The recognition, frequency, and taxonomic association of skeletal pathology from selected Plio-Pleistocene-aged sites from the Cradle of Humankind, Witwatersrand, South Africa

Skeletal pathology has been largely unexplored from South African Plio-Pleistocene cave contexts. As a result, there is little known about the types of pathology present in these assemblages or the frequencies at which they occur. This study was designed to identify and analyze skeletal pathology from two sites in the Cradle of Humankind, South Africa. Over 7000 postcranial fossils, representing the broad range of macromammalian taxa from the early hominid sites of Cooper‟s D and Swartkrans (Members 1-3), were examined for evidence of gross skeletal pathology. Frequencies of pathology were recorded at order and family levels and the elements were categorized to skeletal section to identify possible trends in the anatomical location of lesions. Chi-square and randomization tests for goodness-of-fit were conducted at family level and by skeletal section to note any significant disagreement between observed and expected frequencies of pathology. Pathological fossils were described and lesions were identified to broad diagnostic categories. In total, twenty-four pathological fossils were identified from Cooper‟s D and forty from Swartkrans. Joint disease, trauma and enthesopathy are the most common disease types from both sites. For the Swartkrans fauna there is the additional presence of neoplasia. The frequency of pathology at order level is similar for both sites, with artiodactyls showing the lowest frequency, followed by carnivores and primates. Pathology by family occurs at frequencies of between 0 and 6%. Hominids fall outside of this range, occurring at a frequency of 100% for Cooper‟s D and 16% for Swartkrans. For both sites there is a significant disagreement between the observed and expected frequencies of pathology for bovids, felids and hominids. This indicates that pathology does not occur in equal proportion throughout the assemblage, but rather occurs at high frequency for felids and hominids and low frequency for bovids, possibly correlated to the trophic roles of the different taxa. It was, however, found that pathology predominantly occurred on the same elements for all families, specifically the vertebrae and distal-limb. Chi-square and randomization tests by skeletal section revealed a non-significant result for Cooper‟s D (P = 0.07) and a significant result for Swartkrans (P = 0.03). For Swartkrans there is a significant disagreement between the observed and expected frequencies of pathology for distal-limb and hindlimb elements. This result may be due to the high frequency of pathology on hominid distal elements, explained, in part, by a mechanical stress aetiology involving activity related to hominid grip and grasping

Too Smart to Fail: Guide for the Struggling Medical Student

Medicine is a vocation of perpetual independent learning; long-term success is critically dependent on finding the right resources and establishing effective study methods and test-taking strategies. Students who struggle with the academic transition in medical school have common risk factors and characteristics. We highlight key resources that are available for struggling medical students with an emphasis on West Virginia\u27s HELP, ASPIRE, and STAT programs

The electrocardiogram and the position of the heart

The profound effects that rotation of the heart, particularly about the longitudinal axis, have on the mean electrical axis, as seen in limb leads, are emphasized, and some of the experimental and clinical studies that bear on this matter are discussed. The advantages that spatial vectorcardiograms may have in the evaluation of electrocardiographic changes due solely to an unusual position of the heart are pointed out, but, for a number of practical reasons, it is felt that such records will not be very useful in the solution of these or similar problems in the near future.Peculiarities in the form of tracings from the precordium due entirely to an unusual position of the heart are mentioned, but it is considered unwise (except for purposes of investigation) to recommend a change from the conventional sites for multiple precordial leads because of the suspicion that the heart may be placed in an unusual fashion.The suggestion of Kossmann and co-workers that signs suggesting right ventricular enlargement in both standard and precordial leads may arise as a result of marked clockwise rotation of the heart about the long axis is discussed, and some evidence for and against this view is presented. Since concepts basic in the interpretation of precordial leads are involved in this problem, the need for further studies to decide the matter is emphasized. It is pointed out that tangential rather than purely radial spread of the activation wave over the ventricles may explain some of the difficulties encountered in interpretation of precordial leads, particularly when right ventricular enlargement or left bundle branch block is present.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32545/1/0000656.pd

The Environment as an Unrecognized Reservoir for Community-Associated Methicillin Resistant Staphylococcus aureus USA300: A Case-Control Study

BACKGROUND: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are spreading, but the source of infections in non-epidemic settings remains poorly defined. METHODS: We carried out a community-based, case-control study investigating socio-demographic risk factors and infectious reservoirs associated with MRSA infections. Case patients presented with CA-MRSA infections to a New York hospital. Age-matched controls without infections were randomly selected from the hospital's Dental Clinic patient population. During a home visit, case and control subjects completed a questionnaire, nasal swabs were collected from index respondents and household members and standardized environmental surfaces were swabbed. Genotyping was performed on S. aureus isolates. RESULTS: We enrolled 95 case and 95 control subjects. Cases more frequently reported diabetes mellitus and a higher number of skin infections among household members. Among case households, 53 (56%) were environmentally contaminated with S. aureus, compared to 36 (38%) control households (p = .02). MRSA was detected on fomites in 30 (32%) case households and 5 (5%; p<.001) control households. More case patients, 20 (21%) were nasally colonized with MRSA than were control indexes, 2 (2%; p<.001). In a subgroup analysis, the clinical isolate (predominantly USA300), was more commonly detected on environmental surfaces in case households with recurrent MRSA infections (16/36, 44%) than those without (14/58, 24%, p = .04). CONCLUSIONS: The higher frequency of environmental contamination of case households with S. aureus in general and MRSA in particular implicates this as a potential reservoir for recolonization and increased risk of infection. Environmental colonization may contribute to the community spread of epidemic strains such as USA300

