Successful Salvage and Long-Term Survival after Recurrent Malignant Rhabdoid Tumor

Purpose. The objective of this study is to report a case of a rare, highly lethal tumor, extrarenal malignant rhabdoid tumor (EMRT) in a 43-year-old man who initially presented with a local recurrence and is now continuously disease free 14 years after aggressive surgical treatment. The case and literature are discussed

Exceptionally elevated triglyceride in severe lipemia retinalis

PURPOSE: To report a case of successful treatment for severe lipemia retinalis with extreme severe hypertriglyceridemia (sHTG). DESIGN: Observational case report. OBSERVATIONS: A 6-week-old infant with severe lipemia retinalis manifested diffuse creamy retinal vessels complicated with vulvar xanthomas. Extreme sHTG with 185-folds of the normal level was reported. Chromosome microarray and lipid gene sequencing confirmed a homozygous lipoprotein lipase gene coding mutation. RESULTS: Under strict adherence to a high medium-chain triglycerides formula and discontinuation of breast milk, the lipemia retinalis and vulval lesions resolved along with a stable plasma lipid level throughout the follow-up period of 6 months. CONCLUSION: Strict adherence to a low-fat diet without breast milk appears to be effective in treating infants with severe lipemia retinalis associated with exceptionally high triglycerides

Distributed Training Large-Scale Deep Architectures

Scale of data and scale of computation infrastructures together enable the current deep learning renaissance. However, training large-scale deep architectures demands both algorithmic improvement and careful system configuration. In this paper, we focus on employing the system approach to speed up large-scale training. Via lessons learned from our routine benchmarking effort, we first identify bottlenecks and overheads that hinter data parallelism. We then devise guidelines that help practitioners to configure an effective system and fine-tune parameters to achieve desired speedup. Specifically, we develop a procedure for setting minibatch size and choosing computation algorithms. We also derive lemmas for determining the quantity of key components such as the number of GPUs and parameter servers. Experiments and examples show that these guidelines help effectively speed up large-scale deep learning training

Far Ultraviolet Observations of the Dwarf Nova VW Hyi in Quiescence

We present a 904-1183 A spectrum of the dwarf nova VW Hydri taken with the Far Ultraviolet Spectroscopic Explorer during quiescence, eleven days after a normal outburst, when the underlying white dwarf accreter is clearly exposed in the far ultraviolet. However, model fitting show that a uniform temperature white dwarf does not reproduce the overall spectrum, especially at the shortest wavelengths. A better approximation to the spectrum is obtained with a model consisting of a white dwarf and a rapidly rotating ``accretion belt''. The white dwarf component accounts for 83% of the total flux, has a temperature of 23,000K, a v sin i = 400 km/s, and a low carbon abundance. The best-fit accretion belt component accounts for 17% of the total flux, has a temperature of about 48,000-50,000K, and a rotation rate Vrot sin i around 3,000-4,000 km/s. The requirement of two components in the modeling of the spectrum of VW Hyi in quiescence helps to resolve some of the differences in interpretation of ultraviolet spectra of VW Hyi in quiescence. However, the physical existence of a second component (and its exact nature) in VW Hyi itself is still relatively uncertain, given the lack of better models for spectra of the inner disk in a quiescent dwarf nova.Comment: 6 figures, 10 printed page in the journal, to appear in APJ, 1 Sept. 2004 issue, vol. 61

Publisher Correction: Copper adparticle enabled selective electrosynthesis of n-propanol.

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Peritoneal and hemodialysis: I. Differences in patient characteristics at initiation

