Nasopharyngeal carcinoma in Sarawak : a 10-year review and update.

AIM: Nasopharyngeal carcinoma (NPC) is prevalent in certain regions, particularly Southeast Asia and Southern China. In Malaysia, it is notably frequent among the Bidayuh community. This study presents a comprehensive review of NPC cases diagnosed and treated at Sarawak General Hospital from 2010 to 2020. METHOD: A retrospective data collection was conducted using the clinical records of patients who were histopathologically diagnosed with NPC at the Otolaryngology-Head & Neck Clinic and the Radiotherapy & Oncology Clinic at Sarawak General Hospital. RESULT: The study comprised a total of 892 patients from 2010 to 2020. Males outnumbered females 3-to-1, with a mean age of 51 years (standard deviation: 13.9). The largest groups of patients were the Iban (34%) and the Bidayuh (21%), followed by the Chinese (19%) and the Malay (15%). The Bidayuh had the highest incidence rate with 81 cases per 100,000. Only 10% of the study population had a family history of NPC. The most common presentation was a neck lump (64.5%). Distant metastasis was discovered in 20% of patients. 82% of the cases were stage 3 or 4 at the time of presentation. The histological types of the 892 cases were mainly undifferentiated carcinoma (73%). Eighty-six patients developed recurrence, with 83% experiencing local recurrence, 10% developing distant metastasis, and 7% developing regional recurrence. Treatment for recurrence included nasopharyngectomy, neck dissection, and chemotherapy. CONCLUSION: The study highlights a significant incidence of NPC among the Bidayuh. Emphasis on screening and early detection is crucial for better outcomes, with lifelong follow-up recommended.

Shared genetics and causal association between plasma levels of SARS-CoV-2 entry receptor ACE2 and Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) is the highest risk of COVID-19 infection, hospitalization, and mortality. However, it remains largely unclear about the link between AD and COVID-19 outcomes. ACE2 is an entry receptor for SARS-CoV-2. Circulating ACE2 is a novel biomarker of death and associated with COVID-19 outcomes. METHODS: Here, we explored the shared genetics and causal association between AD and plasma ACE2 levels using large-scale genome-wide association study, gene expression, expression quantitative trait loci, and high-throughput plasma proteomic profiling datasets. RESULTS: We found a significant causal effect of genetically increased circulating ACE2 on increased risk of AD. Cross-trait association analysis identified 19 shared genetic variants, and three variants rs3104412, rs2395166, and rs3135344 at chromosome 6p21.32 were associated with COVID-19 infection, hospitalization, and severity. We mapped 19 variants to 117 genes, which were significantly upregulated in lung, spleen, and small intestine, downregulated in brain tissues, and involved in immune system, immune disease, and infectious disease pathways. The plasma proteins corresponding to LST1, AGER, TNXB, and APOC1 were predominantly associated with COVID-19 infection, ventilation, and death. CONCLUSION: Together, our findings suggest the shared genetics and causal association between AD and plasma ACE2 levels, which may partially explain the link between AD and COVID-19.

Therapeutic potential of cannabidiol (CBD) in anxiety disorders: A systematic review and meta-analysis.

Cannabidiol (CBD), as one of the phytocannabinoids, has a wide range of therapeutic properties for various neuropsychiatric disorders due to central nervous system effects. These therapeutic properties demonstrated by preclinical and clinical studies encompass more than just anticonvulsant, anti-arthritic, analgesic, anti-inflammatory, antioxidant, antitumor, antiemetic, antipsychotic and neuroprotective effects. It has been hypothesized that CBD holds potential in the treatment of various neuropsychiatric and anxiety disorders. Thus, PRISMA was used as a guide for our systematic review. Eight of the 1550 articles screened in June 2023 were eligible for meta-analysis. Based on the 316 participants included in these eight articles, this meta-analysis revealed a substantial significant impact of CBD on anxiety with a considerable effect size (Hedges' g = -0.92, 95% CI -1.80 to -0.04). In addition, this meta-analysis focuses on the efficacy of CBD in treating anxiety disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). However, caution should be exercised in interpreting our findings due to the limited size of the clinical sample, and additional trials ought to be carried out if deemed necessary.

Exploring Chinese and Korean American Teachers' Perceptions of Their Cultural Identity as Assets and Barriers.

