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Carbon monoxide (CO) poisoning presents an interesting challenge for postmortem toxicology laboratories. The discontinuation of the CO-oximeter manufactured by Instrumentation Laboratories has left many forensic laboratories without this simple but reliable choice for the analysis of CO in blood. A comparable alternative that is quick and simple is analysis using a standard ultraviolet–visible spectrophotometer, which offers sufficient precision and accuracy for the measurement of percentage carboxyhemoglobin (%COHb) in postmortem blood. The hurdle for laboratories then becomes the selection of an appropriate spectrophotometric method since a variety of procedures have been published over the years. Four methods were evaluated based on literature findings and/or the appropriateness for postmortem testing. These methods are based on (i) relating %COHb to the ratio of COHb and Hb absorbance of a two-component system (two wavelengths), (ii) the multicomponent analysis of all hemoglobin species, (iii) the multicomponent analysis of a two-component system, and (iv) derivative spectroscopy. While all four methods performed similarly in terms of typical validation requirements, the ability to more effectively handle decomposed samples and the ease of sample preparation afforded (v) the multicomponent analysis of a two-component system—the most suitable for routine postmortem testing.

This multicenter study aims to analyze outcome as well as early versus late patterns of recurrence following pulmonary stereotactic body radiotherapy (SBRT) for patients with oligometastatic non-small-cell lung cancer (NSCLC).This analysis included 301 patients with oligometastatic NSCLC treated with SBRT for 336 lung metastases. Although treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and/or systemic therapy, pulmonary oligometastases were treated with SBRT.The median follow-up time was 16.1 months, resulting in 2-year overall survival (OS), local control (LC), and distant control (DC) of 62.2%, 82.0%, and 45.2%, respectively. Multivariate analysis identified age (P = .019) and histologic subtype (P = .028), as well as number of metastatic organs (P .001) as independent prognostic factors for OS. LC was superior for patients with favorable histologic subtype (P = .046) and SBRT with a higher biological effective dose at isocenter (P = .037), whereas DC was inferior for patients with metastases in multiple organs (P .001) and female gender (P = .027). Early (within 24 months) local or distant progression was observed in 15.3% and 36.5% of the patients. After 24 months, the risk of late local failure was low, with 3- and 4-year local failure rates of only 4.0%, and 7.6%. In contrast, patients remained at a high risk of distant progression with 3- and 4-year failure rates of 13.3% and 24.1%, respectively, with no plateau observed.SBRT for pulmonary oligometastatic NSCLC resulted in favorable LC and promising OS. The dominant failure pattern is distant with a continuously high risk of disease progression for many years.

Parallel zur gestiegenen Uberlebenswahrscheinlichkeit der Patienten mit malignen Tumorerkrankungen stieg in den letzten Jahren auch die Zahl der Patienten mit Metastasen — sehr haufig sind dies komplexe Knochenmetastasen zum Beispiel in der Wirbelsaule. Fur diese multidisziplinare therapeutische Herausforderung bietet das NOMS-Framework einen zuverlassigen Algorithmus.

The (±)-threo-4-fluoromethylphenidate (4F-MPH) is a fluorinated analog of the prescription central nervous system stimulant medication, methylphenidate. This novel psychoactive substance was first detected in drug paraphernalia at the Miami-Dade County Medical Examiner Department Toxicology Laboratory in 2016 but was not detected in a biological specimen until 2018. Limited literature is available on 4F-MPH, with predominate literature being published out of Europe, and no known toxicities reported in the USA. Post-mortem specimens were screened using both gas chromatography mass spectrometry and liquid chromatography ion trap mass spectrometry (LC–Ion Trap-MSn). In addition, a validated method for the quantification of 4F-MPH was developed using liquid chromatography–tandem mass spectrometry (LC–MS-MS), with a linear range of 0.01–0.500 mg/L and acceptable validation criteria including precision, bias, carry-over, linearity and endogenous/exogenous interferences. In addition to the detection of 4F-MPH, 3-methoxy-PCP, amphetamine, methamphetamine, 6-monoacetylmorphine, morphine, codeine and tetrahydrocannabinol were also identified in the decedent. A single source of blood was collected (femoral vein) and quantified in all blood tubes used for collection, with concentrations varying from 0.012 to 0.05 mg/L. Additional specimens available for screening included gastric contents and urine. An additional peak having the same targeted ions and transitions as 4F-MPH was identified in both the LC–Ion Trap-MSn screening procedure and the LC–MS-MS quantitative procedure. This peak suggests the presence of a structural isomer, possibly (±)-erythro-4-fluoromethylphenidate, which cannot be confirmed due to there being no available certified reference material. This case report presents the first time that 4F-MPH was detected in a decedent, as well as the first time 4F-MPH has been listed in the official cause of death of a decedent in Florida.

