Brachial plexus injury mimicking a spinal-cord injury.

Objective High-energy impact to the head, neck, and shoulder can result in cervical spine as well as brachial plexus injuries. Because cervical spine injuries are more common, this tends to be the initial focus for management. We present a case in which the initial magnetic resonance imaging (MRI) was somewhat misleading and a detailed neurological exam lead to the correct diagnosis.Clinical presentation A 19-year-old man presented to the hospital following a shoulder injury during football practice. The patient immediately complained of significant pain in his neck, shoulder, and right arm and the inability to move his right arm. He was stabilized in the field for a presumed cervical-spine injury and transported to the emergency department.Intervention Initial radiographic assessment (C-spine CT, right shoulder x-ray) showed no bony abnormality. MRI of the cervical-spine showed T2 signal change and cord swelling thought to be consistent with a cord contusion. With adequate pain control, a detailed neurological examination was possible and was consistent with an upper brachial plexus avulsion injury that was confirmed by CT myelogram. The patient failed to make significant neurological recovery and he underwent spinal accessory nerve grafting to the suprascapular nerve to restore shoulder abduction and external rotation, while the phrenic nerve was grafted to the musculocutaneous nerve to restore elbow flexion.Conclusion Cervical spinal-cord injuries and brachial plexus injuries can occur by the same high energy mechanisms and can occur simultaneously. As in this case, MRI findings can be misleading and a detailed physical examination is the key to diagnosis. However, this can be difficult in polytrauma patients with upper extremity injuries, head injuries or concomitant spinal-cord injury. Finally, prompt diagnosis and early surgical renerveration have been associated with better long-term recovery with certain types of injury

Many-body superradiance and dynamical mirror symmetry breaking in waveguide QED

The many-body decay of extended collections of two-level systems remains an open problem. Here, we investigate whether an array of emitters coupled to a one-dimensional bath undergoes Dicke superradiance. This is a process whereby a completely inverted system becomes correlated via dissipation, leading to the release of all the energy in the form of a rapid photon burst. We derive the minimal conditions for the burst to happen as a function of the number of emitters, the chirality of the waveguide, and the single-emitter optical depth, both for ordered and disordered ensembles. Many-body superradiance occurs because the initial fluctuation that triggers the emission is amplified throughout the decay process. In one-dimensional baths, this avalanchelike behavior leads to a spontaneous mirror symmetry breaking, with large shot-to-shot fluctuations in the number of photons emitted to the left and right. Superradiant bursts may thus be a smoking gun for the generation of correlated photon states of exotic quantum statistics.Comment: 16 pages, 9 figure

HK-2: An immortalized proximal tubule epithelial cell line from normal adult human kidney

HK-2: An immortalized proximal tubule epithelial cell line from normal adult human kidney. Studies assessing mechanisms of proximal tubular cell (PTC) physiology and pathophysiology increasingly utilize cell culture systems to avoid the complexity of whole organ/whole animal experiments. However, no well-differentiated PTC line derived from adult human kidney currently exists. Therefore, the goal of this research was to establish such a line by transduction with human papilloma virus (HPV 16) E6/E7 genes. A primary PTC culture from normal adult human renal cortex was exposed to a recombinant retrovirus containing the HPV 16 E6/E7 genes, resulting in a cell line designated HK-2 (human kidney-2) which has grown continuously in serum free media for more than one year. HK-2 cell growth is epidermal growth factor dependent and the cells retain a phenotype indicative of well-differentiated PTCs (positive for alkaline phosphatase, gamma glutamyltranspeptidase, leucine aminopeptidase, acid phosphatase, cytokeratin, α3β1 integrin, fibronectin; negative for factor VHI-related antigen, 6.19 antigen and CALLA endopeptidase). Furthermore, HK-2 cells retain functional characteristics of proximal tubular epithelium (Na+ dependent/phlorizin sensitive sugar transport; adenylate cyclase responsiveness to parathyroid, but not to antidiuretic, hormone). The E6/E7 genes are present in the HK-2 genome, as determined by PCR. To assess its potential usefulness as a tool for studying injury and repair, HK-2 cells were exposed to a toxic concentration of H2O2 ± iron chelation (deferoxamine) or hydroxyl radical scavenger (Na benzoate) therapy. Only the former blocked H2O2 cytotoxicity, reproducing results previously obtained with freshly isolated rat proximal tubular segments. In conclusion, an immortalized adult human PTC line has been established by transduction with HPV 16 E6/E7 genes. It appears to be well-differentiated on the basis of its histochemical, immune cytochemical, and functional characteristics, and it can reproduce experimental results obtained with freshly isolated PTCs. Thus, this new PTC line could have substantial research application

