Complete response of skull base inverted papilloma to chemotherapy: Case report.

BackgroundInverted papilloma (IP) is the most common benign sinonasal neoplasm. Endoscopic techniques, improved understanding of pathophysiology, and novel surgical approaches have allowed rhinologists to treat IPs more effectively, with surgery being the mainstay of therapy. Frontal sinus IP poses a challenge for surgical therapy due to complex anatomy and potentially difficult surgical access.ObjectivesWe reported a unique case of a massive frontal sinus IP that presented with intracranial and orbital extension, with near resolution after chemotherapy.MethodsA retrospective case review of a patient with a frontal sinus IP treated at a tertiary academic medical center.ResultsA 75-year-old male patient presented with nasal obstruction, purulent nasal discharge, and a growing left supraorbital mass. Endoscopy demonstrated a mass that filled both frontal and ethmoid sinuses, with orbital invasion. There also was substantial erosion of the posterior table, which measured 1.73 × 1.40 cm. A biopsy specimen demonstrated IP with carcinoma in situ. The patient was deemed unresectable on initial evaluation and, subsequently, underwent chemotherapy (carboplatin and paclitaxel). The tumor had a dramatic response to chemotherapy, and the patient elected for definitive surgery to remove any residual disease. During surgery, only a small focus of IP was found along the superior wall of the frontal sinus. No tumor was found elsewhere, including at the site of skull base erosion. The final pathology was IP without carcinoma in situ or dysplasia.ConclusionThis was the first reported case of chemotherapeutic "debulking" of IP, which facilitated surgical resection, despite substantial intracranial and orbital involvement. Although nearly all IPs can be treated surgically, rare cases, such as unresectable tumors, may benefit from systemic chemotherapy

Malignancy within a tail gut cyst:a case of retrorectal carcinoid tumour

Purpose. Tailgut cysts with malignant transformation are rare entities. We discuss the diagnostic strategy and treatment of a malignancy within a tailgut cyst. Methods. In this study we report on the case of a 61-year-old man with a malignant neuroendocrine tumour arising within a tailgut cyst and an overview of the literature emphasising the histopathological characteristics and differential diagnosis. Results. Our patient presented with lower back pain, rectal pain, and increased urgency of defecation. MRI scan and CT-guided biopsy on histological analysis revealed a diagnosis of carcinoid tumour of the presacral space. The patient subsequently underwent an abdominoperineal excision of the rectum. Conclusions. This case highlights the importance of tailgut cysts as a differential diagnosis of presacral masses. It is a rare congenital lesion developing from remnants of the embryonic postanal gut and is predominantly benign in nature. Approximately half of cases remain asymptomatic; therefore, diagnosis is often delayed. Magnetic resonance imaging is the investigation of choice and an awareness of the possibility of malignant potential is critical to avoiding missed diagnosis and subsequent morbidity. Complete surgical excision allows accurate diagnosis, confirmation of oncological clearance, and prevention of mortality

Coordinating Supply Chains with a Credit Mechanism

This paper studies the supply chain coordination with a trade credit under symmetric and asymmetric information, where the retailer has an individual profit target from the business and the vendor is the decision-maker of the supply chain. We propose a coordination mechanism through credit contracts and show that a win-win outcome is achieved by redistributing the cost savings from coordination mechanism under certain constraints. Numerical examples are given to illustrate our results

Molecular dynamics simulations of lead clusters

Molecular dynamics simulations of nanometer-sized lead clusters have been performed using the Lim, Ong and Ercolessi glue potential (Surf. Sci. {\bf 269/270}, 1109 (1992)). The binding energies of clusters forming crystalline (fcc), decahedron and icosahedron structures are compared, showing that fcc cuboctahedra are the most energetically favoured of these polyhedral model structures. However, simulations of the freezing of liquid droplets produced a characteristic form of ``shaved'' icosahedron, in which atoms are absent at the edges and apexes of the polyhedron. This arrangement is energetically favoured for 600-4000 atom clusters. Larger clusters favour crystalline structures. Indeed, simulated freezing of a 6525-atom liquid droplet produced an imperfect fcc Wulff particle, containing a number of parallel stacking faults. The effects of temperature on the preferred structure of crystalline clusters below the melting point have been considered. The implications of these results for the interpretation of experimental data is discussed.Comment: 11 pages, 18 figues, new section added and one figure added, other minor changes for publicatio

