Goblet cell carcinoid of the appendix

BACKGROUND: Goblet cell carcinoid (GCC) of the appendix is a rare neoplasm that share histological features of both adenocarcinoma and carcinoid tumor. While its malignant potential remains unclear, GCC's are more aggressive than conventional carcinoid. The clinical presentations of this neoplasm are also varied. This review summarizes the published literature on GCC of the appendix. The focus is on its diagnosis, histopathological aspects, clinical manifestations, and management. METHODS: Published studies in the English language between 1966 to 2004 were identified through Medline keyword search utilizing terms "goblet cell carcinoid," "adenocarcinoid", "mucinous carcinoid" and "crypt cell carcinoma" of the appendix. RESULTS: Based on the review of 57 published papers encompassing nearly 600 diagnosed patients, the mean age of presentation for GCC of the appendix was 58.89 years with equal representation in both males and females. Accurate diagnosis of this neoplasm requires astute observations within an acutely inflamed appendix as this neoplasm has a prominent pattern of submucosal growth and usually lacks the formation of a well-defined tumor mass. The mesoappendix was involved in 21.64% followed by perineural involvement in 2.06%. The most common clinical presentations in order of frequency were acute appendicitis in 22.5%; asymptomatic in 5.4%; non-localized abdominal pain in 5.15% and an appendicular mass in 3.09%. The most common surgical treatment of choice was appendectomy with right hemicolectomy in 34.70% followed by simple appendectomy in 24.57%. Concomitant distant metastasis at diagnosis was present in 11.16% of patients with the ovaries being the most common site in 3.60% followed by disseminated abdominal carcinomatosis in 1.03%. Local lymph node involvement was seen in 8.76% of patients at the time of diagnosis. The reported 5-year survival ranges from 60 % to 84%. GCC's of the appendix remains a neoplasm of unpredictable biological behavior and thus warrants lifelong surveillance for recurrence of the disease upon diagnosis and successful surgical extirpation. CONCLUSION: GCC of the appendix is a rare neoplasm. Due to its wide range of presentation, this tumor should be considered as a possible diagnosis in many varied situations leading to abdominal surgery. Histopathological features such as increased number of Paneth cells, increased amount of mucin secretion and presence of pancreatic polypeptide may predict a more aggressive behavior. The advocated plan of management recommended for patients with tumors that involve the adjacent caecum or with high-grade tumors with histological features such as an increased mitotic rate involve initial appendectomy with completion right hemicolectomy due to the high possibility of local recurrence with intraperitoneal seeding prior to lymph node involvement and a 20% risk of metastatic behavior. In female patients with GCC of the appendix regardless of age, bilateral salpingo-oophorectomy is advocated. In cases with obvious spread of the disease chemotherapy, mostly with 5-FU and leucovorin is advised. Cytoreductive surgery with adjuvant intraperitoneal chemotherapy can offer improved survival in cases with advanced peritoneal dissemination

Multiplexing Free-Space Channels using Twisted Light

We experimentally demonstrate an interferometric protocol for multiplexing optical states of light, with potential to become a standard element in free-space communication schemes that utilize light endowed with orbital angular momentum (OAM). We demonstrate multiplexing for odd and even OAM superpositions generated using different sources. In addition, our technique permits one to prepare either coherent superpositions or statistical mixtures of OAM states. We employ state tomography to study the performance of this protocol, and we demonstrate fidelities greater than 0.98.Comment: 4 pages, 3 figure

Performance of short and long range wireless communication technologies in construction

The ever increasing complexity of construction projects asks for improved communication and automated data collection supported by continually improving electronic tools. Advances in information technologies enable us to link critical resources on construction sites, such as trucks and cranes, to the project website creating many opportunities to drastically improve productivity, safety and quality. While the use of electronic equipment is nothing new in construction, no model exists to integrate them into one unified framework. This paper presents a wireless site-network concept consisting of information hubs enabled to automatically connect data sinks with sources supported by software agents. Included in this paper is the discussion of a mobile information hub, the eCKiosk, enabled to connect the work crew electronically to the project network while collecting automatically live “as-built” data. It begins with a review of long range wireless as the basis for designing a robust Agile Site Communication Network (ASCNet). Site experiments with short range wireless conduits and embedded RFID tags showed that they are able to provide information far beyond an identification number. While wireless technologies are poised to open totally new avenues to manage construction, more field-tests are needed to establish a solid knowledge base to create a pervasive network for the dynamically changing building site

