Ulceroglandular Tularemia: A Typical Case of Relapse

Tularemia is an infectious disease that continues to occur sporadically and in epidemics in the United States. It is characterized as an acute febrile illness with constitutional symptoms associated with skin, glandular, respiratory, or gastrointestinal involvement. Tularemia usually can be treated effectively with streptomycin. Relapse most often occurs when patients are treated with bacteriostatic agents such as chloramphenicol or tetracycline. We present a case of ulceroglandular tularemia distinguished by its relapse after initial streptomycin/doxycycline therapy and subsequent slow response to additional streptomycin

Paraneoplastic hypoglycaemia secondary to IGF-2 secretion from a metastatic gastrointestinal stromal tumour

We report the case of a 79-year-old male with previous history of non-Hodgkin's lymphoma in remission, who presented acutely to the Accident and Emergency department with recurrent episodes of hypoglycaemia. At the time of presentation, a random glucose was low at 1.4 mmol/l, which upon correction resolved his symptoms. In hindsight, the patient recalled having had similar episodes periodically over the past 2 months to which he did not give much notice. While hospitalized, he continued having episodes of symptomatic hypoglycaemia, requiring treatment with intravenous dextrose and per os steroids. Once stable, he was discharged on oral prednisolone and dietary advice. A computed tomography scan performed during inpatient stay showed multiple deposits in the abdomen. An ultrasound guided biopsy of one of the liver deposits was performed. Immunohistochemistry supported the diagnosis of a gastrointestinal stromal tumour (GIST) positive for CD34 and CD117. The diagnosis of non-islet cell tumour hypoglycaemia (NICTH) secondary to an IGF2 secreting GIST was confirmed with further biochemical investigations (IGF2=105.9 nmol/l; IGF2:IGF1 ratio 23, Upper Level of Normal (ULN) <10). Targeted cytoreductive treatment with Imatinib mesylate following assessment of the tumour's mutational status was successful in preventing hypoglycaemia over a 21-month follow-up observation period

Path Crossing Exponents and the External Perimeter in 2D Percolation

2D Percolation path exponents $x^{\cal P}_{\ell}$ describe probabilities for traversals of annuli by $\ell$ non-overlapping paths, each on either occupied or vacant clusters, with at least one of each type. We relate the probabilities rigorously to amplitudes of $O(N=1)$ models whose exponents, believed to be exact, yield $x^{\cal P}_{\ell}=({\ell}^2-1)/12$. This extends to half-integers the Saleur--Duplantier exponents for $k=\ell/2$ clusters, yields the exact fractal dimension of the external cluster perimeter, $D_{EP}=2-x^{\cal P}_3=4/3$, and also explains the absence of narrow gate fjords, as originally found by Grossman and Aharony.Comment: 4 pages, 2 figures (EPSF). Revised presentatio

Using Metaphors in Dynamic Social Stratification Visualizations

We present three information visualizations for studying social stratification. Each Web-based applet uses a different metaphor to display U.S. Census income data along with the categories of race, marital status, and profession. Each system is completely dynamic, affording the user the choice of categorical variable to compare, as well as the choice of categories within each visualization. Two different user interfaces have also been implemented. The systems are described, compared, and their respective merits and deficiencies discussed

Adaptation to Different Human Populations by HIV-1 Revealed by Codon-Based Analyses

Several codon-based methods are available for detecting adaptive evolution in protein-coding sequences, but to date none specifically identify sites that are selected differentially in two populations, although such comparisons between populations have been historically useful in identifying the action of natural selection. We have developed two fixed effects maximum likelihood methods: one for identifying codon positions showing selection patterns that persist in a population and another for detecting whether selection is operating differentially on individual codons of a gene sampled from two different populations. Applying these methods to two HIV populations infecting genetically distinct human hosts, we have found that few of the positively selected amino acid sites persist in the population; the other changes are detected only at the tips of the phylogenetic tree and appear deleterious in the long term. Additionally, we have identified seven amino acid sites in protease and reverse transcriptase that are selected differentially in the two samples, demonstrating specific population-level adaptation of HIV to human populations

On theories of enhanced CP violation in B_s,d meson mixing

The DO collaboration has measured a deviation from the standard model (SM) prediction in the like sign dimuon asymmetry in semileptonic b decay with a significance of 3.2 sigma. We discuss how minimal flavour violating (MFV) models with multiple scalar representations can lead to this deviation through tree level exchanges of new MFV scalars. We review how the two scalar doublet model can accommodate this result and discuss some of its phenomenology. Limits on electric dipole moments suggest that in this model the coupling of the charged scalar to the right handed u-type quarks is suppressed while its coupling to the d-type right handed quarks must be enhanced. We construct an extension of the MFV two scalar doublet model where this occurs naturally.Comment: 10 pages, 7 figures, v3 final JHEP versio

Measuring the Photon Helicity in Radiative B Decays

We propose a way of measuring the photon polarization in radiative B decays into K resonance states decaying to K\pi\pi, which can test the Standard Model and probe new physics. The photon polarization is shown to be measured by the up-down asymmetry of the photon direction relative to the K\pi\pi decay plane in the K resonance rest frame. The integrated asymmetry in K_1(1400)\to K\pi\pi, calculated to be 0.34\pm 0.05 in the Standard Model, is measurable at currently operating B factories.Comment: 4 pages, final version to appear in Physical Review Letter

An evolutionary stage model of outsourcing and competence destruction : a Triad comparison of the consumer electronics industry

Outsourcing has gained much prominence in managerial practice and academic discussions in the last two decades or so. Yet, we still do not understand the full implications of outsourcing strategy for corporate performance. Traditionally outsourcing across borders is explained as a cost-cutting exercise, but more recently the core competency argument states that outsourcing also leads to an increased focus, thereby improving effectiveness. However, no general explanation has so far been provided for how outsourcing could lead to deterioration in a firm‟s competence base. We longitudinally analyze three cases of major consumer electronics manufacturers, Emerson Radio from the U.S., Japan‟s Sony and Philips from the Netherlands to understand the dynamic process related to their sourcing strategies. We develop an evolutionary stage model that relates outsourcing to competence development inside the firm and shows that a vicious cycle may emerge. Thus it is appropriate to look not only at how outsourcing is influenced by an organization‟s current set of competences, but also how it alters that set over time. The four stages of the model are offshore sourcing, phasing out, increasing dependence on foreign suppliers, and finally industry exit or outsourcing reduction. The evolutionary stage model helps managers understand for which activities and under which conditions outsourcing across borders is not a viable option. Results suggest that each of these firms had faced a loss of manufacturing competitiveness in its home country, to which it responded by offshoring and then outsourcing production. When a loss of competences occurred, some outsourcing decisions were reversed