Accessory left testicular artery in association with double renal vessels: a rare anomaly

A rare association of accessory testicular artery along with double renal arteries and accessory renal vein was observed unilaterally on the left side. In addition, the left inferior phrenic artery was arising from the left gastric branch of the coeliac trunk. This was observed in the dissection of an adult male cadaver during a routine undergraduate teaching programme. In this case, the accessory left testicular artery originated superior to the normal testicular artery from the descending abdominal aorta immediately below the origin of the normal left renal artery. In addition to this artery, a variant renal artery was noted with three segmental branches before entering the hilum. The accessory renal vein emerged from the lower pole after the receiving testicular vein joined the main renal vein. The left inferior phrenic artery arose from the left gastric branch of the coeliac trunk. An anatomical description of this uncommon variation is presented in this case report, highlighting its clinical implications. (Folia Morphol 2011; 70, 4: 309–311

A Comparative study on two doses of Clonidine added to Hyperbaric Bupivacaine in Spinal Anaesthesia

INTRODUCTION: Spinal anaesthesia is commonly used for abdominal, perineal, gynaecological and lower limb operations. It offers excellent anaesthesia and fewer side effects than General anaesthesia. It is easy to perform and provides faster onset and effective sensory and motor block. Bupivacaine produces long lasting spinal anaesthesia without Transient neurological symptoms. Recently there has been an interest in using additives to intra thecal local anasesthetics to decrease the dose of local anaesthetics and also provide effective post operative analgesia. Various studies have been conducted to evaluate the addition of clonidine to hyperbaric bupivacaine. The alpha 2 adrenergic agonist clonidine has a variety of actions including the ability to potentiate the effect of local anesthetics. It prolongs sensory blockade and also reduces requirement of post operative analgesics. This study was designed to evaluate the addition of two doses of clonidine( 40 μg and 60μg) added to hyperbaric bupivacaine (0.5%) 2.75ml in spinal anaesthesia for sub umbilical surgeries. AIM OF THE STUDY: To compare the effect of addition of two doses of clonidine (40μg and 60μg) to 0.5% hyperbaric bupivacaine 2.75 ml, intrathecally for sub umbilical surgeries. To evaluate : • Time to onset of sensory and motor block, • Duration of sensory and motor block, • Duration of effective post operative analgesia, • Side effects, MATERIALS AND METHODS: This study was conducted at the Chengalpattu Medical College Hospital, Chengalpattu - between May 2009 to August 2009 on 60 patients of ASA physical status I and II undergoing infra umbilical surgeries. This study was done after Ethical Committee approval and written informed consent obtained from all patients included in the study. Study Design: This study was done in a prospective double blinded randomized manner. Selection of Cases: Inclusion Criteria: 1. Patients in age group of 20 to 50 yrs, 2. ASA –PS I & II, 3. Infra umbilical surgeries. Exclusion criteria: 1. ASA –PS III & IV, 2. Patient refusal, 3. Renal / hepatic dysfunction, 4. Allergy to drugs, 5. Contra indication to sub arachnoid block. 60 patients were included in this double blinded randomized controlled study. patients were divided into 3 groups. Patients in group B received 2.75ml of 0.5% hyperbaric bupivacaine plus 0.4ml saline. Patients in group C1 received 2.75ml of hyperbaric bupivacaine with 40 μg of clonidine . Patients in group C2 received 2.75ml of hyperbaric bupivacaine with 60μg of clonidine. Statistical Analysis: All recorded data were entered using MS Excel software and analysed using STATA software for determining the statistical significance. Analysis of Variance was used to study the significance of mean of various study parameters between the three groups. Student’s ‘t’ test was used to compare the two groups on mean values of various parameters. The p-value taken for significance is 0.05. CONCLUSION: In conclusion the addition of clonidine as an adjuvant to bupivacaine in subarachnoid block prolongs duration of both sensory and motor block. I conclude that 60μg of clonidine hydrochloride added to local anaesthetic in subarachnoid block has proved to be a better adjuvant in prolonging the sensory and motor blockade intra operatively and duration of effective post operative analgesia compared to 40μg, without significant adverse effects

