Subcutaneous Plasmacytoma Metastasis Precipitated by Tunneled Central Venous Catheter Insertion

Extramedullary plasmacytomas are tumors of monoclonal plasma cells arising within soft tissue that uncommonly occur in multiple myeloma patients. While sporadic development of these tumors at cutaneous trauma sites, including venous catheter access sites, has been reported, interventional radiologists seldom encounter this disease. Herein, we describe a case of metastatic subcutaneous plasmacytoma precipitated by tunneled central venous catheter insertion in a male patient undergoing stem cell therapy for treatment of multiple myeloma. In addition, we review the identification, diagnostic pitfalls, pathogenesis, and treatment of this rare entity

From Galaxy-Galaxy Lensing to Cosmological Parameters

Galaxy-galaxy lensing measures the mean excess surface density DS(r) around a sample of lensing galaxies. We develop a method for combining DS(r) with the galaxy correlation function xi_gg(r) to constrain Omega_m and sigma_8, going beyond the linear bias model to reach the level of accuracy demanded by current and future measurements. We adopt the halo occupation distribution (HOD) framework, and we test its applicability to this problem by examining the effects of replacing satellite galaxies in the halos of an SPH simulation with randomly selected dark matter particles from the same halos. The difference between dark matter and satellite galaxy radial profiles has a ~10% effect on DS(r) at r<1 Mpc/h. However, if radial profiles are matched, the remaining impact of individual subhalos around satellite galaxies and environmental dependence of the HOD at fixed halo mass is <5% in DS(r) for 0.1<r<15 Mpc/h. We develop an analytic approximation for DS(r) that incorporates halo exclusion and scale-dependent halo bias, and we demonstrate its accuracy with tests against a suite of populated N-body simulations. We use the analytic model to investigate the dependence of DS(r) and the galaxy-matter correlation function xi_gm(r) on Omega_m and sigma_8, once HOD parameters for a given cosmological model are pinned down by matching xi_gg(r). The linear bias prediction is accurate for r>2 Mpc/h, but it fails at the 30-50% level on smaller scales. The scaling of DS(r) ~ Omega_m^a(r) sigma_8^b(r) approaches the linear bias expectation a=b=1 at r>10 Mpc/h, but a(r) and b(r) vary from 0.8 to 1.6 at smaller r. We calculate a fiducial DS(r) and scaling indices a(r) and b(r) for two SDSS galaxy samples; galaxy-galaxy lensing measurements for these samples can be combined with our predictions to constrain Omega_m and sigma_8.Comment: 18 pages, 10 figures, accepted for publication in The Astrophysical Journa

Collapse Barriers and Halo Abundance: Testing the Excursion Set Ansatz

Our heuristic understanding of the abundance of dark matter halos centers around the concept of a density threshold, or "barrier", for gravitational collapse. If one adopts the ansatz that regions of the linearly evolved density field smoothed on mass scale M with an overdensity that exceeds the barrier will undergo gravitational collapse into halos of mass M, the corresponding abundance of such halos can be estimated simply as a fraction of the mass density satisfying the collapse criterion divided by the mass M. The key ingredient of this ansatz is therefore the functional form of the collapse barrier as a function of mass M or, equivalently, of the variance sigma^2(M). Several such barriers based on the spherical, Zel'dovich, and ellipsoidal collapse models have been extensively discussed. Using large scale cosmological simulations, we show that the relation between the linear overdensity and the mass variance for regions that collapse to form halos by the present epoch resembles expectations from dynamical models of ellipsoidal collapse. However, we also show that using such a collapse barrier with the excursion set ansatz predicts a halo mass function inconsistent with that measured directly in cosmological simulations. This inconsistency demonstrates a failure of the excursion set ansatz as a physical model for halo collapse. We discuss implications of our results for understanding the collapse epoch for halos as a function of mass, and avenues for improving consistency between analytical models for the collapse epoch and the results of cosmological simulations.Comment: Version accepted by ApJ, scheduled for May 2009, v696. High-res version available at http://kicp.uchicago.edu/~brant/astro-ph/excursion_set_ansatz/robertson_excursion_set_ansatz.pd

The Job Search Intensity Supply Curve: How Labor Market Conditions Affect Job Search Effort

