Unusual Instances Research Articles

Sudden deflation of the tissue expander used in two-stage breast reconstruction surgery: two cases of this rare complication

For breast cancer patients, the goal after mastectomy is to reconstruct a cosmetically beautiful, natural-appearing breast that is symmetrical to the contralateral breast. Breast reconstruction using a tissue expander is one of the most commonly employed methods. This two-stage method involves initially placing a tissue expander, followed by its exchange for a permanent implant. It is recognized as safe and effective, and demand for this procedure is gradually increasing. However, we encountered two unusual instances of sudden deflation of tissue expanders used in two-stage breast reconstruction surgery. Both expanders were placed using a dual-plane technique beneath an acellular dermal matrix. One patient had undergone radiation therapy, while the other had not. Upon removal of the tissue expanders, they were examined for physical rupture, but no abnormalities were detected. Postoperative malfunction of tissue expanders or implants is relatively uncommon, and there have been no reports of delayed leakage without rupture of the expander. In this study, we present a rare complication involving tissue expanders and discuss potential causes and solutions.

Sondheim at the disco

Songs from Stephen Sondheim’s musicals have occasionally left the theatre to circulate through popular culture – and, in some unusual instances, they have even made their way to the dance floor. This article examines three disco adaptations of Sondheim show tunes: ‘Send in the Clowns’ by Grace Jones, ‘The Ballad of Sweeney Todd’ by Gordon Grody and ‘Losing My Mind’ by Liza Minnelli. Informed by histories of queerness and cultural production, the author interprets these dance tracks as reflections of queer life in the 1970s and 1980s, from gay liberation and radically camp exuberance to the homophobic ‘disco sucks’ backlash and the devastation of AIDS. While casting a critical eye on the artistic merit of these cover versions, the article argues that taking Sondheim from the Broadway stage to the discotheque can create new understandings of the meaning and social significance of a great songwriter’s work.

A Content Inflamed Appendix Within Right Inguinal Hernia Sac: A Case Report

Content inflamed within right inguinal hernia is also known as Amyand’s hernia, is a rare clinical condition characterized by the similar complaints of an appendicitis. In case of strangulation or acute appendicitis occurring inside the hernia sac, the condition may be asymptomatic or manifest as an incarcerated hernia. Every surgeon should be ready to handle such an unforeseen event because the majority of these unusual instances are treated by urgent surgery without a preoperative diagnosis which makes this report informative. Keywords: Inguinal hernia, content inflamed, laparoscopic appendicectomy, hernia repair

Improving anomaly detection in SCADA network communication with attribute extension

Network anomaly detection for critical infrastructure supervisory control and data acquisition (SCADA) systems is the first line of defense against cyber-attacks. Often hybrid methods, such as machine learning with signature-based intrusion detection methods, are employed to improve the detection results. Here an attempt is made to enhance the support vector-based outlier detection method by leveraging behavioural attribute extension of the network nodes. The network nodes are modeled as graph vertices to construct related attributes that enhance network characterisation and potentially improve unsupervised anomaly detection ability for SCADA network. IEC 104 SCADA protocol communication data with good domain fidelity is utilised for empirical testing. The results demonstrate that the proposed approach achieves significant improvements over the baseline approach (average F_{1} score increased from 0.6 to 0.9, and Matthews correlation coefficient (MCC) from 0.3 to 0.8). The achieved outcome also surpasses the unsupervised scores of related literature. For critical networks, the identification of attacks is indispensable. The result shows an insignificant missed-alert rate (0.3% on average), the lowest among related works. The gathered results show that the proposed approach can expose rouge SCADA nodes reasonably and assist in further pruning the identified unusual instances.

