Renal Cell Carcinoma Presenting as Metastasis to Scrotum and Spermatic Cord

Unusual site metastasis as presenting complaint of renal cell carcinoma (RCC) has been reported previously in literature. RCC is a notorious tumor with unpredictable behavior. We present a case of RCC who presented with scrotal mass and on subsequent investigation was found to have metastasis to scrotum and spermatic cord. Both testes were normal with no evidence of metastasis

Fundamental Limits of "Ankylography" due to Dimensional Deficiency

Single-shot diffractive imaging of truly 3D structures suffers from a dimensional deficiency and does not scale. The applicability of "ankylography" is limited to objects that are small-sized in at least one dimension or that are essentially 2D otherwise.Comment: 2 pages, no figur

Remotely acting SMCHD1 gene regulatory elements: in silico prediction and identification of potential regulatory variants in patients with FSHD

Background: Facioscapulohumeral dystrophy (FSHD) is commonly associated with contraction of the D4Z4 macro-satellite repeat on chromosome 4q35 (FSHD1) or mutations in the SMCHD1 gene (FSHD2). Recent studies have shown that the clinical manifestation of FSHD1 can be modified by mutations in the SMCHD1 gene within a given family. The absence of either D4Z4 contraction or SMCHD1 mutations in a small cohort of patients suggests that the disease could also be due to disruption of gene regulation. In this study, we postulated that mutations responsible for exerting a modifier effect on FSHD might reside within remotely acting regulatory elements that have the potential to interact at a distance with their cognate gene promoter via chromatin looping. To explore this postulate, genome-wide Hi-C data were used to identify genomic fragments displaying the strongest interaction with the SMCHD1 gene. These fragments were then narrowed down to shorter regions using ENCODE and FANTOM data on transcription factor binding sites and epigenetic marks characteristic of promoters, enhancers and silencers

Multilevel models of age-related changes in facial shape in adolescents

Here we study the effects of age on facial shape in adolescents by using a method called multilevel principal components analysis (mPCA). An associated multilevel multivariate probability distribution is derived and expressions for the (conditional) probability of age-group membership are presented. This formalism is explored via Monte Carlo (MC) simulated data in the first dataset; where age is taken to increase the overall scale of a three-dimensional facial shape represented by 21 landmark points and all other “subjective” variations are related to the width of the face. Eigenvalue plots make sense and modes of variation correctly identify these two main factors at appropriate levels of the mPCA model. Component scores for both single-level PCA and mPCA show a strong trend with age. Conditional probabilities are shown to predict membership by age group and the Pearson correlation coefficient between actual and predicted group membership is r = 0.99. The effects of outliers added to the MC training data are reduced by the use of robust covariance matrix estimation and robust averaging of matrices. These methods are applied to another dataset containing 12 GPA-scaled (3D) landmark points for 195 shapes from 27 white, male schoolchildren aged 11 to 16 years old. 21% of variation in the shapes for this dataset was accounted for by age. Mode 1 at level 1 (age) via mPCA appears to capture an increase in face height with age, which is consistent with reported pubertal changes in children. Component scores for both single-level PCA and mPCA again show a distinct trend with age. Conditional probabilities are again shown to reflect membership by age group and the Pearson correlation coefficient is given by r = 0.63 in this case. These analyses are an excellent first test of the ability of multilevel statistical methods to model age-related changes in facial shape in adolescents

One-shot Localization and Segmentation of Medical Images with Foundation Models

Recent advances in Vision Transformers (ViT) and Stable Diffusion (SD) models with their ability to capture rich semantic features of the image have been used for image correspondence tasks on natural images. In this paper, we examine the ability of a variety of pre-trained ViT (DINO, DINOv2, SAM, CLIP) and SD models, trained exclusively on natural images, for solving the correspondence problems on medical images. While many works have made a case for in-domain training, we show that the models trained on natural images can offer good performance on medical images across different modalities (CT,MR,Ultrasound) sourced from various manufacturers, over multiple anatomical regions (brain, thorax, abdomen, extremities), and on wide variety of tasks. Further, we leverage the correspondence with respect to a template image to prompt a Segment Anything (SAM) model to arrive at single shot segmentation, achieving dice range of 62%-90% across tasks, using just one image as reference. We also show that our single-shot method outperforms the recently proposed few-shot segmentation method - UniverSeg (Dice range 47%-80%) on most of the semantic segmentation tasks(six out of seven) across medical imaging modalities.Comment: Accepted at NeurIPS 2023 R0-FoMo Worksho

Quality Of Antenatal Care In Rural Southern Tanzania: A Reality Check.

