Thiotepa hyperpigmentation preceding epidermal necrosis: malignant intertrigo misdiagnosed as Stevens-Johnson syndrome-toxic epidermal necrolysis overlap

Thiotepa is a common alkylating agent known to precipitate cutaneous reactions consistent with toxic erythema of chemotherapy, including erythema and hyperpigmentation. Herein, we describe an atypical case of malignant intertrigo involving preferential erythema and desquamation not only of skin folds but also of occluded areas after thiotepa-based conditioning. The diagnosis was complicated by concurrent stomatitis and oral petechiae in the setting of autologous stem cell transplant 11 days prior for diffuse large B-cell lymphoma. Histopathological examination from two cutaneous sites demonstrated epidermal dysmaturation and eccrine gland necrosis consistent with thiotepa-induced desquamation and not Stevens-Johnson syndrome or graft-versus-host-disease. Malignant intertrigo can present with extensive cutaneous involvement, as evidenced by our patient who had 25% body surface area affected. Mucosal involvement is common with most chemotherapeutic regimens and its presence should not deter the astute clinician from consideration of a diagnosis of toxic erythema of chemotherapy. No further interventions were needed and the patient healed spontaneously

Exploring tablet PC lectures: lecturer experiences and student perceptions in biomedicine

Lecturers using tablet PCs with specialised pens can utilise real-time changes in lecture delivery via digital inking. We investigated student perceptions and lecturer experiences of tablet PC lectures in large-enrolment biomedicine subjects. Lecturers used PowerPoint or Classroom Presenter software for lecture preparation and in-lecture pen-based inking. Using surveys and lecturer interviews, students and lecturers were asked to reflect on their tablet PC lectures in comparison to non-tablet lectures that used prepared images and a laser pointer. Quantitative survey responses suggested that students felt that the tablet lectures were more interesting, that they were more capable of keeping up with the lecturer, and they enhanced their understanding of the lecture content. Qualitative analysis of written comments indicated that students appreciated the real-time writing and drawings, particularly because these were visible on lecture recordings. When reflecting on their non-tablet lectures, most lecturers used the pen-based writing, drawing and highlighting tablet functions and reduced lecture pace and content for their tablet lectures. Long-term tablet use led to lecturers making more use of digital inking, with less use of prepared images. Our results support the idea that tablet PC-supported lectures are conducive to improved management of cognitive load via reduced lecture pace and content

NASA/MSFC Large Stretch Press Study

The purpose of this study was to: A. assess and document the advantages/disadvantages of a government agency investment in a large stretch form press on the order of 5000 tons capacity (per jaw); B. develop a procurement specification for the press; and C. provide trade study data that will permit an optimum site location. Tasks were separated into four major elements: cost study, user survey, site selection, and press design/procurement specification

A review on cement degradation under CO2-rich environment of sequestration projects

Global warming arising from the release of greenhouse gasses into the atmosphere is one of the biggest issues attracting a lot of attention. One of the conventional problems in sequestration projects is the degradation of Portland cement due to its exposure to supercritical CO2. This paper gives a review on the laboratory work performed to understand changes in the mechanical and transport properties of cement when it is in a CO2 rich environment. The results obtained indicated that pozzolanic material could be useful in enhancing the cement resistance against CO2, although more studies are still required to confirm this conclusion

Small amplitude oscillatory flows of nematic liquid crystal polymers

This dissertation presents two theoretical predictions of the behavior of solutions of nematic liquid crystal polymers when subjected to small amplitude flows that are oscillatory in time. First, we review theoretical models for predicting the behavior of nematic liquid crystals, including Leslie-Ericksen theory, which only attempts to capture the mean direction of molecular orientation, and Doi-Hess kinetic theory, which defines a probability density function on the unit sphere for the molecular orientation and also the mesocscopic orientation tensor models derived from it, which are the models that we will examine. In Chapter 2, we examine shear flow in the monodomain limit, in which there are no spatial gradients in molecular orientation, and we use multiple timescale perturbation analysis to capture very slowly developing effects in the dynamic moduli, similar to experimental observations. Then, in Chapter 3, we relax the monodomain restriction and examine the effect of heterogeneity in the molecular orientation and the choice of two special anchoring conditions for the orientation at the plates. We re- cover a Leslie-Ericksen-type prediction, formally connect imposed stress and imposed velocity boundary conditions in shear flow, and establish an equivalence at the level of the storage and loss moduli between shear flow and Poiseuille flow

