An adolescent girl with signs and symptoms of anaphylaxis and negative immunologic workup: a case report.

BackgroundThe increasing incidence of allergies and allergic reactions among children and adults has become a major public health concern. The etiology of allergic reactions can often be confirmed based on a detailed history and supportive testing. However, there are cases where the underlying factors are more complex and difficult to identify.Case presentationHere we present the case report of a 14-year-old Caucasian  girl with weight loss and a 3-year history of reported angioedema culminating in five intensive care unit admissions over the course of 2.5 months. Her initial clinical presentation included hypotension, dyspnea, and reported facial edema, but allergy and immunological workup were negative. A psychiatric workup identified an eating disorder with food restriction, comorbid major depression, obsessive compulsive disorder, and posttraumatic stress disorder. A close collaboration between Adolescent Medicine, Allergy and Immunology, and Psychiatry helped disentangle medical from psychiatric problems, including fluoxetine medication effects, as well as develop a treatment plan that was acceptable to the family. The angioedema was ultimately diagnosed as factitious disorder.ConclusionsThis patient's treatment highlights the importance of a multidisciplinary team approach, a multifactorial etiology that needed to be addressed by multiple specialists, and the importance of long-term treatment and support

Design as conversation with digital materials

This paper explores Donald Schön's concept of design as a conversation with materials, in the context of designing digital systems. It proposes material utterance as a central event in designing. A material utterance is a situated communication act that depends on the particularities of speaker, audience, material and genre. The paper argues that, if digital designing differs from other forms of designing, then accounts for such differences must be sought by understanding the material properties of digital systems and the genres of practice that surround their use. Perspectives from human-computer interaction (HCI) and the psychology of programming are used to examine how such an understanding might be constructed.</p

Non-obviousness and Screening

The paper offers a novel justification for the non-obviousness patentability requirement. An innovation involves two stages: research results in a technology blueprint, which development transforms into a profitable activity. An innovator, who is either efficient or inefficient, must rely on outside finance for the development. Only patented technologies are developed. Strengthening the non-obviousness requirement alleviates adverse selection by discouraging inefficient innovators from doing research, but creates inefficiencies by excluding marginal innovations. We show that it is socially optimal to raise the non-obviousness requirement so as to exclude bad innovators; we also provide several robustness checks and discuss the policy implications

Sewing the Tiger’s Stripes Back On: Examining Dress and the “Female Other”

I’ve been seduced by the Moulin Rouge, World Fairs, the Isabella Stuart Gardener Museum, Wunderkammers, and the world of parasols and painted fans. I read the story the Western world told without questioning it and cherished its opulent beauty. I loved what I was looking at but my art historical education has deepened my understanding of what I was looking at, Orientalism, and its partners exoticism and primitivism, all of which particularly project onto the female image. My own art appreciation has turned into an urgency to deconstruct and reassess history and ideas through material culture. Othering and alterity studies offer stories yet untold because they belong to the outsiders and the silent members of society

DEXA Body Composition and Cardiovascular Risk Factors Weakly Related in Police Officers

There is currently little research on whether fat mass and distribution is a predictive factor of cardiovascular risk. PURPOSE: To determine if obesity measures, such as fat mass and distribution (android vs gynoid), could be used to predict cardiovascular risk, particularly lipid levels, systolic blood pressure (SBP) and blood glucose. Our hypothesis was that fat mass is not an accurate predictor of these cardiovascular risk factors. METHODS: 182 police officers (166 males, 16 females; age 37.6±8.1 yrs; ht 1.7±0.1 m; wt 92.2±17.8 kg; BMI 28.9±4.8) were part of an annual cardiovascular risk profile testing group. We measured resting heart rate and blood pressure, and body composition via DEXA scan (SBP 127.16±10.33 mmHg; fat mass 26.85±9.99 kg; lean mass 62.01±9.90 kg; percent android fat 35.54±10.07; percent gynoid fat 29.65±6.91). Fasting blood samples were drawn and analyzed by a clinically certified lab to determine total blood cholesterol (TC) (191.79±37.31 mg/dL), LDL (119.23±34.74 mg/dL), HDL (46.39±10.48 mg/dL), triglycerides (128.94±99.25 mg/dL), and glucose (86.67±18.65 mg/dL). Correlations were determined by using a bivariate Pearson correlation matrix, significance was set at and p\u3c0.01**. RESULTS: As fat mass increased, total cholesterol and LDL increased and HDL decreased. Triglycerides, glucose, and SBP also increased as fat mass increased. There were also significant increases in total cholesterol, LDL, triglycerides, glucose and SBP as android fat percentage increased. HDL decreased significantly as android fat percentage increased. CONCLUSION: Fat mass weakly correlates with blood cholesterol levels. We suggest that factors other than fat mass affect cholesterol, such as genetics and lifestyle. More research is needed to see if this correlation holds or is stronger in similar and different populations

Atmospheric and Solar Neutrinos from Single Right-Handed Neutrino Dominance and U(1) Family Symmetry

We argue that in order to provide a natural explanation of both neutrino mass hierarchies and large neutrino mixing angles, as required by the atmospheric neutrino data, a single right-handed neutrino must give the dominant contribution to the 23 block of the light effective neutrino matrix, and illustrate this mechanism in the framework of models with U(1) family symmetries. Sub-dominant contributions from other right-handed neutrinos are required to give small mass splittings appropriate to the small angle MSW solution to the solar neutrino problem. We give general conditions for achieving this in the framework of U(1) family symmetry models containing arbitrary numbers of right-handed neutrinos, and show how the resulting neutrino mass hierarchies and mixing angles may be expanded in terms of the Wolfenstein parameter.Comment: 30 latex pages. Final version to appear in Nucl.Phys.

Changes in the relationship between self-reference and emotional valence as a function of dysphoria

The self-positivity bias is found to be an aspect of normal cognitive function. Changes in this bias are usually associated with changes in emotional states, such as dysphoria or depression. The aim of the present study was to clarify the role of emotional valence within self-referential processing. By asking non-dysphoric and dysphoric individuals to rate separately the emotional and self-referential content of a set of 240 words, it was possible to identify the differences in the relationship between self-reference and emotional valence, which are associated with dysphoria. The results support the existence of the self-positivity bias in non-dysphoric individuals. More interestingly, dysphoric individuals were able to accurately identify the emotional content of the word stimuli. They failed, however, to associate this emotional valence with self-reference. These findings are discussed in terms of attributional self-biases and their consequences for cognition

An integrated low carbon energy solution to cooking fuel, tailored to Niger state’s rural population

Niger State (Nigeria) was selected as a case study of renewable, affordable and user friendly clean energy provision in remote areas of developing countries. Niger state has 80% of its 4.5 million population living in rural agrarian areas with low literacy rates, there is a lack of wind thus eliminating wind as widely available potential power source. Based on the assessment of the local large insolation, the type of agricultural, biomass and husbandry resources, this study selected the design of anaerobic digestion units processing mostly animal and human waste, and whose heating and power requirement would be entirely provided by solar photovoltaic/thermal to maintain optimum efficiency of the biogas production. The designs was carried out at the scale of up to 15 household demand (community scale). Volume and therefore the production of biogas maybe increased or decreased in the design considered, and local, low cost resilient material were proposed. The proposed system was costed for a community of 24 people, demonstrating the potential for clean and renewable gas production economically