Incidental renocolic fistula with xanthogranulomatous pyelonephritis

AbstractINTRODUCTIONWe report the case of a 66-year-old female undergoing elective nephrectomy for a non-functioning kidney in whom an incidental renocolic fistula was detected.PRESENTATION OF CASEShe presented with recurrent urinary tract infections and left flank pain. Investigations revealed a nonfunctioning left kidney with a large staghorn calculus and features suggestive of xanthogranulomatous pyelonephritis (XPG). At nephrectomy, an incidental renocolic fistula was found and excised.DISCUSSIONXGP is a rare, chronic inflammatory disorder of the kidney characterized by a destructive mass invading the renal parenchyma. Renocolic fistulae complicating XGP are uncommon and not widely reported in the literature.CONCLUSIONHerein, we describe a case of XGP with renocolic fistula formation, its management and a review of the literature

Boundary conditions of workplace coaching outcomes

Purpose In order to address the need for greater understanding about the occupational and practice determinants of effective workplace coaching, this study examines the associations of two coaching practice factors (coaching format and external versus internal coaching provision), and coachees’ job complexity with perceived outcomes from coaching. Design/methodology/approach A survey of 161 individuals who had received workplace coaching was conducted. Participants provided data on two outcome criteria (self-reported work well-being and personal effectiveness at work). Findings Analysis indicated that external coaches and blended format coaching were most strongly associated with work well-being outcomes. Our examination of interaction effects showed that coaching provided by external coaches was more strongly associated with outcomes for individuals working in the most complex job roles. Originality/value The original contribution of our findings are in terms of the implications for coaches, managers and HR practitioners by showing how coaching can be implemented differentially and most effectively based on desired outcome criteria and features of coachees’ job situations

Growing Environmental Activists: Developing Environmental Agency and Engagement Through Children’s Fiction.

We explore how story has the potential to encourage environmental engagement and a sense of agency provided that critical discussion takes place. We illuminate this with reference to the philosophies of John Macmurray on personal agency and social relations; of John Dewey on the primacy of experience for philosophy; and of Paul Ricoeur on hermeneutics, dialogue, dialectics and narrative. We view the use of fiction for environmental understanding as hermeneutic, a form of conceptualising place which interprets experience and perception. The four writers for young people discussed are Ernest Thompson Seton, Kenneth Grahame, Michelle Paver and Philip Pullman. We develop the concept of critical dialogue, and link this to Crick's demand for active democratic citizenship. We illustrate the educational potential for environmental discussions based on literature leading to deeper understanding of place and environment, encouraging the belief in young people that they can be and become agents for change. We develop from Zimbardo the key concept of heroic resister to encourage young people to overcome peer pressure. We conclude with a call to develop a greater awareness of the potential of fiction for learning, and for writers to produce more focused stories engaging with environmental responsibility and activism

Large-amplitude driving of a superconducting artificial atom: Interferometry, cooling, and amplitude spectroscopy

Superconducting persistent-current qubits are quantum-coherent artificial atoms with multiple, tunable energy levels. In the presence of large-amplitude harmonic excitation, the qubit state can be driven through one or more of the constituent energy-level avoided crossings. The resulting Landau-Zener-Stueckelberg (LZS) transitions mediate a rich array of quantum-coherent phenomena. We review here three experimental works based on LZS transitions: Mach-Zehnder-type interferometry between repeated LZS transitions, microwave-induced cooling, and amplitude spectroscopy. These experiments exhibit a remarkable agreement with theory, and are extensible to other solid-state and atomic qubit modalities. We anticipate they will find application to qubit state-preparation and control methods for quantum information science and technology.Comment: 13 pages, 5 figure

Measurement of the Bottom-Strange Meson Mixing Phase in the Full CDF Data Set

We report a measurement of the bottom-strange meson mixing phase \beta_s using the time evolution of B0_s -> J/\psi (->\mu+\mu-) \phi (-> K+ K-) decays in which the quark-flavor content of the bottom-strange meson is identified at production. This measurement uses the full data set of proton-antiproton collisions at sqrt(s)= 1.96 TeV collected by the Collider Detector experiment at the Fermilab Tevatron, corresponding to 9.6 fb-1 of integrated luminosity. We report confidence regions in the two-dimensional space of \beta_s and the B0_s decay-width difference \Delta\Gamma_s, and measure \beta_s in [-\pi/2, -1.51] U [-0.06, 0.30] U [1.26, \pi/2] at the 68% confidence level, in agreement with the standard model expectation. Assuming the standard model value of \beta_s, we also determine \Delta\Gamma_s = 0.068 +- 0.026 (stat) +- 0.009 (syst) ps-1 and the mean B0_s lifetime, \tau_s = 1.528 +- 0.019 (stat) +- 0.009 (syst) ps, which are consistent and competitive with determinations by other experiments.Comment: 8 pages, 2 figures, Phys. Rev. Lett 109, 171802 (2012

