Long-term survival of a patient with diffuse midline glioma in the pineal region: A case report and literature review

Background: Diffuse midline glioma (DMG) is an invasive astrocytic tumor arisen from midline structures, such as the pons and thalamus. Five cases of DMG in the pineal region have been reported, but the clinical course was poor; there was no case of survival for more than 2 years. Case Description: We report the case of a 12-year-old boy with DMG in the pineal region who is living a normal daily life for more than 6 years following multimodal treatment. He complained of a headache accompanied by vomiting that had gradually worsened 1 month previously, and initial magnetic resonance imaging revealed a pineal tumor. Germinoma was initially suspected; however, a combination of chemotherapy using carboplatin and etoposide was ineffective. The first surgery was performed through the left occipital transtentorial approach (OTA); the diagnosis was DMG. After 60 Gy radiotherapy concomitant with temozolomide (TMZ), the tumor enlarged. Second surgery was performed through bilateral OTAs, and 90% of the tumor was removed. In addition, stereotactic radiotherapy (30 Gy, six fractions) was administered, and the local equivalent dose in 2 Gy/fraction reached 97.5 Gy. Maintenance chemotherapy using TMZ and bevacizumab was continued for 2 years. After finishing chemotherapy, the enhancing lesion enlarged again, and bevacizumab monotherapy was effective. Now, at 6 years after diagnosis, the patient leads an ordinary life as a student. Conclusion: Maximum resection and high-dose radiotherapy followed by bevacizumab may have been effective in the present case.

Nucleon-nucleus velocity-dependent optical model: Revisited

In this work we study nucleon-nucleus elastic scattering using a nonlocal, velocity-dependent optical potential. The potential parameters are determined by fitting elastic angular distributions and polarization data for nucleon scattering off a wide range of nuclei falling in the mass range $12 \leq A \leq 208$ and over the energy range 10 - 60 MeV. Our potential parameters lead to smoothly varying local equivalent potentials and, unlike previous works, the potential depths corresponding to the real volume, imaginary surface, and imaginary volume terms show systematic linear dependences on energy. In addition, for each nuclear target, we determined constant sets of geometric parameters. Including the polarization data in the fitting procedure helped in reducing the large variations in the depths of the spin-orbit term. Our best-fit angular distributions and polarization data are in very good agreement with measured data, and are either as good as the cross sections obtained with widely-used systematics or better.

Upper plate deformation during blueschist exhumation, ancestral western California forearc basin, from stratigraphic and structural relationships at Mount Diablo and in the Rio Vista Basin

ABSTRACT Late Cenozoic growth of the Mount Diablo anticline in the eastern San Francisco Bay area, California, USA, has produced unique 3D exposures of stratigraphic relationships and normal faults that record Late Cretaceous uplift and early Tertiary extension in the ancestral California forearc basin. Several early Tertiary normal faults on the northeast flank of Mount Diablo have been correlated with structures that accommodated Paleogene subsidence of the now-buried Rio Vista basin north of Mount Diablo. Stepwise restoration of deformation at Mount Diablo reveals that the normal faults probably root into the “Mount Diablo fault,” a structure that juxtaposes blueschist-facies rocks of the Franciscan accretionary complex with attenuated remnants of the ophiolitic forearc basement and relatively unmetamorphosed marine forearc sediments. This structure is the local equivalent of the Coast Range fault, which is the regional contact between high-pressure Franciscan rocks and structurally overlying forearc basement in the northern Coast Ranges and Diablo Range, and it is folded about the axis of the Mount Diablo anticline. Apatite fission-track analyses indicate that the Franciscan rocks at Mount Diablo were exhumed and cooled from depths of 20+ km in the subduction zone between ca. 70−50 Ma. Angular unconformities and growth relations in the Cretaceous and Paleogene stratigraphic sections on the northeast side of Mount Diablo, and in the Rio Vista basin to the north, indicate that wholesale uplift, eastward tilting, and extension of the western forearc basin were coeval with blueschist exhumation. Previous workers have interpreted the structural relief associated with this uplift and tilting, as well as the appearance of Franciscan blueschist detritus in Late Cretaceous and early Tertiary forearc strata, as evidence for an “ancestral Mount Diablo high,” an emergent Franciscan highland bordering the forearc basin to the west. This outer-arc high is here interpreted to be the uplifted footwall of Coast Range fault. The stratigraphic and structural relations exposed at Mount Diablo support models for exposure of Franciscan blueschists primarily through syn-subduction extension and attenuation of the overlying forearc crust in the hanging wall of the Coast Range fault, accompanied by (local?) uplift and erosion of the exhumed accretionary prism in the footwall.