The representation of Asian American teachers in schools is a unique asset in promoting diversity and advocating for social justice. However, they also face various barriers that negatively affect their work experiences. The diverse nature of the Asian American population is likely to yield different assets and barriers among teachers from different ethnic groups. To gain insight into how Chinese and Korean American teachers perceive their cultural identity in their teaching practices, we utilized a qualitative approach by conducting semi-structured interviews with nine teachers who identified as Chinese and/or Korean American in K-12 public schools in California. Findings based on thematic analyses of the interview data revealed several assets, including empathy and understanding towards minority groups, more exposure to diversity, increased representation, and shared language skills. However, there were also identified barriers, including internalized model minority beliefs, cultural expectations of being passive observers, internalized racism, an overemphasis on education, and a savior complex. Based on our findings, we provide practical suggestions for recruiting and retaining Chinese and Korean American teachers in schools.

A Rare Case and Literature Review of Endoscopic Endonasal.

We report a rare case of localized anterior clinoid mucocele (ACM) with acute visual loss and a literature review of the endoscopic endonasal surgery. We advocate that endoscopic endonasal approach is the best choice. To our knowledge there a limited report on localized ACM that treated via endoscopic endonasal approach.

Autonomous Binarized Focal Loss Enhanced Model Compression Design Using Tensor Train Decomposition.

Deep learning methods have exhibited the great capacity to process object detection tasks, offering a practical and viable approach in many applications. When researchers have advanced deep learning models to improve their performance, the model derived from the algorithmic improvement may itself require complementary increases in computational and power demands. Recently, model compression and pruning techniques have received more attention to promote the wide employment of the DNN model. Although these techniques have achieved a remarkable performance, the class imbalance issue during the mode compression process does not vanish. This paper exploits the Autonomous Binarized Focal Loss Enhanced Model Compression (ABFLMC) model to address the issue. Additionally, our proposed ABFLMC can automatically receive the dynamic difficulty term during the training process to improve performance and reduce complexity. A novel hardware architecture is proposed to accelerate inference. Our experimental results show that the ABFLMC can achieve higher accuracy, faster speed, and smaller model size.

Computer-Vision-Based Vibration Tracking Using a Digital Camera: A Sparse-Optical-Flow-Based Target Tracking Method.

Computer-vision-based target tracking is a technology applied to a wide range of research areas, including structural vibration monitoring. However, current target tracking methods suffer from noise in digital image processing. In this paper, a new target tracking method based on the sparse optical flow technique is introduced for improving the accuracy in tracking the target, especially when the target has a large displacement. The proposed method utilizes the Oriented FAST and Rotated BRIEF (ORB) technique which is based on FAST (Features from Accelerated Segment Test), a feature detector, and BRIEF (Binary Robust Independent Elementary Features), a binary descriptor. ORB maintains a variety of keypoints and combines the multi-level strategy with an optical flow algorithm to search the keypoints with a large motion vector for tracking. Then, an outlier removal method based on Hamming distance and interquartile range (IQR) score is introduced to minimize the error. The proposed target tracking method is verified through a lab experiment-a three-story shear building structure subjected to various harmonic excitations. It is compared with existing sparse-optical-flow-based target tracking methods and target tracking methods based on three other types of techniques, i.e., feature matching, dense optical flow, and template matching. The results show that the performance of target tracking is greatly improved through the use of a multi-level strategy and the proposed outlier removal method. The proposed sparse-optical-flow-based target tracking method achieves the best accuracy compared to other existing target tracking methods.

Combination of pasireotide and octreotide: effects on GH and IGF-I secretion and glucose metabolism in healthy volunteers.

PURPOSE: To assess the pharmacokinetics, pharmacodynamics and tolerability of different doses of octreotide and pasireotide (subcutaneous [sc] and long-acting release [LAR]) when co-administered in healthy volunteers. METHODS: This was an exploratory, Phase I, single-centre study. Healthy adults were enrolled in a staggered approach into seven cohorts to receive octreotide and pasireotide (sc and LAR formulations), alone or in combination. Plasma drug concentrations, growth hormone (GH), insulin-like growth factor I (IGF-I), and plasma glucose were assessed at baseline, immediately after sc treatment, and 21 and 28 days after LAR treatment. RESULTS: Of 88 enrolled subjects, 52 and 82 participated in sc and LAR dosing phases, respectively. There were no relevant pharmacokinetic interactions between octreotide and pasireotide. In combination, pasireotide sc (150 µg) and octreotide sc (100/300 µg) resulted in numerically greater reductions in insulin levels and a higher incidence of AEs than either single agent; the rapid (within 1 h) increase in plasma glucose after pasireotide was delayed with combination treatment. Octreotide sc and pasireotide sc, alone or in combination, reduced IGF-I levels and led to undetectable GH levels in most subjects. During the LAR phase, addition of a low dose of pasireotide (5 mg) to a standard dose of octreotide (20 mg) resulted in an ~2-fold reduction in median IGF-I versus octreotide 20 mg 21 days post-dose; this effect was numerically greater than seen for pasireotide 20 mg alone. Peak plasma glucose was substantially lower after LAR than sc dosing. Interestingly, glucose levels were also numerically lower in the pasireotide 5 mg plus octreotide 20 mg group than for 20 mg of octreotide or pasireotide alone. AEs were less frequent after LAR than sc dosing. CONCLUSIONS: Combined low doses of pasireotide LAR (5 mg) and octreotide LAR (10-30 mg) provided greater suppression of IGF-I than either single agent and did not increase blood glucose or incidence of AEs versus either agent alone.

