Bullous hemorrhagic lichen sclerosus of the breast: a report of two cases and review of the literature

Lichen sclerosus (LS) is a chronic dermatologic condition characterized by atrophic porcelain-appearing plaques that can cause intense discomfort and eventually lead to destruction of local architecture. Lichen sclerosus most commonly arises in the anogenital area, but up to 20% of cases can present on extragenital skin. Rarely, LS can also present with hemorrhage and bullae; the mechanism by which this occurs is unknown. We report two cases of bullous hemorrhagic LS of the breast arising in 66-year-old and 77-year-old women. Bullous hemorrhagic LS of the breast is exceedingly rare, with few reported cases, and presents a diagnostic challenge to clinicians

Interactions of technology and society: Impacts of improved airtransport. A study of airports at the grass roots

The feasibility of applying a particular conception of technology and social change to specific examples of technological development was investigated. The social and economic effects of improved airport capabilities on rural communities were examined. Factors which led to the successful implementation of a plan to construct sixty small airports in Ohio are explored and implications derived for forming public policies, evaluating air transportation development, and assessing technology

Assessing digital preservation frameworks: the approach of the SHAMAN project

How can we deliver infrastructure capable of supporting the preservation of digital objects, as well as the services that can be applied to those digital objects, in ways that future unknown systems will understand? A critical problem in developing systems is the process of validating whether the delivered solution effectively reflects the validated requirements. This is a challenge also for the EU-funded SHAMAN project, which aims to develop an integrated preservation framework using grid-technologies for distributed networks of digital preservation systems, for managing the storage, access, presentation, and manipulation of digital objects over time. Recognising this, the project team ensured that alongside the user requirements an assessment framework was developed. This paper presents the assessment of the SHAMAN demonstrators for the memory institution, industrial design and engineering and eScience domains, from the point of view of user’s needs and fitness for purpose. An innovative synergistic use of TRAC criteria, DRAMBORA risk registry and mitigation strategies, iRODS rules and information system models requirements has been designed, with the underlying goal to define associated policies, rules and state information, and make them wherever possible machine-encodable and enforceable. The described assessment framework can be valuable not only for the implementers of this project preservation framework, but for the wider digital preservation community, because it provides a holistic approach to assessing and validating the preservation of digital libraries, digital repositories and data centres

Charge-Focusing Readout of Time Projection Chambers

Time projection chambers (TPCs) have found a wide range of applications in particle physics, nuclear physics, and homeland security. For TPCs with high-resolution readout, the readout electronics often dominate the price of the final detector. We have developed a novel method which could be used to build large-scale detectors while limiting the necessary readout area. By focusing the drift charge with static electric fields, we would allow a small area of electronics to be sensitive to particle detection for a much larger detector volume. The resulting cost reduction could be important in areas of research which demand large-scale detectors, including dark matter searches and detection of special nuclear material. We present simulations made using the software package Garfield of a focusing structure to be used with a prototype TPC with pixel readout. This design should enable significant focusing while retaining directional sensitivity to incoming particles. We also present first experimental results and compare them with simulation.Comment: 5 pages, 17 figures, Presented at IEEE Nuclear Science Symposium 201

Detection of a z=0.0515, 0.0522 absorption system in the QSO S4 0248+430 due to an intervening galaxy

In some of the few cases where the line of sight to a Quasi-Stellar Object (QSO) passes near a galaxy, the galaxy redshift is almost identical to an absorption redshift in the spectrum of the QSO. Although these relatively low redshift QSO-galaxy pairs may not be typical of the majority of the narrow heavy-element QSO absorption systems, they provide a direct measure of column densities in the outer parts of galaxies and some limits on the relative abundances of the gas. Observations are presented here of the QSO S4 0248+430 and a nearby anonymous galaxy (Kuhr 1977). The 14 second separation of the line of sight to the QSO (z sub e = 1.316) and the z=0.052 spiral galaxy, (a projected separation of 20 kpc ((h sub o = 50, q sub o = 0)), makes this a particularly suitable pair for probing the extent and content of gas in the galaxy. Low resolution (6A full width half maximum), long slit charge coupled device (CCD) spectra show strong CA II H and K lines in absorption at the redshift of the galaxy (Junkkarinen 1987). Higher resolution spectra showing both Ca II H and K and Na I D1 and D2 in absorption and direct images are reported here

Tree Islands in the Shark Slough Landscape: Interactions of Vegetation, Hydrology, and Soils

Executive Summary: This report presents what we have learned about tree islands of Shark Slough and adjacent marshes of Everglades National Park (ENP), based on ecological studies carried out in these wetlands during the period 2000-2003. The tree islands of Shark Slough share many features with tree islands elsewhere in the Everglades. Their current composition and community structure is determined to a large extent by recent hydrology, as well as by disturbances (fire, freezes, hurricanes, man). Tree islands have historical, cultural, and biological values that are recognized by nearly all parties to the Comprehensive Everglades Restoration Plan (CERP). Maintaining and/or restoring the health of tree islands are major objectives of CERP. Consequently, there is a need within CERP for tools to assess the health of tree islands, and to relate these measures to the hydrologic regime to which they are exposed

Association is not causation: treatment effects cannot be estimated from observational data in heart failure

Aims: Treatment ‘effects’ are often inferred from non-randomized and observational studies. These studies have inherent biases and limitations, which may make therapeutic inferences based on their results unreliable. We compared the conflicting findings of these studies to those of prospective randomized controlled trials (RCTs) in relation to pharmacological treatments for heart failure (HF). Methods and results: We searched Medline and Embase to identify studies of the association between non-randomized drug therapy and all-cause mortality in patients with HF until 31 December 2017. The treatments of interest were: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, mineralocorticoid receptor antagonists (MRAs), statins, and digoxin. We compared the findings of these observational studies with those of relevant RCTs. We identified 92 publications, reporting 94 non-randomized studies, describing 158 estimates of the ‘effect’ of the six treatments of interest on all-cause mortality, i.e. some studies examined more than one treatment and/or HF phenotype. These six treatments had been tested in 25 RCTs. For example, two pivotal RCTs showed that MRAs reduced mortality in patients with HF with reduced ejection fraction. However, only one of 12 non-randomized studies found that MRAs were of benefit, with 10 finding a neutral effect, and one a harmful effect. Conclusion: This comprehensive comparison of studies of non-randomized data with the findings of RCTs in HF shows that it is not possible to make reliable therapeutic inferences from observational associations. While trials undoubtedly leave gaps in evidence and enrol selected participants, they clearly remain the best guide to the treatment of patients