Incomplete Excision of Cutaneous Squamous Cell Carcinoma; Systematic Review of the Literature

The treatment of choice for cutaneous squamous cell carcinoma is complete surgical excision. Incomplete excision of cutaneous squamous cell carcinoma has an increased risk of local recurrence, deep subclinical progression, and metastasis. This study aimed to investigate the proportion and risk factors of incomplete excised cutaneous squamous cell carcinoma. A systematic review of the literature was performed. Incomplete excision rates for cutaneous squamous cell carcinoma ranged from 0.4% to 35.7%. The pooled incomplete excision risk estimate was 13% (95% confidence interval 9-17%). Risk factors noted in more than one study for incomplete excision included tumor depth and size, type of operator, head and neck localization, and former incomplete excision. We found an overall incomplete excision rate of 13% for cutaneous squamous cell carcinoma. Risk factors should be taken into account in the management of cutaneous squamous cell carcinoma surgical treatment

Rotation in Event Horizon Telescope Movies

The Event Horizon Telescope (EHT) has produced images of M87* and Sgr A*, and will soon produce time sequences of images, or movies. In anticipation of this, we describe a technique to measure a rotation rate, or pattern speed $\Omega_p$, from movies using an autocorrelation technique. We validate the technique on Gaussian random field models with a known rotation rate and apply it to a library of synthetic images of Sgr A* based on general relativistic magnetohydrodynamics (GRMHD) simulations. We predict that EHT movies will have $\Omega_p \approx 1$ degree per $\mathrm{GMc^{-3}}$, which is of order $15\%$ of the Keplerian orbital frequency in the emitting region. We can plausibly attribute the slow rotation seen in our models to the pattern speed of inward-propagating spiral shocks. We also find that $\Omega_p$ depends strongly on inclination. Application of this technique will enable us to compare future EHT movies with the clockwise rotation of Sgr A* seen in near-infrared flares by GRAVITY. Pattern speed analysis of future EHT observations of M87* and Sgr A* may also provide novel constraints on black hole inclination and spin, as well as an independent measurement of black hole mass

Successful Treatment of Protein-Losing Gastroenteropathy with Steroid Pulse and Immunosuppressive Therapies in a Patient with Sjögren Syndrome

We report the case of a 59-year-old female who developed facial edema together with hypoproteinemia. On the basis of 99mTc-human serum albumin scintigraphy and a1-antitrypsin clearance, she was diagnosed with protein-losing gastroenteropathy. Furthermore, she was diagnosed with Sjögren syndrome on the basis of eye and oral dryness, positive result with anti-SSA antibody, and salivary gland biopsy. Her symptoms improved with the use of immunosuppressive agents following steroid pulse therapy. Therefore, steroid pulse therapy and immunosuppressive agents should be considered as possible effective treatment strategies for protein-losing gastroenteropathy associated with autoimmune diseases

Changes in reflectin protein phosphorylation are associated with dynamic iridescence in squid

Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of The Royal Society for personal use, not for redistribution. The definitive version was published in Journal of The Royal Society Interface 6 (2010): 549-560, doi:10.1098/rsif.2009.0299.Many cephalopods exhibit remarkable dermal iridescence, a component of their complex, dynamic camouflage and communication. In the species Euprymna scolopes, the light-organ iridescence is static and is due to reflectin protein-based platelets assembled into lamellar thin-film reflectors called iridosomes, contained within iridescent cells called iridocytes. Squid in the family Loliginidae appear to be unique in that the dermis possesses a dynamic iridescent component, with reflective, colored structures that are assembled and disassembled under the control of the muscarinic cholinergic system and the associated neurotransmitter acetylcholine (Mathger et al. 2004). Here we present the sequences and characterization of three new members of the reflectin family associated with the dynamically changeable iridescence in Loligo and not found in static Euprymna iridophores. In addition, we show that application of genistein, a protein tyrosine kinase inhibitor, suppresses acetylcholine- and calcium-induced iridescence in Loligo. We further demonstrate that two of these novel reflectins are extensively phosphorylated in concert with the activation of iridescence by exogenous acetylcholine. This phosphorylation and the correlated iridescence can be blocked with genistein. Our results suggest that tyrosine phosphorylation of reflectin proteins is involved in the regulation of dynamic iridescence in Loligo.We gratefully acknowledge support from Anteon contract F33615-03-D-5408 to the Marine Biological Laboratory, Woods Hole, MA and grant # W911NF-06-1-0285 from the Army Research Office to D.E.M