Pharyngeal Lipoma-A Potentially Life Threatening Presentation.

Pharyngeal lipoma of the upper aero-digestive system is extremely rare. It is typically benign, slow growing and symptoms would depend on its size and location. Surgical intervention is often needed especially for large tumour with impending airway obstruction. Here we present a case of potentially life threatening presentation of pharyngeal lipoma.

Endoscopic Endonasal Approach in Clival Chordoma Surgery: Case Series.

Chordomas are rare and slow-growing locally destructive bone tumors that can develop in the craniospinal axis. It is commonly found in the sacrococcygeal region whereas only 25-35% are found in the clival region. Headache with neurological deficits are the most common clinical presentations. Complete surgical resection either via open or endoscopic endonasal approaches are the main mode of treatment. Here, we report a series of 5 cases of clival chordomas which was managed via endoscopic endonasal approaches in our center. A retrospective analysis of patients who had undergone endoscopic endonasal resection of clival chordoma in Sarawak General Hospital from 2014 to 2018. A total of 5 cases were operated on endoscopically via a combine effort of both the otorhinolaryngology team and the neurosurgical team during the study period from year 2013 to 2018. From our patient, 2 were female and 3 were male patients. The main clinical presentation was headache, squinting of eye and nasopharyngeal fullness. All our patient had endoscopic endonasal debulking of clival tumor done, with average of hospital stay from 9 - 23 days. Pos-operatively, patients were discharged back well. Endoscopic endonasal resection of clival chordomas gives good surgical resection results with low morbidity rates and therefore can be considered as a surgical option in centers where the surgical specialties are available.

Dust-Sized High-Power-Density Photovoltaic Cells on Si and SOI Substrates for Wafer-Level-Packaged Small Edge Computers.

Advancement in microelectronics technology enables autonomous edge computing platforms in the size of a dust mote (<1 mm), bringing efficient and low-cost artificial intelligence close to the end user and Internet-of-Things (IoT) applications. The key challenge for these compact high-performance edge computers is the integration of a power source that satisfies the high-power-density requirement and does not increase the complexity and cost of the packaging. Here, it is shown that dust-sized III-V photovoltaic (PV) cells grown on Si and silicon-on-insulator (SOI) substrates can be integrated using a wafer-level-packaging process and achieve higher power density than all prior micro-PVs on Si and SOI substrates. The high-throughput heterogeneous integration unlocks the potential of large-scale manufacturing of these integrated systems with low cost for IoT applications. The negative effect of crystallographic defects in the heteroepitaxial materials on PV performance diminishes at high power density. Simultaneous power delivery and data transmission to the dust mote with heteroepitaxially grown PV are also demonstrated using hand-held illumination sources.

Adenoid Cystic Carcinoma of the Nasopharynx: A Case Series.

Adenoid cystic carcinomas are tumors that are more commonly seen in the salivary glands than in the nasopharynx. Nasopharyngeal adenoid cystic carcinomas are rare and cases that are reported in the literatures are few. Treatment is mainly by surgical resection. Here, we report 2 cases of nasopharyngeal adenoid cystic carcinoma.

Laryngeal Leiomyosarcoma: A Rare Case.

Laryngeal leiomyosarcoma is a rare smooth muscle malignancy of the head and neck region. Diagnosis is based on immunohistochemistry. Here we present a case of laryngeal leiomyosarcoma that was diagnosed and treated in our center, focusing on the clinical features, histological diagnosis and management of this rare disease.

Inverse design optimization for efficient coupling of an electrically injected optical antenna-LED to a single-mode waveguide.

Efficient high-speed nanoscale optical sources are required for low-power next-generation data communication. Here we propose an integrated antenna-LED on a single-mode optical waveguide. By leveraging inverse design optimization, we achieved a waveguide coupling efficiency of 94% and an antenna efficiency of 64%, while maintaining a high average enhancement of 144 - potentially enabling >100GHz direct modulation.

