A Case of Bowen’s Disease and Small-Cell Lung Carcinoma: Long-Term Consequences of Chronic Arsenic Exposure in Chinese Traditional Medicine

Chronic arsenic toxicity occurs primarily through inadvertent ingestion of contaminated water and food or occupational exposure, but it can also occur through medicinal ingestion. This case features a 53-year-old lifetime nonsmoker with chronic asthma treated for 10 years in childhood with Chinese traditional medicine containing arsenic. The patient was diagnosed with Bowen’s disease and developed extensive-stage small-cell carcinoma of the lung 10 years and 47 years, respectively, after the onset of arsenic exposure. Although it has a long history as a medicinal agent, arsenic is a carcinogen associated with many malignancies including those of skin and lung. It is more commonly associated with non–small-cell lung cancer, but the temporal association with Bowen’s disease in the absence of other chemical or occupational exposure strongly points to a causal role for arsenic in this case of small-cell lung cancer. Individuals with documented arsenic-induced Bowen’s disease should be considered for more aggressive screening for long-term complications, especially the development of subsequent malignancies

Physician-Delivered Weight Management Counseling (PD-WMC)

Introduction: Individuals with excess weight have increased morbidity and mortality compared to those of normal weight, and there are differences in disease risk between overweight and obese men and women. However, limited information on how physicians counsel these groups and on patients’ experiences with weight management counseling (WMC) is available. The goals of this study are to describe specific WMC approaches provided to patients, reported benefit of these strategies, and study participants’ WMC preferences. Methods:103 participants, stratified by BMI (Overweight: 25.0 ≤ BMI ≤ 29.9; Obese: BMI ≥ 30.0) and gender, completed surveys. Survey questions focused on WMC approaches (e.g., discussions about diet, generation of specific weight loss goals) currently provided by physicians, reported benefit of these methods, and patients’ WMC preferences for future care. Frequency counts were used in analysis of all questions. Chi-square and Fisher’s exact test (p \u3c .05) were performed to assess significance between stratified groups. Results: Participants reported receiving a wide-range of WMC, from discussions about diet to surgery. Overweight participants and women reported less counseling compared to obese individuals and men, respectively. Compared to men, women reported fewer discussions in areas such as past weight loss attempts (p=0.014) and effects of weight on long-term health (p=0.008). In general, participants found scheduling follow-up appointments most beneficial (72.8%). There were no significant differences by BMI or gender. Overall, participants most preferred that physicians increase support in generating specific strategies to assist in weight loss (74.8%) and in helping them to develop specific weight loss goals (65.1%). By gender, men most preferred increased development of weight loss strategies (70.0%) by their physicians and desired more discussions about the effects of weight on long-term health (63.3%). Women most preferred increased development of specific weight loss strategies (79.2%) as well as increased generation of specific weight loss goals (67.9%) by their physicians. Both overweight and obese participants (68.6% and 80.7%, respectively) sought increased development of weight loss strategies. Conclusions: This appears to be the first cross-sectional study comparing patients’ WMC experiences and preferences, stratified by BMI and gender. Results demonstrate that regardless of BMI and gender, patients want more WMC, with preference for certain strategies. Differences were noted between stratified groups

Interferon γ (IFN-γ) Is Necessary for the Genesis of Acetylcholine Receptor–induced Clinical Experimental Autoimmune Myasthenia gravis in Mice