Stres na radu i zdravlje medicinskih sestara u jedinicama intenzivne njege u Srbiji

The aim of this study was to identify and analyse professional stressors, evaluate the level of stress in nurses in Intensive Care Units (ICU), and assess the correlation between the perception of stress and psychological and somatic symptoms or diseases shown by nurses. The research, designed as a crosssectional study, was carried out in the Intensive Care Units (ICU), in health centres in Serbia. The sample population encompassed 1000 nurses. Expanded Nursing Stress Scale (ENSS) was used as the research instrument. ENSS revealed a valid metric characteristic within our sample population. Nurses from ICUs rated situations involving physical and psychological working environments as the most stressful ones, whereas situations related to social working environment were described as less stressful; however, the differences in the perception of stressfulness of these environments were minor. Socio-demographic determinants of the participants (age, marital status and education level) significantly affected the perception of stress at work. Significant differences in the perception of stressfulness of particular stress factors were observed among nurses with respect to psychological and somatic symptoms (such as headache, insomnia, fatigue, despair, lower back pain, mood swings etc.) and certain diseases (such as hypertension, myocardial infarction, stroke, diabetes mellitus etc). In view of permanent escalation of professional stressors, creating a supportive working environment is essential for positive health outcomes, prevention of job-related diseases and better protection of already ill nurses.Cilj je ovoga rada bio identifi cirati i analizirati profesionalne stresore, procijeniti razinu stresa kod medicinskih sestara u jedinicama intenzivne njege te procijeniti korelaciju između percepcije stresa i prisutnosti psiholoških i somatskih simptoma ili bolesti kod medicinskih sestara. Istraživanje je provedeno u obliku studije presjeka u Jedinicama intenzivne njege u zdravstvenim centrima u Srbiji. Uzorak se sastojao od 1000 medicinskih sestara-tehničara. Za procjenu i analizu profesionalnih stresora korišten je upitnik Expanded Nursing Stress Scale (ENSS), koji je pokazao validne metrijske karakteristike na našoj ispitanoj populaciji. Medicinske sestre u Jedinicama intenzivne njege ocijenile su situacije iz fizičkoga i psihološkoga radnog okruženja kao izrazito opterećujuće, a situacije iz socijalnoga radnog okruženja kao manje opterećujuće. Razlika u percepciji stresogenosti navedenih radnih okruženja nije bila statistički značajna. Sociodemografske determinante ispitanika (dob, bračno stanje i stupanj obrazovanja) značajno utječu na percepciju stresa na radnom mjestu. Utvrđena je statistički značajna razlika u opažanju stresogenosti pojedinih stresnih situacija na radnom mjestu između medicinskih sestara u odnosu na postojanje psihosomatskih simptoma (kao što su glavobolja, nesanica, umor, očaj, bol u leđima, česte promjene raspoloženja) ili određenih bolesti (kao što su povišena hipertenzija, infarkt miokarda, cerebrovaskularni inzult, šećerna bolest). Zbog sve izraženije prisutnosti profesionalnih stresora nužno je poduzeti određene strateške mjere kod medicinskih sestara u Jedinicama intenzivne njege. Strateške mjere podrazumijevaju unaprjeđenje psihosocijalne radne klime, što bi unaprijedilo njihovo zdravlje i spriječilo nastanak bolesti u svezi s radom, ali i omogućilo bolju zaštitu već oboljelim medicinskim sestrama