Recurrent Polymicrobial Bloodstream Infections as Harbingers of a Duodenal-Inferior Vena Cava Fistula

This is a case of an 82-year-old patient who presented with recurrent polymicrobial bloodstream infections and no obvious undrained source of infection. She had prior double barrel iliocaval stenting for post thrombotic syndrome. The patient underwent exploratory laparotomy and primary repair of a duodenal-caval fistula with a fascia lata patch and an omental pedicle flap. No further bloodstream infections were documented after the repair. This discussion highlights an uncommon complication of IVC stenting, its presentation as well as the operative approach used to repair the fistula

A Process Of Learning: Planning Education At East Carolina University

What was the planning profession like a quarter century ago? For one thing, old timers may recall that a substantial number of planners did not hold planning degrees while those with degrees were mainly graduates of master's level programs. Within the Southeast Chapter of the American Institute of Planners (SEAIP) only Georgia Tech and the University of North Carolina were granting planning degrees at that time. As the demand for planners grew in the late 1950s and 1960s, planning schools were hard pressed to produce enough graduates, and planning agencies sometimes recruited entry-level personnel from disciplines such as architecture, engineering, geography, and political science. These developments set the stage for the establishment of an undergraduate planning curriculum at East Carolina University in Greenville, North Carolina. In this article the authors trace the evolution of undergraduate planning education at East Carolina University (ECU) with emphasis on curriculum development

Erratum to: Estimation of country-specific and global prevalence of male circumcision.

[This corrects the article DOI: 10.1186/s12963-016-0073-5.]

Estimation of country-specific and global prevalence of male circumcision.

BACKGROUND: Male circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence. METHODS: MC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15-64 years. RESULTS: The estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries. CONCLUSIONS: The present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37-39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries

Observation of the Askaryan Effect: Coherent Microwave Cherenkov Emission from Charge Asymmetry in High Energy Particle Cascades

We present the first direct experimental evidence for the charge excess in high energy particle showers predicted nearly 40 years ago by Askaryan. We directed bremsstrahlung photons from picosecond pulses of 28.5 GeV electrons at the SLAC Final Focus Test Beam facility into a 3.5 ton silica sand target, producing electromagnetic showers several meters long. A series of antennas spanning 0.3 to 6 GHz were used to detect strong, sub-nanosecond radio frequency pulses produced whenever a shower was present. The measured electric field strengths are consistent with a completely coherent radiation process. The pulses show 100% linear polarization, consistent with the expectations of Cherenkov radiation. The field strength versus depth closely follows the expected particle number density profile of the cascade, consistent with emission from excess charge distributed along the shower. These measurements therefore provide strong support for experiments designed to detect high energy cosmic rays and neutrinos via coherent radio emission from their cascades.Comment: 10 pages, 4 figures. Submitted to Phys. Rev. Let

Morphology and characteristics of radio pulsars

This review describes the observational properties of radio pulsars, fast rotating neutron stars, emitting radio waves. After the introduction we give a list of milestones in pulsar research. The following chapters concentrate on pulsar morphology: the characteristic pulsar parameters such as pulse shape, pulsar spectrum, polarization and time dependence. We give information on the evolution of pulsars with frequency since this has a direct connection with the emission heights, as postulated in the radius to frequency mapping (RFM) concept. We deal successively with the properties of normal (slow) pulsars and of millisecond (fast-recycled) pulsars. The final chapters give the distribution characteristics of the presently catalogued 1300 objects.Comment: 33 pages, PDF with 30 PostScript figures, see http://springerlink.metapress.com/link.asp?id=d6k3a6wunb138dpl Accepted by Astronomy & Astrophysivs Review

Radio-Frequency Measurements of Coherent Transition and Cherenkov Radiation: Implications for High-Energy Neutrino Detection

We report on measurements of 11-18 cm wavelength radio emission from interactions of 15.2 MeV pulsed electron bunches at the Argonne Wakefield Accelerator. The electrons were observed both in a configuration where they produced primarily transition radiation from an aluminum foil, and in a configuration designed for the electrons to produce Cherenkov radiation in a silica sand target. Our aim was to emulate the large electron excess expected to develop during an electromagnetic cascade initiated by an ultra high-energy particle. Such charge asymmetries are predicted to produce strong coherent radio pulses, which are the basis for several experiments to detect high-energy neutrinos from the showers they induce in Antarctic ice and in the lunar regolith. We detected coherent emission which we attribute both to transition and possibly Cherenkov radiation at different levels depending on the experimental conditions. We discuss implications for experiments relying on radio emission for detection of electromagnetic cascades produced by ultra high-energy neutrinos.Comment: updated figure 10; fixed typo in equation 2.2; accepted by PR

Discovery of an intermediate-luminosity red transient in M51 and its likely dust-obscured, infrared-variable progenitor

We present the discovery of an optical transient (OT) in Messier 51, designated M51 OT2019-1 (also ZTF19aadyppr, AT 2019abn, ATLAS19bzl), by the Zwicky Transient Facility (ZTF). The OT rose over 15 days to an observed luminosity of $M_r=-13$ (${\nu}L_{\nu}=9\times10^6~L_{\odot}$), in the luminosity gap between novae and typical supernovae (SNe). Spectra during the outburst show a red continuum, Balmer emission with a velocity width of $\approx400$ km s$^{-1}$, Ca II and [Ca II] emission, and absorption features characteristic of an F-type supergiant. The spectra and multiband light curves are similar to the so-called "SN impostors" and intermediate-luminosity red transients (ILRTs). We directly identify the likely progenitor in archival Spitzer Space Telescope imaging with a $4.5~\mu$m luminosity of $M_{[4.5]}\approx-12.2$ and a $[3.6]-[4.5]$ color redder than 0.74 mag, similar to those of the prototype ILRTs SN 2008S and NGC 300 OT2008-1. Intensive monitoring of M51 with Spitzer further reveals evidence for variability of the progenitor candidate at [4.5] in the years before the OT. The progenitor is not detected in pre-outburst Hubble Space Telescope optical and near-IR images. The optical colors during outburst combined with spectroscopic temperature constraints imply a higher reddening of $E(B-V)\approx0.7$ mag and higher intrinsic luminosity of $M_r\approx-14.9$ (${\nu}L_{\nu}=5.3\times10^7~L_{\odot}$) near peak than seen in previous ILRT candidates. Moreover, the extinction estimate is higher on the rise than on the plateau, suggestive of an extended phase of circumstellar dust destruction. These results, enabled by the early discovery of M51 OT2019-1 and extensive pre-outburst archival coverage, offer new clues about the debated origins of ILRTs and may challenge the hypothesis that they arise from the electron-capture induced collapse of extreme asymptotic giant branch stars.Comment: 21 pages, 5 figures, published in ApJ

Transmission of HIV-1 infection in sub-Saharan Africa and effect of elimination of unsafe injections

During the past year, a group has argued that unsafe injections are a major if not the main mode of HIV-1 transmission\ud in sub-Saharan Africa. We review the main arguments used to question the epidemiological interpretations on the lead\ud role of unsafe sex in HIV-1 transmission, and conclude there is no compelling evidence that unsafe injections are a\ud predominant mode of HIV-1 transmission in sub-Saharan Africa. Conversely, though there is a clear need to eliminate\ud all unsafe injections, epidemiological evidence indicates that sexual transmission continues to be by far the major\ud mode of spread of HIV-1 in the region. Increased efforts are needed to reduce sexual transmission of HIV-1