Mucoepidermoid carcinoma of the hard palate: A case report

Mucoepidermoid Carcinoma is an epithelial salivary gland tumor which usually occurs in younger patients and females. The following case report deals with a case of mucoepidermoid carcinoma in a 38-year-old male patient who reported with a chief complaint of swelling in the palatal region for 1 year. At first, it was diagnosed as a benign minor salivary gland tumor of the palate. Upon incisional biopsy, an impression was made according to the features present. Complete excision of the lesion was done which was then diagnosed as mucoepidermoid carcinoma. The conflict between whether the lesion was a benign minor salivary gland tumor of the palate or a malignant counterpart, was resolved and confirmed after excisional biopsy.The article focuses on various diagnostic aspects of this tumor and its surgical management

Ethyl 4′-ethenyl-2′-oxo-4-phenyl-2-(3,4,5-trimethoxy­phen­yl)spiro­[pyrrolidine-3,3′-indoline]-5-carboxyl­ate monohydrate

In the title compound, C31H32N2O6·H2O, the pyrrolidine ring adopts an envelope conformation. The ethyl C atoms of the ethoxy­cabonyl group are disordered over two positions with occupancies of ca 0.80 and 0.20. Intra­molecular N—H⋯O hydrogen bonds form S(5) and S(6) ring motifs. Mol­ecules are linked into a three-dimensional framework by O—H⋯O, N—H⋯O and C—H⋯O hydrogen bonds, and by C—H⋯π inter­actions

Delivering evidence-based interventions for type 1 diabetes in the virtual world - A review of UK practice during the SARS-CoV-2 pandemic.

Funder: Abbott Diabetes CareFunder: SanofiFunder: Novo NordiskFunder: MedtronicAIMS: This review considers the impact of the SARS-CoV-2 pandemic on access to interventions for those living with type 1 diabetes and discusses the solutions which have been considered and actioned to ensure ongoing access care. METHODS: We performed a focussed review of the published literature, and the guidelines for changes that have been effected during the pandemic. We also drew from expert recommendations and information about local practice changes for areas where formal data have not been published. RESULTS: Evidence based interventions which support the achievement of improved glucose levels and/or reduction in hypoglycaemia include group structured education to support self-management, insulin pump therapy and continuous glucose monitoring. The SARS-CoV-2 pandemic had impacted the ability of diabetes services to deliver these intervention. Multiple adaptations have been put in place - transition to online delivery of education and care, and usage of diabetes technology. CONCLUSIONS: Although various adaptations have been made during the pandemic that have positively influenced uptake of services, there are many areas of delivery that need immediate improvement in the UK. We recommend a proactive approach in recognising the digital divide and inequity in distribution of these changes and we recommend introducing measures to reduce them

Delivering evidence-based interventions for type 1 diabetes in the virtual world - A review of UK practice during the SARS-CoV-2 pandemic.

Funder: Abbott Diabetes CareFunder: SanofiFunder: Novo NordiskFunder: MedtronicAIMS: This review considers the impact of the SARS-CoV-2 pandemic on access to interventions for those living with type 1 diabetes and discusses the solutions which have been considered and actioned to ensure ongoing access care. METHODS: We performed a focussed review of the published literature, and the guidelines for changes that have been effected during the pandemic. We also drew from expert recommendations and information about local practice changes for areas where formal data have not been published. RESULTS: Evidence based interventions which support the achievement of improved glucose levels and/or reduction in hypoglycaemia include group structured education to support self-management, insulin pump therapy and continuous glucose monitoring. The SARS-CoV-2 pandemic had impacted the ability of diabetes services to deliver these intervention. Multiple adaptations have been put in place - transition to online delivery of education and care, and usage of diabetes technology. CONCLUSIONS: Although various adaptations have been made during the pandemic that have positively influenced uptake of services, there are many areas of delivery that need immediate improvement in the UK. We recommend a proactive approach in recognising the digital divide and inequity in distribution of these changes and we recommend introducing measures to reduce them

