Cutaneous metastasis from penile squamous cell carcinoma resembling carcinoma en cuirasse

Penile squamous cell carcinoma is a rare malignancy seen more frequently in developing nations. Metastasis occurs in a predictable manner, with superficial lymph node involvement occurring first, followed by deep lymph node involvement, and then distant spread. Brain, lung, liver, and bone are the typical sites of distant metastasis. We present the unusual case of an 81-year-old man with penile squamous cell carcinoma requiring total penectomy who developed a confluent red to violaceous, indurated suprapubic plaque with satellite papules and bulky inguinal lymphadenopathy. The shield-like clinical presentation and infiltrating strands and cords on histology resembled carcinoma en cuirasse, a rare form of cutaneous metastasis frequently associated with breast cancer but not reported with penile squamous cell carcinoma

Harmful Algae Bloom Identification Laboratory for Virginia Shellfish Hatcheries and Nurseries

HAB Identification Laboratory Training Module This laboratory is one part of a collaborative effort funded by NOAA Sea Grant to deliver timely and practical shellfish culture information to the commercial industr

Submm/mm Galaxy Counterpart Identification Using a Characteristic Density Distribution

We present a new submm/mm galaxy counterpart identification technique which builds on the use of Spitzer IRAC colors as discriminators between likely counterparts and the general IRAC galaxy population. Using 102 radio- and SMA-confirmed counterparts to AzTEC sources across three fields (GOODS-N, GOODS-S, and COSMOS), we develop a non-parametric IRAC color-color characteristic density distribution (CDD), which, when combined with positional uncertainty information via likelihood ratios, allows us to rank all potential IRAC counterparts around SMGs and calculate the significance of each ranking via the reliability factor. We report all robust and tentative radio counterparts to SMGs, the first such list available for AzTEC/COSMOS, as well as the highest ranked IRAC counterparts for all AzTEC SMGs in these fields as determined by our technique. We demonstrate that the technique is free of radio bias and thus applicable regardless of radio detections. For observations made with a moderate beamsize (~18"), this technique identifies ~85 per cent of SMG counterparts. For much larger beamsizes (>30"), we report identification rates of 33-49 per cent. Using simulations, we demonstrate that this technique is an improvement over using positional information alone for observations with facilities such as AzTEC on the LMT and SCUBA-2 on JCMT.Comment: 30 pages, 9 figures, 5 tables. Accepted for publication in MNRA

A Randomized Controlled Trial of Interleukin-1 Receptor Antagonist in a Rabbit Model of Ascending Infection in Pregnancy

Objective: To determinewhether treatment with interleukin-1 receptor antagonist (IL1-ra) would affect amniotic fluid concentrations of tumor necrosis factor alpha (TNF-α) and prostaglandins or clinical or microbiological outcomes in a model of ascending bacterial infection in pregnancy. Methods: Timed pregnant New Zealand white rabbits at 70% of gestation underwent endoscopic inoculation of the cervices with 10(6)–10(6) cfu Escherichia coli . Animals were randomly assigned in a blinded manner to a 5-h intravenous infusion of human IL1-ra (10 mg/kg) or placebo beginning 1 – 2 h after inoculation. Blood was drawn fromthe does for assay of serum IL1-ra concentration before inoculation, at mid-infusion, after the infusion ended and at necropsy. At necropsy, temperature and cultures were taken, and aspirated amniotic fluid was pooled for assays of TNF-α, prostaglandin E(2) (PGE(2)) and IL1-ra. Results: Serum IL1-ra concentrations rose to a mean of 2 mg/ml at mid-infusion and fell markedly after the infusion to concentrations barely detectable at necropsy. Between the two groups, there were no significant differences in the rates of fever or positive cultures or in amniotic fluid concentrations of PGE(2) or TNF-α.One unique finding was the demonstration that administration of human IL1-ra to the does resulted inmeasurable concentrationsof human IL1-ra in the amniotic fluid. Conclusions: Treatment with an intravenous infusion of human IL1-ra after cervical inoculation with E. coli did not affect clinical or microbiological outcomes or amniotic fluid concentrations of TNF-α or PGE(2). This experiment provides the first demonstration of passageof human IL1-ra from the maternal bloodstreamto the amniotic fluid

The Fine Line Between Normal and Starburst Galaxies

Recent literature suggests that there are two modes through which galaxies grow their stellar mass - a normal mode characterized by quasi-steady star formation, and a highly efficient starburst mode possibly triggered by stochastic events such as galaxy mergers. While these differences are established for extreme cases, the population of galaxies in-between these two regimes is poorly studied and it is not clear where the transition between these two modes of star formation occurs. We utilize ALMA observations of the CO J=3-2 line luminosity in a sample of 20 infrared luminous galaxies that lie in the intermediate range between normal and starburst galaxies at z ~ 0.25-0.6 in the COSMOS field to examine the gas content and star formation efficiency of these galaxies. We compare these quantities to the galaxies' deviation from the well-studied "main sequence" correlation between star formation rate and stellar mass (MS) and find that at log($SFR/SFR_{MS}$) < 0.6, a galaxy's distance to the main sequence is mostly driven by increased gas content, and not a more efficient star formation process.Comment: 21 pages, 10 figure

Review article: diagnosis, management and patient perspectives of the spectrum of constipation disorders.