Peritoneal and hemodialysis: I. Differences in patient characteristics at initiation.BackgroundComparisons of mortality outcomes between peritoneal dialysis (PD) and hemodialysis (HD) patients have shown varying results, which may be caused by the unequally distributed clinical conditions of patients at initiation. To address this issue, we evaluated the clinical characteristics of 105,954 patients at the initiation of PD and HD, using the U.S. national incidence data on treated end-stage renal disease from the Medical Evidence Form, 1995 to 1997.MethodsA general linear model was used to analyze differences of age, albumin, creatinine, blood urea nitrogen (BUN), and hematocrit; categorical data analysis to evaluate body mass index (BMI), grouped into four categories: !19, 19–25 (!25), 25–30 (!30), and 30+; and logistic regression to assess the likelihood of initiating PD versus HD. Diabetics (DM) were analyzed separately from non-diabetics (NDM). Explanatory variables in the logistic regression included incidence year, race, gender, age, BMI, albumin, creatinine, BUN, and hematocrit. Race included white and black. Age was categorized into four groups: 20–44, 45–64, 65–74, and 75+.ResultsAt the initiation of dialysis PD patients were approximately 6 years younger (P ! 0.0001) than HD patients. PD patients also had higher (P ! 0.0001) albumin (+0.35 g/dL for DM and +0.23 g/dL for NDM) and hematocrit (+1.64% for DM and +1.71% for NDM) levels, and lower (P ! 0.04) BUN (-8.75 mg/dL for DM and -5.24 mg/dL for NDM) and creatinine (-0.51 mg/dL for DM and -0.23 mg/dL for NDM) levels than HD patients. Whites had a higher (P ! 0.0001) likelihood of starting PD than blacks, and patients with BMI !19 had a lower (P ! 0.0001) chance of beginning on PD.ConclusionPD patients had favorable clinical conditions at the initiation of dialysis, which should be taken into consideration when comparing dialysis outcomes between the two modalities

33356 A multinational chart review to examine gastrointestinal symptoms and their management in patients treated with apremilast for plaque psoriasis

Background: Diarrhea and nausea are the most common adverse events observed in phase 3 clinical trials and real-world studies of apremilast, an oral phosphodiesterase-4 inhibitor indicated for moderate-to-severe plaque psoriasis. Methods: A retrospective chart review was conducted between June and November 2020 in the United States (US) and France among patients with moderate psoriasis experiencing gastrointestinal (GI) symptoms within 3 months of initiating apremilast. Results: Dermatologists in US (200) and in France (52) abstracted patient charts (US: 494, France: 128). The following GI symptoms were reported: ‒diarrhea (US: 67% [331/494]; France: 76% [97/128]) with median time from onset to resolution/improvement of 26 days (US) and 21 days (France) ‒nausea (US: 52% [255/494]; France: 34% [44/128]) with median time from onset to resolution/improvement of 21 days (US) and 24 days (France). Management strategies for diarrhea included pharmacologic (loperamide/bismuth subsalicylate/racecadotril) with or without nonpharmacologic (dietary modifications, taking with food)/fiber (US: 30% [99/331], France: 41% [40/97]) and nonpharmacologic only (US: 32% [105/331], France: 27% [26/97]). Management strategies for nausea included pharmacologic (diphenhydramine/metoclopramide/metopimazine) with or without nonpharmacologic (dietary modifications, taking with food, avoidance of vigorous activity) (US: 5% [14/255], France: 30% [13/44]) and nonpharmacologic only (US: 58% [147/255], France: 36% [16/44]). Resolution/improvement of GI symptoms was observed in patients who used pharmacologic strategies and nonpharmacologic strategies. Conclusions: Recommendations to manage diarrhea and nausea after apremilast initiation with pharmacologic or non-pharmacologic strategies were effective and symptoms usually resolved within 3-4 weeks of onset

The relationship of self-efficacy to catastrophizing and depressive symptoms in community-dwelling older adults with chronic pain: A moderated mediation model

Self-efficacy has been consistently found to be a protective factor against psychological distress and disorders in the literature. However, little research is done on the moderating effect of self-efficacy on depressive symptoms in the context of chronic pain. This cross-sectional study aimed to examine if pain self-efficacy attenuated the direct relationship between pain intensity and depressive symptoms, as well as their indirect relationship through reducing the extent of catastrophizing when feeling pain (moderated mediation). 664 community-dwelling Chinese older adults aged 60–95 years who reported chronic pain for at least three months were recruited from social centers. They completed a battery of questionnaires on chronic pain, pain self-efficacy, catastrophizing, and depressive symptoms in individual face-to-face interviews. Controlling for age, gender, education, self-rated health, number of chronic diseases, pain disability, and pain self-efficacy, pain catastrophizing was found to partially mediate the connection between pain intensity and depressive symptoms. Furthermore, the relationship between pain intensity and depressive symptoms was moderated by pain self-efficacy. Self-efficacy was also found to moderate the relationship between pain intensity and catastrophizing and the moderated mediation effect was confirmed using bootstrap analysis. The results suggested that with increasing levels of self-efficacy, pain intensity’s direct effect on depressive symptoms and its indirect effect on depressive symptoms via catastrophizing were both reduced in a dose-dependent manner. Our findings suggest that pain self-efficacy is a significant protective factor that contributes to psychological resilience in chronic pain patients by attenuating the relationship of pain intensity to both catastrophizing and depressive symptoms