Refractory Hypocalcemia Following Total Thyroidectomy in an Adult Patient With Bariatric Surgery.

Obesity poses a global health challenge with significant individual and societal impacts. Bariatric surgery, including Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion/duodenal switch (BPD/DS), is effective for long-term weight management but can lead to serious nutritional deficiencies, particularly hypocalcemia. This report presents the rare case of a 35-year-old woman with severe, recurrent hypocalcemia following BPD/DS surgery, complicated by iatrogenic hypoparathyroidism from prior thyroidectomy.

Does timing of tocilizumab administration affect mortality in COVID-19? A Scottish multicentre retrospective cohort study.

Background: The optimal timing of tocilizumab treatment during the disease course of COVID-19 has yet to be adequately defined in the context of randomised controlled trials and the effect of tocilizumab on real-world populations remains unclear. We examined the effect of different timing of tocilizumab, on mortality, in a cohort of adults with COVID-19.

Methods: All adults (≥18 years old) with confirmed COVID-19 admitted to four hospitals in the West of Scotland between 8 January 2021 and 31 March 2021 and who received tocilizumab were included in a retrospective observational cohort study.

Substituent directed cellular imaging in the 800-850 nm range with BF-azadipyrromethene fluorophores.

Three bis(anilino)-substituted NIR-AZA fluorophores have been designed, synthesized and tested to bridge the availability gap of molecular fluorophores for live-cell microscopy imaging in the 800-850 nm spectral range. The concise synthetic route allows for the later stage introduction of three tailored peripheral substituents which guides the sub-cellular localization and imaging. Live-cell fluorescence imaging of lipid droplets, plasma membrane and cytosolic vacuoles was successfully achieved.

Robust and efficient identification of optimal mixing perturbations using proxy multiscale measures.

Understanding and optimizing passive scalar mixing in a diffusive fluid flow at finite Péclet number [Formula: see text] (where [Formula: see text] and [Formula: see text] are characteristic velocity and length scales, and [Formula: see text] is the molecular diffusivisity of the scalar) is a fundamental problem of interest in many environmental and industrial flows. Particularly when [Formula: see text], identifying initial perturbations of given energy that optimally and thoroughly mix fluids of initially different properties can be computationally challenging. To address this challenge, we consider the identification of initial perturbations in an idealized two-dimensional flow on a torus that extremize various measures over finite time horizons.

Stability of the Interaction between Two Sand Dunes in an Idealized Laboratory Experiment.

Sand dunes, which arise spontaneously due to the dynamical interplay between a sedimentary interface and a fluid flow, are one of the most famous examples of emergence in a geological system. The large scale organization of a dune field is believed to be controlled by pairwise (either remote or direct) dune-dune interactions. Recent studies have shown that remote long-range feedback is closely related to the turbulent wake structure forming downstream of a dune.

Frequency and yield of blood cultures for observation patients with skin and soft tissue infections.

Objectives: 1) To measure frequency and yield of blood cultures obtained for observation status adult patients with skin and soft tissue infection (SSTI), 2) describe how often blood cultures were performed according to Infectious Diseases Society of America (IDSA) SSTI guideline indications, 3) identify proportion of patients meeting Center for Medicare Services (CMS) sepsis criteria.

Design: Retrospective cohort.

Setting: Tertiary academic center.

Wake Induced Long Range Repulsion of Aqueous Dunes.

Sand dunes rarely occur in isolation, but usually form vast dune fields. The large scale dynamics of these fields is hitherto poorly understood, not least due to the lack of longtime observations. Theoretical models usually abstract dunes in a field as self-propelled autonomous agents, exchanging mass, either remotely or as a consequence of collisions.

Asymptotic Dynamics of High Dynamic Range Stratified Turbulence.

Direct numerical simulations of homogeneous sheared and stably stratified turbulence are considered to probe the asymptotic high dynamic range regime suggested by Gargett et al. J. Fluid Mech.

Patients discharged from the emergency department after referral for hospitalist admission.

Objectives: To describe the characteristics and outcomes of patients discharged from the emergency department (ED) by hospitalist physicians.

Study Design: Retrospective cohort study at a tertiary academic medical center.

Methods: We used consultation Current Procedural Technology codes to identify patients discharged from the ED after referral for hospitalist admission from April 2011 to April 2014.

Detrainment of plumes from vertically distributed sources.

We present experimental results demonstrating that, for the turbulent plume from a buoyancy source that is vertically distributed over the full area of a wall, detrainment qualitatively changes the shape of the ambient buoyancy profile that develops in a sealed space. Theoretical models with one-way-entrainment predict stratifications that are qualitatively different from the stratifications measured in experiments. A peeling plume model, where density and vertical velocity vary linearly across the width of the plume, so that plume fluid "peels" off into the ambient at intermediate heights, more accurately captures the shape of the ambient buoyancy profiles measured in experiments than a conventional one-way-entrainment model does.