A fully integrated violence detection system using CNN and LSTM

Recently, the number of violence-related cases in places such as remote roads, pathways, shopping malls, elevators, sports stadiums, and liquor shops, has increased drastically which are unfortunately discovered only after it’s too late. The aim is to create a complete system that can perform real-time video analysis which will help recognize the presence of any violent activities and notify the same to the concerned authority, such as the police department of the corresponding area. Using the deep learning networks CNN and LSTM along with a well-defined system architecture, we have achieved an efficient solution that can be used for real-time analysis of video footage so that the concerned authority can monitor the situation through a mobile application that can notify about an occurrence of a violent event immediately

BOOTH RECODED WALLACE TREE MULTIPLIER USING NAND BASED DIGITALLY CONTROLLED DELAY LINES

ABSTRACT Digital controlled delay line (DCDL) is a digital circuit used to provide the desired delay for a circuit whose delay line is controlled by a digital control word. There are wide varieties of approaches available for constructing the DCDL. The previous approach deals about designing a DCDL with and without glitches. More over Glitches are the most considerable factor that limits the use of DCDL in many applications. The Glitches in a circuit can be analyzed by increasing delay control code in a circuit. By reducing the number of glitches a delay line also further reduced. . In this paper NAND based DCDL improved using Wallace tree multiplier, which used to give an accurate value, as well increase speed of operation. It aims at additional reduction of latency and area of the Wallace tree multiplier using the delay control units based on the DCDL unit. The simulation have been carried out using modelsim and xilinx tools

EVALITA Evaluation of NLP and Speech Tools for Italian - December 17th, 2020

Welcome to EVALITA 2020! EVALITA is the evaluation campaign of Natural Language Processing and Speech Tools for Italian. EVALITA is an initiative of the Italian Association for Computational Linguistics (AILC, http://www.ai-lc.it) and it is endorsed by the Italian Association for Artificial Intelligence (AIxIA, http://www.aixia.it) and the Italian Association for Speech Sciences (AISV, http://www.aisv.it)

The evolution of lung cancer and impact of subclonal selection in TRACERx

Lung cancer is the leading cause of cancer-associated mortality worldwide. Here we analysed 1,644 tumour regions sampled at surgery or during follow-up from the first 421 patients with non-small cell lung cancer prospectively enrolled into the TRACERx study. This project aims to decipher lung cancer evolution and address the primary study endpoint: determining the relationship between intratumour heterogeneity and clinical outcome. In lung adenocarcinoma, mutations in 22 out of 40 common cancer genes were under significant subclonal selection, including classical tumour initiators such as TP53 and KRAS. We defined evolutionary dependencies between drivers, mutational processes and whole genome doubling (WGD) events. Despite patients having a history of smoking, 8% of lung adenocarcinomas lacked evidence of tobacco-induced mutagenesis. These tumours also had similar detection rates for EGFR mutations and for RET, ROS1, ALK and MET oncogenic isoforms compared with tumours in never-smokers, which suggests that they have a similar aetiology and pathogenesis. Large subclonal expansions were associated with positive subclonal selection. Patients with tumours harbouring recent subclonal expansions, on the terminus of a phylogenetic branch, had significantly shorter disease-free survival. Subclonal WGD was detected in 19% of tumours, and 10% of tumours harboured multiple subclonal WGDs in parallel. Subclonal, but not truncal, WGD was associated with shorter disease-free survival. Copy number heterogeneity was associated with extrathoracic relapse within 1 year after surgery. These data demonstrate the importance of clonal expansion, WGD and copy number instability in determining the timing and patterns of relapse in non-small cell lung cancer and provide a comprehensive clinical cancer evolutionary data resource

