OBJECTIVE This paper describes our experience and outcomes from 54 cases presented to the (Molecular tumor board) MTB. METHODS 54 Cases presented between July 2017 and April 2018 were included in this analysis. These patients had different types of cancers that had either failed standard therapy or were expected to fail and physicians were looking for future options for anticipated progression. Patients who had obvious mutations and were candidates for Targeted Agent and Profiling Utilization Registry or Molecular Analysis for Treatment Choice clinical trials were not included. Oncologists presented the cases virtually and Foundation Medicine scientific and clinical team discussed the molecular pathways to find targeted options or trials. Tumor board attendees included oncologists, nurses, pharmacists, mid-level providers, residents and staff of the Cancer Center. RESULTS Amongst the 54 cases presented 81% had one or more potentially actionable alteration. 12 (22%) patients received genomically matched therapy as per MTB recommendations. Additional 13 (24%) patients have options available when they progress. Out of 12 patients who got treatment six are alive at the time of this analysis. Genomically matched therapy or Clinical Trials option were offered to the 46% of patients based on the MTB discussion. CONCLUSION More widespread use of molecular diagnostics, better physician education and multidisciplinary collaboration between the staff involved in diagnosis and treatment, as well as third party payers are necessary for consensus on treatment and care of oncology patients.

The purpose of this study was to compare unenhanced MR angiography with contrast-enhanced MR angiography and visualisation of renal arteries with its segment branches using both techniques. We performed renal MRA on 22 patients using a 1.5T MRI unit. For renal MRA, a three dimensional balanced type steady-state free precession (SSFP) sequence (Time-SLIP, Canon) was used with respiratory gating and conventional CE-MRA sequnce (upisati tačan naziv). For analysis, two radiologists independently evaluated the visual quality of the axial images and axial maximum intensity projection images (MIP) of Time SLIP and CE MRA. Visualisation of aorta and main stem of the renal arteries were satisfactory on both techniques, and there was no statistically significant difference. The score of segmental renal artery appeared superior with Time-SLIP and showed a statistically significant difference (P<0.05). Visualisation of segmental renal arteries, interlobar renal arteries and kidneys parenchyma was significantly superiorwith Time-SLIP technique. We compared visualisation of renal arteries and its branches using unenhanced MRA, Time-SLIP, in comparison with contrast-enhanced MRA. Although it is slightly time-consuming and its clinical utility is necessary to further investigate, unenhanced MRA provides superior visualization of peripheral branches even in this study. Further improvement of the technique would make it even more sensitive in detecting small vessel abnormalities and it is promising for clinical use.

INTRODUCTION: Diseases of the locomotor system or musculoskeletal disease are on the rise, mainly due to the ageing of the population but also due to lifestyle changes. Those are the main cause of chronic pain and disability in the modern world. Thanks to the achievements of modern medicine, in patients with advanced osteoarthritis of the hip or knee it is possible to replace the diseased joint with an endoprosthesis, with very good long-term results related to pain reduction and function improvement. The aim of this study is to examine are there any differences in the quality of people's life before and after implantation of total knee endoprosthesis. RESPONDENTS AND RESEARCH METHODS: There were 30 subjects of both genders with knee joint disease enrolled in the study, who were treated with the surgical course at the Orthopedics clinic and the traumatology of the UKCS by implanting a total endoprosthesis, from the beginning of April until the end of October 2018. As an instruments of this research are used standardized SF-36 questionnaire for assessing the quality of life and overall health status and a modified questionnaire on the socio-demographic characteristics of the respondents. RESULTS: Patients after implantation of total knee endoprosthesis have a better quality of life, i.e. statistical significance at physical function level (P = 0.0001), role limits due to physical problems (P = 0.0001), social functions (p = 0.0001), energy or vitality (P = 0.0001), pain (p = 0.0001), limitations of the role due to emotional problems (P = 0.0001), and emotional prosperity (P = 0.0001) and general health (P = 0.004). CONCLUSIONS: The quality of life of patients was worse before the period after the total knee endoprosthesis, where statistically significant improvement was demonstrated.

