A Case of Reactive Cervical Lymphadenopathy with Fat Necrosis Impinging on Adjacent Vascular Structures.

A tender neck mass in adults can be a diagnostic challenge due to a wide differential diagnosis, which ranges from reactive lymphadenopathy to malignancy. In this report, we describe a case of a young female with an unusually large and tender reactive lymph node with fat necrosis. The diagnostic imaging findings alone mimicked that of scrofula and malignancy, which prompted a complete workup. Additionally, the enlarged lymph node was compressing the internal jugular vein in the setting of oral contraceptive use by the patient, raising concern for Lemierre's syndrome or internal jugular vein thrombosis. This report shows how, in the appropriate clinical context, and especially with the involvement of adjacent respiratory or neurovascular structures, aggressive diagnostic testing can be indicated

Which Universities Should Provide Extension Services?

Do cost considerations justify the current production of Extension services in which one or more providers exists in virtually all of the contiguous U.S. states? Using 1995-96 data, we estimate a multi-product cost function for 1,450 public institutions of higher education (IHEs) in the United States, including 65 that provide Extension services. We find significant (diseconomies) economies of scale with respect to the provision of Extension services by the (largest) smaller IHEs. We conclude that regionalizing the provision of Extension services and/or shifting the provision of Extension services from the largest 1862 institutions to smaller 1890 institutions would improve cost-effectiveness

A textural examination of the Yamato 980459 and Los Angeles shergottites using crystal size distribution analysis

The basaltic shergottite group is the most plentiful of the Martian meteorite types. Within that compositional category are three distinct textural groups, each suggesting distinct crystallization histories. We present results of a textural study, using crystal size distribution (CSD) analysis, of Yamato (Y) 980459 and Los Angeles, the most primitive and evolved shergottites respectively, and we compare these results to previous CSD work on basaltic shergottites. Y980459 resembles picritic shergottites (e.g. DaG 476), with large zoned olivine set in a groundmass dominated by orthopyroxene. It is unique in having a glassy mesostasis with dendritic olivine and pyroxene, rather than maskelynite. Los Angeles resembles other co-saturated shergottites (e.g. QUE 94201) with a subophitic intergrowth of zoned clinopyroxene and maskelynite. CSD results show Y980459 pyroxenes grew in one stage of steady-state nucleation and growth, cooling at 3-7°C /hr. A CSD of the olivine population suggests slower cooling rates during megacryst formation with an increase during groundmass olivine growth, probably reflecting magma ascent. A CSD plot of Los Angeles pyroxenes shows a smooth downward curvature, also noted in previous analyses of QUE 94201 and EETA79001B. The plot reflects co-crystallization of plagioclase and pyroxene, and supports a single continuous interval of growth

Low and variable ecosystem calcification in a coral reef lagoon under natural acidification

© The Author(s), 2017. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Limnology and Oceanography 63 (2018): 714–730, doi:10.1002/lno.10662.Laboratory‐based CO2 experiments and studies of naturally low pH coral reef ecosystems reveal negative impacts of ocean acidification on the calcifying communities that build coral reefs. Conversely, in Palau's low pH lagoons, coral cover is high, coral communities are diverse, and calcification rates of two reef‐building corals exhibit no apparent sensitivity to the strong natural gradient in pH and aragonite saturation state (Ωar). We developed two methods to quantify rates of Net Ecosystem Calcification (NEC), the ecosystem‐level balance between calcification and dissolution, in Risong Lagoon, where average daily pH is ∼ 7.9 and Ωar ∼ 2.7. While coral cover in the lagoon is within the range of other Pacific reefs (∼ 26%), NEC rates were among the lowest measured, averaging 25.9 ± 13.7 mmol m−2 d−1 over two 4 d study periods. NEC rates were highly variable, ranging from a low of 13.7 mmol m−2 d−1 in March 2012 to a high of 40.3 mmol m−2 d−1 in November 2013, despite no significant changes in temperature, salinity, inorganic nutrients, Ωar, or pH. Our results indicate that the coral reef community of Risong Lagoon produces just enough calcium carbonate to maintain net positive calcification but comes dangerously close to net zero or negative NEC (net dissolution). Identifying the factors responsible for low NEC rates as well as the drivers of NEC variability in naturally low pH reef systems are key to predicting their futures under 21st century climate change.This work was supported by NSF award 1220529 to A.L.C., S.J.L., and K.E.F.S. and a Woods Hole Oceanographic Institution Postdoctoral Scholarship to K.E.F.S

