An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report.

BackgroundThe increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify.Case presentationHere we present the case report of a 14-year-old Caucasian  girl with weight loss and a 3-year history of reported angioedema culminating in five intensive care unit admissions over the course of 2.5 months. Her initial clinical presentation included hypotension, dyspnea, and reported facial edema, but allergy and immunological workup were negative. A psychiatric workup identified an eating disorder with food restriction, comorbid major depression, obsessive compulsive disorder, and posttraumatic stress disorder. A close collaboration between Adolescent Medicine, Allergy and Immunology, and Psychiatry helped disentangle medical from psychiatric problems, including fluoxetine medication effects, as well as develop a treatment plan that was acceptable to the family. The angioedema was ultimately diagnosed as factitious disorder.ConclusionsThis patient's treatment highlights the importance of a multidisciplinary team approach, a multifactorial etiology that needed to be addressed by multiple specialists, and the importance of long-term treatment and support

Impact of a smoking ban in hospitality venues on second hand smoke exposure : a comparison of exposure assessment methods

In May 2010, Switzerland introduced a heterogeneous smoking ban in the hospitality sector. While the law leaves room for exceptions in some cantons, it is comprehensive in others. This longitudinal study uses different measurement methods to examine airborne nicotine levels in hospitality venues and the level of personal exposure of non-smoking hospitality workers before and after implementation of the law.; Personal exposure to second hand smoke (SHS) was measured by three different methods. We compared a passive sampler called MoNIC (Monitor of NICotine) badge, to salivary cotinine and nicotine concentration as well as questionnaire data. Badges allowed the number of passively smoked cigarettes to be estimated. They were placed at the venues as well as distributed to the participants for personal measurements. To assess personal exposure at work, a time-weighted average of the workplace badge measurements was calculated.; Prior to the ban, smoke-exposed hospitality venues yielded a mean badge value of 4.48 (95%-CI: 3.7 to 5.25; n = 214) cigarette equivalents/day. At follow-up, measurements in venues that had implemented a smoking ban significantly declined to an average of 0.31 (0.17 to 0.45; n = 37) (p = 0.001). Personal badge measurements also significantly decreased from an average of 2.18 (1.31-3.05 n = 53) to 0.25 (0.13-0.36; n = 41) (p = 0.001). Spearman rank correlations between badge exposure measures and salivary measures were small to moderate (0.3 at maximum).; Nicotine levels significantly decreased in all types of hospitality venues after implementation of the smoking ban. In-depth analyses demonstrated that a time-weighted average of the workplace badge measurements represented typical personal SHS exposure at work more reliably than personal exposure measures such as salivary cotinine and nicotine

Evaluation of grit properties at a medium-capacity wastewater treatment plant: A case study

The optimized, tailored approaches in the design of wastewater treatment plants (WWTPs) minimize expenditure of the resources, increase treatment effectiveness, and prolong useful life of the infrastructure. In this study, wastewater grit characteristics were evaluated over the course of one year at the headworks and collection network of the Atlantic County Utilities Authority (ACUA) WWTP, located in New Jersey, USA. The mixed grit at the ACUA WWTP can be characterized as particles prevalently in the fine sand size range with high content of organic matter, low fraction of fats, oils, and grease (FOG), and very low settling velocity. A significant seasonal variability was observed in the measured parameters. These results will be utilized in the design of the most effective, fiscally responsible, and sustainable method of grit removal at the study site and may serve to promote utilization of WWTP-specific design at other facilities

CONCEPTUALIZING CONTEXT FOR ADAPTIVE PERVASIVE COMMERCE

In retail, demographics are currently regarded as the most convenient base for successful personalized marketing. However, signs point to the dormant power of context recognition. While technologies that can sense the environment are advanced, questions such as what to sense and how to adapt context are largely unanswered. In this paper, we analyze the purchase context of a retail outlet and suggest a context model for adaptive pervasive commerce. Furthermore, we introduce one approach how to conceptualize context that may be applied to conceptualize context for adaptive pervasive advertising applications so that they really deliver on their potential: showing the right message to the right recipient at the right time

Application of Osteopathic Manipulative Medicine to Ameliorate Sepsis Induced Ileus

