A glance at imaging bladder cancer.

Purpose: Early and accurate diagnosis of Bladder cancer (BCa) will contribute extensively to the management of the disease. The purpose of this review was to briefly describe the conventional imaging methods and other novel imaging modalities used for early detection of BCa and outline their pros and cons. Methods: Literature search was performed on Pubmed, PMC, and Google scholar for the period of January 2014 to February 2018 and using such words as bladder cancer, bladder tumor, bladder cancer detection, diagnosis and imaging . Results: A total of 81 published papers were retrieved and are included in the review. For patients with hematuria and suspected of BCa, cystoscopy and CT are most commonly recommended. Ultrasonography, MRI, PET/CT using 18F-FDG or 11C-choline and recently PET/MRI using 18F-FDG also play a prominent role in detection of BCa. Conclusion: For initial diagnosis of BCa, cystoscopy is generally performed. However, cystoscopy can not accurately detect carcinoma insitu (CIS) and can not distinguish benign masses from malignant lesions. CT is used in two modes, CT and computed tomographic urography (CTU), both for dignosis and staging of BCa. However, they cannot differentiate T1 and T2 BCa. MRI is performed to diagnose invasive BCa and can differentiate muscle invasive bladder carcinoma (MIBC) from non-muscle invasive bladder carcinoma (NMIBC). However, CT and MRI have low sensitivity for nodal staging. For nodal staging PET/CT is preferred. PET/MRI provides better differentiation of normal and pathologic structures as compared with PET/CT. Nonetheless none of the approaches can address all issues related for the management of BCa. Novel imaging methods that target specific biomarkers, image BCa early and accurately, and stage the disease are warranted

Raman scattering mediated by neighboring molecules

Raman scattering is most commonly associated with a change in vibrational state within individual molecules, the corresponding frequency shift in the scattered light affording a key way of identifying material structures. In theories where both matter and light are treated quantum mechanically, the fundamental scattering process is represented as the concurrent annihilation of a photon from one radiation mode and creation of another in a different mode. Developing this quantum electrodynamical formulation, the focus of the present work is on the spectroscopic consequences of electrodynamic coupling between neighboring molecules or other kinds of optical center. To encompass these nanoscale interactions, through which the molecular states evolve under the dual influence of the input light and local fields, this work identifies and determines two major mechanisms for each of which different selection rules apply. The constituent optical centers are considered to be chemically different and held in a fixed orientation with respect to each other, either as two components of a larger molecule or a molecular assembly that can undergo free rotation in a fluid medium or as parts of a larger, solid material. The two centers are considered to be separated beyond wavefunction overlap but close enough together to fall within an optical near-field limit, which leads to high inverse power dependences on their local separation. In this investigation, individual centers undergo a Stokes transition, whilst each neighbor of a different species remains in its original electronic and vibrational state. Analogous principles are applicable for the anti-Stokes case. The analysis concludes by considering the experimental consequences of applying this spectroscopic interpretation to fluid media; explicitly, the selection rules and the impact of pressure on the radiant intensity of this process

Optical vortex generation from molecular chromophore arrays

The generation of light endowed with orbital angular momentum, frequently termed optical vortex light, is commonly achieved by passing a conventional beam through suitably constructed optical elements. This Letter shows that the necessary phase structure for vortex propagation can be directly produced through the creation of twisted light from the vacuum. The mechanism is based on optical emission from a family of chromophore nanoarrays that satisfy specific geometric and symmetry constraints. Each such array can support pairs of electronically delocalized doubly degenerate excitons whose azimuthal phase progression is responsible for the helical wave front of the emitted radiation. The exciton symmetry dictates the maximum magnitude of topological charge; detailed analysis secures the conditions necessary to deliver optical vortices of arbitrary order

A case of severe adolescent obsessive-compulsive disorder treated with inpatient hospitalization, risperidone and sertraline

Background: The initial treatment of obsessive-compulsive disorder (OCD) has generally been limited to serotonergic agents, cognitive-behavioral therapy (CBT), or a combination of the two. These findings were supported by the POTS study for OCD in children and adolescents. However, treatment with serotonergic agents or CBT can take several weeks before benefit is seen; severe cases of OCD may require more immediate treatment. Case report: The authors present a case of severe OCD in an adolescent that required immediate treatment due to her critical medical condition. The patient's symptoms included not eating or taking medications or fluids by mouth due to fears of contamination. A medical hospitalization was previously required due to dehydration. As treatment with an SSRI would not have quick enough onset and the patient was initially resistant to participating in CBT, the patient was psychiatrically hospitalized and first started on liquid risperidone. After several doses of risperidone, the patient was able to participate in CBT and start sertraline. Discussion: The authors discuss the differential diagnosis of such a patient, including the continuum of OCD symptoms and psychotic symptoms. The authors discuss the different treatment options, including the utilization of inpatient psychiatric hospitalization. The authors discuss the potential risks and benefits of using atypical antipsychotics in lieu of benzodiazepines for the initial treatment of severe adolescent OCD. The authors also discuss other current treatment recommendations and rationale for the treatment that was pursued. Conclusions: This patient received benefit of her symptoms relatively quickly with psychiatric hospitalization and an atypical antipsychotic. The diagnosis of a psychotic disorder should be considered. These treatment options must be weighed against the risks of atypical antipsychotics, including extrapyramidal symptoms, weight gain, and metabolic syndrome; benzodiazepines also have their risks and benefits. Additionally, the cost of time and finances of inpatient hospitalization must be considered. More research is needed regarding the short- and long-term efficacy and safety of antipsychotics in the treatment of OCD in the child and adolescent population

Methodology for finding optimum cell size for a grid based cellular automata traffic flow model