Quantitative analysis of cell types during growth and morphogenesis in Hydra

Tissue maceration was used to determine the absolute number and the distribution of cell types in Hydra. It was shown that the total number of cells per animal as well as the distribution of cells vary depending on temperature, feeding conditions, and state of growth. During head and foot regeneration and during budding the first detectable change in the cell distribution is an increase in the number of nerve cells at the site of morphogenesis. These results and the finding that nerve cells are most concentrated in the head region, diminishing in density down the body column, are discussed in relation to tissue polarity

Dedicated teams to optimize quality and safety of surgery:A systematic review

BACKGROUND: A dedicated operating team is defined as a surgical team consisting of the same group of people working together over time, optimally attuned in both technical and/or communicative aspects. This can be achieved through technical and/or communicative training in a team setting. A dedicated surgical team may contribute to the optimization of healthcare quality and patient safety within the perioperative period. METHOD: A systematic review was conducted to evaluate the effects of a dedicated surgical team on clinical and performance outcomes. MEDLINE and Embase were searched on 23 June 2022. Both randomized controlled trials (RCTs) and non-randomized studies (NRSs) were included. Primary outcomes were mortality, complications and readmissions. Secondary outcomes were costs and performance measures. RESULTS: Fourteen studies were included (RCTs n = 1; NRSs n = 13). Implementation of dedicated operating teams was associated with improvements in mortality, turnover time, teamwork, communication and costs. No significant differences were observed in readmission rates and length of hospital stay. Results regarding duration, glitch counts and complications of surgery were inconclusive. Limitations include study conduct and heterogeneity between studies. CONCLUSIONS: The institution of surgical teams who followed communicative and/or technical training appeared to have beneficial effects on several clinical outcome measures. Dedicated teams provide a feasible way of improving healthcare quality and patient safety. A dose-response effect of team training was reported, but also a relapse rate, suggesting that repetitive training is of major concern to high-quality patient care. Further studies are needed to confirm these findings, due to limited level of evidence in current literature. PROSPERO REGISTRATION NUMBER: CRD42020145288

Community production modulates coral reef pH and the sensitivity of ecosystem calcification to ocean acidification

Author Posting. © American Geophysical Union, 2017. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research: Oceans 122 (2017): 745–761, doi:10.1002/2016JC012326.Coral reefs are built of calcium carbonate (CaCO3) produced biogenically by a diversity of calcifying plants, animals, and microbes. As the ocean warms and acidifies, there is mounting concern that declining calcification rates could shift coral reef CaCO3 budgets from net accretion to net dissolution. We quantified net ecosystem calcification (NEC) and production (NEP) on Dongsha Atoll, northern South China Sea, over a 2 week period that included a transient bleaching event. Peak daytime pH on the wide, shallow reef flat during the nonbleaching period was ∼8.5, significantly elevated above that of the surrounding open ocean (∼8.0–8.1) as a consequence of daytime NEP (up to 112 mmol C m−2 h−1). Diurnal-averaged NEC was 390 ± 90 mmol CaCO3 m−2 d−1, higher than any other coral reef studied to date despite comparable calcifier cover (25%) and relatively high fleshy algal cover (19%). Coral bleaching linked to elevated temperatures significantly reduced daytime NEP by 29 mmol C m−2 h−1. pH on the reef flat declined by 0.2 units, causing a 40% reduction in NEC in the absence of pH changes in the surrounding open ocean. Our findings highlight the interactive relationship between carbonate chemistry of coral reef ecosystems and ecosystem production and calcification rates, which are in turn impacted by ocean warming. As open-ocean waters bathing coral reefs warm and acidify over the 21st century, the health and composition of reef benthic communities will play a major role in determining on-reef conditions that will in turn dictate the ecosystem response to climate change.NSF Grant Number: 12205292017-07-3