Current perspectives on biosimilars.

In this work, an overview of the biosimilars market, pipeline and industry targets is discussed. Biosimilars typically have a shorter timeline for approval (8 years) compared to 12 years for innovator drugs and the development cost can be 10-20% of the innovator drug. The biosimilar pipeline is reviewed as well as the quality management system (QMS) that is needed to generate traceable, trackable data sets. One difference between developing a biosimilar compared to an originator is that a broader analytical foundation is required for biosimilars and advances made in developing analytical similarity to characterize these products are discussed. An example is presented on the decisions and considerations explored in the development of a biosimilar and includes identification of the best process parameters and methods based on cost, time, and titer. Finally factors to consider in the manufacture of a biosimilar and approaches used to achieve the target-directed development of a biosimilar are discussed.

A Framework of Human-Motion Based Structural Dynamics Simulation Using Mobile Devices.

Due to the nature of real-world problems in civil engineering, students have had limited hands-on experiences in structural dynamics classes. To address this challenge, this paper aims to bring real-world problems in structural dynamics into classrooms through a new interactive learning tool that promotes physical interaction among students and enhances their engagement in classrooms. The main contribution is to develop and test a new interactive computing system that simulates structural dynamics by integrating a dynamic model of a structure with multimodal sensory data obtained from mobile devices. This framework involves integrating multiple physical components, estimating students' motions, applying these motions as inputs to a structural model for structural dynamics, and providing students with an interactive response to observe how a given structure behaves. The mobile devices will capture dynamic movements of the students in real-time and take them as inputs to the dynamic model of the structure, which will virtually simulate structural dynamics affected by moving players. Each component of synchronizing the dynamic analysis with motion sensing is tested through case studies. The experimental results promise the potential to enable complex theoretical knowledge in structural dynamics to be more approachable, leading to more in-depth learning and memorable educational experiences in classrooms.

Cavernous sinus fungal infection: a rare case.

Intracranial fungal infection of the cavernous sinus is a condition that usually affects immunocompromised individuals and is rarely seen in immunocompetent individuals. It is a potentially life threatening condition which requires prompt treatment. Here we present a case of an immunocompetent patient with a fungal infection of the cavernous sinus.

Large-area and bright pulsed electroluminescence in monolayer semiconductors.

Transition-metal dichalcogenide monolayers have naturally terminated surfaces and can exhibit a near-unity photoluminescence quantum yield in the presence of suitable defect passivation. To date, steady-state monolayer light-emitting devices suffer from Schottky contacts or require complex heterostructures. We demonstrate a transient-mode electroluminescent device based on transition-metal dichalcogenide monolayers (MoS2, WS2, MoSe2, and WSe2) to overcome these problems. Electroluminescence from this dopant-free two-terminal device is obtained by applying an AC voltage between the gate and the semiconductor. Notably, the electroluminescence intensity is weakly dependent on the Schottky barrier height or polarity of the contact. We fabricate a monolayer seven-segment display and achieve the first transparent and bright millimeter-scale light-emitting monolayer semiconductor device.

Label-free tissue scanner for colorectal cancer screening.

The current practice of surgical pathology relies on external contrast agents to reveal tissue architecture, which is then qualitatively examined by a trained pathologist. The diagnosis is based on the comparison with standardized empirical, qualitative assessments of limited objectivity. We propose an approach to pathology based on interferometric imaging of "unstained" biopsies, which provides unique capabilities for quantitative diagnosis and automation. We developed a label-free tissue scanner based on "quantitative phase imaging," which maps out optical path length at each point in the field of view and, thus, yields images that are sensitive to the "nanoscale" tissue architecture. Unlike analysis of stained tissue, which is qualitative in nature and affected by color balance, staining strength and imaging conditions, optical path length measurements are intrinsically quantitative, i.e., images can be compared across different instruments and clinical sites. These critical features allow us to automate the diagnosis process. We paired our interferometric optical system with highly parallelized, dedicated software algorithms for data acquisition, allowing us to image at a throughput comparable to that of commercial tissue scanners while maintaining the nanoscale sensitivity to morphology. Based on the measured phase information, we implemented software tools for autofocusing during imaging, as well as image archiving and data access. To illustrate the potential of our technology for large volume pathology screening, we established an "intrinsic marker" for colorectal disease that detects tissue with dysplasia or colorectal cancer and flags specific areas for further examination, potentially improving the efficiency of existing pathology workflows.