Observing superluminous supernovae and long gamma ray bursts as potential birthplaces of repeating fast radio bursts

Superluminous supernovae (SLSNe) and long gamma ray bursts (LGRBs) have been proposed as progenitors of repeating Fast Radio Bursts (FRBs). In this scenario, bursts originate from the interaction between a young magnetar and its surrounding supernova remnant (SNR). Such a model could explain the repeating, apparently non-Poissonian nature of FRB121102, which appears to display quiescent and active phases. This bursting behaviour is better explained with a Weibull distribution, which includes parametrisation for clustering. We observed 10 SLSNe/LGRBs for 63 hours, looking for repeating FRBs with the Effelsberg-100 m radio telescope, but have not detected any bursts. We scale the burst rate of FRB121102 to an FRB121102-like source inhabiting each of our observed targets, and compare this rate to our upper burst rate limit on a source by source basis. By adopting a fiducial beaming fraction of 0.6, we obtain 99.99\% and 83.4\% probabilities that at least one, and at least half of our observed sources are beamed towards us respectively. One of our SLSN targets, PTF10hgi, is coincident with a persistent radio source, making it a possible analogue to FRB121102. We performed further observations on this source using the Effelsberg-100~m and Parkes-64~m radio telescopes. Assuming that PTF10hgi contains an FRB121102-like source, the probabilities of not detecting any bursts from a Weibull distribution during our observations are 14\% and 16\% for Effelsberg and Parkes respectively. We conclude by showing that a survey of many short observations increases burst detection probability for a source with Weibull distributed bursting activity.Comment: 11 pages, 5 figure

Evidence of mTOR Activation by an AKT-Independent Mechanism Provides Support for the Combined Treatment of PTEN-Deficient Prostate Tumors with mTOR and AKT Inhibitors

AbstractActivation of the phosphoinositide 3-kinase pathway is commonly observed in human prostate cancer. Loss of function of phosphatase and tensin homolog (PTEN) is associated with the activation of AKT and mammalian target of rapamycin (mTOR) in many cancer cell lines as well as in other model systems. However, activation of mTOR is also dependent of kinases other than AKT. Here, we show that activation of mTOR is not dependent on AKT in a prostate-specific PTEN-deficient mouse model of prostate cancer. Pathway bifurcation of AKT and mTOR was noted in both mouse and human prostate tumors. We demonstrated for the first time that cotargeting mTOR and AKT with ridaforolimus/MK-8669 and M1K-2206, respectively, delivers additive antitumor effects in vivo when compared to single agents. Our preclinical data suggest that the combination of AKT and mTOR inhibitors might be more effective in treating prostate cancer patients than current treatment regimens or either treatment alone

Swarm Learning for decentralized and confidential clinical machine learning

Fast and reliable detection of patients with severe and heterogeneous illnesses is a major goal of precision medicine1,2. Patients with leukaemia can be identified using machine learning on the basis of their blood transcriptomes3. However, there is an increasing divide between what is technically possible and what is allowed, because of privacy legislation4,5. Here, to facilitate the integration of any medical data from any data owner worldwide without violating privacy laws, we introduce Swarm Learning—a decentralized machine-learning approach that unites edge computing, blockchain-based peer-to-peer networking and coordination while maintaining confidentiality without the need for a central coordinator, thereby going beyond federated learning. To illustrate the feasibility of using Swarm Learning to develop disease classifiers using distributed data, we chose four use cases of heterogeneous diseases (COVID-19, tuberculosis, leukaemia and lung pathologies). With more than 16,400 blood transcriptomes derived from 127 clinical studies with non-uniform distributions of cases and controls and substantial study biases, as well as more than 95,000 chest X-ray images, we show that Swarm Learning classifiers outperform those developed at individual sites. In addition, Swarm Learning completely fulfils local confidentiality regulations by design. We believe that this approach will notably accelerate the introduction of precision medicine

Polymorphous adenocarcinoma of the salivary glands : reappraisal and update

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.Peer reviewe