Graduate Basi

Unbased calculus for functors to chain complexes

Recently, the Johnson-McCarthy discrete calculus for homotopy functors was extended to include functors from an unbased simplicial model category to spectra. This paper completes the constructions needed to ensure that there exists a discrete calculus tower for functors from an unbased simplicial model category to chain complexes over a fixed commutative ring. Much of the construction of the Taylor tower for functors to spectra carries over to this context. However, one of the essential steps in the construction requires proving that a particular functor is part of a cotriple. For this, one needs to prove that certain identities involving homotopy limits hold up to isomorphism, rather than just up to weak equivalence. As the target category of chain complexes is not a simplicial model category, the arguments for functors to spectra need to be adjusted for chain complexes. In this paper, we take advantage of the fact that we can construct an explicit model for iterated fibers, and prove that the functor is a cotriple directly. We use related ideas to provide concrete infinite deloopings of the first terms in the resulting Taylor towers when evaluated at the initial object in the source category.Comment: 20 page

Celebrating Diversity: Using and Measuring the Impact of StrengthsQuest

This panel fits the “Best-practice examples of instructional/assessment practice to develop diversity outcomes.” Students who experience StrengthsQuest based learning will have a greater appreciation for their own strengths and better understand/appreciate the actions of students with different strengths from their own. Each presenter has different outcomes and assessments in using the StrengthsQuest learning approach. In the Department of Communication Studies, Communication and Leadership class (COMM 535), students use strengths in class activities, to self-select more diverse work teams for a group project, and write self-reflections about how they are actively using their strengths to be successful as a student and leader. Assessments include reflection papers, group project work, and a learning portfolio. In Leadership Studies, students taking Introduction to Leadership Concepts (LEAD 212) explore StrengthsQuest as a way to learn about self and how they can best leverage their own strengths and the strengths of others when exercising leadership. Through a service-learning experience students apply their knowledge of strengths in working with a team, and practice various approaches of engaging with one another throughout the service experience. At the Academic and Career Information Center, students are guided to majors, minors, and career opportunities that allow them to capitalize on their strengths. In addition to a follow-up survey for appointments, students in the Academic and Career Decisions class (EDCEP 120) take a pre- and post- test regarding their Career Self Confidence. This assessment includes questions to better understand identification and application of Strengths

Evaluating the Impacts of ACP Management on the Energy Performance of Hydrothermal Liquefaction via Nutrient Recovery

Hydrothermal liquefaction (HTL) is of interest in producing liquid fuels from organic waste, but the process also creates appreciable quantities of aqueous co-product (ACP) containing high concentrations of regulated wastewater pollutants (e.g., organic carbon, nitrogen (N), and phosphorus (P)). Previous literature has not emphasized characterization, management, or possible valorization of ACP wastewaters. This study aims to evaluate one possible approach to ACP management via recovery of valuable scarce materials. Equilibrium modeling was performed to estimate theoretical yields of struvite (MgNH4PO4·6H2O) from ACP samples arising from HTL processing of selected waste feedstocks. Experimental analyses were conducted to evaluate the accuracy of theoretical yield estimates. Adjusted yields were then incorporated into a life-cycle energy modeling framework to compute energy return on investment (EROI) for the struvite precipitation process as part of the overall HTL life-cycle. Observed struvite yields and residual P concentrations were consistent with theoretical modeling results; however, residual N concentrations were lower than model estimates because of the volatilization of ammonia gas. EROI calculations reveal that struvite recovery is a net-energy producing process, but that this benefit offers little to no improvement in EROI performance for the overall HTL life-cycle. In contrast, corresponding economic analysis suggests that struvite precipitation may be economically appealing

Evaluating the Impacts of ACP Management on the Energy Performance of Hydrothermal Liquefaction via Nutrient Recovery

Hydrothermal liquefaction (HTL) is of interest in producing liquid fuels from organic waste, but the process also creates appreciable quantities of aqueous co-product (ACP) containing high concentrations of regulated wastewater pollutants (e.g., organic carbon, nitrogen (N), and phosphorus (P)). Previous literature has not emphasized characterization, management, or possible valorization of ACP wastewaters. This study aims to evaluate one possible approach to ACP management via recovery of valuable scarce materials. Equilibrium modeling was performed to estimate theoretical yields of struvite (MgNH4PO4·6H2O) from ACP samples arising from HTL processing of selected waste feedstocks. Experimental analyses were conducted to evaluate the accuracy of theoretical yield estimates. Adjusted yields were then incorporated into a life-cycle energy modeling framework to compute energy return on investment (EROI) for the struvite precipitation process as part of the overall HTL life-cycle. Observed struvite yields and residual P concentrations were consistent with theoretical modeling results; however, residual N concentrations were lower than model estimates because of the volatilization of ammonia gas. EROI calculations reveal that struvite recovery is a net-energy producing process, but that this benefit offers little to no improvement in EROI performance for the overall HTL life-cycle. In contrast, corresponding economic analysis suggests that struvite precipitation may be economically appealing