Moving from “Do Not Resuscitate” Orders to Standardized Resuscitation Plans and Shared-Decision Making in Hospital Inpatients

Not for Cardiopulmonary Resuscitation (No-CPR) orders, or the local equivalent, help prevent futile or unwanted cardiopulmonary resuscitation. The importance of unambiguous and readily available documentation at the time of arrest seems self-evident, as does the need to establish a patient’s treatment preferences prior to any clinical deterioration. Despite this, the frequency and quality of No-CPR orders remains highly variable, while discussions with the patient about their treatment preferences are undervalued, occur late in the disease process, or are overlooked entirely. This review explores the evolution of hospital patient No-CPR/Do Not Resuscitate decisions over the past 60 years. A process based on standardized resuscitation plans has been shown to increase the frequency and clarity of documentation, reduce stigma attached to the documentation of a No-CPR order, and support the delivery of medically appropriate and desired care for the hospital patient.

Biosensor Using a One-Port Interdigital Capacitor: A Resonance-Based Investigation of the Permittivity Sensitivity for Microfluidic Broadband Bioelectronics Applications

Electronics is a field of study ubiquitous in our daily lives, since this discipline is undoubtedly the driving force behind developments in many other disciplines, such as telecommunications, automation, and computer science. Nowadays, electronics is becoming more and more widely applied in life science, thus leading to an increasing interest in bioelectronics that is a major segment of bioengineering. A bioelectronics application that has gained much attention in recent years is the use of sensors for biological samples, with emphasis given to biosensors performing broadband sensing of small-volume liquid samples. Within this context, this work aims at investigating a microfluidic sensor based on a broadband one-port coplanar interdigital capacitor (IDC). The microwave performance of the sensor loaded with lossless materials under test (MUTs) is achieved by using finite-element method (FEM) simulations carried out with Ansoft’s high frequency structure simulator (HFSS). The microfluidic channel for the MUT has a volume capacity of 0.054 μL. The FEM simulations show a resonance in the admittance that is reproduced with a five-lumped-element equivalent-circuit model. By changing the real part of the relative permittivity of the MUT up to 70, the corresponding variations in both the resonant frequency of the FEM simulations and the capacitance of the equivalent-circuit model are analyzed, thereby enabling assessment of the permittivity sensitivity of the studied IDC. Furthermore, it is shown that, although the proposed local equivalent-circuit model is able to mimic faithfully the FEM simulations locally around the resonance in the admittance, a higher number of circuit elements can achieve a better agreement between FEM and equivalent-circuit simulation over the entire broad frequency going range from 0.3 MHz to 35 GHz.

A short note on Helmholtz decompositions for bounded domains in $\mathbb{R}^3$

In this short note we consider several widely used $\mathsf {L}^{2}$-orthogonal Helmholtz decompositions for bounded domains in $\mathbb {R}^3$. It is well known that one part of the decompositions is a subspace of the space of functions with zero mean. We refine this global property into a local equivalent: we show that functions from these spaces have zero mean in every subdomain of specific decompositions of the domain. An application of the zero mean properties is presented for convex domains. We introduce a specialized Poincaré-type inequality, and estimate the related unknown constant from above. The upper bound is derived using the upper bound for the Poincaré constant proven by Payne and Weinberger. This is then used to obtain a small improvement of upper bounds of two Maxwell-type constants originally proven by Pauly. Although the two dimensional case is not considered, all derived results can be repeated in $\mathbb {R}^2$ by similar calculations.

Perceptions of HIV-related trauma in people living with HIV in Zimbabwe’s Friendship Bench Program: A qualitative analysis of counselors’ and clients’ experiences

This study investigated the experience of lay health workers (LHWs) delivering problem-solving therapy (PST) for common mental disorders (CMD) as well as clients’ views of the PST program referred to as the Friendship Bench (FB). Semi-structured interviews were conducted with LHWs (n = 5) and clients living with HIV (PLWH) (n = 10). Data were analyzed using thematic content analysis. LHWs described a severe form of CMD amongst PLWH with a history of trauma, naming it kufungisisa kwe njodzi (excessive thinking due to trauma), a local cultural equivalent of PTSD. The term kufungisisa (thinking too much) has been used as the local equivalent for CMD. Trauma or njodzi was seen both as a circumscribed event and as linked to ongoing pervasive experiences such as living with HIV, stigma, and poverty. Although LHWs recognized symptoms of PTSD such as intrusion, avoidance, and hyper-arousal, they did not know how to address these specifically and chose to address them as a severe form of kufungisisa. There is a need to integrate aspects of PTSD management within care packages for CMD delivered by LHWs.