Co-existent breast malignancy and contralateral primary axillary tuberculosis

Breast tuberculosis is an extremely rare entity representing less than 0.1% of all breast disease in developed countries1. Tuberculous infections within the United Kingdom have seen a steady decline with the highest rates present within North West London where infection rates reach 24.8 per 1000002. The presentation can mimic malignancy and lymphatic involvement of the breast both clinically and mammographically, with nodules within the upper outer quadrant, making accurate diagnosis challenging.3 Approximately 30% of breast TB cases present with axillary lymphadenopathy and a recent case series review of approximately 44 cases in London found that the most common presenting feature was a solitary breast lump in 87% of cases.4 We present a case of a patient presenting with primary malignancy and contralateral nodal disease highly suspicious for breast malignancy. Subsequent investigation led to the identification of synchronous localized cancer and tuberculous lymphadenitis. Synchronous presentation is uncommon and recognition and differentiation is vital as axillary lymph node metastasis is the most important factor in the staging of breast carcinoma and determining the subsequent oncological and surgical management.

Devising criteria for the authenticity of historical cold weapons based on X-ray fluorescence analysis of their surface

This paper reports the results of studying the chemical composition of the surface of 4 objects of cold weapons of the 19th and early 20th centuries, made of iron – bayonet knives and sabers. This makes it possible to establish the signs of authenticity of cold weapon samples made of iron in that chronological period. An authentic procedure has been proposed for examining the chemical composition of the surface of historical objects of cold weapons by rubbing the samples with cotton wool swabs and their subsequent investigation. This makes it possible to explore objects of cold weapons, whose size is large, as well as simplify the very procedure for studying objects of historical and cultural value. Using the X-ray fluorescent chemical analyzer Expert Mobile, chemical elements were found at the surface of samples of cold weapons made of iron. The presence of such elements is the result of the process of re-crystallization and self-purification of metal during a long history of its life. Elements found in almost every rubbing sample were identified: calcium, ferrum, zinc, cuprum, and chlorine. The studies of cold weapons samples testify to the heterogeneity of the composition of patina formations on their surface, which confirms the authenticity of ancient objects. In addition, the studies have shown a difference in the chemical composition of surface layers of different parts of individual samples of antique cold weapons, which may indicate different times or different technology for their manufacture. The fluorescence spectra of the obtained rubbing of individual samples of cold weapons were compared with "pure" material, which made it possible to identify elements removed from the surface of objects. The study results are important indicators to confirm the authenticity of cultural monuments and the technology of their manufacture in the past.

Investigating performance of transformer health index in machine learning application using dominant features

Transformer Health Index (HI) has become a standard tool for performing transformer health evaluations. Due to economic constraints, the recently published paper focuses on developing various techniques to identify the most dominant features for transformer HI prediction. However, the fundamental problems concerning their input features remain unresolved since most suggested features contradict industry practice. In this paper, the primary objective is to investigate the performance of the transformer HI by developing and utilizing only dominant features following the industry recommendation. The investigated dominant features in this paper using 1) CO2/CO ratio and 2) the Incipient fault for detecting temperature abnormalities, and 3) the Dissipation Factor (DF) for detecting oil contamination. The performance validation is carried out using various machine learning (ML) classifiers. Also, the performance of the ML model is validated based on 10-fold type cross-validation to avoid biases in the experiment. As a result, the proposed Artificial Neural Network (ANN) network utilizing the investigated dominant features following the industry practice has produced the highest average accuracy of 80.09% than others ML techniques as a classifier. Hence, additional studies to complement the investigated dominant features may be considered for the subsequent investigation.

Tracking the Source of Enantioselectivity

<p>Enantioselectivity remains one of synthetic chemistry’s most formidable problems. It arises due to the formation of diastereomeric species in a reaction, either in the form of diastereomeric intermediates or a set of diastereomeric transition states. Without control a racemic mixture is formed. A resolution method is then required to separate the enantiomers. Any given resolution method will rely on the differing energies of diastereomers to allow for their separation. Experimentally there are a myriad of different options that may be used to induce separation; for example chromatography and/or crystallisation. The actual process that occurs through- out this separation has not, however, been fully investigated in all cases. A better understanding of the process is able to provide an understanding of how resolution methods work i.e. when diastereomers occur and how great their energy differences are. This is vital in increasing the efficiency and effectiveness of any given resolution method. This theoretical study completed an investigation of the reaction pathway between the enantiomers of 2-formyl-3-hydroxyl[2.2]paracyclophane (FHPC) with (S)-valyl-(S)-valine. A subsequent investigation of an alternative resolution method, involving (R)-α-PEAM, was also conducted. This latter resolution method was proposed experimentally as a simpler method that could aid in improving the separation of the enantiomers. This investigation was carried out using Density Functional Theory (DFT) with the PBE0 functional and the triple-ζ TZVP basis set. The complete reaction profile was determined and diastereomeric intermediates and transition states for both resolution methods along two different pathways were determined; the ‘N-deprotonation Pathway’ and the ‘O-deprotonation Pathway’. The inadequacy of the first resolution method was found to be due to the presence of copper(II). Furthermore it was discovered that the re- action for both pathways would most likely proceed through the ‘O-deprotonation Pathway’ due to the barriers being lower in energy.</p>