Mimesis of Remembering

Abstract Literary narratives not only often thematize memory as a topic; they also directly represent or stage concrete processes of remembering by way of various narrative techniques. This article offers a systematic approach to these techniques which is informed both by narratology and interdisciplinary memory studies. Specifically, the contribution offers a toolbox for the analysis of what we refer to as the ›mimesis of remembering‹: through a variety of textual strategies, literary texts can create ›memory-like‹ effects. How such ›mnestic narration‹ is achieved and what functions it might fulfil is the main concern of this article. Most generally, we argue, two basic structural principles are the basis for a narrative mimesis of remembering: first, such narratives feature a centre of subjective perception, a consciousness who performs the process of remembering (either on the level of the narrative mediation or the level of the characters), and second, they need to feature at least two distinct time levels. However, not all narratives that contain these very common aspects are equally invested in representing processes of remembering. We propose to think of the mnestic quality of texts as a scalar phenomenon, where passages set in the narrative past can be more or less emphatically (and continuously) marked as rendering products or processes of remembering. Besides introducing various basic aspects of a mimesis of remembering – representation of time and space, narrative mediation and focalization, and questions of narrative unreliability –, the article not only offers a toolbox for analysis, but also discusses, on the basis of selected texts, how these aspects can be designed and combined in ways that serve to highlight a text’s mnestic qualities. We come to the conclusion that in order to fully understand these effects, one must set them into broader cultural and historical contexts. For one thing, it needs to be considered how the representations in the texts relate to evolving conceptualizations of the process of remembering itself. Moreover, one must be aware of changing narrative conventions for the representations of ›normal‹ or unmarked acts of remembering, which may also serve as a foil to foreground unusual instances.

Sensory Organ Investment Varies with Body Size and Sex in the Butterfly Pieris napi.

Simple SummaryPollinating insects rely on a range of senses such as vision, olfaction, gustation, and mechanosensation to utilise, locate, and fly between floral resources. The size of different sensory organs determines their sensitivity and provides an indication of their relative importance—larger organs can enhance sensitivity by increasing the number or size of sensing structures. However, increasing the relative size of an organ would require additional energy for developing and maintaining it. This likely leads to a trade-off between the energy invested into different sensory systems within individuals. To explore how the size of the sensory organs vary with body size in insect pollinators and how the energetic investment is divided, we performed a series of morphological measurements on the eyes, antennae, proboscis, and wings of male and female Pieris napi butterflies with a range of body sizes. We found that only antenna (in females) and wing size (in males and females) increased with body size. Males also had larger eyes and antennae compared to females regardless of body size. Our results provide insights into how the sensory morphology of these butterflies varies with body size and sex, and highlights unusual instances of organs that do not scale with body size.In solitary insect pollinators such as butterflies, sensory systems must be adapted for multiple tasks, including nectar foraging, mate-finding, and locating host-plants. As a result, the energetic investments between sensory organs can vary at the intraspecific level and even among sexes. To date, little is known about how these investments are distributed between sensory systems and how it varies among individuals of different sex. We performed a comprehensive allometric study on males and females of the butterfly Pieris napi where we measured the sizes and other parameters of sensory traits including eyes, antennae, proboscis, and wings. Our findings show that among all the sensory traits measured, only antenna and wing size have an allometric relationship with body size and that the energetic investment in different sensory systems varies between males and females. Moreover, males had absolutely larger antennae and eyes, indicating that they invest more energy in these organs than females of the same body size. Overall, the findings of this study reveal that the size of sensory traits in P. napi are not necessarily related to body size and raises questions about other factors that drive sensory trait investment in this species and in other insect pollinators in general.

Performance analysis of optimal cluster selection and intrusion detection by hierarchical K-means clustering with hybrid ABC-DT

PurposeThis paper aims to propose a multi-dimensional hierarchical K-means clustering algorithm for the purpose of intrusion detection. Initially, the clustering set of rules is proposed to shape some of clusters in the network and then the most beneficial clusters are decided on by the use of Cuckoo search optimization set of rules. Finally, an Artificial Bee Colony primarily based selection tree (ABC-DT) classifier is rented to classify the regular and unusual instances present in the network with the aid of the extracted features.Design/methodology/approachIntrusion detection system (IDS) is crucial for the network system; the intruder can take sensitive details about the network. IDS are said to be more effective when it has both high intrusion detection rate and low false alarm rate. Numerous strategies including gadget mastering, records mining and statistical techniques were tested for IDS mission. Recent study reveals that combining multiple classifiers, i.e. classifiers ensemble, can also own better performance than unmarried classifier. In this paper, a comparative study is conducted of the overall performance of four classifiers, i.e. hybrid ABC-DT particle swarm optimization-based K-means clustering (PSO-KM), help vector device (SVM) and K-Nearest neighbour (KNN). All the four classifiers are tested with exceptional packet sizes 1470, 1024, 512 and 256. The experiment is carried out for the speed ranging from turned into done for the velocity ranging from 250Mbps, 500Mbps, 750Mbps, 1.0Gpbs, 1.5Gbps, and 2.0Gbps in terms of accuracy, detection charge, specificity, false alarm charge and computational time. The experimental results reveals that the hybridization of classifiers performs better than the base classifiers in all scenarios.FindingsThis study analyses the performance of hybrid ABC-DT classifier and compares the performance against three well-known classifiers such as PSO-KM, SVM and K-NN. The performances of all the four classifiers are tested with Discovery in Data Mining (KDD) CUP 99 dataset with different packet sizes 1470, 1024, 512 and 256. The results show the classifier performance variations with different speed ranges. From the experimental results and analysis, the hybridization of classifiers such as ABC-DT outperforms the base classifiers in all scenarios.Originality/valueThe novel approach in this paper is used to study the hybrid ABC-DT classifier and compare the performance against three well-known classifiers such as PSO-KM, SVM and K-NN. The discussed concept is used within the network to monitor the traffic to and from all the devices connected in that network.

