Venous bullet embolism and subsequent endovascular retrieval – A case report and review of the literature

AbstractINTRODUCTIONVascular bullet embolism is a rare phenomenon with fewer than 200 cases reported in the literature.PRESENTATION OF CASEA 22 year-old male presented with a gunshot wound to the right lower quadrant. Imaging demonstrated a bullet lodged in his left lower quadrant. Upon operative exploration, a single hole was found in the right external iliac vein without injury into the left lower quadrant. The bullet was found to have migrated intravascularly from the right external to the left common iliac vein, and was subsequently removed endovascularly.DISCUSSIONBullet embolism occurs infrequently, with arterial more common than venous. Arterial embolization usually requires emergency operative intervention due to ischemia. While venous embolization is often asymptomatic, removal of the bullet is recommended to avoid delayed complications when possible.CONCLUSIONVenous bullet emboli should be removed endovascularly whenever technically possible

Paleocurrent reconstruction of the deep Pacific inflow during the middle Miocene : reflections of East Antarctic Ice Sheet growth

Today the deep western boundary current (DWBC) east of New Zealand is the most important route for deep water entering the Pacific Ocean. Large-scale changes in deep water circulation patterns are thought to have been associated with the development of the East Antarctic Ice Sheet (EAIS) close to the main source of bottom water for the DWBC. Here we reconstruct the changing speed of the southwest Pacific DWBC during the middle Miocene from ∼15.5-12.5 Ma, a period of significant global ice accumulation associated with EAIS growth. Sortable silt mean grain sizes from Ocean Drilling Program Site 1123 reveal variability in the speed of the Pacific inflow on the timescale of the 41 kyr orbital obliquity cycle. Similar orbital period flow changes have recently been demonstrated for the Pleistocene epoch. Collectively, these observations suggest that a strong coupling between changes in the speed of the deep Pacific inflow and high-latitude climate forcing may have been a persistent feature of the global thermohaline circulation system for at least the past 15 Myr. Furthermore, long-term changes in flow speed suggest an intensification of the DWBC under an inferred increase in Southern Component Water production. This occurred at the same time as decreasing Tethyan outflow and major EAIS growth between ∼15.5 and 13.5 Ma. These results provide evidence that a major component of the deep thermohaline circulation was associated with the middle Miocene growth of the EAIS and support the view that this time interval represents an important step in the development of the Neogene icehouse climate

Functional Leadership in Interteam Contexts: Understanding ‘What’ in the Context of Why? Where? When? and Who?

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordResearch on team leadership has primarily focused on leadership processes targeted within teams, in support of team objectives. Yet, teams are open systems that interact with other teams to achieve proximal as well as distal goals. This review clarifies that defining ‘what’ constitutes functionally effective leadership in interteam contexts requires greater precision with regard to where (within teams, across teams) and why (team goals, system goals) leadership processes are enacted, as well as greater consideration of when and among whom leadership processes arise. We begin by synthesizing findings from empirical studies published over the past 30 years that shed light on questions of what, where, why, when, and who related to interteam leadership and end by providing three overarching recommendations for how research should proceed in order to provide a more comprehensive picture of leadership in interteam contexts

Physics with Supernovae

Core-collapse supernovae (SNe) are powerful neutrino sources and as such important targets for the growing array of neutrino observatories. We review the current status of SN theory and the expected characteristics of the neutrino signal. After recalling what we have learned from SN 1987A and general SN properties we review the physics potential of a future galactic SN observation.Comment: Contribution to TAUP 200

Probing Quantum Geometry at LHC

We present an evidence, that the volumes of compactified spaces as well as the areas of black hole horizons must be quantized in Planck units. This quantization has phenomenological consequences, most dramatic being for micro black holes in the theories with TeV scale gravity that can be produced at LHC. We predict that black holes come in form of a discrete tower with well defined spacing. Instead of thermal evaporation, they decay through the sequence of spontaneous particle emissions, with each transition reducing the horizon area by strictly integer number of Planck units. Quantization of the horizons can be a crucial missing link by which the notion of the minimal length in gravity eliminates physical singularities. In case when the remnants of the black holes with the minimal possible area and mass of order few TeV are stable, they might be good candidates for the cold dark matter in the Universe.Comment: 14 pages, Late

Multibeam bathymetric surveys of submarine volcanoes and mega-pockmarks on the Chatham Rise, New Zealand

Author Posting. © The Author(s), 2011. This is the author's version of the work. It is posted here by permission of Taylor & Francis for personal use, not for redistribution. The definitive version was published in New Zealand Journal of Geology and Geophysics 54 (2011): 329-339, doi:10.1080/00288306.2011.589860.Multibeam bathymetric surveys east of the South Island of New Zealand present images of submarine volcanoes and pockmarks west of Urry Knolls on the Chatham Rise, and evidence of submarine erosion on the southern margin of the Chatham Rise. Among numerous volcanic cones, diameters of the largest reach ~2000 m, and some stand as high as 400 m above the surrounding seafloor. The tops of most of the volcanic cones are flat, with hints of craters, and some with asymmetric shapes may show flank collapses. There are hints of both northeast-southwest and northwest-southeast alignments of volcanoes, but no associated faulting is apparent. Near and to the west of these volcanoes, huge pockmarks, some more than ~1 km in diameter, disrupt bottom topography. Pockmarks in this region seem to be confined to sea floor shallower than ~1200 m, but we see evidence of deeper pockmarks at water depths of up to 2100 m on profiles crossing the Bounty Trough. The pockmark field on the Chatham Rise seems to be bounded on the south by a trough near 1200 m depth; like others, we presume that contour currents have eroded the margin and created the trough.This research was supported by the National Science Foundation under grants EAR-0409564, EAR-0409609, and EAR-0409835.2012-08-3

