Synchronous gastric and duodenal metastases from head and neck squamous cell carcinoma: a unique presentation of upper gastrointestinal bleeding.

Metastatic disease to the stomach or duodenum is an infrequent diagnosis, and head and neck squamous cell carcinoma (HNSCC) is one of the least common primary malignancies that lead to gastric or duodenal metastases. We report the case of a 65-year-old man with human immunodeficiency virus infection and previously diagnosed HNSCC who presented with melena. The patient had a percutaneous endoscopic gastrostomy tube placed 3 months prior to his presentation. Laboratory testing was significant for normocytic anemia and a digital rectal examination was positive for melena. Esophagogastroduodenoscopy revealed numerous cratered nodules with contact bleeding in the stomach as well as the duodenum that appeared malignant. Biopsies of the gastric and duodenal nodules were positive for p40 and CK 5/6, consistent with metastatic squamous cell carcinoma

Metastatic Uveal Malignant Melanoma: A Case Report

Case Report A 77-year-old woman presented with a chief complaint of one day history of severe, acute abdominal pain. The patient described the pain as intense, non-radiating, and located primarily in the left upper abdominal quadrant.The pain was associated with nausea and multiple episodes of non-bilious, non-bloody emesis. She denied melena and hematochezia. On physical examination, her abdomen was soft and exquisitely tender in the left upper quadrant and epigastric regions. Aside from trace lower extremity edema.the remainder of her physical examination was unremarkable. Laboratory results at the time of admission were notable for:hemoglobin 10.8 g/dL, alkaline phosphatase 459 U/L, aspartate transaminase 56 U/L, and alanine transaminase 66 U/L. The patient\u27s past medical history was significant for hypertension, gastroesophageal reflux disease, papillary thyroid carcinoma. and right eye uveal melanoma. The ocular melanoma was treated 16 years ago with radioactive plaque followed by transpupillary thermal therapy. The patient was diagnosed with metastatic disease to her liver approximately 6 years prior and she had received several rounds of hepatic radiation and chemotherapeutic embolizations. The patient\u27s oncologist closely monitored her for disease progression through regular abdominal imaging studies

Deep learning segmentation of triple-negative breast cancer (TNBC) patient derived tumor xenograft (PDX) and sensitivity of radiomic pipeline to tumor probability boundary

Preclinical magnetic resonance imaging (MRI) is a critical component in a co-clinical research pipeline. Importantly, segmentation of tumors in MRI is a necessary step in tumor phenotyping and assessment of response to therapy. However, manual segmentation is time-intensive and suffers from inter- and intra- observer variability and lack of reproducibility. This study aimed to develop an automated pipeline for accurate localization and delineation of TNBC PDX tumors from preclinical T1w and T2w MR images using a deep learning (DL) algorithm and to assess the sensitivity of radiomic features to tumor boundaries. We tested five network architectures including U-Net, dense U-Net, Res-Net, recurrent residual UNet (R2UNet), and dense R2U-Net (D-R2UNet), which were compared against manual delineation by experts. To mitigate bias among multiple experts, the simultaneous truth and performance level estimation (STAPLE) algorithm was applied to create consensus maps. Performance metrics (F1-Score, recall, precision, and AUC) were used to assess the performance of the networks. Multi-contrast D-R2UNet performed best with F1-score = 0.948; however, all networks scored within 1-3% of each other. Radiomic features extracted from D-R2UNet were highly corelated to STAPLE-derived features with 67.13% of T1w and 53.15% of T2w exhibiting correlation ρ ≥ 0.9

Clumped isotope evidence for episodic, rapid flow of fluids in a mineralized fault system in the Peak District, UK

We have used clumped isotope thermometry to study a fault-hosted hydrothermal calcite vein associated with the Mississippi Valley Type (MVT) mineralization on the Derbyshire Platform in the southern Pennines, UK. This is the first published dataset obtained using a new mass spectrometer, MIRA, optimized for clumped isotope analysis and an associated clumped isotope-temperature calibration. We analysed multiple generations of vein growth at high spatial resolution in two transects across the vein. The vein grew episodically at temperatures between 40 and 100°C. We interpret each episode of growth as being associated with an increasing flux of formation waters from deep sedimentary basins next to the mineralized platform and an accompanying increase in the precipitation temperatures. Heat is conserved in the fluid as it ascends along the fault surface and, thus, flow must have been fast and restricted to short-lived pulses. The flux could have been driven by high pore pressures associated with rapid sedimentation, hydrocarbon generation and diagenesis in the basinal facies of the Visean Bowland-Hodder group. Natural hydraulic fracturing of shale units and failure of capillary seals, possibly triggered by uplift, allowed the release of fluids into aquifers within the sediment pile. The transmission of high pore fluid pressures from the shales to the fault zone, aided by the compressibility of the gas phase in two-phase pore fluids, may have resulted in fault rupture, accompanied by enhanced fracture permeability and rapid fluid flow. Vein growth ceased as pore pressures dissipated. Such behaviour is closely related to a seismic valve type model for mineralization

tofacitinib treatment is associated with modest and reversible increases in serum lipids in patients with ulcerative colitis