During the Great Recession of 2007, unemployment reached nearly 10 percent and the ratio of unemployment to open positions (as measured by the Help Wanted OnLine Index) more than tripled. The weak labor market prompted an unprecedented extension in the length of time in which a claimant can collect unemployment insurance (UI) to 99 weeks, at an expense to date of $226.4 billion. While many claim that extending UI during a recession will reduce search intensity, the effect of weak labor market conditions on search remains a mystery. As a result, policymakers are in the dark as to whether UI extensions reduce already low search effort during recessions or perhaps decrease excessive search, which causes congestion in the labor market. At the same time, modelers of the labor market have little empirical justification for their assumptions on how search intensity changes over the business cycle. This paper develops a search model where the impact of macro labor market conditions on a worker’s search effort depends on whether these two factors are substitutes or complements in the job search process. Parameter estimates of the structural model using a sample of unemployment spells from the National Longitudinal Survey of Youth 1997 indicate that macro labor market conditions and individual search effort are complements and move together over the business cycle. The estimation also reveals that more risk-averse and less wealthy individuals exhibit less search effort

Child feces disposal practices in rural Orissa: a cross sectional study.

BACKGROUND: An estimated 2.5 billion people worldwide lack access to improved sanitation facilities. While large-scale programs in some countries have increased latrine coverage, they sometimes fail to ensure optimal latrine use, including the safe disposal of child feces, a significant source of exposure to fecal pathogens. We undertook a cross-sectional study to explore fecal disposal practices among children in rural Orissa, India in villages where the Government of India's Total Sanitation Campaign had been implemented at least three years prior to the study. METHODS AND FINDINGS: We conducted surveys with heads of 136 households with 145 children under 5 years of age in 20 villages. We describe defecation and feces disposal practices and explore associations between safe disposal and risk factors. Respondents reported that children commonly defecated on the ground, either inside the household (57.5%) for pre-ambulatory children or around the compound (55.2%) for ambulatory children. Twenty percent of pre-ambulatory children used potties and nappies; the same percentage of ambulatory children defecated in a latrine. While 78.6% of study children came from 106 households with a latrine, less than a quarter (22.8%) reported using them for disposal of child feces. Most child feces were deposited with other household waste, both for pre-ambulatory (67.5%) and ambulatory (58.1%) children. After restricting the analysis to households owning a latrine, the use of a nappy or potty was associated with safe disposal of feces (OR 6.72, 95%CI 1.02-44.38) though due to small sample size the regression could not adjust for confounders. CONCLUSIONS: In the area surveyed, the Total Sanitation Campaign has not led to high levels of safe disposal of child feces. Further research is needed to identify the actual scope of this potential gap in programming, the health risk presented and interventions to minimize any adverse effect

Using decision analysis to support proactive management of emerging infectious wildlife diseases

Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases

Using decision analysis to support proactive management of emerging infectious wildlife diseases

Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases

Site identification in high-throughput RNA-protein interaction data

Motivation: Post-transcriptional and co-transcriptional regulation is a crucial link between genotype and phenotype. The central players are the RNA-binding proteins, and experimental technologies [such as cross-linking with immunoprecipitation-(CLIP-) and RIP-seq] for probing their activities have advanced rapidly over the course of the past decade. Statistically robust, flexible computational methods for binding site identification from high-throughput immunoprecipitation assays are largely lacking however.Results: We introduce a method for site identification which provides four key advantages over previous methods: (i) it can be applied on all variations of CLIP and RIP-seq technologies, (ii) it accurately models the underlying read-count distributions, (iii) it allows external covariates, such as transcript abundance (which we demonstrate is highly correlated with read count) to inform the site identification process and (iv) it allows for direct comparison of site usage across cell types or conditions. © The Author 2012. Published by Oxford University Press. All rights reserved

Does clinical equipoise apply to cluster randomized trials in health research?

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, Weijer and colleagues set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the third of the questions posed, namely, does clinical equipoise apply to CRTs in health research? The ethical principle of beneficence is the moral obligation not to harm needlessly and, when possible, to promote the welfare of research subjects. Two related ethical problems have been discussed in the CRT literature. First, are control groups that receive only usual care unduly disadvantaged? Second, when accumulating data suggests the superiority of one intervention in a trial, is there an ethical obligation to act