Immunologic finding of disseminated granuloma reaction in patients with Mycobacterium tuberculosis and sarcoidosis

AbstractIntroductionNecrotizing sarcoid granulomatosis (NSG) is a rare syndrome with unknown etiology. The disease is frequently confused with sarcoidosis and other granulomatous diseases. Diagnosis is made based on typical histologic criteria. No specific laboratory finding can confirm NSG diagnosis. The gender ratio of women to men has been reported as being as high as 4:1 and has a good prognosis.Methods and resultsIn this report, the clinical and genetic features were surveyed of a 36-year-old male with extra-pulmonary NSG with unique manifestations, such as inguinal mass with positive smear and negative culture for the infection of Mycobacterium tuberculosis (MTB), which was not responsive to the first-line TB treatment and was characterized as a multidrug-resistant (MDR) tuberculosis (TB). Later on, he was admitted for the MDR cure, and he did not react to the gold standard of MDR treatment. Finally, he presented with a huge lymphoid granuloma with massive ascites that was diagnosed as an NSG by IHC. He cured well with prednisolone and all symptoms of the disease were gone. At the hospitalization time, all laboratory experiments were well planned, such as a workup for the detection of defects of loop IL-12/IFN-γ, HLA-DR typing, and immunologic workup by flow-cytometry analysis.ConclusionThis is the first case report from patients with unique features of NSG combined with MTB

Biomarkers of Tuberculosis Severity and Treatment Effect: A Directed Screen of 70 Host Markers in a Randomized Clinical Trial.

More efficacious treatment regimens are needed for tuberculosis, however, drug development is impeded by a lack of reliable biomarkers of disease severity and of treatment effect. We conducted a directed screen of host biomarkers in participants enrolled in a tuberculosis clinical trial to address this need. Serum samples from 319 protocol-correct, culture-confirmed pulmonary tuberculosis patients treated under direct observation as part of an international, phase 2 trial were screened for 70 markers of infection, inflammation, and metabolism. Biomarker assays were specifically developed for this study and quantified using a novel, multiplexed electrochemiluminescence assay. We evaluated the association of biomarkers with baseline characteristics, as well as with detailed microbiologic data, using Bonferroni-adjusted, linear regression models. Across numerous analyses, seven proteins, SAA1, PCT, IL-1β, IL-6, CRP, PTX-3 and MMP-8, showed recurring strong associations with markers of baseline disease severity, smear grade and cavitation; were strongly modulated by tuberculosis treatment; and had responses that were greater for patients who culture-converted at 8weeks. With treatment, all proteins decreased, except for osteocalcin, MCP-1 and MCP-4, which significantly increased. Several previously reported putative tuberculosis-associated biomarkers (HOMX1, neopterin, and cathelicidin) were not significantly associated with treatment response. In conclusion, across a geographically diverse and large population of tuberculosis patients enrolled in a clinical trial, several previously reported putative biomarkers were not significantly associated with treatment response, however, seven proteins had recurring strong associations with baseline radiographic and microbiologic measures of disease severity, as well as with early treatment response, deserving additional study

