396 research outputs found
Extraosseous Osteosarcoma of the Esophagus: A Case Report
Extraosseous osteosarcoma (EOO) is a malignant mesenchymal neoplasm that is located in the soft tissues without direct attachment to the skeletal system and that produces osteoid, bone, or chondroid material. EOO is an extremely rare disease, accounting for only 1% of soft tissue sarcomas, and typically presents in either an extremity or the retroperitoneum. This paper presents the case of a 45-year-old Caucasian male with extraosseous osteosarcoma of the esophagus
An interdisciplinary framework for measuring and supporting adherence in HIV prevention trials of ARVâbased vaginal rings
Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138229/1/jia29158.pd
Sequential cavity method for computing free energy and surface pressure
We propose a new method for the problems of computing free energy and surface
pressure for various statistical mechanics models on a lattice . Our
method is based on representing the free energy and surface pressure in terms
of certain marginal probabilities in a suitably modified sublattice of .
Then recent deterministic algorithms for computing marginal probabilities are
used to obtain numerical estimates of the quantities of interest. The method
works under the assumption of Strong Spatial Mixing (SSP), which is a form of a
correlation decay.
We illustrate our method for the hard-core and monomer-dimer models, and
improve several earlier estimates. For example we show that the exponent of the
monomer-dimer coverings of belongs to the interval ,
improving best previously known estimate of (approximately)
obtained in \cite{FriedlandPeled},\cite{FriedlandKropLundowMarkstrom}.
Moreover, we show that given a target additive error , the
computational effort of our method for these two models is
\emph{both} for free energy and surface pressure. In
contrast, prior methods, such as transfer matrix method, require
computation effort.Comment: 33 pages, 4 figure
Low-Energy Signals from Kinetic Mixing with a Warped Abelian Hidden Sector
We investigate the detailed phenomenology of a light Abelian hidden sector in
the Randall-Sundrum framework. Relative to other works with light hidden
sectors, the main new feature is a tower of hidden Kaluza-Klein vectors that
kinetically mix with the Standard Model photon and Z. We investigate the decay
properties of the hidden sector fields in some detail, and develop an approach
for calculating processes initiated on the ultraviolet brane of a warped space
with large injection momentum relative to the infrared scale. Using these
results, we determine the detailed bounds on the light warped hidden sector
from precision electroweak measurements and low-energy experiments. We find
viable regions of parameter space that lead to significant production rates for
several of the hidden Kaluza-Klein vectors in meson factories and fixed-target
experiments. This offers the possibility of exploring the structure of an extra
spacetime dimension with lower-energy probes.Comment: (1+32) Pages, 13 Figures. v2: JHEP version (minor modifications,
results unchanged
Histological Examination in Obtaining a Diagnosis in Patients with Lymphadenopathy in Lima, Peru.
The differential diagnosis for lymphadenopathy is wide and clinical presentations overlap, making obtaining an accurate diagnosis challenging. We sought to characterize the clinical and radiological characteristics, histological findings, and diagnoses for a cohort of patients with lymphadenopathy of unknown etiology. 121 Peruvian adults with lymphadenopathy underwent lymph node biopsy for microbiological and histopathological evaluation. Mean patient age was 41 years (Interquartile Range 26-52), 56% were males, and 39% were HIV positive. Patients reported fever (31%), weight loss (23%), and headache (22%); HIV infection was associated with fever (P < 0.05) and gastrointestinal symptoms (P < 0.05). Abnormalities were reported in 40% of chest X-rays (N = 101). Physicians suspected TB in 92 patients (76%), lymphoma in 19 patients (16%), and other malignancy in seven patients (5.8%). Histological diagnoses (N = 117) included tuberculosis (34%), hyperplasia (27%), lymphoma (13%), and nonlymphoma malignancy (14%). Hyperplasia was more common (P < 0.001) and lymphoma less common (P = 0.005) among HIV-positive than HIV-negative patients. There was a trend toward reduced frequency of caseous necrosis in samples from HIV-positive than HIV-negative TB patients (67 versus 93%, P = 0.055). The spectrum of diagnoses was broad, and clinical and radiological features correlated poorly with diagnosis. On the basis of clinical features, physicians over-diagnosed TB, and under-diagnosed malignancy. Although this may not be inappropriate in resource-limited settings where TB is the most frequent easily treatable cause of lymphadenopathy, diagnostic delays can be detrimental to patients with malignancy. It is important that patients with lymphadenopathy undergo a full diagnostic work-up including sampling for histological evaluation to obtain an accurate diagnosis
Re-Inventing Adherence: Toward a Patient-Centered Model of Care for Drug-Resistant Tuberculosis and HIV
BACKGROUNDâDespite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care.
OBJECTIVEâTo review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support.