A pricing optimization modelling for assisted decision making in telecommunication product-service bundling

Product service bundle (PSB) is a marketing strategy that offers attractive product-service packages with competitive pricing to ensure sustained profitability. However, designing suitable pricing for PSB is a non-trivial task that involves complex decision-making. This paper explores the significance of pricing optimization in the telecommunication industry, focusing on product-service bundling (PSB). It delves into the challenges associated with pricing PSB and highlights the transformative impact of big data analytics on decision-making for PSB strategies. The study presents a data-driven pricing optimization model tailored for designing appropriate pricing structures for product-service bundles within the telecommunication services domain. This model integrates customer preference knowledge and involves intricate decision-making processes. To demonstrate the feasibility of the proposed approach, the paper conducts a case study encompassing two design scenarios, wherein the results reveal that the model offers competitive pricing compared to existing telecommunication service providers, facilitating PSB design and decision-making. The findings from the case study indicate that the data-driven pricing optimization model can significantly aid PSB design and decision-making, leading to competitive pricing strategies that open avenues for new market exploration and ensure business sustainability. By considering both product and service features concurrently, the proposed model provides a pricing reference for optimal decision-making. The case study validates the feasibility and effectiveness of the approach within the telecommunication industry and highlights its potential for broader applications. The model's capability to generate competitive pricing strategies offers opportunities for new market exploration, ensuring business growth and adaptability

Investigating the benefits of molecular profiling of advanced non-small cell lung cancer tumors to guide treatments.

In this study we utilized data on patient responses to guided treatments, and we evaluated their benefit for a non-small cell lung cancer cohort. The recommended therapies used were predicted using tumor molecular profiles that involved a range of biomarkers but primarily used immunohistochemistry markers. A dataset describing 91 lung non-small cell lung cancer patients was retrospectively split into two. The first group's drugs were consistent with a treatment plan whereby all drugs received agreed with their tumor's molecular profile. The second group each received one or more drug that was expected to lack benefit. We found that there was no significant difference in overall survival or mortality between the two groups. Patients whose treatments were predicted to be of benefit survived for an average of 402 days, compared to 382 days for those that did not (P = 0.7934). In the matched treatment group, 48% of patients were deceased by the time monitoring had finished compared to 53% in the unmatched group (P = 0.6094). The immunohistochemistry biomarker for the ERCC1 receptor was found to be a marker that could be used to predict future survival; ERCC1 loss was found to be predictive of poor survival

Large mixing angle oscillations as a probe of the deep solar interior

We re-examine the sensitivity of solar neutrino oscillations to noise in the solar interior using the best current estimates of neutrino properties. Our results show that the measurement of neutrino properties at KamLAND provides new information about fluctuations in the solar environment on scales to which standard helioseismic constraints are largely insensitive. We also show how the determination of neutrino oscillation parameters from a combined fit of KamLAND and solar data depends strongly on the magnitude of solar density fluctuations. We argue that a resonance between helioseismic and Alfven waves might provide a physical mechanism for generating these fluctuations and, if so, neutrino-oscillation measurements could be used to constrain the size of magnetic fields deep within the solar radiative zone.Comment: 13 pages, LaTeX file using AASLaTeX, 6 figures included. Improved version including the new KamLAND data. To appear in APJ letter

A Similarity Measure for GPU Kernel Subgraph Matching

Accelerator architectures specialize in executing SIMD (single instruction, multiple data) in lockstep. Because the majority of CUDA applications are parallelized loops, control flow information can provide an in-depth characterization of a kernel. CUDAflow is a tool that statically separates CUDA binaries into basic block regions and dynamically measures instruction and basic block frequencies. CUDAflow captures this information in a control flow graph (CFG) and performs subgraph matching across various kernel's CFGs to gain insights to an application's resource requirements, based on the shape and traversal of the graph, instruction operations executed and registers allocated, among other information. The utility of CUDAflow is demonstrated with SHOC and Rodinia application case studies on a variety of GPU architectures, revealing novel thread divergence characteristics that facilitates end users, autotuners and compilers in generating high performing code