The affordances and constraints of situation and genre

Abstract Visuals are generally considered to be rich in information, but also to be open to many different interpretations. As a consequence, many argumentation scholars doubt that visuals can constitute argumentation (e.g. Fleming, 1996; Johnson, 2003, 2010; Patterson, 2010). In this paper, we argue that the rhetorical and argumentative potential of visuals and multimodal texts is strengthened if they belong to recognizable genres, genres being governed by discourse-internal factors as well as situational/pragmatic understanding. The genre of traffic signs can draw on specific genre conventions thanks to these signs’ highly coded nature. As a consequence, traffic signs constitute an exemplary category to make the point that visuals and multimodal texts can function rhetorically or even argumentatively. We support our claim by first analysing a number of unusual instances of the genre and then discussing a few visual and multimodal signs whose argumentative potential no longer depends on specific traffic-related circumstances but crucially depends on the pretence that they are traffic signs.

Singing behaviour in a client with traumatic brain injury: a conversation analysis investigation

ABSTRACTBackground: Traumatic brain injury (TBI) is associated with pragmatic communication difficulties that lead to difficulty in social interaction. Research on conversation abilities in persons with TBI is limited, but has revealed unique patterns of behaviour that result in success or breakdown in conversation. Only a handful of studies have examined real-world conversations of persons with TBI to better understand how these behaviours might be motivated by conversation moves of partners.Aims: This study involved an exploration of a particular behaviour in a man with TBI, singing, to better understand the interactional environment, and goals associated with the behaviour.Methods & Procedures: Over 7 h of conversation data were videorecorded from 10 therapy sessions in which a man with TBI recurrently employed singing during conversation. Instances of singing were identified and transcribed according to principles of conversation analysis (CA). A total of 39 instances were included and analysed independently, focusing on explaining the sequential context of the device and the interactional work that was achieved.Outcomes & Results: Data analysis revealed four distinct sequences involving instances of singing. These included a normative sequence in which the participant inserted singing in ways similar to neurotypical speakers. The other three sequences comprised of unusual instances of singing that allowed the participant to nominate new topics, demonstrate disalignment, and close topics in conversation.Conclusions: CA revealed that the participant produced singing in response to the actions of his conversation partners. All sequences were jointly produced and dependent upon the conversation turns before and after the instance of singing. The findings suggest that conversational partners pursue various interactional agendas during conversation in therapy sessions and the participant uses singing to perform facework in this context.

Unusual Depredatory Birds in Sunflower and Sorghum

There are about 18 species of depredatory birds listed on Sorghum and Sunflower. Majority of the damage is done by Rose-ringed Parakeets, Common Myna, House Crow, Scaly-breasted Munia and Baya Weavers. Unusual instance of Red-breasted Parakeet in Hyderabad feeding on Sorghum was observed. Similarly, unusual instances of Great Tits, Indian Peafowl and Large Grey Babbler were observed to feed on Sunflower heads.

The Difference a Single Atom Can Make: Synthesis and Design at the Chemistry-Biology Interface.

A Perspective of work in our laboratory on the examination of biologically active compounds, especially natural products, is presented. In the context of individual programs and along with a summary of our work, selected cases are presented that illustrate the impact single atom changes can have on the biological properties of the compounds. The examples were chosen to highlight single heavy atom changes that improve activity, rather than those that involve informative alterations that reduce or abolish activity. The examples were also chosen to illustrate that the impact of such single-atom changes can originate from steric, electronic, conformational, or H-bonding effects, from changes in functional reactivity, from fundamental intermolecular interactions with a biological target, from introduction of a new or altered functionalization site, or from features as simple as improvements in stability or physical properties. Nearly all the examples highlighted represent not only unusual instances of productive deep-seated natural product modifications and were introduced through total synthesis but are also remarkable in that they are derived from only a single heavy atom change in the structure.