DISCUSSIONâCurrent national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully implementing team-based patient-centered care, empowering patients through counseling and support, maintaining a rights-based approach while acknowledging the responsibility of health care systems in providing comprehensive care, and prioritizing critical research gaps.
CONCLUSIONâIt is time to re-invent our understanding of adherence in drug-resistant TB and HIV by focusing attention on the complex clinical, behavioral, social, and structural needs of affected patients and communities
High-dimensional analysis of the aging immune system: verification of age-associated differences in immune signaling responses in healthy donors.
BACKGROUND
Single-cell network profiling (SCNP) is a multiparametric flow cytometry-based approach that simultaneously measures evoked signaling in multiple cell subsets. Previously, using the SCNP approach, age-associated immune signaling responses were identified in a cohort of 60 healthy donors.
METHODS
In the current study, a high-dimensional analysis of intracellular signaling was performed by measuring 24 signaling nodes in 7 distinct immune cell subsets within PBMCs in an independent cohort of 174 healthy donors [144 elderly (>65Â yrs); 30 young (25-40Â yrs)].
RESULTS
Associations between age and 9 immune signaling responses identified in the previously published 60 donor cohort were confirmed in the current study. Furthermore, within the current study cohort, 48 additional immune signaling responses differed significantly between young and elderly donors. These associations spanned all profiled modulators and immune cell subsets.
CONCLUSIONS
These results demonstrate that SCNP, a systems-based approach, can capture the complexity of the cellular mechanisms underlying immunological aging. Further, the confirmation of age associations in an independent donor cohort supports the use of SCNP as a tool for identifying reproducible predictive biomarkers in areas such as vaccine response and response to cancer immunotherapies
Low-Energy Probes of a Warped Extra Dimension
We investigate a natural realization of a light Abelian hidden sector in an
extended Randall-Sundrum (RS) model. In addition to the usual RS bulk we
consider a second warped space containing a bulk U(1)_x gauge theory with a
characteristic IR scale of order a GeV. This Abelian hidden sector can couple
to the standard model via gauge kinetic mixing on a common UV brane. We show
that if such a coupling induces significant mixing between the lightest U(1)_x
gauge mode and the standard model photon and Z, it can also induce significant
mixing with the heavier U(1)_x Kaluza-Klein (KK) modes. As a result it might be
possible to probe several KK modes in upcoming fixed-target experiments and
meson factories, thereby offering a new way to investigate the structure of an
extra spacetime dimension.Comment: 26 pages, 1 figure, added references, corrected minor typos, same as
journal versio
Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales
Background: Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. Methods: This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary's Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George's Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patientsâ performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary's Hospital TBI clinic in London (UK). Findings: The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Interpretation: Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. Funding: This work was funded by a National Institute for Health Research (NIHR) Invention for Innovation (i4i) grant awarded to DJS and AH ( II-LB-0715-20006)
Dynamics of Cough Frequency in Adults Undergoing Treatment for Pulmonary Tuberculosis.
Background: Cough is the major determinant of tuberculosis transmission. Despite this, there is a paucity of information regarding characteristics of cough frequency throughout the day and in response to tuberculosis therapy. Here we evaluate the circadian cycle of cough, cough frequency risk factors, and the impact of appropriate treatment on cough and bacillary load. Methods: We prospectively evaluated human immunodeficiency virus-negative adults (n = 64) with a new diagnosis of culture-proven, drug-susceptible pulmonary tuberculosis immediately prior to treatment and repeatedly until treatment day 62. At each time point, participant cough was recorded (n = 670) and analyzed using the Cayetano Cough Monitor. Consecutive coughs at least 2 seconds apart were counted as separate cough episodes. Sputum samples (n = 426) were tested with microscopic-observation drug susceptibility broth culture, and in culture-positive samples (n = 252), the time to culture positivity was used to estimate bacillary load. Results: The highest cough frequency occurred from 1 pm to 2 pm, and the lowest from 1 am to 2 am (2.4 vs 1.1 cough episodes/hour, respectively). Cough frequency was higher among participants who had higher sputum bacillary load (P < .01). Pretreatment median cough episodes/hour was 2.3 (interquartile range [IQR], 1.2-4.1), which at 14 treatment days decreased to 0.48 (IQR, 0.0-1.4) and at the end of the study decreased to 0.18 (IQR, 0.0-0.59) (both reductions P < .001). By 14 treatment days, the probability of culture conversion was 29% (95% confidence interval, 19%-41%). Conclusions: Coughs were most frequent during daytime. Two weeks of appropriate treatment significantly reduced cough frequency and resulted in one-third of participants achieving culture conversion. Thus, treatment by 2 weeks considerably diminishes, but does not eliminate, the potential for airborne tuberculosis transmission
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