Development and deployment of COVID-19 vaccines forthose most vulnerable

Development of safe and effective COVID-19 vaccines is a global priority and the best hope for ending the COVID-19 pandemic. Remarkably, in less than 1 year, vaccines have been developed and shown to be efficacious and are already being deployed worldwide. Yet, many challenges remain. Immune senescence and comorbidities in aging populations and immune dysregulation in populations living in low-resource settings may impede vaccine effectiveness. Distribution of vaccines among these populations where vaccine access is historically low remains challenging. In this Review, we address these challenges and provide strategies for ensuring that vaccines are developed and deployed for those most vulnerable

Formulation and Search of Assembly Sequence Design Spaces for Efficient Use of Assembly Plant Resources for New Products

Efficient procedures for generation of feasible assembly sequences and effective utilization of available assembly plant resources can greatly reduce the development time and cost of platforms for new product family members. This article presents a method to generate feasible assembly sequences and an approach to select an assembly process that reduces the existing plant modification cost. Assembly sequence design space is combinatorial in nature. Mathematical models to solve the effects of constraints on these spaces and algorithms to efficiently enumerate feasible spaces are explored in this research. Algorithms to search the feasible space to identify assembly process that can reduce the modification cost of the existing assembly plant can help increase utilization of existing resources. A software application that implements the method and algorithms has been developed. The algorithms use the concept of recursive partitioning of set of components to generate assembly sequence space. The assembly processes are then evaluated to determine the process that maximizes resource utilization for new platforms. The application of the proposed approach is demonstrated using automotive underbody front structure family.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Estimating Cost Savings when Implementing a Product Platform Approach

Many market forces are driving companies to improve their targeting of increasingly small market niches. To accomplish this efficiently, products are organized into product families that typically share common platforms. To reorganize the current product offerings or new products into a product family, using a platform approach, requires estimating the savings for such a modification. One of the problems encountered in estimating development and design cost is the lack of availability of hard information during the initial design phases. The purpose of this paper is to estimate the design and development cost, when moving towards a platform approach, using simple models. The activity based product family cost models are developed from existing single product design activities, which are modified and extended to reflect activities related to development of product platform and subsequent product family members supported by the platform. Uncertainty related to cost associated with activities are included in the model, which is solved using Monte Carlo simulation. The approach is demonstrated using a hard disk drive spindle motor platform development for a family of hard disks.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Multi-system neurological disease is common in patients with OPA1 mutations

Additional neurological features have recently been described in seven families transmitting pathogenic mutations in OPA1, the most common cause of autosomal dominant optic atrophy. However, the frequency of these syndromal ‘dominant optic atrophy plus’ variants and the extent of neurological involvement have not been established. In this large multi-centre study of 104 patients from 45 independent families, including 60 new cases, we show that extra-ocular neurological complications are common in OPA1 disease, and affect up to 20% of all mutational carriers. Bilateral sensorineural deafness beginning in late childhood and early adulthood was a prominent manifestation, followed by a combination of ataxia, myopathy, peripheral neuropathy and progressive external ophthalmoplegia from the third decade of life onwards. We also identified novel clinical presentations with spastic paraparesis mimicking hereditary spastic paraplegia, and a multiple sclerosis-like illness. In contrast to initial reports, multi-system neurological disease was associated with all mutational subtypes, although there was an increased risk with missense mutations [odds ratio = 3.06, 95% confidence interval = 1.44–6.49; P = 0.0027], and mutations located within the guanosine triphosphate-ase region (odds ratio = 2.29, 95% confidence interval = 1.08–4.82; P = 0.0271). Histochemical and molecular characterization of skeletal muscle biopsies revealed the presence of cytochrome c oxidase-deficient fibres and multiple mitochondrial DNA deletions in the majority of patients harbouring OPA1 mutations, even in those with isolated optic nerve involvement. However, the cytochrome c oxidase-deficient load was over four times higher in the dominant optic atrophy + group compared to the pure optic neuropathy group, implicating a causal role for these secondary mitochondrial DNA defects in disease pathophysiology. Individuals with dominant optic atrophy plus phenotypes also had significantly worse visual outcomes, and careful surveillance is therefore mandatory to optimize the detection and management of neurological disability in a group of patients who already have significant visual impairment