High-pH inclined stress corrosion cracking in Australian and Canadian gas pipeline X65 steels

High-pH stress corrosion cracking is a form of environmental degradation of gas pipeline steels. The crack path is intergranular by nature and typically perpendicular to the maximum applied (hoop) stress (i.e. perpendicular to the pipe outer surface). Some unusual instances of cracks have been observed in Canadian and Australian X65 pipes, where cracks grow away from the perpendicular for considerable distances. This paper presents a comparative study in terms of crack morphology, mechanical properties and crystallographic texture for these Australian and Canadian pipe steels. It is shown that the crack morphologies are quite similar, the main difference being the angle at which the cracks propagate into the material. This difference could be explained by the different through-wall texture and grain aspect ratio measured in the two materials. The interdependency of crack tip plasticity, crack tip electrochemistry and anisotropy in microstructural texture seems to heavily affect the resulting inclined crack path.

A Retrospective Study of Blade Wound Characteristics in Suicide and Homicide.

The distinction between self-inflicted blade wounds and blade wounds inflicted by another can be difficult in situations where there is little available history or context. We reviewed homicides and suicides in the past 10 years at the Vermont Office of the Chief Medical Examiner to define the characteristics of homicidal and suicidal blade wounds. All homicides and suicides involving blade wounds, not just those in which blade wounds were the cause of death, were included. Information regarding victim demographics, location and type of injuries, toxicology, and evidence of suicidality was gathered. Blade wounds were the cause of death in 85.7% of homicides but only in 36% of suicides. Hanging and gunshot wounds were the cause of death in 28% and 24% of suicides, respectively. Multiple stab wounds were found in 10% of homicides and in 0% of suicides, whereas multiple incised wounds were found in 60% of suicides and only 10% of homicides. However, several unusual instances of suicide were found, including suicides with clothing damage or bone or cartilage injury from blade wounds. No characteristics of blade wounds were definitive for homicide or suicide. History and circumstances of the scene are thus crucial in determining the manner of death.

When is dreaming waking? Continuity, lucidity and transcendence in modern contexts of dreaming

The continuity hypothesis suggests that dreaming is not fully independent of our waking lives. Several factors common to waking have been demonstrated to manifest in the dream-state. Yet, unusual instances of being awake in dreaming may represent autochthonous forms of consciousness that are not necessarily correlated with the parameters of the waking world. This juxtaposition of continuity/discontinuity parallels the natural attitude in the waking world and challenges to it in reenchantment. Addressing the correspondencce between debates on continuity/discontinuity and contextual changes may provide an alternative perspective for redefining the boundaries between waking and dreaming.

Cochlear Implantation in Extraordinary Cases.

Although cochlear implantation has been almost a standard otological procedure worldwide, it may still create a dilemma for the surgeon in some unusual instances such as Seckel syndrome, aural atresia and posterior fossa arachnoid cyst. Three extraordinary cases of cochlear implantation were reported. The first case was a case of Seckel syndrome with a cardiac pacemaker due to complete atrioventricular block. The second case had posterior fossa arachnoid cyst that had retrosigmoid cyst removal and cochlear implantation simultaneously. The last case had cochlear implantation in the ear with congenital aural atresia. All cases could be implanted successfully with full electrode insertion and good audiological outcome. Delayed facial paralysis that occurred in the patient with arachnoid cyst resolved spontaneously. This study addressed the efficiency of cochlear implantation in cases of Seckel syndrome, complete atrioventricular block managed with cardiac pacemaker, congenital aural atresia and posterior fossa arachnoid cyst. In addition, the retrosigmoid approach and cochlear implantation can be performed simultaneously.

The Shape of Things: The Origin of Young Children’s Knowledge of the Names and Properties of Geometric Forms

How do toddlers learn the names of geometric forms? Previous work suggests that preschoolers have fragmentary knowledge and that defining properties are not understood until well into elementary school. The current study investigated when children first begin to understand shape names and how they apply those labels to unusual instances. We tested 25- and 30-month-old children’s (N = 30 each) understanding of names for canonical shapes (commonly encountered instances, e.g., equilateral triangles), noncanonical shapes (more irregular instances, e.g., scalene triangles), and embedded shapes (shapes within a larger picture, e.g., triangular slices of pizza). At 25 months, children knew very few names, including those for canonical shapes. By 30 months, however, children had acquired more shape names and were beginning to apply them to some of the less typical instances of the shapes. Possible mechanisms driving this initial development of shape knowledge and implications of that development for school readiness are explored.

