Anaplastic Thyroid Carcinoma Histologically Mimicking a Plasmacytoma.

Anaplastic (undifferentiated) thyroid carcinoma (ATC) is a rare malignancy which may arise from transformation of a pre-existing differentiated carcinoma. We report the unique case where a lesion of thyroid origin presented with the histological features of mature plasma cells. Immunohistochemistry confirmed the lesion to be an anaplastic thyroid carcinoma arising from papillary thyroid carcinoma. A tumor mimicking a malignancy of a different cellular origin can lead clinicians to incorrect treatment approaches. Careful correlation with clinical details and knowledge of these unique presentations is important for reaching the correct diagnosis

Pengaruh Bahan Organik Pada Tailing Emas Terhadap Pertumbuhan Dan Translokasi Merkuri (Hg) Pada Sawi (Brassica Parachinensis L.) Dan Tomat (Lycopersicum Esculentum Mill.)

Pertambangan emas yang menggunakan metode arsenik dan merkuri dalam proses pemurnian akan selalu menimbulkan dampak lingkungan. Sisa tanah hasil penambangan (tailing) akan dibuang atau didepositkan, dan akan menimbulkan masalah lingkungan dan juga mencemari pangan. Tanaman yang ditumbuhkan pada lahan terkontaminasi dapat bersifat adaptif terhadap kontaminan tetapi tidak mentranslokasikan, ataupun bersifat adaptif dan mentranslokasikan dengan dan tanpa translokasi kontaminan. Penelitian ini bertujuan untuk menguji sifat adaptif/toleran Sawi dan Tomat jika ditanam pada tanah tercemar merkuri dan juga kemampuan translokasi merkuri. Total 6 perlakuan dengan 3 kali pengulangan ditentukan untuk setiap jenis tanaman supaya dapat menarik kesimpulan penelitian, seperti perlakuan tanah tailing saja, tanah tailing campur pupuk (100 mg N, 50 mg P, dan 50 mg K), tanah tailing dengan kotoran ayam, tanah tailing dengan campuran rumput laut, tanah tailing dengan dosis pupuk rendah (50 mg N, 25 mg P dan 25 mg K), dan tanah non tailing yang dicampur pupuk N,P,K dosis rendah. Untuk sawi dan tomat digunakan masing-masing 18 unit percobaan untuk tomat. Dosis rumput laut maupun kotoran ayam adalah 5g kering angin kg-1 tanah. Statistik mengunakan analisa Anova 1 arah dengan uji lanjut BNJ. Sawi yang tumbuh pada tanah tailing terkontaminasi 85.700 ηg g-1 mentranslokasikan Hg hingga 17.477 ηg g-1 dan hanya 6.281 ηg g-1 pada tomat. Efisiensi Sawi sangat tinggi untuk membersihkan kontaminan Hg, minimal 68 kali lebih efisien dari tomat. Pemberian N, P, K pada tanah tailing berkontribusi negatif pada pertumbuhan tanaman berbeda dengan pemberian bahan organik asal kotoran ayam yang memberikan kontribusi positif pada pertumbuhan sawi maupun tomat, juga menurunkan penyerapan Hg

The subsurface habitability of small, icy exomoons

Context. Assuming our Solar System as typical, exomoons may outnumber exoplanets. If their habitability fraction is similar, they would thus constitute the largest portion of habitable real estate in the Universe. Icy moons in our Solar System, such as Europa and Enceladus, have already been shown to possess liquid water, a prerequisite for life on Earth. Aims: We intend to investigate under what thermal and orbital circumstances small, icy moons may sustain subsurface oceans and thus be "subsurface habitable". We pay specific attention to tidal heating, which may keep a moon liquid far beyond the conservative habitable zone. Methods: We made use of a phenomenological approach to tidal heating. We computed the orbit averaged flux from both stellar and planetary (both thermal and reflected stellar) illumination. We then calculated subsurface temperatures depending on illumination and thermal conduction to the surface through the ice shell and an insulating layer of regolith. We adopted a conduction only model, ignoring volcanism and ice shell convection as an outlet for internal heat. In doing so, we determined at which depth, if any, ice melts and a subsurface ocean forms. Results: We find an analytical expression between the moon's physical and orbital characteristics and the melting depth. Since this expression directly relates icy moon observables to the melting depth, it allows us to swiftly put an upper limit on the melting depth for any given moon. We reproduce the existence of Enceladus' subsurface ocean; we also find that the two largest moons of Uranus (Titania and Oberon) could well sustain them. Our model predicts that Rhea does not have liquid water. Conclusions: Habitable exomoon environments may be found across an exoplanetary system, largely irrespective of the distance to the host star. Small, icy subsurface habitable moons may exist anywhere beyond the snow line. This may, in future observations, expand the search area for extraterrestrial habitable environments beyond the circumstellar habitable zone

Outcomes and prognostic factors in parotid gland malignancies: A 10-year single center experience.

