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Classical leptomeningeal disease (cLMD) has historically been considered a global phenomenon impacting the entire craniospinal axis, but isolated parenchymal metastases sometimes display focal leptomeningeal extension into the surrounding leptomeninges without diffuse LMD elsewhere. Descriptions of this phenomenon are lacking, and the optimal management of such patients remains unclear. We hypothesized that, in order to spare such patients the deleterious outcomes of whole brain radiation (WBRT), patients with focal LMD (fLMD) could be successfully managed with stereotactic radiation (SRS/SRT) without excess development of adverse sequelae such marginal recurrences or subsequent cLMD. We identified 796 patients with 2,354 newly-diagnosed brain metastases (BrM) secondary to a solid tumor primary without cLMD at diagnosis managed at a tertiary cancer center between 2007-2022. Each metastasis was assessed for fLMD, which was defined as isolated focal leptomeningeal extension of an intact brain metastasis or single, isolated focal leptomeningeal enhancement without cytologic or radiographic evidence of cLMD (enhancement of cranial nerves or multifocal involvement of subarachnoid spaces including the cerebellar folia and supratentorial sulci). Multivariable Fine and Gray's models were constructed for the primary outcomes of local recurrence and development of cLMD. Among 796 patients, 138 (17.3%) displayed evidence of fLMD, corresponding to 185 of 2,354 (7.9%) BrM. Patients with versus without fLMD were not more likely to display distant intracranial failures post-initial treatment (56.8% vs. 58.3% at 1 year, respectively, p=0.78) or local recurrence (4.4% vs. 8.2% at 1 year, respectively, p=0.14), including in lesions managed with SRS/SRT (1-year local recurrence: 4.4% vs. 4.9%, respectively; p=0.63). On a per-patient level, the presence of fLMD was not a significant predictor of development of cLMD (1-year rate: 5.2% vs 5.2%, HR: 0.99 [0.52-1.89], p=0.97). We describe a novel pattern of LMD that has not been well-characterized in prior literature; fLMD appears to be a distinct oncologic entity whose pattern of intracranial failure resembles that of parenchymal BrM. Nationally, it may be that patients with fLMD are managed as having cLMD with routine use of WBRT. Our study suggests that despite the presence of enhancing disease in the leptomeningeal space, stereotactic approaches may be viable in this population given the lack of detectable excess risk of local recurrence or development of cLMD. [ABSTRACT FROM AUTHOR]

In the present scenario, the whole world struggling with COVID-19 which affects highly transmittable and pathogenic viral infection that rose by a newly discovered coronavirus and believed to be originated in China. The more serious effects of the virus occur for the people who are under medical problems as diabetes, chronic respiratory diseases, cancer, and cardiovascular diseases also in older persons. Because of the unavailability of proper vaccine, medical facility and medical experts the current situation becomes worst and uncontrollable for many countries. Hence, in order to overcome and reduce the spread of infection there is a necessity to prepare the predictive mathematical model due to prevention factor and suitability conditions. Enlightened by the coronavirus, the present study deals with a novel mathematical model of COVID-19 to investigate the impact of S-I-R-M model due to the influence of prevention factor and suitability conditions. Numerical calculation for infectious rate, recovery rate and mortality rate have been discussed and displayed graphically. Moreover, some comparisons have been shown in figure to estimate the effect of prevention factor. [ABSTRACT FROM AUTHOR]

