Synchronous gastric and duodenal metastases from head and neck squamous cell carcinoma: a unique presentation of upper gastrointestinal bleeding.

Metastatic disease to the stomach or duodenum is an infrequent diagnosis, and head and neck squamous cell carcinoma (HNSCC) is one of the least common primary malignancies that lead to gastric or duodenal metastases. We report the case of a 65-year-old man with human immunodeficiency virus infection and previously diagnosed HNSCC who presented with melena. The patient had a percutaneous endoscopic gastrostomy tube placed 3 months prior to his presentation. Laboratory testing was significant for normocytic anemia and a digital rectal examination was positive for melena. Esophagogastroduodenoscopy revealed numerous cratered nodules with contact bleeding in the stomach as well as the duodenum that appeared malignant. Biopsies of the gastric and duodenal nodules were positive for p40 and CK 5/6, consistent with metastatic squamous cell carcinoma

Planning and control in the 19th century ice trade

This paper describes selected accounting records of the Tudor Ice Company which were devised to manage and control the far-flung business activities of Frederic Tudor, a 19th century entrepreneur who has been called America\u27s first monopolist. Tudor\u27s business genius lay in developing methods of harvesting, transporting, storing, and marketing commercial quantities of ice taken from New England ponds and shipped to tropical ports around the world. Frederic Tudor employed relatively sophisticated accounting techniques to analyze and control transportation costs and the costs of product shrinkage. He also routinely analyzed and translated foreign currency transactions for his geographically dispersed operations and evaluated the impact of competition on his operations

Common Causes and The Direction of Causation

Is the common cause principle merely one of a set of useful heuristics for discovering causal relations, or is it rather a piece of heavy duty metaphysics, capable of grounding the direction of causation itself? Since the principle was introduced in Reichenbach’s groundbreaking work The Direction of Time (1956), there have been a series of attempts to pursue the latter program—to take the probabilistic relationships constitutive of the principle of the common cause and use them to ground the direction of causation. These attempts have not all explicitly appealed to the principle as originally formulated; it has also appeared in the guise of independence conditions, counterfactual overdetermination, and, in the causal modelling literature, as the causal markov condition. In this paper, I identify a set of difficulties for grounding the asymmetry of causation on the principle and its descendents. The first difficulty, concerning what I call the vertical placement of causation, consists of a tension between considerations that drive towards the macroscopic scale, and considerations that drive towards the microscopic scale—the worry is that these considerations cannot both be comfortably accommodated. The second difficulty consists of a novel potential counterexample to the principle based on the familiar Einstein Podolsky Rosen (EPR) cases in quantum mechanics

Evaluation of nonmetallic thermal protection materials for the manned space shuttle. Volume 1, task 1: Assessment of technical risks associated with utilization of nonmetallic thermal protection system

Technical problems of design and flight qualification of the proposed classes of surface insulation materials and leading edge materials were reviewed. A screening test plan, a preliminary design data test plan and a design data test plan were outlined. This program defined the apparent critical differences between the surface insulators and the leading edge materials, structuring specialized screening test plans for each of these two classes of materials. Unique testing techniques were shown to be important in evaluating the structural interaction aspects of the surface insulators and a separate task was defined to validate the test plan. In addition, a compilation was made of available information on proposed material (including metallic TPS), previous shuttle programs, pertinent test procedures, and other national programs of merit. This material was collected and summarized in an informally structured workbook

An Unexpectedly Swift Rise in the Gamma-ray Burst Rate

The association of long gamma-ray bursts with supernovae naturally suggests that the cosmic GRB rate should trace the star formation history. Finding otherwise would provide important clues concerning these rare, curious phenomena. Using a new estimate of Swift GRB energetics to construct a sample of 36 luminous GRBs with redshifts in the range z=0-4, we find evidence of enhanced evolution in the GRB rate, with ~4 times as many GRBs observed at z~4 than expected from star formation measurements. This direct and empirical demonstration of needed additional evolution is a new result. It is consistent with theoretical expectations from metallicity effects, but other causes remain possible, and we consider them systematically.Comment: 4 pages, 4 figures; minor changes to agree with published versio

Spiking Neurons Learning Phase Delays

Time differences between the two ears are an important cue for animals to azimuthally locate a sound source. The first binaural brainstem nucleus, in mammals the medial superior olive, is generally believed to perform the necessary computations. Its cells are sensitive to variations of interaural time differences of about 10 μs. The classical explanation of such a neuronal time-difference tuning is based on the physical concept of delay lines. Recent data, however, are inconsistent with a temporal delay and rather favor a phase delay. By means of a biophysical model we show how spike-timing-dependent synaptic learning explains precise interplay of excitation and inhibition and, hence, accounts for a physical realization of a phase delay

Gamma-ray signatures of annihilation to charged leptons in dark matter substructure

Due to their higher concentrations and small internal velocities, Milky Way subhalos can be at least as important as the smooth halo in accounting for the GeV positron excess via dark matter annihilation. After showing how this can be achieved in various scenarios, including in Sommerfeld models, we demonstrate that, in this case, the diffuse inverse-Compton emission resulting from electrons and positrons produced in substructure leads to a nearly-isotropic signal close to the level of the isotropic GeV gamma-ray background seen by Fermi. Moreover, we show that HESS cosmic-ray electron measurements can be used to constrain multi-TeV internal bremsstrahlung gamma rays arising from annihilation to charged leptons.Comment: 8 pages, 4 figures; minor updates to match published versio