An Annotated Checklist of the Vascular Plant Flora of Guthrie County, Iowa

The known vascular plant flora of Guthrie County, Iowa, based on field, herbarium, and literature studies, consists of 748 taxa (species, varieties, and hybrids), 135 of which are naturalized. Species which appear on the state\u27s list of endangered and threatened species, or are otherwise rare, are discussed. There is an affinity of the plants of Guthrie County with those of the Ozark plateau, and with specialized habitats providing extensions of ranges for species normally found farther north or east

'Prove me the bam!': victimization and agency in the lives of young women who commit violent offences

This article reviews the evidence regarding young women’s involvement in violent crime and, drawing on recent research carried out in HMPYOI Cornton Vale in Scotland, provides an overview of the characteristics, needs and deeds of young women sentenced to imprisonment for violent offending. Through the use of direct quotations, the article suggests that young women’s anger and aggression is often related to their experiences of family violence and abuse, and the acquisition of a negative worldview in which other people are considered as being 'out to get you' or ready to 'put one over on you'. The young women survived in these circumstances, not by adopting discourses that cast them as exploited victims, but by drawing on (sub)cultural norms and values which promote pre-emptive violence and the defence of respect. The implications of these findings for those who work with such young women are also discussed

Momentum-independent magnetic excitation continuum in the honeycomb iridate H3_3LiIr2_2O6_6

In the search for realizations of Quantum Spin Liquids (QSL), it is essential to understand the interplay between inherent disorder and the correlated fluctuating spin ground state. H$_3$LiIr$_2$O$_6$ is regarded as a spin liquid proximate to the Kitaev-limit (KQSL) in which H zero-point motion and stacking faults are known to be present. Bond disorder has been invoked to account for the existence of unexpected low-energy spin excitations. Controversy remains about the nature of the underlying correlated state and if any KQSL physics survives. Here, we use resonant X-ray spectroscopies to map the collective excitations in H$_3$LiIr$_2$O$_6$ and characterize its magnetic state. We uncover a broad bandwidth and momentum-independent continuum of magnetic excitations at low temperatures that are distinct from the paramagnetic state. The center energy and high-energy tail of the continuum are consistent with expectations for dominant ferromagnetic Kitaev interactions between dynamically fluctuating spins. The absence of a momentum dependence to these excitations indicates a broken translational invariance. Our data support an interpretation of H$_3$LiIr$_2$O$_6$ as a disordered topological spin liquid in close proximity to bond-disordered versions of the KQSL. Our results shed light on how random disorder affects topological magnetic states and have implications for future experimental and theoretical works toward realizing the Kitaev model in condensed matter system

A human cell atlas of fetal gene expression

The gene expression program underlying the specification of human cell types is of fundamental interest. We generated human cell atlases of gene expression and chromatin accessibility in fetal tissues. For gene expression, we applied three-level combinatorial indexing to >110 samples representing 15 organs, ultimately profiling ~4 million single cells. We leveraged the literature and other atlases to identify and annotate hundreds of cell types and subtypes, both within and across tissues. Our analyses focused on organ-specific specializations of broadly distributed cell types (such as blood, endothelial, and epithelial), sites of fetal erythropoiesis (which notably included the adrenal gland), and integration with mouse developmental atlases (such as conserved specification of blood cells). These data represent a rich resource for the exploration of in vivo human gene expression in diverse tissues and cell types