Despite complete surgical resection brain metastases are at significant risk of local recurrence without additional radiation therapy. Traditionally, the addition of postoperative whole brain radiotherapy (WBRT) has been considered the standard of care on the basis of randomized studies demonstrating its efficacy in reducing the risk of recurrence in the surgical bed as well as the incidence of new distant metastases. More recently, postoperative stereotactic radiosurgery (SRS) to the surgical bed has emerged as an effective and safe treatment option for resected brain metastases. Published randomized trials have demonstrated that postoperative SRS to the resection cavity provides superior local control compared to surgery alone, and significantly decreases the risk of neurocognitive decline compared to WBRT, without detrimental effects on survival. While studies support the use of postoperative SRS to the resection cavity as the standard of care after surgery, there are several issues that need to be investigated further with the aim of improving local control and reducing the risk of leptomeningeal disease and radiation necrosis, including the optimal dose prescription/fractionation, the timing of postoperative SRS treatment, and surgical cavity target delineation. We provide a clinical overview on current status and recent advances in resection cavity irradiation of brain metastases, focusing on relevant strategies that can improve local control and minimize the risk of radiation-induced toxicity.

Many animals provide essential ecosystem services in the form of plant pollination. A rich literature documents considerable variation in the single visit pollination effectiveness of different plant visitors, but this literature has yet to be comprehensively synthesized. We conducted a hierarchical meta-analysis of 193 studies and extracted 1716 single visit effectiveness (SVE) comparisons for 252 plant species. We paired SVE data with visitation frequency data for 75 of these studies. Given the global dominance of honeybees in pollinator communities, we used these data to ask: 1) Do honeybees (Apis mellifera) and other floral visitors vary in their SVE?; 2) To what extent do plant and pollinator attributes predict the difference in SVE between honeybees and other visitors?; and 3) Is there a correlation between floral visitation frequency and SVE? We found that honeybees were significantly less effective than the most effective non-honeybee pollinator. Although not significantly different, honeybees also tended to be less effective than the mean community effectiveness. Honeybees were less effective as pollinators of crop plants and when compared to birds and other bees. Visitation frequency and pollination effectiveness were positively correlated, but this trend was largely driven by data from communities where honeybees were absent, suggesting that honeybees generally combine high visitation frequency and lower SVE. Our study demonstrates that non-honeybee floral visitors are highly effective pollinators of many crop and non-crop plants. While the high visitation frequency typically displayed by honeybees undoubtably makes them important pollinators, we show that honeybees are slightly less effective than the average pollinator and rarely the most effective pollinator of the plants they visit. As such, honeybees may be imperfect substitutes for the loss of wild pollinators and safeguarding global crop production will benefit from conservation of non-honeybee taxa.Open Research Statement:Although we are fully committed to data transparency, we are also aware of different research teams working on related meta-analyses. As such, we prefer to wait until our paper is accepted to make data publicly available but are happy to share data upon request. Data will be permanently archived on Figshare following acceptance.

This activity elucidates a critical and pragmatic means by which students and instructors can examine the practice of labor exploitation by neoliberal corporations. By employing critical communicat...

Since 2013, opioid-related deaths have increased in Miami-Dade County, FL due to fentanyl and fentanyl analogs in the local heroin supply. From 2014 to 2015, a near 600% increase in fentanyl and fentanyl analog-related deaths was observed, followed by another 200% increase in 2016. In addition to fentanyl, six fentanyl analogs were identified in this time period: β-hydroxythiofentanyl, acetyl fentanyl, furanyl fentanyl, carfentanil, butyryl fentanyl and para-fluoroisobutyryl fentanyl. As a result, an analytical method to quantify these compounds in postmortem biological fluids and tissues using solid-phase extraction with analysis by ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS-MS) was developed and validated. All analytes except carfentanil were linear from 1 to 50 ng/mL with a limit of detection (LOD) of 0.5 ng/mL; carfentanil was linear from 0.2 to 10 ng/mL with a LOD of 0.1 ng/mL. For all analytes, bias was within ±14%, intra- and inter-day precision were ≤5% and extraction efficiency was >87%. Dilution integrity was assessed at 1:1, 1:4 and 1:9 (v/v) ratios; percent error from target was

Courses: Instructional Communication, Graduate Teaching Assistant Training ProgramsObjectives: Students will (1) understand critical communication pedagogy (CCP); (2) evaluate traditional and critical objectives and assessment procedures; and (3) create critical objectives and assessment procedures.

