first comprehensive case series and review of the literature reporting outcomes following amputation of the affected region for treatment of upper extremity SCC. We present a series of six patients with squamous cell carcinoma of the upper limb that required amputation alongside that of data from literature review. Patient demographics, risk factors, tumour characteristics and rates of recurrence, metastasis and mortality were recorded. A total of 45 patients with 49 histologically confirmed squamous cell carcinomas were identified from case series and literature review. Patients presenting with upper limb SCC were predominantly male and in their sixth decade of life. Mean follow up time was 30.5 months and the overall recurrence and metastatic rates were 8.2% and 14.3%, respectively. Mortality was 14.3% however only 6.1% was related to SCC metastasis. Rates of recurrence and metastasis are higher for SCCs affecting the hand as compared to other body sites. Furthermore, different regions of the hand appear to behave differently. SCC affecting the nail unit has a high recurrence and a low metastatic rate, whereas, SCC involving the palm and webspaces are aggressive and this is true despite amputation of the affected site. Keywords: Squamous cell carcinoma, Upper limb, Upper extremity, Hand, Digit

Autologous platelet-rich plasma for treatment of ischemic ulcers in buerger's disease: A pilot study with short-term results

Background: Many treatment modalities are available for the treatment of ischemic ulcers in Buerger's disease (thromboangiitis obliterans [TAO]). Objectives: The objective of the study was to evaluate the efficacy and clinical outcome of autologous platelet-rich plasma (PRP) for the treatment of ischemic ulcers in TAO patients. Methods: This prospective observational study was conducted on selected TAO patients who underwent autologous PRP treatment in surgery department of a teaching hospital in Central India. Diagnosis of TAO was made on clinical grounds and Color Doppler study. Autologous PRP was injected subcutaneously around the area of ulcer on day 0 and then on the 5th and 10th day. Results were noted on day 1, day 5, day 10, and on day 15. Outcome monitored was improvement in pain (using visual analog scale) and healing of ischemic ulcers. Results: All 14 patients were males, chronic smokers, and most of the patients were in the 4th decade of life. All had involvement of lower limbs; one had upper limb ischemia as well. All patients had ischemic ulcers. Pain relief, as measured with visual analog scale score, was good; most of the patients had 50% relief within 24 h of injecting PRP, which persisted/continued to improve on days 5, 10, and 15. Similarly, ulcer healing showed improvement on days 5, 10, and 15. Conclusions: PRP can provide efficient treatment for pain and healing of ischemic ulcers in TAO patients