Field-directed assembly of responsive colloids

Field-directed self-assembly (DSA) has recently moved into the focus of the soft-matter and nanotechnology community. It employs the basic principles of self-assembly through carefully chosen building blocks, but the underlying self-assembly process is then aided or modulated using external fields. Here we demonstrate how we can apply a combination of responsive nanoparticles and external electromagnetic fields in order to modulate the intrinsic interparticle interactions and tune the subtle balance between thermal motion and the action of interparticle forces, and thus generate novel self-assembled structures. We will show in particular how we can use field-driven self-assembly to induce phase transitions, cycle through various equilibrium and non-equilibrium phases, and study the micro-structural changes and the underlying kinetic mechanisms of these phase transitions in-situ and in real time. Moreover, we will demonstrate the effect of particle anisotropy in field-driven assembly. References [1] J. J. Crassous, A. M. Mihut, E. Wernersson, P. Pfleiderer, J. Vermant, P. Linse, and P. Schurtenberger, Nature Communications 5 (2014) 5516. [2] P. S. Mohanty, P. Bagheri, S. Nöjd, A. Yethiraj and P. Schurtenberger, Phys. Rev. X 5 (2015) 011030

Sport and exercise psychology research from the Asian and South Pacific region: A bibliometric analysis

Given that the Asian-South Pacific Association of Sport Psychology has recently passed 30 years since its creation, it would be interesting to examine the pattern of scientific publications of researchers from the Asian and South Pacific region over that period. This bibliometric analysis summarizes and analyses sport and exercise psychology publications from the region from the establishment of the Association in 1989 to the present. We conducted a systematic search of publications authored by researchers from the Asian and South Pacific region in nine sport and exercise psychology journals indexed in the Web of Science from 1989 to 2020. We analysed overall trends, the most prominent authors in terms of number of publications and citations, keywords as a reflection of noteworthy topics, and maps representing co-authorship, country, and institution clusters. Of the total of 1,003 publications, more than half were published after 2012. The most prolific authors with at least 30 publications each were James A. Dimmock, Ben Jackson, and Daniel F. Gucciardi who are all affiliated to Australian universities. Authors of the top 10 most cited publications are affiliated to Australian, New Zealand, and Singapore universities. The universities with the most publications were from Australia (University of Western Australia, University of Queensland, Curtin University, Victoria University, University of Wollongong, and Australian Catholic University), Hong Kong (University of Hong Kong), New Zealand (University of Otago), Singapore (Nanyang Technological University), and Taiwan (National Taiwan Sport University). There is co-authorship between countries in the Asian and South Pacific region as well as outside the region. Most of the collaborations outside the region were with the USA and England

Development of a collaborative model of low back pain: report from the 2017 NASS consensus meeting

Low back pain (LBP) is a multifactorial problem with complex interactions among many biological, psychological and social factors. It is difficult to fully appreciate this complexity because the knowledge necessary to do so is distributed over many areas of expertise that span the biopsychosocial domains.This study describes the collaborative modeling process, undertaken among a group of participants with diverse expertise in LBP, to build a model to enhance understanding and communicate the complexity of the LBP problem.The study involved generating individual models that represented participants' understanding of the LBP problem using fuzzy cognitive mapping (FCM), and 4 subsequent phases of consultation and consensus with the participants to characterize and refine the interpretation of the FCMs.The phases consisted of: proposal of Categories for clustering of model Components; preliminary evaluation of structure, composition and focal areas of participant's FCMs; refinement of Categories and Components with consensus meeting; generation of final structure and composition of individual participant's FCMs. Descriptive statistics were applied to the structural and composition metrics of individual FCMs to aid interpretation.From 38 invited contributors, 29 (76%) agreed to participate. They represented 9 disciplines and 8 countries. Participants' models included 729 Components, with an average of 25 (SD = 7) per model. After the final FCM refinement process (Components from separate FCMs that used similar terms were combined, and Components from an FCM that included multiple terms were separated), there were 147 Components allocated to ten Categories. Although individual models varied in their structure and composition, a common opinion emerged that psychological factors are particularly important in the presentation of LBP. Collectively, Components allocated to the "Psychology" Category were the most central in almost half (14/29) of the individual models.The collaborative modeling process outlined in this paper provides a foundation upon which to build a greater understanding and to communicate the complexity of the LBP problem. The next step is to aggregate individual FCMs into a metamodel and begin disentangling the interactions among its Components. This will lead to an improved understanding of the complexity of LBP, and hopefully to improved outcomes for those suffering from this condition