Time delays in the diagnosis and treatment of malaria in non-endemic countries: a systematic review

Background Delays in diagnosis and treatment for malaria are associated with an increased risk for severe disease and mortality. Identifying the extent of patient and health system delay can provide a benchmark against which interventions to reduce delays can be measured. Methods We performed an electronic search in PubMed, EMBASE, Web of Science and LILACS for studies reporting time to diagnosis and treatment after return from travel, onset of symptoms and seeking healthcare in non-endemic countries. Additionally, theses, conference proceedings and nationally reported surveillance data were also searched for information on time delays. There were no language restrictions and all the studies were assessed for methodological quality. Results Data from 69 papers out of 1719 identified records published between 2005 and 2017 were extracted; our findings show that median diagnosis delays of four or more days are common and patient delays accounted for a large proportion of diagnostic delay. There were limited data available on medical diagnostic delay. Conclusion Patient delays accounted for a large proportion of the overall diagnostic delay; however the retrospective nature of the studies could have overestimated patient delay since previous healthcare contacts were not included. Additionally, the high frequency of studies reporting a clinically significant delay is a major concern

A tale of two lakes: a multi-proxy comparison of Lateglacial and Holocene environmental change in Cappadocia, Turkey

Individual palaeoenvironmental records represent a combination of regional-scale (e.g. climatic) and site-specific local factors. Here we compare multiple climate proxies from two nearby maar lake records, assuming that common signals are due to regional-scale forcing. A new core sequence from Nar Lake in Turkey is dated by varves and U–Th to the last 13.8 ka. Markedly dry periods during the Lateglacial stadial, at 4.3–3.7 and at 3.2–2.6 ka BP, are associated with peaks in Mg/dolomite, positive δ18O, elevated diatom-inferred electrical conductivity, an absence of laminated sediments and low Quercus/chenopod ratios. Wet phases occurred during the early–mid Holocene and 1.5–0.6 ka BP, characterized by negative δ18O, calcite precipitation, high Ca/Sr ratios, a high percentage of planktonic diatoms, laminated sediments and high Quercus/chenopod ratios. Comparison with the record from nearby Eski Acıgöl shows good overall correspondence for many proxies, especially for δ18O. Differences are related to basin infilling and lake ontogeny at Eski Acıgöl, which consequently fails to register climatic changes during the last 2 ka, and to increased flux of lithogenic elements into Nar Lake during the last 2.6 ka, not primarily climatic in origin. In attempting to separate a regional signal from site-specific ‘noise’, two lakes may therefore be better than one

On the Integrand-Reduction Method for Two-Loop Scattering Amplitudes

We propose a first implementation of the integrand-reduction method for two-loop scattering amplitudes. We show that the residues of the amplitudes on multi-particle cuts are polynomials in the irreducible scalar products involving the loop momenta, and that the reduction of the amplitudes in terms of master integrals can be realized through polynomial fitting of the integrand, without any apriori knowledge of the integral basis. We discuss how the polynomial shapes of the residues determine the basis of master integrals appearing in the final result. We present a four-dimensional constructive algorithm that we apply to planar and non-planar contributions to the 4- and 5-point MHV amplitudes in N=4 SYM. The technique hereby discussed extends the well-established analogous method holding for one-loop amplitudes, and can be considered a preliminary study towards the systematic reduction at the integrand-level of two-loop amplitudes in any gauge theory, suitable for their automated semianalytic evaluation.Comment: 26 pages, 11 figure

Political opportunity structures, democracy, and civil war

Theories of mobilization suggest that groups are more likely to resort to violence in the presence of political opportunity structures that afford greater prospects for extracting concessions from the government or better opportunities to topple ruling governments. However, existing efforts to consider the possible influences of political opportunity structures on incentives for violence and civil war empirically have almost invariably relied upon measures of democracy to proxy for the hypothesized mechanisms, most notably the argument that the opposing effects of political accommodation and repression will give rise to an inverted U-shaped relationship between democracy and the risk of civil war. The authors detail a number of problems with measures of democracy as proxies for political opportunity structures and develop alternative measures based on the likely risks that political leaders will lose power in irregular challenges and their implications for the incentives for resort to violence. The authors evaluate empirically how the security with which leaders hold office influences the prospects of violent civil conflict. The findings indicate that recent irregular leader entry and transitions indeed increase the risk of conflict onset, while democratic institutions are found to decrease the risk of civil war, after controlling for the new measures of state weakness. </jats:p