A Rare Case of Rectal Metastasis from Sarcomatoid Variant of Urothelial Carcinoma: A Case Report

Introduction: Urothelial carcinoma of the bladder with sarcomatoid differentiation is known to display aggressive biological behaviour. To our knowledge, this is the first reported case of isolated rectal metastasis from sarcomatoid urothelial carcinoma of the bladder following curative surgery.Presentation of Case: A 72-year-old male presented with tenesmus 6 months after radical cystoprostatectomy, lymph node dissection and ileal conduit formation for pathological T1N0M0 bladder carcinoma.Digital rectal examination revealed thickening of the distal rectum with no bleeding. Computerised tomography demonstrated thickening in the rectal mucosa and submucosa with intact perirectal fat. Rectal biopsy performed via colonoscopy confirmed metastases of urothelial carcinoma origin. The patient was treated with palliative radiation.Conclusion: This case report illustrates an unusual location of urothelial carcinoma metastasis. A high clinical suspicion in patients with this aggressive variant of cancer is required

Real-time Digital Double Framework to Predict Collapsible Terrains for Legged Robots

Inspired by the digital twinning systems, a novel real-time digital double framework is developed to enhance robot perception of the terrain conditions. Based on the very same physical model and motion control, this work exploits the use of such simulated digital double synchronized with a real robot to capture and extract discrepancy information between the two systems, which provides high dimensional cues in multiple physical quantities to represent differences between the modelled and the real world. Soft, non-rigid terrains cause common failures in legged locomotion, whereby visual perception solely is insufficient in estimating such physical properties of terrains. We used digital double to develop the estimation of the collapsibility, which addressed this issue through physical interactions during dynamic walking. The discrepancy in sensory measurements between the real robot and its digital double are used as input of a learning-based algorithm for terrain collapsibility analysis. Although trained only in simulation, the learned model can perform collapsibility estimation successfully in both simulation and real world. Our evaluation of results showed the generalization to different scenarios and the advantages of the digital double to reliably detect nuances in ground conditions.Comment: IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS). Preprint version. Accepted June 202

Epidemiological risk factors for adult dengue in Singapore: an 8-year nested test negative case control study

10.1186/s12879-016-1662-4BMC Infectious Diseases16132

"I wouldn't really believe statistics" - Challenges with influenza vaccine acceptance among healthcare workers in Singapore.

BACKGROUND: Influenza vaccine acceptance among healthcare workers (HCWs) is a worldwide problem, but relatively little research has focussed on Asia, including Singapore. Despite widespread access and recommendations from public health authorities, influenza vaccine uptake remains suboptimal among HCWs. METHODS: Our qualitative study used focus group discussions to identify and explain factors limiting influenza vaccine acceptance among HCWs in Singapore. A total of 73 doctors, nurses, allied health and ancillary staff across three public hospitals were included. RESULTS: Challenges identified include a fear of contracting influenza from vaccination exacerbated by negative anecdotes regarding vaccine safety and efficacy, distrust of published efficacy data, uncertainty regarding relevance of existing data for Singapore, reluctance to introduce chemicals or overmedicate, pain from injection, low risk attributed to influenza and limited awareness of influenza transmission with a preference for alternatives in patient protection. Differences in attitudes were observed across vocational groups. Lack of overt promotion by hospital leadership in some institutions, perceived vaccine hesitancy among doctors, access, and work culture that implicitly encourages working through illness were further barriers. CONCLUSION: Our findings highlight a combination of misperceptions about influenza vaccination and cognitive biases at the individual level, and challenges at the institutional level limiting uptake. Findings indicate an urgent need to provide targeted education and communication. Rather than providing more data, we recommend a widely-disseminated, locally-compiled synthesis addressing specific concerns of hesitant HCWs. Tailoring interventions to specific vocational groups should be considered. Institutional norms and culture may have a powerful influence in setting default behaviours: more effort is needed in improving influenza vaccine promotion and priority at some institutions, integrating vaccine-related communication with other infection control communication and addressing influenza vaccine hesitancy among doctors as a priority. Finally, further study of strategies to address cognitive biases affecting influenza vaccine acceptance in Singapore is desirable

An Unusual Case of Ovarian Carcinomatosis with Microscopic Tumor Embolism Leading to Rectal Ischemia and Perforation

We present an unusual case of advanced ovarian carcinoma with postoperative complications of ischemia and perforation of the rectum as a result of tumor embolism. The interval progression from ischemia to infarction of the rectum was captured in repeated sigmoidoscopies. A brief discussion on tumor embolism and management of this case is also included

The Integration of Smart Lock in Vacation Rental Management System

Current vacation rental management system still lack of the feature to manage the key for door access. This paper reports on the design and development of the vacation rental management system integrated with the smart lock system to solve the key issue for door access. A prototype has been designed and developed to investigate the feasibility of such integration. The prototype system has been tested to evaluate the performance of the integrated system. The use of digital key in the form of password entry and/or Quick Response (QR) code scanning is posited to provide users with an easy way for door access and minimize the physical key issue. Advanced Encryption Standard (AES) technique is used to ensure secure data transmission in the networ

Distributed under Creative Commons CC-BY 4.0 Genomic insight into pathogenicity of dematiaceous fungus Corynespora cassiicola

ABSTRACT Corynespora cassiicola is a common plant pathogen that causes leaf spot disease in a broad range of crop, and it heavily affect rubber trees in Malaysia (Hsueh, 2011