Tracking the Source of Enantioselectivity

<p>Enantioselectivity remains one of synthetic chemistry’s most formidable problems. It arises due to the formation of diastereomeric species in a reaction, either in the form of diastereomeric intermediates or a set of diastereomeric transition states. Without control a racemic mixture is formed. A resolution method is then required to separate the enantiomers. Any given resolution method will rely on the differing energies of diastereomers to allow for their separation. Experimentally there are a myriad of different options that may be used to induce separation; for example chromatography and/or crystallisation. The actual process that occurs through- out this separation has not, however, been fully investigated in all cases. A better understanding of the process is able to provide an understanding of how resolution methods work i.e. when diastereomers occur and how great their energy differences are. This is vital in increasing the efficiency and effectiveness of any given resolution method. This theoretical study completed an investigation of the reaction pathway between the enantiomers of 2-formyl-3-hydroxyl[2.2]paracyclophane (FHPC) with (S)-valyl-(S)-valine. A subsequent investigation of an alternative resolution method, involving (R)-α-PEAM, was also conducted. This latter resolution method was proposed experimentally as a simpler method that could aid in improving the separation of the enantiomers. This investigation was carried out using Density Functional Theory (DFT) with the PBE0 functional and the triple-ζ TZVP basis set. The complete reaction profile was determined and diastereomeric intermediates and transition states for both resolution methods along two different pathways were determined; the ‘N-deprotonation Pathway’ and the ‘O-deprotonation Pathway’. The inadequacy of the first resolution method was found to be due to the presence of copper(II). Furthermore it was discovered that the re- action for both pathways would most likely proceed through the ‘O-deprotonation Pathway’ due to the barriers being lower in energy.</p>

Diguanylate cyclase and phosphodiesterase interact to maintain the specificity of c-di-GMP signaling in the regulation of antibiotic synthesis in Lysobacter enzymogenes

Cyclic dimeric GMP (c-di-GMP) is a universal second messenger in bacteria. The large number of c-di-GMP-related diguanylate cyclases (DGCs), phosphodiesterases (PDEs) and effectors are responsible for the complexity and dynamics of c-di-GMP signaling. Some of these components deploy various methods to avoid undesired crosstalk to maintain signaling specificity. Synthesis of the antibiotic HSAF ( H eat S table A ntifungal F actor) in Lysobacter enzymogenes is regulated by a specific c-di-GMP signaling pathway that includes a PDE LchP and a c-di-GMP effector Clp (also a transcriptional regulator). In the present study, from among 19 DGCs, we identified a diguanylate cyclase, LchD, which participates in this pathway. Subsequent investigation indicates that LchD and LchP physically interact and that the catalytic center of LchD is required for both the formation of the LchD-LchP complex and HSAF production. All the detected phenotypes support that LchD and LchP dispaly local c-di-GMP signaling to regulate HSAF biosynthesis. Although direct evidence is lacking, our investigation, which shows that the interaction between a DGC and a PDE maintains the specificity of c-di-GMP signaling, suggests the possibility of the existence of local c-di-GMP pools in bacteria. Importance Cyclic dimeric GMP (c-di-GMP) is a universal second messenger in bacteria. Signaling of c-di-GMP is complex and dynamic, and it is mediated by a large number of components, including c-di-GMP synthases (diguanylate cyclases. DGCs), c-di-GMP degrading enzymes (phosphodiesterases, PDEs), and c-di-GMP effectors. These components deploy various methods to avoid undesired crosstalk to maintain signaling specificity. In the present study, we identified a DGC that interacted with a PDE to specifically regulate antibiotic biosynthesis in L. enzymogenes . We provide direct evidence to show that the DGC and PDE form a complex, and also indirect evidence to argue that they may balance a local c-di-GMP pool to control the antibiotic production. The results represent an important finding regarding the mechanism of a pair of DGC and PDE to control the expression of specific c-di-GMP signaling pathways.

