Tree of Life Synagogue Shooting in Pittsburgh: Preparedness, Prehospital Care, and Lessons Learned

On Saturday, October 27, 2018, a man with anti-Semitic motivations entered Tree of Life synagogue in the Squirrel Hill section of Pittsburgh, Pennsylvania; he had an AR-15 semi-automatic rifle and three handguns, opening fire upon worshippers. Eventually 11 civilians died at the scene and eight people sustained non-fatal injuries, including five police officers. Each person injured but alive at the scene received care at one of three local level-one trauma centers.  The injured had wounds often seen in war-settings, with the signature of high velocity weaponry.  We describe the scene response, specific elements of our hospital plans, the overall out-of-hospital preparedness in Pittsburgh, and the lessons learned

Effect of Continuous Phorbol Ester Treatment on Muscarinic Receptor-Mediated Calmodulin Redistribution in SK-N-SH Neuroblastoma Cells

Stimulation of muscarinic receptors by carbachol and activation of protein kinase C elicits the translocation of calmodulin (CaM) from membranes to cytosol in the human neuroblastoma cell line SK-N-SH. Our previous studies have suggested a role for protein kinase C in the regulation of CaM redistribution. To explore further the role of protein kinase C in carbachol-induced calmodulin translocation, we treated cells for 17 h with 12- O -tetradecanoylphorbol 13-acetate (TPA) to down-regulate protein kinase C isozymes or 72 h to differentiate the cells. Treatment of SK-N-SH cells for 17 h with 70 n M TPA nearly abolished the effect of carbachol on CaM redistribution. After 72 h of TPA, however, the cells appeared differentiated, and the ability of carbachol to increase cytosolic CaM levels was restored. In untreated control cells, the carbachol-mediated increase in cytosolic CaM content was mimicked by TPA and blocked by pretreatment with the selective protein kinase C inhibitor Ro 31-8220 at 10 µ M . In the 72-h TPA-treated cells, however, the ability of TPA to increase cytosolic CaM levels was significantly reduced, and the action of carbachol was no longer blocked by Ro 31-8220. The effect of prolonged TPA treatment on select protein kinase C isozymes was examined by immunoblotting. Treatment of cells for either 17 or 72 h abolished the Α-isozyme in the cytosol and reduced (17 h) or abolished (72 h) the content in the membranes. In both 17- and 72-h TPA-treated cells, the ε-isozyme was nearly abolished in the cytosol and slightly reduced in the membranes. Some protein kinase C activity may have been maintained during TPA treatment because the basal level of phosphorylation of the protein kinase C substrate myristoylated alanine-rich C kinase substrate was enhanced in cells treated for either 17 or 72 h with TPA. The potential dissociation of carbachol and protein kinase C in eliciting increases in cytosolic CaM content was a function of prolonged TPA treatment and not differentiation per se because carbachol-mediated increases in cytosolic CaM levels were inhibited by Ro 31-8220 in retinoic acid-differentiated SK-N-SH cells. This study demonstrates that continuous TPA treatment, although initially down-regulating the protein kinase C-mediated effect of carbachol on CaM redistribution, uncouples carbachol and protein kinase C at longer times.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65656/1/j.1471-4159.1997.68010040.x.pd

ECONOMIC VIABILITY AND ECOLOGICAL FRIENDLINESS OF MADRASAH EDUCATIONAL INSTITUTION IN REGION XII, PHILIPPINES

This study covered a total of 434 respondents from selected Madaris in the provinces of Cotabato and Maguindanao, Philippines, broken down as follows: 350 students, 70 Asatids, and 14 administrators.The general objective of the study was to investigate the economic viability and ecological friendliness of Madrasah educational institution operating in Mindanao Muslim communities. Specifically, it sought to determine the profiles of the Asatids, level of adequacy of existing resource capabilities of Madrasah, level of Madrasahs’ economic viability and ecological friendliness, influence of the level of adequacy of existing resource capabilities on the economic viability and ecological friendliness of Madrasah educational institution in Region XII, Philippines.Important findings of the study revealed that 90% of the Asatids were college graduate in Arabic education, receiving an honorarium of 1,000 pesos a month, high school graduate in Western education, and with a monthly net income of 7,800 – 8,800.Madrasah resource capabilities like physical, instructional, and financial aspect were found to be adequate while manpower capabilities were moderately adequate.Selected Madaris were assessed to have highly sustained their ecological friendliness and economic viability.The factors which had significantly influence the Madrasah economic viability were manpower capabilities and financial aspect of the Madrasah institution. However, ecological friendliness of the Madrasah institution in Southern Philippines was influence by Madrasahs’ resource capabilities like physical facilities, manpower capabilities, and financial aspect.In order to sustain the Madrasah educational system in Mindanao, it is recommended that more funds shall be provided both from local and foreign sources