A methodology for determining optimum cell size for a grid based traffic flow model for heterogeneous traffic is proposed in this paper. The cell size is an important factor to determine as it affects the computational efficiency and model accuracy. The objective function minimizes three aspects namely the difference of distance headway in case of cellular automata and grid based traffic flow model, the total number of cells to represent different types of vehicles and multiple of cell width that gives closer representation of the different road widths. The presented method is found better then the previous attempt which tries to find the cell size by trial and error

Geochronology and Depositional History of the Sandy Springs Aeolian Landscape in the Unglaciated Upper Ohio River Valley, United States

The study of active and stabilized late Quaternary aeolian landforms provides important proxies for past climate events and environmental transitions. Despite an overall increase in the study of aeolian landforms in previously glaciated and coastal settings in eastern North America, the history of aeolian sedimentation in many unglaciated inland alluvial settings remain poorly understood. This study reports on the geochronology and depositional history of aeolian landforms and sediments in the unglaciated upper Ohio Valley at the Sandy Springs site. Aeolian landforms and sediments include complex, linear, barchan-like, and climbing dunes; an interdune sand sheet; and sandy loess that blankets high valley surfaces. At Sandy Springs, aeolian dune sands and sandy loess are restricted to intermediate (S2) and higher (S3) geomorphic surfaces. Eight optically stimulated luminescence age estimates constrain the initiation of aeolian processes on the S2 surface to sometime after 17 ka and episodic deposition on the S2 and S3 surfaces between 11 and 1.4 ka. The distribution of aeolian sediments at Sandy Springs is influenced by several past factors including local wind fetch potential, sediment availability, and underlying alluvial topography. Sediment availability is interpreted as the primary factor controlling aeolian processes and appear linked to several pan-regional paleoclimate events. Sandy loess deposition at ca. 8.2 ka on the S3 surface may reflect hydrologic variability and cooling, associated with the final pulse of meltwater into the North Atlantic from the Laurentide Ice Sheet. Dune reactivation and erosion at ca. 4.5 ka on the S2 surface indicate enhanced sediment availability possibly associated with drought conditions. These results illustrate that the deciphering the coupled fluvial-aeolian records in this catchment of the Ohio River provides new insight into the nature of changing surface processes against the backdrop of climate variability over the past ca. 20 ka

Direct generation of optical vortices

A detailed scheme is established for the direct generation of optical vortices, signifying light endowed with orbital angular momentum. In contrast to common techniques based on the tailored conversion of the wave front in a conventional beam, this method provides for the direct spontaneous emission of photons with the requisite field structure. This form of optical emission results directly from the electronic relaxation of a delocalized exciton state that is supported by a ringlike array of three or more nanoscale chromophores. An analysis of the conditions leads to a general formulation revealing a requirement for the array structure to adhere to one of a restricted set of permissible symmetry groups. It is shown that the coupling between chromophores within each array leads to an energy level splitting of the exciton structure, thus providing for a specific linking of exciton phase and emission wavelength. For emission, arrays conforming to one of the given point-group families’ doubly degenerate excitons exhibit the specific phase characteristics necessary to support vortex emission. The highest order of exciton symmetry, corresponding to the maximum magnitude of electronic orbital angular momentum supported by the ring, provides for the most favored emission. The phase properties of the emission produced by the relaxation of such excitons are exhibited on plots which reveal the azimuthal phase progression around the ring, consistent with vortex emission. It is proven that emission of this kind produces electromagnetic fields that map with complete fidelity onto the phase structure of a Laguerre-Gaussian optical mode with the corresponding topological charge. The prospect of direct generation paves the way for practicable devices that need no longer rely on the modification of a conventional laser beam by a secondary optical element. Moreover, these principles hold promise for the development of a vortex laser, also based on nanoscale exciton decay, enabling the production of coherent radiation with a tailor-made helical wave front

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

Kikuchi-Fujimoto Disease Masquerading as Metastatic Papillary Carcinoma of the Thyroid

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenitis is a rare cervical inflammatory lymphadenitis that is most commonly seen in young Asian women. It is mainly characterized by lymphadenopathy, hepatosplenomegaly, fever, nocturnal sweats, myalgia, weight loss, and arthralgia, and commonly follows a self-limited course. The differential diagnosis is challenging as many other conditions such as malignant lymphoma, metastatic disease, tuberculosis and infectious lymphadenopathies can present in a similar way. We present an unusual case of Kikuchi-Fujimoto disease masquerading as metastatic papillary carcinoma of the thyroid. A 30-year-old young female presented, 2 months post-partum, with complaints of neck pain and fever. A computed tomography scan showed enlarged right-sided lymph nodes and a thyroid nodule. Subsequent biopsy of a thyroid nodule revealed papillary thyroid carcinoma and reactive inflammation in one of the lymph nodes. She underwent an elective total thyroidectomy, central node dissection and a right modified lymph node dissection for enlarged lymph nodes. Her recovery was uneventful and the pathology report was consistent with a papillary carcinoma of the thyroid with one lymph node positive for metastatic disease and several other lymph nodes showing histiocytic necrotizing lymphadenitis. This coexistence of Kikuchi-Fujimoto disease with localized metastatic papillary thyroid cancer is unusual and presents an interesting, challenging, and complex management dilemma

Mathematics of random growing interfaces

We establish a thermodynamic limit and Gaussian fluctuations for the height and surface width of the random interface formed by the deposition of particles on surfaces. The results hold for the standard ballistic deposition model as well as the surface relaxation model in the off-lattice setting. The results are proved with the aid of general limit theorems for stabilizing functionals of marked Poisson point processes.Comment: 12 page