The Berkeley Sample of Stripped-Envelope Supernovae

We present the complete sample of stripped-envelope supernova (SN) spectra observed by the Lick Observatory Supernova Search (LOSS) collaboration over the last three decades: 888 spectra of 302 SNe, 652 published here for the first time, with 384 spectra (of 92 SNe) having photometrically-determined phases. After correcting for redshift and Milky Way dust reddening and reevaluating the spectroscopic classifications for each SN, we construct mean spectra of the three major spectral subtypes (Types IIb, Ib, and Ic) binned by phase. We compare measures of line strengths and widths made from this sample to the results of previous efforts, confirming that O I {\lambda}7774 absorption is stronger and found at higher velocity in Type Ic SNe than in Types Ib or IIb SNe in the first 30 days after peak brightness, though the widths of nebular emission lines are consistent across subtypes. We also highlight newly available observations for a few rare subpopulations of interest.Comment: 13 pages; 14 figures; 3 tables. Accepted for publication in MNRA

First-in-human clinical trial of ultrasonic propulsion of kidney stones

PURPOSE: Ultrasonic propulsion is a new technology using focused ultrasound energy applied transcutaneously to reposition kidney stones. We report what are to our knowledge the findings from the first human investigational trial of ultrasonic propulsion toward the applications of expelling small stones and dislodging large obstructing stones. MATERIALS AND METHODS: Subjects underwent ultrasonic propulsion while awake without sedation in clinic, or during ureteroscopy while anesthetized. Ultrasound and a pain questionnaire were completed before, during and after propulsion. The primary outcome was to reposition stones in the collecting system. Secondary outcomes included safety, controllable movement of stones and movement of stones less than 5 mm and 5 mm or greater. Adverse events were assessed weekly for 3 weeks. RESULTS: Kidney stones were repositioned in 14 of 15 subjects. Of the 43 targets 28 (65%) showed some level of movement while 13 (30%) were displaced greater than 3 mm to a new location. Discomfort during the procedure was rare, mild, brief and self-limited. Stones were moved in a controlled direction with more than 30 fragments passed by 4 of the 6 subjects who had previously undergone a lithotripsy procedure. The largest stone moved was 10 mm. One patient experienced pain relief during treatment of a large stone at the ureteropelvic junction. In 4 subjects a seemingly large stone was determined to be a cluster of small passable stones after they were moved. CONCLUSIONS: Ultrasonic propulsion was able to successfully reposition stones and facilitate the passage of fragments in humans. No adverse events were associated with the investigational procedure

Earliest hominin cancer: 1.7-million-year old osteosarcoma from Swartkrans Cave, South Africa

The reported incidence of neoplasia in the extinct human lineage is rare, with only a few confirmed cases of Middle or Later Pleistocene dates reported. It has generally been assumed that premodern incidence of neoplastic disease of any kind is rare and limited to benign conditions, but new fossil evidence suggests otherwise. We here present the earliest identifiable case of malignant neoplastic disease from an early human ancestor dated to 1.8–1.6 million years old. The diagnosis has been made possible only by advances in 3D imaging methods as diagnostic aids. We present a case report based on re-analysis of a hominin metatarsal specimen (SK 7923) from the cave site of Swartkrans in the Cradle of Humankind, South Africa. The expression of malignant osteosarcoma in the Swartkrans specimen indicates that whilst the upsurge in malignancy incidence is correlated with modern lifestyles, there is no reason to suspect that primary bone tumours would have been any less frequent in ancient specimens. Such tumours are not related to lifestyle and often occur in younger individuals. As such, malignancy has a considerable antiquity in the fossil record, as evidenced by this specimen

Berkeley Supernova Ia Program I: Observations, Data Reduction, and Spectroscopic Sample of 582 Low-Redshift Type Ia Supernovae

In this first paper in a series we present 1298 low-redshift (z\leq0.2) optical spectra of 582 Type Ia supernovae (SNe Ia) observed from 1989 through 2008 as part of the Berkeley SN Ia Program (BSNIP). 584 spectra of 199 SNe Ia have well-calibrated light curves with measured distance moduli, and many of the spectra have been corrected for host-galaxy contamination. Most of the data were obtained using the Kast double spectrograph mounted on the Shane 3 m telescope at Lick Observatory and have a typical wavelength range of 3300-10,400 Ang., roughly twice as wide as spectra from most previously published datasets. We present our observing and reduction procedures, and we describe the resulting SN Database (SNDB), which will be an online, public, searchable database containing all of our fully reduced spectra and companion photometry. In addition, we discuss our spectral classification scheme (using the SuperNova IDentification code, SNID; Blondin & Tonry 2007), utilising our newly constructed set of SNID spectral templates. These templates allow us to accurately classify our entire dataset, and by doing so we are able to reclassify a handful of objects as bona fide SNe Ia and a few other objects as members of some of the peculiar SN Ia subtypes. In fact, our dataset includes spectra of nearly 90 spectroscopically peculiar SNe Ia. We also present spectroscopic host-galaxy redshifts of some SNe Ia where these values were previously unknown. [Abridged]Comment: 34 pages, 11 figures, 11 tables, revised version, re-submitted to MNRAS. Spectra will be released in January 2013. The SN Database homepage (http://hercules.berkeley.edu/database/index_public.html) contains the full tables, plots of all spectra, and our new SNID template