Objectives:To describe a 10-year single center experience with parotid gland malignancies and to determine factors affecting outcomes. Study Design:Retrospective review. Methods:The institutional cancer registry was used to identify patients treated surgically for malignancies of the parotid gland between January 2005 and December 2014. Clinical and pathologic data were collected retrospectively from patient charts and analyzed for their association with overall survival (OS) and disease-free survival (DFS). Results:Two hundred patients were identified. Mean age at surgery was 57.8 years, and mean follow-up time was 52 months. One hundred two patients underwent total parotidectomy, while 77 underwent superficial parotidectomy, and 21 underwent deep lobe resection. Seventy patients (35%) required facial nerve (FN) sacrifice. Acinic cell carcinoma was the most common histologic type (22%), followed by mucoepidermoid carcinoma (21.5%) and adenoid cystic carcinoma (12.5%). Twenty-nine patients (14.5%) experienced recurrences, with mean time to recurrence of 23.6 months (range: 1-82 months). Five- and 10-year OS were 81% and 73%, respectively. Five- and 10-year DFS were 80% and 73%, respectively. In univariate analyses, age > 60, histologic type, positive margins, high grade, T-stage, node positivity, perineural invasion, and FN involvement were predictors of OS and DFS. In the multivariate analysis, histology, positive margins, node positivity, and FN involvement were independent predictors of OS and DFS. Conclusions:Our single-center experience of 200 patients suggests that histology, positive margins, node positivity, and FN involvement are independently associated with outcomes in parotid malignancies. Level of Evidence:4

Modelling Clock Synchronization in the Chess gMAC WSN Protocol

We present a detailled timed automata model of the clock synchronization algorithm that is currently being used in a wireless sensor network (WSN) that has been developed by the Dutch company Chess. Using the Uppaal model checker, we establish that in certain cases a static, fully synchronized network may eventually become unsynchronized if the current algorithm is used, even in a setting with infinitesimal clock drifts

First-Trimester Follistatin-Like-3 Levels in Pregnancies Complicated by Subsequent Gestational Diabetes Mellitus

Objective: To determine whether maternal levels of follistatin-like-3 (FSTL3), an inhibitor of activin and myostatin involved in glucose homeostasis, are altered in the first trimester of pregnancies complicated by subsequent gestational diabetes mellitus (GDM). Research Design and Methods: This was a nested case-control study of subjects enrolled in a prospective cohort of pregnant women with and without GDM ($\geq$2 abnormal values on a 100-g glucose tolerance test at ~28 weeks of gestation). We measured FSTL3 levels in serum collected during the first trimester of pregnancy. Logistic regression analyses were used to determine the risk of GDM. Results: Women who developed GDM (n = 37) had lower first-trimester serum levels of FSTL3 compared with women who did not (n = 127) (median 10,789 [interquartile range 7,013-18,939] vs. 30,670 [18,370-55,484] pg/ml, P < 0.001). When subjects were divided into tertiles based on FSTL3 levels, women with the lowest levels demonstrated a marked increase in risk for developing GDM in univariate (odds ratio 11.2 [95% CI 3.6-35.3]) and multivariate (14.0 [4.1-47.9]) analyses. There was a significant negative correlation between first-trimester FSTL3 levels and ~28-week nonfasting glucose levels (r = -0.30, P < 0.001). Conclusions: First-trimester FSTL3 levels are associated with glucose intolerance and GDM later in pregnancy

Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

<p>Abstract</p> <p>Background</p> <p>The Ministry of Health (MOH) in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH) strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear.</p> <p>Methods</p> <p>We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007), the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018.</p> <p>Results</p> <p>With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels.</p> <p>Conclusions</p> <p>Meeting the minimum need for health workers in Zambia this decade will require an increase in health training school enrolment. Supplemental interventions targeting attrition, graduation and public sector entry rates can help close the gap. HRH modelling can help MOH policy makers determine the relative priority and level of investment needed to expand Zambia's workforce to target staffing levels.</p

Dendritic cells loaded with killed breast cancer cells induce differentiation of tumor-specific cytotoxic T lymphocytes

BACKGROUND: Early clinical trials, mostly in the setting of melanoma, have shown that dendritic cells (DCs) expressing tumor antigens induce some immune responses and some clinical responses. A major difficulty is the extension to other tumors, such as breast carcinoma, for which few defined tumor-associated antigens are available. We have demonstrated, using both prostate carcinoma and melanoma as model systems, that DCs loaded with killed allogeneic tumor cell lines can induce CD8(+ )T cells to differentiate into cytotoxic T lymphocytes (CTLs) specific for shared tumor antigens. METHODS: The present study was designed to determine whether DCs would capture killed breast cancer cells and present their antigens to autologous CD4(+ )and CD8(+ )T cells. RESULTS: We show that killed breast cancer cells are captured by immature DCs that, after induced maturation, can efficiently present MHC class I and class II peptides to CD8(+ )and CD4(+ )T lymphocytes. The elicited CTLs are able to kill the target cells without a need for pretreatment with interferon gamma. CTLs can be obtained by culturing the DCs loaded with killed breast cancer cells with unseparated peripheral blood lymphocytes, indicating that the DCs can overcome any potential inhibitory effects of breast cancer cells. CONCLUSION: Loading DCs with killed breast cancer cells may be considered a novel approach to breast cancer immunotherapy and to identification of shared breast cancer antigens