Malignant neuroleptic syndrome following deep brain stimulation surgery: a case report

<p>Abstract</p> <p>Background</p> <p>The neuroleptic malignant syndrome is an uncommon but dangerous complication characterized by hyperthermia, autonomic dysfunction, altered mental state, hemodynamic dysregulation, elevated serum creatine kinase, and rigor. It is most often caused by an adverse reaction to anti-psychotic drugs or abrupt discontinuation of neuroleptic or anti-parkinsonian agents. To the best of our knowledge, it has never been reported following the common practice of discontinuation of anti-parkinsonian drugs during the pre-operative preparation for deep brain stimulation surgery for Parkinson's disease.</p> <p>Case presentation</p> <p>We present the first case of neuroleptic malignant syndrome associated with discontinuation of anti-parkinsonian medication prior to deep brain stimulation surgery in a 54-year-old Caucasian man.</p> <p>Conclusion</p> <p>The characteristic neuroleptic malignant syndrome symptoms can be attributed to other, more common causes associated with deep brain stimulation treatment for Parkinson's disease, thus requiring a high index of clinical suspicion to timely establish the correct diagnosis. As more centers become eligible to perform deep brain stimulation, neurologists and neurosurgeons alike should be aware of this potentially fatal complication. Timely activation of the deep brain stimulation system may be important in accelerating the patient's recovery.</p

Gate Coupling to Nanoscale Electronics

The realization of single-molecule electronic devices, in which a nanometer-scale molecule is connected to macroscopic leads, requires the reproducible production of highly ordered nanoscale gaps in which a molecule of interest is electrostatically coupled to nearby gate electrodes. Understanding how the molecule-gate coupling depends on key parameters is crucial for the development of high-performance devices. Here we directly address this, presenting two- and three-dimensional finite-element electrostatic simulations of the electrode geometries formed using emerging fabrication techniques. We quantify the gate coupling intrinsic to these devices, exploring the roles of parameters believed to be relevant to such devices. These include the thickness and nature of the dielectric used, and the gate screening due to different device geometries. On the single-molecule (~1nm) scale, we find that device geometry plays a greater role in the gate coupling than the dielectric constant or the thickness of the insulator. Compared to the typical uniform nanogap electrode geometry envisioned, we find that non-uniform tapered electrodes yield a significant three orders of magnitude improvement in gate coupling. We also find that in the tapered geometry the polarizability of a molecular channel works to enhance the gate coupling

The Geometry of D=11 Killing Spinors

We propose a way to classify all supersymmetric configurations of D=11 supergravity using the G-structures defined by the Killing spinors. We show that the most general bosonic geometries admitting a Killing spinor have at least a local SU(5) or an (Spin(7)\ltimes R^8)x R structure, depending on whether the Killing vector constructed from the Killing spinor is timelike or null, respectively. In the former case we determine what kind of local SU(5) structure is present and show that almost all of the form of the geometry is determined by the structure. We also deduce what further conditions must be imposed in order that the equations of motion are satisfied. We illustrate the formalism with some known solutions and also present some new solutions including a rotating generalisation of the resolved membrane solutions and generalisations of the recently constructed D=11 Godel solution.Comment: 36 pages. Typos corrected and discussion on G-structures improved. Final version to appear in JHE

Submesothelial deposition of carbon nanoparticles after toner exposition: Case report

Inhalation of carbon nanoparticles (CNP) from toner dust has been shown to have impact on the respiratory health of persons exposed. Office printers are known emitters of CNP. We report about a female open office worker who developed weight loss and diarrhoea. Laparoscopy done for suspected endometriosis surprisingly revealed black spots within the peritoneum. Submesothelial aggregates of CNP with a diameter of 31-67 nm were found by scanning and transmission electron microscopy in these tissue specimens. Colon biopsies showed inflammatory bowel disease with typically signs of Crohn disease, but no dust deposits. Transport of CNP via lymphatic and blood vessels after inhalation in the lungs has to be assumed. In this case respiratory symptoms were not reported, therefore no lung function tests were done. We have shown that workers with toner dust exposure from laser printers can develop submesothelial deposition of CNP in the peritoneum. Impact of toner dust exposure on the respiratory health of office workers, as suspected in other studies, has to be evaluated further

Copanlisib synergizes with conventional and targeted agents including venetoclax in B- And T-cell lymphoma models

Copanlisib is a pan-class I phosphoinositide 3-kinase (PI3K) inhibitor with preferred activity toward PI3Ka and PI3Kd. Despite the clear overall clinical benefit, the number of patients achieving complete remissions with the single agent is relatively low, a problem shared by the vast majority of targeted agents. Here, we searched for novel copanlisib-based combinations. Copanlisib was tested as a single agent, in combination with an additional 17 drugs in 26 cell lines derived from mantle cell lymphoma (MCL), marginal zone lymphoma (MZL), and T-cell lymphomas. In vivo experiments, transcriptome analyses, and immunoblotting experiments were also performed. Copanlisib as a single agent showed in vitro dose-dependent antitumor activity in the vast majority of the models. Combination screening identified several compounds that synergized with copanlisib. The strongest combination was with the B-cell lymphoma 2 (BCL2) inhibitor venetoclax. The benefit of the combination over single agents was also validated in an MZL xenograft model and in MCL primary cells, and was due to increased induction of apoptosis, an effect likely sustained by the reduction of the antiapoptotic proteins myeloid cell leukemia 1 (MCL1) and BCL-XL, observed in MCL and MZL cell lines, respectively. These data supported the rationale for the design of the Swiss Group for Clinical Cancer Research (SAKK) 66/18phase 1 study currently exploring the combination of copanlisib and venetoclax in relapsed/refractory lymphomas

Eliciting Co-Creation Best Practices of Virtual Reality Reusable e-Resources

Immersive experiential technologies find fertile grounds to grow and support healthcare education. Virtual, Augmented, or Mixed reality (VR/AR/MR) have proven to be impactful in both the educational and the affective state of the healthcare student’s increasing engagement. However, there is a lack of guidance for healthcare stakeholders on developing and integrating virtual reality resources into healthcare training. Thus, the authors applied Bardach’s Eightfold Policy Analysis Framework to critically evaluate existing protocols to determine if they are inconsistent, ineffective, or result in uncertain outcomes, following systematic pathways from concepts to decision-making. Co-creative VR resource development resulted as the preferred method. Best practices for co-creating VR Reusable e-Resources identified co-creation as an effective pathway to the prolific use of immersive media in healthcare education. Co-creation should be considered in conjunction with a training framework to enhance educational quality. Iterative cycles engaging all stakeholders enhance educational quality, while co-creation is central to the quality assurance process both for technical and topical fidelity, and tailoring resources to learners’ needs. Co-creation itself is seen as a bespoke learning modality. This paper provides the first body of evidence for co-creative VR resource development as a valid and strengthening method for healthcare immersive content development. Despite prior research supporting co-creation in immersive resource development, there were no established guidelines for best practices

Loncastuximab tesirine in relapsed/refractory high-grade B-cell lymphoma: a subgroup analysis from the LOTIS-2 study

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