BACKGROUND: Chronic constipation is a common, heterogeneous disorder with multiple symptoms and pathophysiological mechanisms. Patients are often referred to a gastroenterology provider after laxatives fail. However, there is limited knowledge of the spectrum and management of constipation disorders. AIM: To discuss the latest understanding of the spectrum of constipation disorders, tools for identifying a pathophysiologic-based diagnosis in the specialist setting, treatment options and the patient\u27s perspective of constipation. METHODS: Literature searches were conducted using PubMed for constipation diagnostic criteria, diagnostic tools and approved treatments. The authors provided insight from their own practices. RESULTS: Clinical assessment, stool diaries and Rome IV diagnostic criteria can facilitate diagnosis, evaluate severity and distinguish between IBS with constipation, chronic idiopathic constipation and dyssynergic defecation. Novel smartphone applications can help track constipation symptoms. Rectal examinations, anorectal manometry and balloon expulsion, assessments of neuromuscular function with colonic transit time and colonic manometry can provide mechanistic understanding of underlying pathophysiology. Treatments include lifestyle and diet changes, biofeedback therapy and pharmacological agents. Several classes of laxatives, as well as prokinetic and prosecretory agents, are available; here we describe their mechanisms of action, efficacy and side effects. CONCLUSIONS: Constipation includes multiple overlapping subtypes identifiable using detailed history, current diagnostic tools and smartphone applications. Recognition of individual subtype(s) could pave the way for optimal, evidence-based treatments by a gastroenterology provider

Developing a Research Mentorship Program: The American Society of Pediatric Nephrology's Experience

Background: Most pediatric nephrologists work in academia. Mentor-mentee relationships provide support and guidance for successful research career. Mentorship program implementation is valuable in medical fields for providing research opportunities to young faculty. Methods: The American Society of Pediatric Nephrology (ASPN) established a research mentorship program to (a) assist with matching of appropriate mentor-mentee dyads and (b) establish metrics for desirable mentor-mentee outcomes with two independent components: (1) the grants review workshop, a short-term program providing mentor feedback on grant proposals, and (2) the longitudinal program, establishing long-term mentor-mentee relationships. Regular surveys of both mentors and mentees were reviewed to evaluate and refine the program. Results: Twelve mentees and 17 mentors participated in the grant review workshop and 19 mentees were matched to mentors in the longitudinal program. A review of NIH RePORTER data indicated that since 2014, 13 NIH grants have been awarded. Mentees in the longitudinal program reported that the program helped most with identifying an outside mentor, improving grant research content, and with general career development. Mentors perceived themselves to be most helpful in assisting with overall career plans. Email communications were preferred over phone or face-to-face communications. Mentees endorsed strong interest in staying in touch with their mentors and 100% of mentors expressed their willingness to serve in the future. Conclusion: This mentorship program was initiated and supported by a relatively small medical society and has shown early success in cultivating mentoring relationships for a future generation of clinician-scientists

Small Group Learning is Associated with Reduced Salivary Cortisol and Testosterone in Undergraduate Students

Small group learning activities have been shown to improve student academic performance and educational outcomes. Yet, we have an imperfect understanding of the mechanisms by which this occurs. Group learning may mediate student stress by placing learning in a context where students have both social support and greater control over their learning. We hypothesize that one of the methods by which small group activities improve learning is by mitigating student stress. To test this, we collected physiological measures of stress and self-reported perceived stress from 26 students in two undergraduate classes. Salivary cortisol and testosterone were measured within students across five contexts: a) pre-instructional baseline, b) following a traditional lecture, c) after participating in a structured small group learning activity, d) following completion of multiple choice, and e) essay sections of an exam. Results indicate students have lower salivary cortisol after small group learning activities, as compared to traditional lectures. Further, there is no evidence of a relationship between physiological measures of stress and self-reported perceived stress levels. We discuss how structured small group activities may be beneficial for reducing stress and improving student-learning outcomes

What Type of Person Would Be Willing to Fly with Children? A Multi-Model Analysis

The purpose of this study was to assess the type of person who would be willing to fly with children in various scenarios. A quantitative methodology and a non-experimental research approach were used in this study. A two-stage approach created a regression equation then assessed model fit. Six hundred and twenty participants were recruited for the study. The dataset was split randomly into two groups to facilitate the two-stage approach, resulting in 310 participants per stage. The study used 14 possible predictors to determine willingness to fly in five different scenarios. Five models were created and found between two and four predictors of passengers who were willing to fly with children in various scenarios. We were able to explain between 14.3% and 18.6% of the variance. All five equations were assessed for model fit and found to support a good model fit. Many aviation studies have examined willingness to fly in various scenarios; however, no research specific to the type of person who would be willing to fly with children has been explored. This study aims to fill that gap by exploring the type of person who would fly with children in five different scenarios