Counselling on the danger signs of unpredictable obstetric complications and the appropriate management of such complications are crucial in reducing maternal mortality. The objectives of this study were to identify gaps in the provision of ANC services and knowledge of danger signs as well as the quality of care women receive in case of complications. The study took place in the Rufiji District of Tanzania in 2008 and was conducted in seven health facilities. The study used (1) observations from 63 antenatal care (ANC) sessions evaluated with an ANC checklist, (2) self-assessments of 11 Health workers, (3) interviews with 28 pregnant women and (4) follow-up of 12 women hospitalized for pregnancy-related conditions.Blood pressure measurements and abdominal examinations were common during ANC visits while urine testing for albumin or sugar or haemoglobin levels was rare which was often explained as due to a lack of supplies. The reasons for measuring blood pressure or abdominal examinations were usually not explained to the women. Only 15/28 (54%) women were able to mention at least one obstetric danger sign requiring medical attention. The outcomes of ten complicated cases were five stillbirths and three maternal complications. There was a considerable delay in first contact with a health professional or the start of timely interventions including checking vital signs, using a partograph, and detailed record keeping. Linking danger signs to clinical and laboratory examination results during ANC with the appropriate follow up and avoiding delays in emergency obstetric care are crucial to the delivery of coordinated, effective care interventions

Oral carcinoma after hematopoietic stem cell transplantation – a new classification based on a literature review over 30 years

BACKGROUND: Patients undergoing hematopoietic stem cell transplantation (HSCT) have a higher risk of developing secondary solid tumors, in particular squamous cell carcinoma, because of several risk factors, including full-body irradiation (TBI), chemotherapy, and chronic graft versus host disease (GVHD). Based on the review presented here, a classification of oral changes is suggested in order to provide a tool to detect high-risk patients. Methods and Results The literature over the last 30 years was reviewed for development of malignoma of the oral cavity after HSCT. Overall, 64 cases were found. In 16 out of 30 cases, the tongue was the primary location, followed by the salivary gland (10 out of 30); 56.4% appeared in a latency time of 5 to 9 years after HSCT. In 76.6%, GVHD was noticed before the occurrence of oral malignancy. Premalignant changes of the oral mucosa were mucositis, xerostomia, and lichenoid changes, developing into erosive form. CONCLUSION: All physicians involved in the treatment of post-HSCT patients should be aware of the increased risk, even after 5 years from the development of oral malignancy, in particular when oral graft versus host changes are visible. In order to develop evidence management and to detect and offer adequate therapy as early as possible in this patient group, multicenter studies, involving oncologists and head and neck surgeons, should be established

Quantifying similarity of pore-geometry in nanoporous materials

In most applications of nanoporous materials the pore structure is as important as the chemical composition as a determinant of performance. For example, one can alter performance in applications like carbon capture or methane storage by orders of magnitude by only modifying the pore structure. For these applications it is therefore important to identify the optimal pore geometry and use this information to find similar materials. However, the mathematical language and tools to identify materials with similar pore structures, but different composition, has been lacking. We develop a pore recognition approach to quantify similarity of pore structures and classify them using topological data analysis. This allows us to identify materials with similar pore geometries, and to screen for materials that are similar to given top-performing structures. Using methane storage as a case study, we also show that materials can be divided into topologically distinct classes requiring different optimization strategies

Human Papilloma Virus (HPV) Oral Prevalence in Scotland (HOPSCOTCH):a feasibility study in dental settings

The purpose of this study was to test the feasibility of undertaking a full population investigation into the prevalence, incidence, and persistence of oral Human Papilloma Virus (HPV) in Scotland via dental settings. Male and female patients aged 16-69 years were recruited by Research Nurses in 3 primary care and dental outreach teaching centres and 2 General Dental Practices (GDPs), and by Dental Care Teams in 2 further GDPs. Participants completed a questionnaire (via an online tablet computer or paper) with socioeconomic, lifestyle, and sexual history items; and were followed up at 6-months for further questionnaire through appointment or post/online. Saline oral gargle/rinse samples, collected at baseline and follow-up, were subject to molecular HPV genotyping centrally. 1213 dental patients were approached and 402 individuals consented (participation rate 33.1%). 390 completed the baseline questionnaire and 380 provided a baseline oral specimen. Follow-up rate was 61.6% at 6 months. While recruitment was no different in Research Nurse vs Dental Care Team models the Nurse model ensured more rapid recruitment. There were relatively few missing responses in the questionnaire and high levels of disclosure of risk behaviours (99% answered some of the sexual history questions). Data linkage of participant data to routine health records including HPV vaccination data was successful with 99.1% matching. Oral rinse/gargle sample collection and subsequent HPV testing was feasible. Preliminary analyses found over 95% of samples to be valid for molecular HPV detection prevalence of oral HPV infection of 5.5% (95%CI 3.7, 8.3). It is feasible to recruit and follow-up dental patients largely representative / reflective of the wider population, suggesting it would be possible to undertake a study to investigate the prevalence, incidence, and determinants of oral HPV infection in dental settings