Background & Aims Tofacitinib is an oral, small-molecule Janus kinase inhibitor for the treatment of ulcerative colitis (UC). We analyzed inflammation, lipid concentrations, and incidence rates of major adverse cardiovascular (CV) events (MACEs) in patients who received tofacitinib in worldwide studies. Methods We collected data from 1157 patients who participated in 3 8-week induction studies (1 phase-2 study and 2 phase-3 studies; patients received tofacitinib 10 mg twice daily or placebo), a 52-week phase-3 maintenance study of responders (patients received tofacitinib 5 or 10 mg twice daily or placebo), and an ongoing long-term extension study of patients who did and did not respond to induction or maintenance therapy (patients received tofacitinib 5 or 10 mg twice daily). Lipid concentrations were assessed from induction baseline to week 61 (week 52 of maintenance therapy). We calculated MACE incidence rates (patients with ≥1 event per 100 patient-years of exposure) and Reynolds risk score (RRS; a composite score used to determine CV risk) for patients given tofacitinib vs placebo. Results The mean RRS was P Conclusions In an analysis of data from 5 trials of patients with UC who received tofacitinib, we found reversible increases in lipids with treatment and inverse correlations with reduced levels of high-sensitivity C-reactive protein. We did not find clinically meaningful changes in lipid ratios or RRS. MACEs were infrequent and not dose-related. Clinical trial registration Clinicaltrials.gov : A3921063 ( NCT00787202 ); OCTAVE Induction 1 ( NCT01465763 ); OCTAVE Induction 2 ( NCT01458951 ); OCTAVE Sustain ( NCT01458574 ); OCTAVE Open ( NCT01470612

Simple measures of climate, soil properties and plant traits predict national scale grassland soil carbon stocks

1. Soil carbon (C) storage is a key ecosystem service. Soil C stocks play a vital role in soil fertility and climate regulation, but the factors that control these stocks at regional and national scales are unknown, particularly when their composition and stability are considered. As a result, their mapping relies on either unreliable proxy measures or laborious direct measurements. 2. Using data from an extensive national survey of English grasslands we show that surface soil (0-7cm) C stocks in size fractions of varying stability can be predicted at both regional and national scales from plant traits and simple measures of soil and climatic conditions. 3. Soil C stocks in the largest pool, of intermediate particle size (50-250 µm), were best explained by mean annual temperature (MAT), soil pH and soil moisture content. The second largest C pool, highly stable physically and biochemically protected particles (0.45-50 µm), was explained by soil pH and the community abundance weighted mean (CWM) leaf nitrogen (N) content, with the highest soil C stocks under N rich vegetation. The C stock in the small active fraction (250-4000 µm) was explained by a wide range of variables: MAT, mean annual precipitation, mean growing season length, soil pH and CWM specific leaf area; stocks were higher under vegetation with thick and/or dense leaves. 4. Testing the models describing these fractions against data from an independent English region indicated moderately strong correlation between predicted and actual values and no systematic bias, with the exception of the active fraction, for which predictions were inaccurate. 5. Synthesis and Applications: Validation indicates that readily available climate, soils and plant survey data can be effective in making local- to landscape-scale (1-100,000 km2) soil C stock predictions. Such predictions are a crucial component of effective management strategies to protect C stocks and enhance soil C sequestration

Injectable and porous PLGA microspheres that form highly porous scaffolds at body temperature

Injectable scaffolds are of interest in the field of regenerative medicine because of their minimally invasive mode of delivery. For tissue repair applications, it is essential that such scaffolds have the mechanical properties, porosity and pore diameter to support the formation of new tissue. In the current study, porous poly(DL-lactic acid-co-glycolic acid) (PLGA) microspheres were fabricated with an average size of 84 ± 24 lm for use as injectable cell carriers. Treatment with ethanolic sodium hydroxide for 2 min was observed to increase surface porosity without causing the microsphere structure to disintegrate. This surface treatment also enabled the microspheres to fuse together at 37 C to form scaffold structures. The average compressive strength of the scaffolds after 24 h at 37 C was 0.9 ± 0.1 MPa, and the average Young’s modulus was 9.4 ± 1.2 MPa. Scaffold porosity levels were 81.6% on average, with a mean pore diameter of 54 ± 38 lm. This study demonstrates a method for fabricating porous PLGA microspheres that form solid porous scaffolds at body temperature, creating an injectable system capable of supporting NIH-3T3 cell attachment and proliferation in vitro