The evolution of non-small cell lung cancer metastases in TRACERx

Metastatic disease is responsible for the majority of cancer-related deaths. We report the longitudinal evolutionary analysis of 126 non-small cell lung cancer (NSCLC) tumours from 421 prospectively recruited patients in TRACERx who developed metastatic disease, compared with a control cohort of 144 non-metastatic tumours. In 25% of cases, metastases diverged early, before the last clonal sweep in the primary tumour, and early divergence was enriched for patients who were smokers at the time of initial diagnosis. Simulations suggested that early metastatic divergence more frequently occurred at smaller tumour diameters (less than 8 mm). Single-region primary tumour sampling resulted in 83% of late divergence cases being misclassified as early, highlighting the importance of extensive primary tumour sampling. Polyclonal dissemination, which was associated with extrathoracic disease recurrence, was found in 32% of cases. Primary lymph node disease contributed to metastatic relapse in less than 20% of cases, representing a hallmark of metastatic potential rather than a route to subsequent recurrences/disease progression. Metastasis-seeding subclones exhibited subclonal expansions within primary tumours, probably reflecting positive selection. Our findings highlight the importance of selection in metastatic clone evolution within untreated primary tumours, the distinction between monoclonal versus polyclonal seeding in dictating site of recurrence, the limitations of current radiological screening approaches for early diverging tumours and the need to develop strategies to target metastasis-seeding subclones before relapse

Genomic–transcriptomic evolution in lung cancer and metastasis

Intratumour heterogeneity (ITH) fuels lung cancer evolution, which leads to immune evasion and resistance to therapy. Here, using paired whole-exome and RNA sequencing data, we investigate intratumour transcriptomic diversity in 354 non-small cell lung cancer tumours from 347 out of the first 421 patients prospectively recruited into the TRACERx study. Analyses of 947 tumour regions, representing both primary and metastatic disease, alongside 96 tumour-adjacent normal tissue samples implicate the transcriptome as a major source of phenotypic variation. Gene expression levels and ITH relate to patterns of positive and negative selection during tumour evolution. We observe frequent copy number-independent allele-specific expression that is linked to epigenomic dysfunction. Allele-specific expression can also result in genomic–transcriptomic parallel evolution, which converges on cancer gene disruption. We extract signatures of RNA single-base substitutions and link their aetiology to the activity of the RNA-editing enzymes ADAR and APOBEC3A, thereby revealing otherwise undetected ongoing APOBEC activity in tumours. Characterizing the transcriptomes of primary–metastatic tumour pairs, we combine multiple machine-learning approaches that leverage genomic and transcriptomic variables to link metastasis-seeding potential to the evolutionary context of mutations and increased proliferation within primary tumour regions. These results highlight the interplay between the genome and transcriptome in influencing ITH, lung cancer evolution and metastasis

Antibodies against endogenous retroviruses promote lung cancer immunotherapy

B cells are frequently found in the margins of solid tumours as organized follicles in ectopic lymphoid organs called tertiary lymphoid structures (TLS). Although TLS have been found to correlate with improved patient survival and response to immune checkpoint blockade (ICB), the underlying mechanisms of this association remain elusive. Here we investigate lung-resident B cell responses in patients from the TRACERx 421 (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy) and other lung cancer cohorts, and in a recently established immunogenic mouse model for lung adenocarcinoma. We find that both human and mouse lung adenocarcinomas elicit local germinal centre responses and tumour-binding antibodies, and further identify endogenous retrovirus (ERV) envelope glycoproteins as a dominant anti-tumour antibody target. ERV-targeting B cell responses are amplified by ICB in both humans and mice, and by targeted inhibition of KRAS(G12C) in the mouse model. ERV-reactive antibodies exert anti-tumour activity that extends survival in the mouse model, and ERV expression predicts the outcome of ICB in human lung adenocarcinoma. Finally, we find that effective immunotherapy in the mouse model requires CXCL13-dependent TLS formation. Conversely, therapeutic CXCL13 treatment potentiates anti-tumour immunity and synergizes with ICB. Our findings provide a possible mechanistic basis for the association of TLS with immunotherapy response