SP4.2.9 Investigation of patients with qFIT >400µg/g during the initial stages of the COVID-19 pandemic

Background During the initial stages of the COVID-19 pandemic non-emergency endoscopy was suspended as per BSG recommendations, resulting in altered pathways for investigation of suspected malignancies. In our unit, patients referred via suspected colorectal cancer (CRC) pathways with a quantitative faecal immunochemical test (qFIT) &gt;400 µg/g were offered CT imaging in the first instance. Methods We accessed our electronic records to retrospectively identify patients referred with a qFIT &gt;400 µg/g between March and May 2020. Patient demographics, previous medical history, and referral details were recorded. Primary outcome was incidence of new CRC diagnosis. Results 21 patients were included. Median follow-up was 218 days, and median time from referral to CT was 17 days. 3 (14.3%) patients had new cancer diagnoses;2 CRC and 1 lung. 42.8% of patients had normal investigations, or benign colorectal pathology. 95.2% patients went on to have an endoscopy; low risk polyps (28.6%), high risk polyps (4.8%) and IBD (9.6%) were identified. 57.1% of patients were discharged following endoscopy, with the remaining 42.9% needing further management which included referral to other specialties and repeat scopes. Discussion and conclusion CT scanning did not reduce the need for subsequent endoscopy, but aided in prioritising patients for subsequent investigation. There were no cases of CRC identified endoscopically which were not identified by CT imaging. In conclusion, CT is a viable alternative to endoscopy when restrictions are placed on endoscopy services.

Edge Computing and Its Convergence with Blockchain in 6G: Security Challenges

Even though the wireless network of 5G has not been investigated exhaustively, the sixth generation (6G) echo systems’ visionaries are already being debated. Therefore, to solidify and consolidate privacy and security within 6G networks, this paper examines edge computing and its convergence with blockchain in 6G: security challenges. Moreover, the paper examines how security might affect the wireless systems of the 6G, potential obstacles characterizing various 6G technologies, alongside possible remedies. This paper unveils the 6G security vision alongside key indicators of performance with tentative landscape threat premised upon predicted sixth generation infrastructure. Furthermore, a discussion of the privacy and security challenges that might emerge from the existing sixth generation applications and demands is presented. Additionally, the paper sheds light into the research-level projects and standardization efforts. Specific attention is accorded to discussion on the security consideration with 6G enhancing technologies, including quantum computing, visible light communication (VLC), distributed ML/AI, physical layer security, and distributed ledger technology (DLT). Overall, this paper seeks to guide the subsequent investigation of sixth generation privacy and security in the early stage of envisioning to practicality.

Reporting and Investigation of Unmanned Aircraft Systems (UAS) Accidents and Serious Incidents. Regulatory Perspective

Naturally, the ever-growing number of drone operations conducted worldwide carries with it an increase in the number of safety-related incidents and occurrences. The reporting and subsequent investigation of unmanned aircraft system (UAS) accidents and serious incidents seems like a proven solution towards improving operational safety. Such procedures also stem from the fact that UAS are of recognized as aircraft – and aircraft accidents and serious incidents are subject to obligatory investigation. From a technical perspective, a key issue concerns discrepancies in the investigation process as there are significant differences between manned and unmanned aviation operations. From a regulatory perspective, one key question is to what extent should it be obligatory to conduct independent technical investigation of occurrences involving UAS? Such occurrences are not only accidents and serious incidents that involve both UAS and manned aircraft, where “traditional” rules of conducting a full and independent technical investigation apply – the majority occurrences involve only UAS that were either destroyed, damaged or acted as a hazard to third parties. The method of study comprised of content analysis of existing legislation. Current doctrines were confronted with existing regulations, documents, materials, safety reports and statistics. Results of the study shows that the extension of regulations created for manned aviation accident reporting and investigation may not be enough, and certain improvements are necessary, e.g. to standardize the reporting of occurrences and the criteria to conduct a formal accidents and serious incidents investigation. It is also reasonable to take actions aimed at raising awareness among UAS users of the need to report accidents and serious incidents, as well as engage them in the investigative process. The lack of standardization in this field has resulted in the lack of data that is “good enough” to indicate the main causes and factors that contribute to UAS accidents.