Experimental autoimmune myasthenia gravis (EAMG) is an animal model of human myasthenia gravis (MG). In mice, EAMG is induced by immunization with Torpedo californica acetylcholine receptor (AChR) in complete Freund's adjuvant (CFA). However, the role of cytokines in the pathogenesis of EAMG is not clear. Because EAMG is an antibody-mediated disease, it is of the prevailing notion that Th2 but not Th1 cytokines play a role in the pathogenesis of this disease. To test the hypothesis that the Th1 cytokine, interferon (IFN)-γ, plays a role in the development of EAMG, we immunized IFN-γ knockout (IFN-gko) (−/−) mice and wild-type (WT) (+/+) mice of H-2b haplotype with AChR in CFA. We observed that AChR-primed lymph node cells from IFN-gko mice proliferated normally to AChR and to its dominant pathogenic α146–162 sequence when compared with these cells from the WT mice. However, the IFN-gko mice had no signs of muscle weakness and remained resistant to clinical EAMG at a time when the WT mice exhibited severe muscle weakness and some died. The resistance of IFN-gko mice was associated with greatly reduced levels of circulating anti-AChR antibody levels compared with those in the WT mice. Comparatively, immune sera from IFN-gko mice showed a dramatic reduction in mouse AChR-specific IgG1 and IgG2a antibodies. However, keyhole limpet hemocyanin (KLH)–priming of IFN-gko mice readily elicited both T cell and antibody responses, suggesting that IFN-γ regulates the humoral immune response distinctly to self (AChR) versus foreign (KLH) antigens. We conclude that IFN-γ is required for the generation of a pathogenic anti-AChR humoral immune response and for conferring susceptibility of mice to clinical EAMG

LEGUS Discovery of a Light Echo Around Supernova 2012aw

We have discovered a luminous light echo around the normal Type II-Plateau Supernova (SN) 2012aw in Messier 95 (M95; NGC 3351), detected in images obtained approximately two years after explosion with the Wide Field Channel 3 on-board the Hubble Space Telescope (HST) by the Legacy ExtraGalactic Ultraviolet Survey (LEGUS). The multi-band observations span from the near-ultraviolet through the optical (F275W, F336W, F438W, F555W, and F814W). The apparent brightness of the echo at the time was ~21--22 mag in all of these bands. The echo appears circular, although less obviously as a ring, with an inhomogeneous surface brightness, in particular, a prominent enhanced brightness to the southeast. The SN itself was still detectable, particularly in the redder bands. We are able to model the light echo as the time-integrated SN light scattered off of diffuse interstellar dust in the SN environment. We have assumed that this dust is analogous to that in the Milky Way with R_V=3.1. The SN light curves that we consider also include models of the unobserved early burst of light from the SN shock breakout. Our analysis of the echo suggests that the distance from the SN to the scattering dust elements along the echo is ~45 pc. The implied visual extinction for the echo-producing dust is consistent with estimates made previously from the SN itself. Finally, our estimate of the SN brightness in F814W is fainter than that measured for the red supergiant star at the precise SN location in pre-SN images, possibly indicating that the star has vanished and confirming it as the likely SN progenitor.Comment: 10 pages, 9 figures, to appear in the Astrophysical Journa

DYNAMIC PRICING AND MINIMUM LENGTH OF STAY CONTROLS AS A HOTEL MANAGEMENT PRACTICE: ARE THERE CUSTOMER PERCEPTION, ETHICAL, AND LEGAL QUESTIONS?

Length of stay controls and dynamic pricing are components of revenue management tools widely used in the lodging industry. Length of stay controls require guests to stay for a minimum number of nights, even if they might wish to stay for only one night. Dynamic pricing characterized by high room rates and length of stay controls are common when hotel demand is strong for a specific event, such as a college graduation, natural disasters and emergencies, New Year’s Eve festivities, July 4 fireworks and concerts, or a major sporting event. While implemented to boost revenue, the combination of dynamic pricing and length of stay controls can raise ethical, legal, and fairness questions that can lead to adverse impacts on hotels. Dynamic pricing may be legal or illegal, depending on state law and the circumstances. Length of stay controls may also be legal or prohibited depending on the state. The authors suggest some alternatives that will allow hoteliers to comply with existing statutes and case law and navigate ethical, legal, and fairness questions