This work follows the recent discovery of a zinc-bearing Egyptian blue (EB) pigment widely used for the production of the early medieval mural paintings cycle in Santa Maria foris portas Church at Castelseprio (Lombardy Region, Italy). The inclusion of zinc in the synthesis of EB has been studied for the first time trying to evaluate whether its addition could be casual or deliberate. Historical reconstructions of the pigment have been carried out with a special focus on the use of zinc besides copper, using the different production methods. The influence of zinc on the pigment’s NIR photoluminescence and VIS-NIR reflectance has been characterized using FORS spectroscopy, X-ray diffraction, optical microscopy, and scanning electron microscopy-energy dispersive X-ray spectroscopy. A comparison of the production methods including salt-flux, solid-state, and Zn-rich syntheses showed that the solid-state synthesis results in particularly efficient NIR photoluminescence and VIS-NIR reflectance. Modern replicas were compared with an ancient sample in order to understand the zinc environment inside the structure of the Zn-enriched EB. Zn was found to be concentrated in a glass-based matrix surrounding cuprorivaite crystals, the main mineral associated with the EB pigment, and not included in a hypothetical Zn-doped cuprorivaite with formula CaCu1−xZnxSi4O10. The Zn-rich synthesis opens up the possibility of producing EB from brass and demonstrates that EB used in Castelseprio’s mural paintings could have been produced in this way. The relationship between the microstructure and the NIR photoluminescence of cuprorivaite-like pigments is of interest also for applications in modern and future technologies.

Fake News appears to be the most modern of social problems. After bursting onto the scene in 2016, spurred in no small part by then Presidential candidate Trump and his commitment to a post-truth s...

Currently, blockchain technology has been widely used due to its support of transaction trust and security in next generation society. Using Internet of Things (IoT) to mine makes blockchain more ubiquitous and decentralized, which has become a main development trend of blockchain. However, the limited resources of existing IoT cannot satisfy the high requirements of on-demand energy consumption in the mining process through a decentralized way. To address this, we propose a decentralized on-demand energy supply approach based on microgrids to provide decentralized on-demand energy for mining in IoT devices. First, energy supply architecture is proposed to satisfy different energy demands of miners in response to different consensus protocols. Then, we formulate the energy allocation as a Stackelberg game and adapt backward induction to achieve an optimal profit strategy for both microgrids and miners in IoT. The simulation results show the fairness and incentive of the proposed approach.

We investigate the potential of stochastic neural networks for learning effective waveform-based acoustic models. The waveform-based setting, inherent to fully end-to-end speech recognition systems, is motivated by several comparative studies of automatic and human speech recognition that associate standard non-adaptive feature extraction techniques with information loss, which can adversely affect robustness. Stochastic neural networks, on the other hand, are a class of models capable of incorporating rich regularization mechanisms into the learning process. We consider a deep convolutional neural network that first decomposes speech into frequency sub-bands via an adaptive parametric convolutional block where filters are specified by cosine modulations of compactly supported windows. The network then employs standard non-parametric 1D convolutions to extract relevant spectro-temporal patterns while gradually compressing the structured high dimensional representation generated by the parametric block. We rely on a probabilistic parametrization of the proposed neural architecture and learn the model using stochastic variational inference. This requires evaluation of an analytically intractable integral defining the Kullback–Leibler divergence term responsible for regularization, for which we propose an effective approximation based on the Gauss–Hermite quadrature. Our empirical results demonstrate a superior performance of the proposed approach over comparable waveform-based baselines and indicate that it could lead to robustness. Moreover, the approach outperforms a recently proposed deep convolutional neural network for learning of robust acoustic models with standard FBANK features.

An H -packing of G is a collection of vertex-disjoint subgraphs of G such that each component is isomorphic to H . An H -packing of G is maximal if it cannot be extended to a larger H -packing of G . In this paper we consider problem of random allocation of a sequential resource into blocks of m consecutive units and show how it can be successfully modeled in terms of maximal P m -packings. We enumerate maximal P m -packings of P n of a given cardinality and determine the asymptotic behavior of the enumerating sequences. We also compute the expected size of m -packings and provide a lower bound on the efficiency of block-allocation.

The human genetic diversity of the Americas has been shaped by several events of gene flow that have continued since the Colonial Era and the Atlantic slave trade. Moreover, multiple waves of migration followed by local admixture occurred in the last two centuries, the impact of which has been largely unexplored. Here we compiled a genome-wide dataset of ∼12,000 individuals from twelve American countries and ∼6,000 individuals from worldwide populations and applied haplotype-based methods to investigate how historical movements from outside the New World affected i) the genetic structure, ii) the admixture profile, iii) the demographic history and iv) sex-biased gene-flow dynamics, of the Americas. We revealed a high degree of complexity underlying the genetic contribution of European and African populations in North and South America, from both geographic and temporal perspectives, identifying previously unreported sources related to Italy, the Middle East and to specific regions of Africa.