Background: Supraglottic airway devices are used for anesthesia in elective surgical procedures circumventing the need for intubation. We investigated the efficacy and safety of Baska® mask in comparison to an I-Gel® device. Methods: In this cross-sectional, observational study, we randomized 100 female patients (age 18–45 years, American Society of Anaesthesiologists grade I or II) undergoing elective short gynecological procedures into two groups, to receive ventilation with either Baska mask® (group 1, n = 50) or an I-Gel® device (group 2, n = 50). We excluded patients with obesity, short neck, and known systemic and upper airway disorders. The primary outcome was the oropharyngeal airway seal pressure, and the secondary outcomes were the ease of insertion and the complication rate. The results were analyzed using Mann–Whitney U-test and Fisher's exact test, and correlation analysis was done by Spearman's correlation test. Results: A total of 56 patients underwent dilatation and curettage, whereas the remaining had hysteroscopy in the study. The airway seal pressure achieved was higher with Baska® mask than I-Gel® device (35.8 ± 10.3 and 26.9 ± 7.5 of cm H2O, respectively; P < 0.0001). The ease of insertion (P < 0.0001) was better in group 1 and the complication rates were similar in both the groups (P > 0.05). Conclusion: Baska® mask offers a superior airway seal pressure with minimum complications in comparison to an I-Gel® device. Further studies with a large number of patients in different surgical settings are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Study Question: How does the psychological well-being and prenatal bonding of Indian surrogates differ from a comparison group of mothers?Summary Answer: Surrogates had higher levels of depression during pregnancy and post-birth, displayed lower emotional connection with the unborn baby, and greater care towards the healthy growth of the foetus, than the comparison group of mothers.What Is Already Known: Studies in the West have found that surrogates do not suffer long-term psychological harm. One study has shown that surrogates bond less with the foetus than expectant mothers.Study, Design, Size, Duration: This study uses a prospective, longitudinal and cross-sectional design. Surrogates and a matched group of expectant mothers were seen twice, during 4-9 months of pregnancy and 4-6 months after the birth.Participants/materials, Setting, Methods: Semi-structured interviews and standardized questionnaires were administered to 50 surrogates and 69 expectant mothers during pregnancy and 45 surrogates and 49 expectant mothers post-birth. All gestational surrogates were hosting pregnancies for international intended parents.Main Results and the Role Of Chance: Surrogates had higher levels of depression compared to the comparison group of mothers, during pregnancy and post-birth (P < 0.02). Low social support during pregnancy, hiding surrogacy and criticism from others were found to be predictive of higher depression in surrogates post-birth (P < 0.05). Regarding prenatal bonding, surrogates interacted less with and thought less about the foetus but adopted better eating habits and were more likely to avoid unhealthy practices during pregnancy, than expectant mothers (P < 0.05). No associations were found between greater prenatal bonding and greater psychological distress during pregnancy or after relinquishment.Limitations, Reasons For Caution: All surrogates were recruited from one clinic in Mumbai, and thus the representativeness of this sample is not known. Also, the possibility of socially desirable responding from surrogates cannot be ruled out.Wider Implications Of the Findings: As this is the first study of the psychological well-being of surrogates in low-income countries, the findings have important policy implications. Providing support and counselling to surrogates, especially during pregnancy, may alleviate some of the psychological problems faced by surrogates.Study Funding/competing Interest(s): This study was supported by the Wellcome Trust [097857/Z/11/Z] and Nehru Trust, Cambridge. K.K. is the Medical Director of Corion Fertility Clinic. All other authors have no conflict of interest to declare. [ABSTRACT FROM AUTHOR]

In the present paper, we have determined the heat conduction and thermal stresses of a hollow cylinder with inhomogeneous material properties and internal heat generation. All the material properties except Poisson's ratio and density are assumed to be given by a simple power law in axial direction. We have obtained the solution of the two dimensional heat conduction equation in the transient state in terms of Bessel's and trigonometric functions. The influence of inhomogeneity on the thermal and mechanical behavior is examined. Numerical computations are carried out for both homogeneous and nonhomogeneous cylinders and are represented graphically. [ABSTRACT FROM AUTHOR]

In this paper, an analytical method of a thermoelastic problem for a medium with functionally graded material properties is developed in a theoretical manner for the elliptic-cylindrical coordinate system under the assumption that the material properties except for Poisson's ratio and density are assumed to vary arbitrarily with the exponential law in the radial direction. An attempt has been made to reconsider the fundamental system of equations for functionally graded solids in a two-dimensional state under thermal and mechanical loads. The general solution of displacement formulation is obtained by the introduction of appropriate transformation and carried out the analysis by taking into account the variation of inhomogeneity parameters. Furthermore, the aforementioned problem degenerated into the problem of the circular region by applying limiting conditions, and the results are validated. Numerical computations are carried out for ceramicmetal-based functionally graded material, in which zirconia is selected as ceramic and aluminium as metal and are represented graphically. [ABSTRACT FROM AUTHOR]

This article deals with the determination of temperature distribution, displacement, and thermal stresses in a rectangular plate with inhomogeneous material properties. All the material properties except Poisson’s ratio and density are assumed to be given by a simple power law inycoordinate. The system of fundamental equations formulated has been solved by integral transform method. The effects of thermal and mechanical inhomogeneity on temperature and thermal stress distributions are examined. Numerical calculations are performed by taking into account the variation in inhomogeneous property of shear modulus of elasticity and depicted graphically. [ABSTRACT FROM AUTHOR]