Higher-order conservative interpolation between control-volume meshes: Application to advection and multiphase flow problems with dynamic mesh adaptivity

© 2016 .A general, higher-order, conservative and bounded interpolation for the dynamic and adaptive meshing of control-volume fields dual to continuous and discontinuous finite element representations is presented. Existing techniques such as node-wise interpolation are not conservative and do not readily generalise to discontinuous fields, whilst conservative methods such as Grandy interpolation are often too diffusive. The new method uses control-volume Galerkin projection to interpolate between control-volume fields. Bounded solutions are ensured by using a post-interpolation diffusive correction. Example applications of the method to interface capturing during advection and also to the modelling of multiphase porous media flow are presented to demonstrate the generality and robustness of the approach

Percutaneous stenting of a dissected superior mesenteric artery in a patient with previous surgical repair of Stanford type a aortic dissection

Background/Aim: We report a case of a 54-year-old male patient with background history of hypertension, which suffered a Stanford type A thoraco-abdominal aortic dissection with extension to the visceral arteries. Description of case: The patient initially underwent surgical repair with replacement of the ascending aorta and of the hemiarch in the acute phase of the dissection. Postoperatively, he developed non-specific abdominal pain that was not related to meals but led to weight loss of 20 kg within the first five post-operative months. Follow-up computerized tomography scan revealed a chronic subphrenic aortic dissection extending to the celiac axis (with involvement of the left gastric and the splenic artery), the left renal artery and the superior mesenteric artery (SMA). The hepatic artery took origin from the SMA and received blood from the true lumen of the vessel, and the right renal artery was entirely supplied from the true aortic lumen. After exclusion of other causes of abdominal pain, the patient was treated with percutaneous stent placement in the dissected SMA with significant improvement of his symptoms. Conclusion: This case report emphasizes the role of visceral artery endovascular techniques in the management of patients with complicated chronic aortic dissectio

Lexical Derivation of the PINT Taxonomy of Goals: Prominence, Inclusiveness, Negativity Prevention, and Tradition

What do people want? Few questions are more fundamental to psychological science than this. Yet, existing taxonomies disagree on both the number and content of goals. We thus adopted a lexical approach and investigated the structure of goal-relevant words from the natural English lexicon. Through an intensive rating process, 1,060 goal-relevant English words were first located. In Studies 1-2, two relatively large and diverse samples (total n = 1,026) rated their commitment to approaching or avoiding these goals. Principal component analyses yielded 4 replicable components: Prominence, Inclusiveness, Negativity prevention, and Tradition (the PINT Taxonomy). Study 3-7 (total n = 1,396) supported the 4-factor structure of an abbreviated scale and found systematic differences in their relationships with past goal-content measures, the Big 5 traits, affect, and need satisfaction. This investigation thus provides a data-driven taxonomy of higher-order goal-content and opens up a wide variety of fascinating lines for future research

Architects of time: Labouring on digital futures

Drawing on critical analyses of the internet inspired by Gilles Deleuze and the Marxist autonomia movement, this paper suggests a way of understanding the impact of the internet and digital culture on identity and social forms through a consideration of the relationship between controls exercised through the internet, new subjectivities constituted through its use and new labour practices enabled by it. Following Castells, we can see that the distinction between user, consumer and producer is becoming blurred and free labour is being provided by users to corporations. The relationship between digital technologies and sense of community, through their relationship to the future, is considered for its dangers and potentials. It is proposed that the internet may be a useful tool for highlighting and enabling social connections if certain dangers can be traversed. Notably, current remedies for the lack of trust on the internet are questioned with an alternative, drawing on Zygmunt Bauman and Georg Simmel, proposed which is built on community through a vision of a ‘shared network’

On the Renormalizability of Theories with Gauge Anomalies

We consider the detailed renormalization of two (1+1)-dimensional gauge theories which are quantized without preserving gauge invariance: the chiral and the "anomalous" Schwinger models. By regularizing the non-perturbative divergences that appear in fermionic Green's functions of both models, we show that the "tree level" photon propagator is ill-defined, thus forcing one to use the complete photon propagator in the loop expansion of these functions. We perform the renormalization of these divergences in both models to one loop level, defining it in a consistent and semi-perturbative sense that we propose in this paper.Comment: Final version, new title and abstract, introduction and conclusion rewritten, detailed semiperturbative discussion included, references added; to appear in International Journal of Modern Physics