 not identified by radiological examination. Evident metastasis in the SVC appeared surrounding a lead of the cardiac pacemaker and surrounding the central vein catheter, suggesting that these leads and the catheter itself may have contributed to the onset of this extremely rare condition. Symptomatic upper extremity and central vein thrombosis attributed to pacemaker leads occurs in 1-3% of patients with permanent pacemakers (19). The pathogenesis of pacemaker lead-related thrombosis may involve local inflammation induced by foreign-body reactions (20) and endothelial cell injury as a result of lead-activated local hypercoagulability (19). Similarly, the pacemaker leads and/or the central venous catheter may provide a nidus for tumor attachment and growth.
The primary tumor in the present case was diagnosed as an adenosquamous carcinoma, which is rarely found among malignant tumors of the small intestine (3). It is not known whether adenosquamous carcinoma of the small intestine has a higher metastatic potential to distant organs than other histological types. With regard to colorectal tumors, significant differences in metastatic potential have been identified between adenocarcinomas and adenosquamous carcinomas (21). Therefore, in the present case, the histological characteristics of the tumor may correlate with the metastatic capacity. Notably, pathohistological examination of the SVC thrombus revealed similar features to those of the poorly-differentiated component of the primary tumor in the duodenum. Immunohistochemical examination of the poorly-differentiated carcinoma components of the primary tumor in the duodenum were negative for the expression of E-cadherin and β-catenin, which was consistent with that observed in the SVC thrombus. Adenocarcinomas of the small intestine, which possess specific markers of epithelial-mesenchymal transition, such as E-cadherin negativity, or vimentin and/or fibronectin positivity, are significantly associated with an undifferentiated histology and poor clinical outcomes (22). Loss of the E-cadherin protein was identified in 41.8% of small intestinal adenocarcinomas, and aberrant β-catenin protein expression was found in 40.7% of small intestinal adenocarcinomas (23). Furthermore, 24% of small intestinal adenocarcinomas exhibit the two phenotypes and were found to closely correlate with a poorly-differentiated histology (23). The decreased expression of E-cadherin may be associated with the loss of the intercellular junctional or cellular polarity of cancer cells and thus, theoretically, this may increase the metastatic potential of tumor cells (24)(25)(26). Additionally, the activation of β-catenin in tumor cells as a result of the loss of E-cadherin expression may induce the expression of metastasis-related genes, including Snail and Twist (27). The tumor phenotype (wild-type KRAS) in the present case may have induced an increased possibility of metastasis and also contributed to the intraluminal metastasis. A recent study showed that the KRAS mutation is associated with poor prognosis in colorectal cancer (28). However, whether KRAS mutation status correlates with poor prognosis and the metastatic capacity of duodenum carcinoma remains unclear.
Overall, aggressive intraluminal SVC metastasis as a result of adenosquamous carcinoma of the duodenum may be associated with the placement of artificial devices in the large vessels, as well as the development of an aggressive metastatic phenotype in the tumor cells. The patient in the present case exhibited intraluminal superior vena cava metastasis from adenosquamous carcinoma of the duodenum. Radiotherapy, chemotherapy and anticoagulant therapy effectively suppressed tumor growth. Thus, the present study indicates that patients with advanced cancer harboring distant metastases to rare organ locations should undergo multidisciplinary therapy in accordance with the pathogenesis of the metastasis, with the type of therapy selected based on patient factors, as well as tumor factors.Blink and ChargePoint join for electric car charging station sharing
ECOtality and ChargePoint announced on Thursday a collaboration that will resolve a minor annoyance in electric vehicle ownership, the need to be a member in multiple charging station networks. The collaboration will allow Blink and ChargePoint network members to use charging stations belonging to either network, while in the background the companies exchange data and financial reconciliation between themselves.
Currently public electric vehicle charging services are divided into several charging station networks. ChargePoint and Blink are the two big dawgs in the field and there are other companies entering such as NRG's eVgo. Most metropolitan areas have a mix of charging station operators, forcing electric car owners to become a member of each network. Each of the networks have different membership requirements and payment strategies, which increases confusion, difficulty and cost to the consumer.
eVgo is based in Texas but is currently expanding into California and the Washington DC area. ChargePoint and Blink are both constantly expanding. In February, ChargePoint announced an expansion into Atlanta.
To implement the agreement, ECOtality and ChargePoint have formed a new company, Collaboratev, LLC. That company will "enable charging network interoperability, exchange session data and allow financial billing reconciliation services among electric vehicle charging networks." The jargon means that Collaboratev will provide a service similar to that which happens between banks to enable sending money from one bank to another.
Additionally Collaboratev plans to encourage other charging station network operators to join, with the vision of a allowing electric car drivers to "seamlessly charge among all affiliated charging networks." The connection between the Blink and ChargePoint networks will be implemented later this year.
The goals sound like a breath of fresh air in the charging station field: Provide EV drivers with easy access to participating charging stations using common authentication credentials; Enable one bill for all charging usage; Accurately provide aggregated EV charging station location data; and Utilize open national interoperability standards.
The announcement also addresses another minor frustration with using public electric car charging stations: Where are they? Many electric car owners also carry smart phones on which we install apps listing charging station locations. Blink has an app, and ChargePoint has an app, and there are several other app's that attempt to aggregate information from not only those two but other charging station networks. The problem we have is, sometimes entries in these maps are inaccurate, sometimes the charging stations are hard to find even when we have an address, and it's difficult to be certain whether the charging station will be available once you arrive.
Sharing aggregated charging station location data should mean the Blink and ChargePoint apps will show each others charging stations. That will improve the situation just described, especially if the shared data also includes current status of the charging station (whether it's broken, or whether it's in use).
.”On Tuesday, 30-year-old correctional officer Thomas Lee Hicks was charged with second-degree murder, violation of an oath of office, and two counts of second-degree cruelty to children.

The incident occurred on August 9, at Waycross Regional Youth Detention Center, in Waycross, Georgia. The juvenile was taken to a medical facility and was declared deceased.
Hicks was terminated from his job and is being held at the Ware County Jail.
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Collaborative, encouraging, and insightful.
This is the moment to begin.
I have encountered hurdles and growth opportunities all throughout my career so far, and each of these have led to a high point in personal and professional growth. It is difficult to rank any one point in my career above the rest because they have all helped my development. If I had to highlight one area that has been most rewarding, it's working with an amazing team at ESD and growing with our automation team over the years. I continue to learn and be inspired every day from my colleagues, clients, and mentors.
I'm respectful of others.
I'm trying not to be too biased, but I do see a big potential for growth in the area of automation. There are a lot of opportunities to drive innovation and with that comes a need to improve on the acceptance of change. While the technology industry has changed and evolved, the ability to accept this change and evolve at the same pace can be a challenge that needs a concerted effort to improve upon.
I see the technology industry becoming more impactful to all other industries and continuing to drive the need for innovation. Particularly in the building automation sector, it has become clear that quickly adapting and proactively evolving to meet the needs of facilities, operations, and occupants is paramount to achieving full-circle success.
Listen before speaking — no matter the scenario, I have found it extremely important to not make assumptions or jump to conclusions without first trying to obtain all of the information and viewpoints posible from all individuals. This has been a valuable lesson that has helped me work through difficult discussions and situations. It has helped me take a broader view by listening and understanding the situation to make sure I am contributing and adding value to the discussion.
Intriguing, diverse, and impactful.Cette situation engendrera une résurgence de