Instabilities of interacting vortex rings generated by an oscillating disk.

We propose a natural model to probe in a controlled fashion the instability of interacting vortex rings shed from the edge of an oblate spheroid disk of major diameter c, undergoing oscillations of frequency f_{0} and amplitude A. We perform a Floquet stability analysis to determine the characteristics of the instability modes, which depend strongly on the azimuthal (integer) wave number m. We vary two key control parameters, the Keulegan-Carpenter number K_{C}=2πA/c and the Stokes number β=f_{0}c^{2}/ν, where ν is the kinematic viscosity of the fluid.

Three-dimensional transition after wake deflection behind a flapping foil.

We report the inherently three-dimensional linear instabilities of a propulsive wake, produced by a flapping foil, mimicking the caudal fin of a fish or the wing of a flying animal. For the base flow, three sequential wake patterns appear as we increase the flapping amplitude: Bénard-von Kármán (BvK) vortex streets; reverse BvK vortex streets; and deflected wakes. Imposing a three-dimensional spanwise periodic perturbation, we find that the resulting Floquet multiplier |μ| indicates an unstable "short wavelength" mode at wave number β=30, or wavelength λ=0.

Variational framework for flow optimization using seminorm constraints.

We present a general variational framework designed to consider constrained optimization and sensitivity analysis of spatially and temporally evolving flows defined as solutions of partial differential equations. We particularly focus on seminorm constraints which naturally arise for instance when the quantity which we wish to optimize can have contributions from several terms in the PDE through different physical mechanisms in a specific physical system. We show that this case implicitly requires that constraints be placed on the magnitude of complementary (with respect to the first constraining seminorm) seminorms of initial perturbations such that the sum of these complementary seminorms defines a total "true" norm of the state vector.

Spatial and temporal visualisation techniques for crash analysis.

Understanding the underlying structure of single vehicle crashes (SVCs) is essential for improving safety on the roads. Past research has found that SVCs tend to cluster both spatially and temporally. However, limited research has been conducted to investigate the interaction between the location of SVCs and the time they occur, especially at different levels of scales or spatial extents.

The experimental induction of leukoencephalomyelopathy in cats.

Leukoencephalomyelopathy of undetermined etiology has been described in specific pathogen-free cats. A study was established to assess if the long-term feeding of a gamma-irradiated diet could induce this disease. Cats fed exclusively on diet irradiated at 25.

Effects of gamma irradiation and pasteurization on the nutritive composition of commercially available animal diets.

Gamma radiation is used to sterilize diets for specific pathogen-free (SPF) animals. Because a gamma-irradiated diet was linked to leukoencephalomyelopathy in SPF cats, we investigated the effects of 'typical' (28.9-34.

Molecular detection of PPAR gamma rearrangements and thyroid carcinoma in preoperative fine-needle aspiration biopsies.

The pathologic diagnosis of thyroid follicular tumors is difficult, particularly in preoperative fine-needle aspiration biopsies. To investigate whether the molecular diagnosis of PPAR gamma rearrangements can detect thyroid carcinomas in fine-needle aspiration biopsies, we performed interphase fluorescence in situ hybridization on 24 thyroid fine-needle aspiration and 17 follow-up thyroidectomy specimens. Two of the 24 fine-needle aspiration biopsies contained PPAR gamma rearrangements, and both were diagnosed suggestive of a thyroid follicular neoplasm by cytology.

Leukoencephalomyelopathy in specific pathogen-free cats.

Investigations were carried out on 8 specific pathogen-free cats (5 male and 3 female) from a colony experiencing "outbreaks" of progressive hind limb ataxia in 190 of 540 at-risk animals ranging from 3 months to 3 years old. These studies identified moderate to severe bilateral axonal degeneration within white matter regions of the cervical, thoracic, and lumbar spinal cord and in the white matter of the cerebral internal capsule and peduncle, in the roof of the fourth ventricle and inferior cerebellar peduncle, and in the external arcuate and pyramidal fibres of the medulla. There were varying degrees of accompanying microgliosis, astrocytosis, and capillary hyperplasia.

Providing a community-based cancer risk assessment service for a socially and ethnically diverse population.

Background: Patients from ethnic minorities are under-represented in referrals to cancer genetics services. In a regional genetics centre that serves two London boroughs, the existing service attracts 3% of its referrals from Black and Minority Ethnic (BME) and other ethnic groups, despite the fact that these groups make up 34% of the population.

Objectives: To improve access to familial cancer risk assessment in a socially and ethnically diverse population.

Partners in Health: a case study of a comprehensive disability management program.

When absenteeism threatened to raise health care costs and affect the quality of care at Tillsonburg District Memorial Hospital, a multidisciplinary team came together to develop a strategic response. The hospital seized the opportunity to initiate the ¿Partners in Health¿ program, an innovative and collaborative disability management program designed to improve its response to the health issues of all its staff. This paper describes how the program was developed and outlines its comprehensive approach.