Publications by authors named "James Keeling"

Programming is a powerful and ubiquitous problem-solving tool. Systems that can assist programmers or even generate programs themselves could make programming more productive and accessible. Recent transformer-based neural network models show impressive code generation abilities yet still perform poorly on more complex tasks requiring problem-solving skills, such as competitive programming problems.

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Nuclear fusion using magnetic confinement, in particular in the tokamak configuration, is a promising path towards sustainable energy. A core challenge is to shape and maintain a high-temperature plasma within the tokamak vessel. This requires high-dimensional, high-frequency, closed-loop control using magnetic actuator coils, further complicated by the diverse requirements across a wide range of plasma configurations.

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Article Synopsis
  • A 63-year-old woman from Central Florida has a 2-year history of a skin condition and joint pain, with a background of seronegative rheumatoid arthritis treated with multiple medications.
  • After a hospitalization where her medications were paused, she developed a skin eruption that led to a biopsy showing subacute cutaneous lupus erythematosus (SCLE).
  • Treatment with hydroxychloroquine and potent topical corticosteroids did not improve her condition, and a repeat biopsy later indicated interstitial granulomatous dermatitis (IGD).
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Pemphigus herpetiformis (PH), a rare type of pemphigus, is characterized by immunologic findings consistent with pemphigus but with a unique clinical and pathologic presentation. PH was first described as resembling dermatitis herpetiformis clinically, but because of its variable presentation, it can also resemble linear immunoglobulin A bullous dermatosis and bullous pemphigoid. We reviewed reported cases to analyze the most frequent clinical, pathologic, and immunologic characteristics and to propose corresponding diagnostic criteria.

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A 41-year-old, right-hand dominant man sought care at our facility one day after trying to pull his boat out of the water. He'd tried to lift the boat with his hands while his forearms were fully supinated and his elbows were flexed to about 90 degrees. He then felt a sharp burning sensation in his left anterior shoulder and was unable to lift the boat.

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Water polo is a unique team sport combining swimming sprints and eggbeater kicking, frequent overhead movements and throwing, and regular physical contact with minimal protective equipment. Accordingly, a wide variety of training methods attempt to enhance all of these skill sets. This usually includes some combination of aerobic/anaerobic fitness (via swimming), sport-specific skills, strengthening, and nutrition.

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Leishmaniasis is a parasitic infection endemic to more than 90 countries worldwide. As travel to endemic areas increases, dermatologists need to keep this entity in the differential for any chronic skin lesion in persons who may have had a possible exposure for any duration. It can be difficult to diagnose because manifestations are varied and sometimes subclinical.

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Background: Patch testing is essential for identification of culprits causing allergic contact dermatitis.

Objective: We sought to identify trends and allergen changes in our standard series during 2006 to 2010, compared with our previous report (2001-2005).

Methods: We conducted a retrospective review of patch-test results.

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Background: The standard allergen series used in patch testing contains metals that most commonly cause allergic contact dermatitis, but testing with additional metal allergens is warranted for select patients.

Objective: To report our experience with patch testing of metals.

Methods: We retrospectively analyzed outcomes of 1,112 patients suspected of having metal allergies.

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Background: Do patch test results vary from one part of the USA to another? Few reports directly compare the results of patch testing across centers within the USA.

Objectives: Our objective was to compare results of patch testing from three geographically disparate Mayo Clinic sites in the USA to ascertain whether there are any differences in allergic patch test rates.

Methods: We retrospectively reviewed patch test results for patients tested with a standard allergen series using our enterprise-wide protocol for patch testing.

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Background: Peristomal dermatitis is a common problem in patients with ostomies that is a source of considerable morbidity. Irritant contact dermatitis is most common, but allergic contact dermatitis can also occur. Because of the lack of published reports on patch testing for this indication, we undertook a retrospective study of patch testing results in patients with suspected peristomal allergic contact dermatitis.

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Background: There is concern that the immunologic tumor malignant melanoma (MM) may have worse outcomes in immunosuppressed hosts than in the general population.

Objective: We sought to describe outcomes of MM in immunosuppressed solid organ transplant recipients and compare them with the general population.

Methods: We conducted a retrospective review of medical charts and pathology slides of cases of MM and solid organ transplantation between 1978 and 2007, with comparison of outcomes.

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We present a case of larva currens in a patient scheduled for renal transplant. Larva currens is an eruption caused by Strongyloides stercoralis, characterized most often by a pathognomonic, migratory, rapidly extending, serpiginous, urticarial eruption. Infected patients who are immunocompromised are at risk for disseminated and often fatal infection.

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A wide variety of superficial soft-tissue masses may be seen in clinical practice, but a systematic approach can help achieve a definitive diagnosis or limit a differential diagnosis. Superficial soft-tissue masses can generally be categorized as mesenchymal tumors, skin appendage lesions, metastatic tumors, other tumors and tumorlike lesions, or inflammatory lesions. With regard to their imaging features, these masses may be further divided into lesions that arise in association with the epidermis or dermis (cutaneous lesions), lesions that arise within the substance of the subcutaneous adipose tissue, or lesions that arise in intimate association with the fascia overlying the muscle.

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Cutaneous sporotrichosis is an uncommon infection, usually reported as sporadic cases resulting from inoculation with sharp environmental vegetative matter. We report such a case of multiple primary inoculations acquired from Solenopsis (fire ant) stings in a 54-year-old white man. The patient was treated effectively with itraconazole 200 mg twice a day for 4 months.

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