An Interesting Case Of Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis (ADEM) is an uncommon inflammatory demyelinating disease of the central nervous system. The disease typically occurs after infections or vaccinations. However, in many patients with ADEM, no evidence of prior infection or vaccination can be found. We are reporting a patient who developed clinical and radiological features of acute disseminated encephalomyelitis after trauma of repeated attempts at lumber puncture for spinal anesthesi

Decomposition Strategies for Constructive Preference Elicitation

We tackle the problem of constructive preference elicitation, that is the problem of learning user preferences over very large decision problems, involving a combinatorial space of possible outcomes. In this setting, the suggested configuration is synthesized on-the-fly by solving a constrained optimization problem, while the preferences are learned itera tively by interacting with the user. Previous work has shown that Coactive Learning is a suitable method for learning user preferences in constructive scenarios. In Coactive Learning the user provides feedback to the algorithm in the form of an improvement to a suggested configuration. When the problem involves many decision variables and constraints, this type of interaction poses a significant cognitive burden on the user. We propose a decomposition technique for large preference-based decision problems relying exclusively on inference and feedback over partial configurations. This has the clear advantage of drastically reducing the user cognitive load. Additionally, part-wise inference can be (up to exponentially) less computationally demanding than inference over full configurations. We discuss the theoretical implications of working with parts and present promising empirical results on one synthetic and two realistic constructive problems.Comment: Accepted at the Thirty-Second AAAI Conference on Artificial Intelligence (AAAI-18

Open vertical sagittal fracture patella with fracture lateral condyle femur: approach to a rare injury

Patellar fracture is a relatively uncommon fracture especially the vertical sagittal type. In cases of high energy trauma injury, it is usually associated with fracture of ipsilateral distal femur or proximal tibia. However, the combination of vertical sagittal fracture patella and ipsilateral fracture lateral condyle is very rare. This necessitates judicious diagnosis and appropriate management to ensure optimal functional outcome. Open reduction and internal fixation is the treatment of choice in managing these types of injuries. This should be followed by gradual mobilization of the affected knee joint. Weight bearing can be started once the fracture starts showing signs of union on X-rays. Literature search shows only one case report describing this pattern. The aim of this case report is to highlight the rarity of this injury, to understand the injury mechanism and surgical approach used for these injuries. The knowledge of this combination will help us manage these injuries so that good functional outcome is achieved. Keywords: Sagittal, Patella, Ipsilateral, Femoral condyl

Quantifying cancer epithelial-mesenchymal plasticity and its association with stemness and immune response

Cancer cells can acquire a spectrum of stable hybrid epithelial/mesenchymal (E/M) states during epithelial-mesenchymal transition (EMT). Cells in these hybrid E/M phenotypes often combine epithelial and mesenchymal features and tend to migrate collectively commonly as small clusters. Such collectively migrating cancer cells play a pivotal role in seeding metastases and their presence in cancer patients indicates an adverse prognostic factor. Moreover, cancer cells in hybrid E/M phenotypes tend to be more associated with stemness which endows them with tumor-initiation ability and therapy resistance. Most recently, cells undergoing EMT have been shown to promote immune suppression for better survival. A systematic understanding of the emergence of hybrid E/M phenotypes and the connection of EMT with stemness and immune suppression would contribute to more effective therapeutic strategies. In this review, we first discuss recent efforts combining theoretical and experimental approaches to elucidate mechanisms underlying EMT multi-stability (i.e. the existence of multiple stable phenotypes during EMT) and the properties of hybrid E/M phenotypes. Following we discuss non-cell-autonomous regulation of EMT by cell cooperation and extracellular matrix. Afterwards, we discuss various metrics that can be used to quantify EMT spectrum. We further describe possible mechanisms underlying the formation of clusters of circulating tumor cells. Last but not least, we summarize recent systems biology analysis of the role of EMT in the acquisition of stemness and immune suppression.Comment: 50 pages, 6 figure