Metallic foreign body deep in the prevertebral space after an endomyocardial biopsy: a case report

INTRODUCTION: Although inspirated or ingested foreign bodies constitute a common otolaryngologic emergency, the removal of a solitary retained foreign body from the neck has seldom been described in the literature. The ingestion of foreign bodies commonly results in perforated viscose or extraluminal migration to adjacent structures quite a long period of time after the fact. To the best of our knowledge, this is the first English language description of an endomyocardial biopsy complicated by a retained foreign body deep in the prevertebral space of the patient’s neck. We report such a case and share our experience in treating it. CASE PRESENTATION: A 68-year-old Asian man suffering right-sided heart failure underwent an endomyocardial biopsy via his right internal jugular vein. After undergoing the procedure, he was found to have retained a metallic cup tip which had become lodged in his neck. A surgeon then performed neck exploration and the foreign body was removed without adverse effect. CONCLUSIONS: Decision making as to whether to remove the foreign body or not remains controversial. However, the later incidence of adhesive fibrosis or, even worse, of a catastrophic abscess or adjacent vascular injury might occur if the foreign body was not removed. Early exploration is suggested, if the patient’s condition makes this feasible

Chess Performance under Time Pressure: Evidence for the Slow Processes in Speed Chess

An influential theory of chess skill holds that expertise in chess is not due to greater depth of search by experts but, rather, to the ability to recognize familiar patterns of pieces. Although there is evidence that experts search deeper than non-experts, the data are not consistent. In this thesis, I propose “key-position theory” which states that only in a small number of key positions is it necessary to search deeply and it is these positions that experts search deeper than non-experts. Study 1 found, consistent with key-position theory, that the distribution of moves times is extremely skewed with some moves taking much longer than others. This pattern was more pronounced for the stronger players. Study 2 found that the errors made by weaker players involved less search than the errors made by stronger players. These findings suggest that search is an important component of chess expertise

A Study of Document Sharing and Managing Behaviors in Cloud Storage

The study focuses on how people use their cloud storage and manage their personal information. Since many cloud storage services allow users to share documents, this study also examines how people manage documents when working collaboratively. There are many cloud storage providers in the market, but this study focuses on two specific systems - Dropbox and Google Drive. The research was conducted by interviews and the results show that with the differently designed interfaces and functions of cloud storage, people developed diverse ways to use them. Participants stored different types of files and practiced different management strategies because of different purposes and reasons. Aspects of the system and user interface also impacted how users managed files. When working on collaborative and shared documents, participants reported tending to not manage files because they prefer following others' decisions or due to a lack of motivation to manage them.Master of Science in Information Scienc

DEVELOPMENT OF A SUSTAINABLE SERIOUS GAME TO SUPPORT CENTRAL VENOUS CATHETER PLACEMENT EDUCATION

The central venous catheter kit, containing over 10 items, can overwhelm first-time trainees. To address this, we’re creating a learning experience that merges an online module with 3D-printed models for medical trainees to start identifying these items in the kit before they learn how to perform the procedure. The study comprised three primary phases. Phase I involved observing experienced medical professionals in the “Expert Group” as they prepared a central venous catheter kit. This observation aimed to provide insights for designing a serious game tailored for trainees, which constituted Phase II. The serious game was developed by transforming medical instruments into 3D assets, creating an online interactive platform, and producing physical game pieces through 3D printing. In Phase III, both trainees and experts were engaged in a usability test to assess the effectiveness and user experience of the developed serious game. Observing the experts underscored the significance of grouping instruments by function rather than assigning them fixed locations, emphasizing the need to adapt their organization to various environments encountered. For 3D-printed game pieces, all users preferred the 3D-printed miniature replicas over the semi-3D cards despite greater durability of the latter. All users firmly support introducing trainees to this serious game prior to working with the actual kits. By leveraging 3D modeling, printing, animation, programming, web design, and AI, we developed an integrated educational tool that will aid medical practitioners in optimizing the organization of sterile instruments for central venous catheter placement. Our experience lays the groundwork for future advancements in serious games for diverse medical procedures

Exosomal miRNA 16-5p/29a-3p from pancreatic cancer induce adipose atrophy by inhibiting adipogenesis and promoting lipolysis.

Over 80% of the patients with pancreatic ductal adenocarcinoma (PDAC) have cachexia/wasting syndrome. Cachexia is associated with reduced survival, decreased quality of life, and higher metastasis rates. Here, we demonstrate that fat loss is the earliest feature of PDAC-exosome-induced cachexia. MicroRNA sequencing of exosomal components from normal and cancer-derived exosomes revealed enrichment of miR-16-5p, miR-21-5p, miR-29a-3p, and miR-125b-5p in serum exosomes of mice harboring PDAC and patients with PDAC. Further, miR-16-5p and miR-29a-3p inhibited adipogenesis through decreasing Erlin2 and Cmpk1 expression which downregulates C/EBPβ and PPARγ. Synergistically, miR-29a-3p promotes lipolysis through increasing ATGL expression by suppressing MCT1 expression. Furthermore, PDAC-exosomes deprived of miR-16-5p and miR-29a-3p fail to induce fat loss. Hence, miR-16-5p and miR-29a-3p exosomal miRs are essential for PDAC-induced fat loss. Thus, we unravel that PDAC induces adipose atrophy via exosomal miRs. This knowledge may provide new diagnostic and therapeutic strategies for PDAC-induced cachexia

Comorbid Mental Disorders in Anxiety Disorders: Genetic Aspects of Bipolar Disorders and of Ethnicity

Anxiety disorder (AD) is commonly comorbid with other mental illness. It could be a state or trait, controversially. Evidence for an association between alcoholism and anxiety has emerged from clinical studies of patients with alcoholism, and those of patients with anxiety disorders. Alcohol dependence (or abuse) as well as bipolar disorder (BP) is usually comorbid with anxiety disorder and/or depressive disorder, which often coexist and are difficult to distinguish from one another. However, in Han Chinese population, the comorbidity rate either with alcoholism or bipolar disorder was not reported as much high as reported in Caucasians, this finding of comorbidity between anxiety/depressive disorders and alcohol dependence (or abuse) or/and bipolar disorders, possibly at the genetic level, makes the differentiation of their categorical diagnoses in the association study vitally important