160 research outputs found
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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
The Liverpool Telescope Spectrograph: FRODOSpec
We describe in some detail one of the instruments that will be available in
2004 to the research community. FRODOSpec is an integral field unit
spectrograph that will be available for use with the 2 m robotic Liverpool
Telescope on the island of La Palma. We anticipate that this instrument will
open up major areas of research that cannot be carried out with conventionally
operated telescopes. Some of these research areas relate to indirect imaging of
astronomical objects like Doppler tomography and eclipse mapping.Comment: Accepted for publication in AN. Proceedings of the Astrotomography
Joint Discussion 09 of the IAU General Assembly 2003. Uses anabs.cl
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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
Immigrant category of admission and the earnings of adults and children: how far does the apple fall?
Immigrants in many Western countries have experienced poor economic outcomes. This has led to a lack of integration of child immigrants (the 1.5 generation) and the second generation in some countries. However, in Canada, child immigrants and the second generation have on average integrated very well economically. We examine the importance of Canada’s admission classes to determine if there is an earnings benefit of the selection under the economic classes to (1) the Adult Arrival immigrants and (2) the Child Arrival immigrants (1.5 generation) once old enough to enter the labour market. We employ unique administrative data on landing records matched with subsequent income tax records that also allows for the linking of the records of Adult Arrival parents and their Child Arrival children. We find, relative to the Family Class, the Adult Arrivals in the Skilled Worker category have earnings that are 29% higher for men and 38% higher for women. These differences persist even after controlling for detailed personal characteristics such as education and language fluency at 21% for men and 27% for women. Child Arrival immigrants landing in the Skilled Worker Class have earnings advantages (as adults) over their Family Class counterparts of 17% for men and 21% for women. These Child Arrival Skilled Worker advantages remain at 9% for men and 14% for women after controlling for child characteristics, the Principal Appl
A New Model for Void Coalescence by Internal Necking
A micromechanical model for predicting the strain increment required to bring a damaged material element from the onset of void coalescence up to final fracture is developed based on simple kinematics arguments. This strain increment controls the unloading slope and the energy dissipated during the final step of material failure. Proper prediction of the final drop of the load carrying capacity is an important ingredient of any ductile fracture model, especially at high stress triaxiality. The model has been motivated and verified by comparison to a large set of finite element void cell calculations.
The Rx for Change database: a first-in-class tool for optimal prescribing and medicines use
<p>Abstract</p> <p>Background</p> <p>Globally, suboptimal prescribing practices and medication errors are common. Guidance to health professionals and consumers alone is not sufficient to optimise behaviours, therefore strategies to promote evidence-based decision making and practice, such as decision support tools or reminders, are important. The literature in this area is growing, but is of variable quality and dispersed across sources, which makes it difficult to identify, access, and assess. To overcome these problems, by synthesizing and evaluating the data from systematic reviews, we have developed <it>Rx for Change </it>to provide a comprehensive, online database of the evidence for strategies to improve drug prescribing and use.</p> <p>Methods</p> <p>We use reliable and valid methods to search and screen the literature, and to appraise and analyse the evidence from relevant systematic reviews. We then present the findings in an online format which allows users to easily access pertinent information related to prescribing and medicines use. The database is a result of the collaboration between the Canadian Agency for Drugs and Technologies in Health (CADTH) and two Cochrane review groups.</p> <p>Results</p> <p>To capture the body of evidence on interventions to improve prescribing and medicines use, we conduct comprehensive and regular searches in multiple databases, and hand-searches of relevant journals. We screen articles to identify relevant systematic reviews, and include them if they are of moderate or high methodological quality. Two researchers screen, assess quality, and extract data on demographic details, intervention characteristics, and outcome data. We report the results of our analysis of each systematic review using a standardised quantitative and qualitative format. <it>Rx for Change </it>currently contains over 200 summarised reviews, structured in a multi-level format. The reviews included in the database are diverse, covering various settings, conditions, or diseases and targeting a range of professional and consumer behaviors.</p> <p>Conclusions</p> <p><it>Rx for Change </it>is a novel database that synthesizes current research evidence about the effects of interventions to improve drug prescribing practices and medicines use.</p
Thermoregulation in colonies of africanized and hybrids with Caucasian, Italian and Carniolan Apis mellifera honey bees
Back pain outcomes in primary care following a practice improvement intervention:- a prospective cohort study
<p>Abstract</p> <p>Background</p> <p>Back pain is one of the UK's costliest and least understood health problems, whose prevalence still seems to be increasing. Educational interventions for general practitioners on back pain appear to have had little impact on practice, but these did not include quality improvement learning, involve patients in the learning, record costs or document practice activities as well as patient outcomes.</p> <p>Methods</p> <p>We assessed the outcome of providing information about quality improvement techniques and evidence-based practice for back pain using the Clinical Value Compass. This included clinical outcomes (Roland and Morris Disability Questionnaire), functional outcomes, costs of care and patient satisfaction. We provided workshops which used an action learning approach and collected before and after data on routine practice activity from practice electronic databases. In parallel, we studied outcomes in a separate cohort of patients with acute and sub-acute non-specific back pain recruited from the same practices over the same time period. Patient data were analysed as a prospective, split-cohort study with assessments at baseline and eight weeks following the first consultation.</p> <p>Results</p> <p>Data for 1014 patients were recorded in the practice database study, and 101 patients in the prospective cohort study. We found that practice activities, costs and patient outcomes changed little after the intervention. However, the intervention was associated with a small, but statistically significant reduction in disability in female patients. Additionally, baseline disability, downheartedness, self-rated health and leg pain had small but statistically significant effects (p < 0.05) on follow-up disability scores in some subgroups.</p> <p>Conclusions</p> <p>GP education for back pain that both includes health improvement methodologies and involves patients may yield additional benefits for some patients without large changes in patterns of practice activity. The effects in this study were small and limited and the reasons for them remain obscure. However, such is the impact of back pain and its frequency of consultation in general practice that this kind of improvement methodology deserves further consideration.</p> <p>Trial registration number</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN30420389">ISRCTN30420389</a></p
Preliminary optical design for a 2.2 degree diameter prime focus corrector for the Blanco 4 meter telescope
We describe a five element corrector for the prime focus of the 4 meter Blanco telescope at the Cerro Tololo Inter-American Observatory (CTIO) in Chile that will be used in conjunction with a new mosaic CCD camera as part of the proposed Dark Energy Survey (DES). The corrector is designed to provide a flat focal plane and good images in the SDSS g, r, i, and z filters. We describe the performance in conjunction with the scientific requirements of the DES, particularly with regard to ghosting and weak-lensing point spread function (PSF) calibration
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