Thiotepa hyperpigmentation preceding epidermal necrosis: malignant intertrigo misdiagnosed as Stevens-Johnson syndrome-toxic epidermal necrolysis overlap

Thiotepa is a common alkylating agent known to precipitate cutaneous reactions consistent with toxic erythema of chemotherapy, including erythema and hyperpigmentation. Herein, we describe an atypical case of malignant intertrigo involving preferential erythema and desquamation not only of skin folds but also of occluded areas after thiotepa-based conditioning. The diagnosis was complicated by concurrent stomatitis and oral petechiae in the setting of autologous stem cell transplant 11 days prior for diffuse large B-cell lymphoma. Histopathological examination from two cutaneous sites demonstrated epidermal dysmaturation and eccrine gland necrosis consistent with thiotepa-induced desquamation and not Stevens-Johnson syndrome or graft-versus-host-disease. Malignant intertrigo can present with extensive cutaneous involvement, as evidenced by our patient who had 25% body surface area affected. Mucosal involvement is common with most chemotherapeutic regimens and its presence should not deter the astute clinician from consideration of a diagnosis of toxic erythema of chemotherapy. No further interventions were needed and the patient healed spontaneously

Getting to know you: Accuracy and error in judgments of character

Character judgments play an important role in our everyday lives. However, decades of empirical research on trait attribution suggest that the cognitive processes that generate these judgments are prone to a number of biases and cognitive distortions. This gives rise to a skeptical worry about the epistemic foundations of everyday characterological beliefs that has deeply disturbing and alienating consequences. In this paper, I argue that this skeptical worry is misplaced: under the appropriate informational conditions, our everyday character-trait judgments are in fact quite trustworthy. I then propose a mindreading-based model of the socio-cognitive processes underlying trait attribution that explains both why these judgments are initially unreliable, and how they eventually become more accurate

The comparative biology of skeletal metastasis

Bone metastasis, a very common sequelae of cancer, is often associated with great morbidity. Understanding the biology of bone metastases may lead to therapeutic interventions to target the metastases. In addition to replacing bone marrow elements, the presence of tumour cells in bone modulates the normal bone remodelling process. Some tumours result in primarily osteolytic bone lesions, whereas others are associated with osteoblastic bone lesions. In either case, the resulting changes in the bone structure result in weakened bone that induces pain and is predisposed to fracture. The mechanisms through which cancer cells modulate bone remodelling are not clearly defined, but ongoing research using a variety of animal models will hopefully provide clues to prevent or slow the progress of bone metastases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73390/1/j.1476-5829.2003.00023.x.pd

Effects of Lightning on Trees: A Predictive Model Based on in situ Electrical Resistivity

The effects of lightning on trees range from catastrophic death to the absence of observable damage. Such differences may be predictable among tree species, and more generally among plant life history strategies and growth forms. We used field‐collected electrical resistivity data in temperate and tropical forests to model how the distribution of power from a lightning discharge varies with tree size and identity, and with the presence of lianas. Estimated heating density (heat generated per volume of tree tissue) and maximum power (maximum rate of heating) from a standardized lightning discharge differed 300% among tree species. Tree size and morphology also were important; the heating density of a hypothetical 10 m tall Alseis blackiana was 49 times greater than for a 30 m tall conspecific, and 127 times greater than for a 30 m tall Dipteryx panamensis. Lianas may protect trees from lightning by conducting electric current; estimated heating and maximum power were reduced by 60% (±7.1%) for trees with one liana and by 87% (±4.0%) for trees with three lianas. This study provides the first quantitative mechanism describing how differences among trees can influence lightning–tree interactions, and how lianas can serve as natural lightning rods for trees

Impact of an improved neutrino energy estimate on outflows in neutron star merger simulations

Binary neutron star mergers are promising sources of gravitational waves for ground-based detectors such as Advanced LIGO. Neutron-rich material ejected by these mergers may also be the main source of r-process elements in the Universe, while radioactive decays in the ejecta can power bright electromagnetic post-merger signals. Neutrino-matter interactions play a critical role in the evolution of the composition of the ejected material, which significantly impacts the outcome of nucleosynthesis and the properties of the associated electromagnetic signal. In this work, we present a simulation of a binary neutron star merger using an improved method for estimating the average neutrino energies in our energy-integrated neutrino transport scheme. These energy estimates are obtained by evolving the neutrino number density in addition to the neutrino energy and flux densities. We show that significant changes are observed in the composition of the polar ejecta when comparing our new results with earlier simulations in which the neutrino spectrum was assumed to be the same everywhere in optically thin regions. In particular, we find that material ejected in the polar regions is less neutron rich than previously estimated. Our new estimates of the composition of the polar ejecta make it more likely that the color and timescale of the electromagnetic signal depend on the orientation of the binary with respect to an observer's line-of-sight. These results also indicate that important observable properties of neutron star mergers are sensitive to the neutrino energy spectrum, and may need to be studied through simulations including a more accurate, energy-dependent neutrino transport scheme.Comment: 19p, 17 figures, Accepted by Phys.Rev.

Selecting ultra-faint dwarf candidate progenitors in cosmological N-body simulations at high redshifts

The smallest satellites of the Milky Way ceased forming stars during the epoch of reionization and thus provide archaeological access to galaxy formation at $z>6$. Numerical studies of these ultra-faint dwarf galaxies (UFDs) require expensive cosmological simulations with high mass resolution that are carried out down to $z=0$. However, if we are able to statistically identify UFD host progenitors at high redshifts \emph{with relatively high probabilities}, we can avoid this high computational cost. To find such candidates, we analyze the merger trees of Milky Way type halos from the high-resolution ${\it Caterpillar}$ suite of dark matter only simulations. Satellite UFD hosts at $z=0$ are identified based on four different abundance matching (AM) techniques. All the halos at high redshifts are traced forward in time in order to compute the probability of surviving as satellite UFDs today. Our results show that selecting potential UFD progenitors based solely on their mass at z=12 (8) results in a 10\% (20\%) chance of obtaining a surviving UFD at $z=0$ in three of the AM techniques we adopted. We find that the progenitors of surviving satellite UFDs have lower virial ratios ($\eta$), and are preferentially located at large distances from the main MW progenitor, while they show no correlation with concentration parameter. Halos with favorable locations and virial ratios are $\approx 3$ times more likely to survive as satellite UFD candidates at $z=0.$Comment: 12 pages, 7 figures, accepted for publication at MNRAS after minor revision

Measuring AGN Feedback with the Sunyaev-Zel'dovich Effect

One of the most important and poorly-understood issues in structure formation is the role of outflows driven by active galactic nuclei (AGN). Using large-scale cosmological simulations, we compute the impact of such outflows on the small-scale distribution of the cosmic microwave background (CMB). Like gravitationally-heated structures, AGN outflows induce CMB distortions both through thermal motions and peculiar velocities, by processes known as the thermal and kinetic Sunyaev-Zel'dovich (SZ) effects, respectively. For AGN outflows the thermal SZ effect is dominant, doubling the angular power spectrum on arcminute scales. But the most distinct imprint of AGN feedback is a substantial increase in the thermal SZ distortions around elliptical galaxies, post-starburst ellipticals, and quasars, which is linearly proportional to the outflow energy. While point source subtraction is difficult for quasars, we show that by appropriately stacking microwave measurements around early-type galaxies, the new generation of small-scale microwave telescopes will be able to directly measure AGN feedback at the level important for current theoretical models.Comment: 12 pages, 12 figures, submitted to ApJ (comments welcome