Odor blocking of stress hormone responses

Scents have been employed for millennia to allay stress, but whether or how they might do so is largely unknown. Fear and stress induce increases in blood stress hormones controlled by hypothalamic corticotropin releasing hormone neurons (CRHNs). Here, we report that two common odorants block mouse stress hormone responses to three potent stressors: physical restraint, predator odor, and male-male social confrontation. One odorant inhibits restraint and predator odor activation of excitatory neurons upstream of CRHNs in the bed nucleus of the stria terminalis (BNSTa). In addition, both activate inhibitory neurons upstream of CRHNs in the hypothalamic ventromedial nucleus (VMH) and silencing of VMH inhibitory neurons hinders odor blocking of stress. Together, these findings indicate that odor blocking can occur via two mechanisms: (1) Inhibition of excitatory neurons that transmit stress signals to CRHNs and (2) activation of inhibitory neurons that act directly or indirectly to inhibit stressor activation of CRHNs

The SINS Survey: Broad Emission Lines in High-Redshift Star-Forming Galaxies

High signal-to-noise, representative spectra of star-forming galaxies at z~2, obtained via stacking, reveal a high-velocity component underneath the narrow H-alpha and [NII] emission lines. When modeled as a single Gaussian, this broad component has FWHM > 1500 km/s; when modeled as broad wings on the H-alpha and [NII] features, it has FWHM > 500 km/s. This feature is preferentially found in the more massive and more rapidly star-forming systems, which also tend to be older and larger galaxies. We interpret this emission as evidence of either powerful starburst-driven galactic winds or active supermassive black holes. If galactic winds are responsible for the broad emission, the observed luminosity and velocity of this gas imply mass outflow rates comparable to the star formation rate. On the other hand, if the broad line regions of active black holes account for the broad feature, the corresponding black holes masses are estimated to be an order of magnitude lower than those predicted by local scaling relations, suggesting a delayed assembly of supermassive black holes with respect to their host bulges.Comment: 11 pages, 5 figures. Accepted version, incorporating referee comments, including changes to title, abstract, figures, and discussion sectio

Advancing Pharmacist Collaborative Care within Academic Health Systems.

INTRODUCTION:The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. SUMMARY:We describe the successful development, implementation and outcomes of three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist-interprofessional teams and (3) physician-pharmacist teams. The outcome measurement of these pharmacist care models varied from the design phase to patient volume measurement and to comprehensive quality dashboards. All of these practice models have been successfully funded by affiliated health systems or grants. CONCLUSIONS:The expansion of pharmacist services delivered by clinical faculty has several benefits to affiliated health systems: (1) significant improvements in patient care quality, (2) access to experts in specialty areas, and (3) the dissemination of outcomes with national and international recognition, increasing the visibility of the health system

ASIS&T Webinar and Discussion: The Role of Information During a Global Health Crisis - Association for Information Science and Technology

You're viewing a past blog from the Good Systems Grand Challenge team at The University of Texas at Austin about free webinars offered to discuss the current and future effects of global crisis.Office of the VP for Researc

Star Formation Histories of the LEGUS dwarf galaxies. II. Spatially resolved star formation history of the Magellanic irregular NGC 4449

We present a detailed study of the Magellanic irregular galaxy NGC 4449 based on both archival and new photometric data from the Legacy Extragalactic UV Survey, obtained with the Hubble Space Telescope Advanced Camera for Surveys and Wide Field Camera 3. Thanks to its proximity ($D=3.82\pm 0.27$ Mpc) we reach stars 3 magnitudes fainter than the tip of the red giant branch in the F814W filter. The recovered star formation history spans the whole Hubble time, but due to the age-metallicity degeneracy of the red giant branch stars, it is robust only over the lookback time reached by our photometry, i.e. $\sim 3$ Gyr. The most recent peak of star formation is around 10 Myr ago. The average surface density star formation rate over the whole galaxy lifetime is $0.01$ M$_{\odot}$ yr$^{-1}$ kpc$^{-2}$. From our study it emerges that NGC 4449 has experienced a fairly continuous star formation regime in the last 1 Gyr with peaks and dips whose star formation rates differ only by a factor of a few. The very complex and disturbed morphology of NGC 4449 makes it an interesting galaxy for studies of the relationship between interactions and starbursts, and our detailed and spatially resolved analysis of its star formation history does indeed provide some hints on the connection between these two phenomena in this peculiar dwarf galaxy.Comment: 16 pages, 25 figures. Accepted for publication in the Astrophysical Journa