This paper deals with the determination of temperature distribution, bending moments and the resulting thermal stresses in a functionally graded thin rectangular plate under unsteady temperature distribution. All the material properties except density and Poisson's ratio are considered to be dependent on the temperature. The temperature dependent three dimensional heat conduction equation is simplified by introducing Kirchhoff's variable transformation. The resultant heat conduction equation is solved by integral transform method. Numerical calculations are carried out and are depicted graphically. [ABSTRACT FROM AUTHOR]

Interacting electrons confined to their lowest Landau level in a high magnetic field can form a variety of correlated states, some of which manifest themselves in a Hall effect. Although such states have been predicted to occur in three-dimensional semimetals, a corresponding Hall response has not yet been experimentally observed. Here, we report the observation of an unconventional Hall response in the quantum limit of the bulk semimetal HfTe5, adjacent to the three-dimensional quantum Hall effect of a single electron band at low magnetic fields. The additional plateau-like feature in the Hall conductivity of the lowest Landau level is accompanied by a Shubnikov-de Haas minimum in the longitudinal electrical resistivity and its magnitude relates as 3/5 to the height of the last plateau of the three-dimensional quantum Hall effect. Our findings are consistent with strong electron-electron interactions, stabilizing an unconventional variant of the Hall effect in a three-dimensional material in the quantum limit. There is a long-standing experimental effort to observe field-induced correlated states in three-dimensional materials. Here, the authors observe an unconventional Hall response in the quantum limit of the bulk semimetal HfTe5 with a plateau-like feature in the Hall conductivity. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about keratoconjunctival injury.

A 29-year-old male with acquired immunodeficiency syndrome presented with a week of left eye blurriness, which then progressed to complete vision loss. On exam, the left pupil was nonreactive to light, and fundoscopy showed significant optic nerve edema. CT and MRI of the left orbit showed a mass lesion compressing the posterior aspect of the sclera with diffuse thickening and contrast enhancement of the retrobulbar portion of the left optic nerve. The lesion demonstrated low T1 and intermediate T2 intensities and heterogeneous contrast enhancement and measured 17.4 mm x 15 mm x 10.6 mm. Anterior orbitotomy with exploration and biopsy were performed. Immunohistochemical studies confirmed diffuse large B-cell lymphoma and a workup showed no systemic involvement. Plans for treatment with chemotherapy and radiation were initiated. Even though rare, primary orbital NHL should be in the differential for relatively acute blindness without other symptoms, especially in patients with AIDS.

Purpose: Neurosurgical resection serves an important role in select patients with breast cancer and brain metastases but can delay systemic therapy and yield complications. Consequently, identification of patients most likely to benefit from surgery is important. Given the poorer long-term intracranial responses to radiotherapy sometimes observed in HER2-positive (HER2 +) patients, we investigated whether neurosurgical resection is differentially beneficial in this population., Methods: We identified 633 patients with newly diagnosed brain metastases arising from breast cancer managed at Brigham and Women's Hospital/Dana-Farber Cancer Institute between 2010 and 2022. Patients were stratified by breast cancer subtype: HER2 + (N = 189), hormone receptor positive (HR +)/HER2- (N = 267), and triple negative (N = 177). Per-patient and per-metastasis outcomes were evaluated; interaction models assessing the impact of neurosurgical resection by subtype were constructed., Results: Relative to HR + /HER2- subtype, omission of upfront neurosurgical resection in patients with HER2 + disease was associated with increased subsequent utilization of salvage stereotactic radiation, whole brain radiotherapy, and craniotomy (interaction HR 2.02 [95% CI, 1.04-3.93], p = 0.04; HR 3.92 [95% CI, 1.24-12.40], p = 0.02; HR 4.98 [95% CI, 1.34-18.58], p = 0.02, respectively). Tumors stemming from HER2 + versus HR + /HER2- primaries displayed increased local recurrence when upfront neurosurgical resection was omitted (interaction HR 3.62 [95% CI, 1.06-12.38], p = 0.04). No such associations were noted when comparing triple negative to HR + /HER2- subtype (p-interaction > 0.05 in all cases)., Conclusion: Patients with HER2 + disease and brain metastases may disproportionately benefit from upfront neurosurgical resection relative to other subtypes. If validated, our results may suggest a lower threshold to consider surgery in brain metastases secondary to HER2 + breast cancer., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)