Corrigendum: Thiotepa hyperpigmentation preceding epidermal necrosis: malignant intertrigo misdiagnosed as Stevens-Johnson syndrome-toxic epidermal necrolysis overlap

The original article was published on February 15, 2020 and corrected on March 15, 2020.The revised version of the article corrects the contact information of the Corresponding Author. The changes appear in the revised online PDF copy of this article

A Note on the Temporary Misregistration of Landsat-8 Operational Land Imager (OLI) and Sentinel-2 Multi Spectral Instrument (MSI) Imagery

The Landsat-8 and Sentinel-2 sensors provide multi-spectral image data with similar spectral and spatial characteristics that together provide improved temporal coverage globally. Both systems are designed to register Level 1 products to a reference image framework, however, the Landsat-8 framework, based upon the Global Land Survey images, contains residual geolocation errors leading to an expected sensor-to-sensor misregistration of 38 m (2σ). These misalignments vary geographically but should be stable for a given area. The Landsat framework will be readjusted for consistency with the Sentinel-2 Global Reference Image, with completion expected in 2018. In the interim, users can measure Landsat-to-Sentinel tie points to quantify the misalignment in their area of interest and if appropriate to reproject the data to better alignment

A Comparison of Defendants with Mental Illness Represented by Public Defenders and Private Attorneys: an Analysis of Court-Ordered Pretrial Psychiatric Evaluations

This study compared the characteristics and court-ordered evaluation questions and responses among 4,430 defendants to determine if differences existed between those represented by public defenders and private attorneys when receiving trial competency or responsibility psychiatric evaluations from a state department of mental health. Defendants represented by public defenders were more likely to be younger, to have less education, to have psychotic disorders, to have a history of inpatient psychiatric treatment, to live in urban or rural counties, and to be jailed at the time of the evaluation. In addition, defendants represented by public defenders were less likely to have a request for a criminal responsibility evaluation and more likely to be evaluated as having a mental illness, to be incompetent to stand trial, and to need hospitalization pending trial. Consideration of whether defendants with public defenders receiving less requests for responsibility evaluations was indicative of a therapeutic jurisprudence approach is discussed. Implications for research on types of legal representation of defendants with mental illness are discussed

Ecological Effects of Fear: How Spatiotemporal Heterogeneity in Predation Risk Influences Mule Deer Access to Forage in a Sky‐Island System

Forage availability and predation risk interact to affect habitat use of ungulates across many biomes. Within sky‐island habitats of the Mojave Desert, increased availability of diverse forage and cover may provide ungulates with unique opportunities to extend nutrient uptake and/or to mitigate predation risk. We addressed whether habitat use and foraging patterns of female mule deer (Odocoileus hemionus) responded to normalized difference vegetation index (NDVI), NDVI rate of change (green‐up), or the occurrence of cougars (Puma concolor). Female mule deer used available green‐up primarily in spring, although growing vegetation was available during other seasons. Mule deer and cougar shared similar habitat all year, and our models indicated cougars had a consistent, negative effect on mule deer access to growing vegetation, particularly in summer when cougar occurrence became concentrated at higher elevations. A seemingly late parturition date coincided with diminishing NDVI during the lactation period. Sky‐island populations, rarely studied, provide the opportunity to determine how mule deer respond to growing foliage along steep elevation and vegetation gradients when trapped with their predators and seasonally limited by aridity. Our findings indicate that fear of predation may restrict access to the forage resources found in sky islands

Early Mobility in the Hospital: Lessons Learned from the STRIDE Program

Immobility during hospitalization is widely recognized as a contributor to deconditioning, functional loss, and increased need for institutional post-acute care. Several studies have demonstrated that inpatient walking programs can mitigate some of these negative outcomes, yet hospital mobility programs are not widely available in U.S. hospitals. STRIDE (assiSTed eaRly mobIlity for hospitalizeD older vEterans) is a supervised walking program for hospitalized older adults that fills this important gap in clinical care. This paper describes how STRIDE works and how it is being disseminated to other hospitals using the Replicating Effective Programs (REP) framework. Guided by REP, we define core components of the program and areas where the program can be tailored to better fit the needs and local conditions of its new context (hospital). We describe key adaptations made by four hospitals who have implemented the STRIDE program and discuss lessons learned for successful implementation of hospital mobility programs