Detention, the War on Terror, and the Federal Courts

Between 2004 and 2009, the United States Supreme Court relied numerous times on habeas corpus to protect the rights of citizens and of aliens detained after 9/11. Various claims could be marshaled to bracket the 9/11 decisions - as “war” cases; “Guantanamo” cases; “torture” cases; aberrational responses to documented procedural unfairness; unusual instances of federal pretrial detention; and either as extraordinary judicial rejections of challenges to the Court’s authority or as disappointingly narrow procedural remedies licensing forms of preventive detention. Further, one could argue that the specter of terrorism raises normative questions distinct from those related to confinement for other reasons.But neither the problems nor the law produced through 9/11 detention are exotic. Rather, they are continuous with judicial responses to decisions by governments trying to maintain peace and security and, hence, incapacitating some individuals feared likely to inflict grave harm. Officials deal with uncertainty about which persons are threatening in the contexts of 9/11, of ordinary criminality, and of border regulation. In response, more than two million persons are detained in the United States, and some 25,000 segregated in solitary confinement in “supermax” facilities. Courts in turn have, over the last several decades, addressed or demurred on claims about the illegality of both the length and conditions of confinement, and Congress has repeatedly sought to structure or limit routes that various kinds of detainees may take to court.Therefore, the 9/11 decisions are exemplary of what Henry Monaghan termed the “timeless” questions within the federal courts canon about the role of courts in this constitutional order. One sees, repeatedly, the many effects of “foreign” law on U.S. precepts, as well as the distinctive contributions made by courts, obliged to function independently, to treat all persons as equally entitled to dignity, and to work in public. But the limited role for courts is also vivid; even as adjudication can frame some parameters of confinement, the protection of human dignity depends on a diverse set of officials interacting at all levels and in all sectors of government.

Cold antibody autoimmune hemolytic anemias

The cold antibody autoimmune hemolytic anemias (AIHAs) are primarily comprised of cold agglutinin syndrome (CAS) and paroxysmal cold hemoglobinuria (PCH) but, in addition, there are unusual instances in which patients satisfy the serologic criteria of both warm antibody AIHA and CAS ("mixed AIHA"). CAS characteristically occurs in middle-aged or elderly persons, often with signs and symptoms exacerbated by cold. The responsible antibody is of the IgM immunoglobulin class, is maximally reactive in the cold but with reactivity up to at least 30 degrees C. Therapy is often ineffective, but newer agents such as rituximab have been beneficial in some patients. PCH occurs primarily in children, often after an upper respiratory infection. The causative antibody is of the IgG immunoglobulin class and is a biphasic hemolysin that is demonstrated by incubation in the cold followed by incubation at 37 degrees C in the presence of complement. Acute attacks are frequently severe but the illness characteristically resolves spontaneously within a few days to several weeks after onset and rarely recurs. Treatment consists of supportive care, with transfusions frequently being needed.

Screening for Acute HIV Infection: Lessons Learned

Human immunodeficiency virus (HIV) nucleic acid testing is increasingly being used by researchers and public health screening programs to identify highly infectious, HIV antibody-negative individuals with acute HIV infection. We present cases to illustrate unusual instances of acute HIV screening, which include "window period" testing and the discovery of low-level HIV RNA.

Model for end-stage liver disease (MELD) exception guidelines: Results and recommendations from the MELD exception study group and conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula

Richard B. Freeman Jr., Robert G. Gish, Ann Harper, Gary L. Davis, John Vierling, Leslie Lieblein, Goran Klintmalm, Jamie Blazek, Robert Hunter, and Jeffrey Punch Division of Transplantation, Department of Surgery, Tufts–New England Medical Center, Boston, MA; Departments of Medicine and Transplantation and the Division of Hepatology and Complex GI, Physicians Foundation, California Pacific Medical Center, San Francisco, CA; United Network for Organ Sharing, Richmond, VA; Baylor Regional Transplant Institute, Baylor University Medical Center, Dallas, TX; Department of Medicine, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA; Ochsner Multi-Organ Transplant Center, New Orleans, LA; and Department of Surgery, University of Michigan, Ann Arbor, MI