Courses: Professional Speaking, Business and Professional Communication, Environmental Communication, or any course covering topics related to neoliberalism and the environment.Objectives: In this single-class activity, students will first examine the possible environmental effects of fracking near the Bakken Oil Formation in North Dakota. Second, students will evaluate how the petroleum industry obscures the effects of fracking through the use of corporate ventriloquism. Third, students will respond to the petroleum industry’s power by utilizing critical communication pedagogy.

N-ethylpentylone (NEP, ephylone, bk-EBDP) was the most prevalent synthetic cathinone detected by the Miami-Dade Medical Examiner Toxicology Laboratory from 2016 to 2018. There is limited information regarding the toxicity of NEP; however, the few published reports suggest that NEP can cause serious toxic effects and sudden death. The purpose of this publication is to describe a validated liquid chromatography--tandem mass spectrometry (LC–MS-MS) method for seven synthetic cathinones (methylone, ethylone, butylone, dibutylone, alpha-Pyrrolidinopentiophenone (α-PVP), pentylone and NEP) and to present a detailed summary regarding the presence of NEP in postmortem casework at the Miami-Dade Medical Examiner Department. Postmortem iliac blood, serum, liver and brain specimens were prepared by solid-phase extraction with analysis by ultra-high-performance liquid chromatography--tandem mass spectrometry. Analyte linearity was established from 0.01 to 0.5 mg/L on a six-point calibration curve. A total of 101 NEP quantitations were performed using this method. Concentrations in postmortem case samples ranged from 0.01 to 2.7 mg/L. Iliac blood concentrations averaged 0.312 mg/L with a median of 0.137 mg/L (n = 72) across all causes and manners of death. Approximately half of the cases were homicides in which the decedent was the victim of gunshot wounds or stabbing. Two of the three highest concentration cases of NEP (2.7 and 1.7 mg/L) involved 38-year-old white males who were tasered by police prior to death. The psychostimulant effect of NEP may result in an excited delirium and/or hallucinogenic state. The concentration of NEP detected in accidental intoxication and polydrug cases overlapped with those attributed to other causes, including homicides and police-involved deaths.

Despite university faculty’s efforts to maintain rigor and high expectations in their classrooms, grade inflation continues to rise. While numerous factors exist to explain this problem, the primary contributor is the ubiquitous pressure of neoliberal forces on the university. Neoliberalism has inculcated society, namely undergraduate students, to resist the belief that the university is a place in which they collectively gather to learn, think, be challenged, grow through failure, and build character. Rather, students now largely believe that they university is merely a business from which they purchase a product—a degree. This producer-consumer mindset has created a deleterious situation for both students and faculty. Students believe that they are merely purchasing a degree; and, they demand that high grades accompany that degree. To them, high grades, coupled with their degree, are the currency with which they purchase a career. Because of this prevalent ideology, faculty are placed in a perilous position because they feel internal and external pressure to reduce the rigor of their courses and/or artificially inflate the grades that students earn. Although all faculty feel the pressure to conform to this neoliberally driven practice, it is especially troublesome for tenure-track, non-tenure track, and other contingent faculty because their continued employment is, often to a large extent, dependent of student ratings of teaching effectiveness. This chapter will address these issues through the lens of critical communication pedagogy (CCP) by offering ways in which faculty can resist the neoliberal pressure to engage in grade inflation by teaching students about the neoliberal system which has inculcated them to believe that profit, success, and individualism are the only measures of a meaningful life. Following CCP, I will discuss how instructors can challenge students to resist neoliberal hegemony, hold high academic standards for themselves, and tie learning to outcomes that affect their futures—power and their response to it. Overall, I will argue that in order for tenure-track and contingent faculty to be able to resist the pressure to inflate grades, they must work to teach students to resist neoliberal ideology that instills the thought processes that lead to grade inflation. In so doing, students may begin to learn to engage in resistance behaviors to neoliberal power structures that marginalize them.

The elastic scattering process for the nuclear reactions induced by the Radioactive Ion Beams Be-7 and B-8 on a Pb-208 target was measured for the first time in the energy range around the Coulomb barrier. Extensive theoretical calculations within the framework of the optical model were performed. An excellent agreement between experimental data and theoretical predictions was achieved for the reaction Be-7 + Pb-208 while a comprehensive understanding of the reaction dynamics induced by the more exotic projectile B-8 is still far to be reached. Predictions of the cross section for the breakup for both systems will also be given.

Critically minded instructors realize that power can manifest itself in manifold ways. One way in which power can manifest itself is through the ways in which instructors use mediated communication. Because of the proliferation of technology in contemporary classrooms, mediated communication now holds an almost ubiquitous presence in schools. Instructors can utilize mediated communication in ways that facilitate marginalization. Special populations of students are often the recipients of this pedagogical marginalization because of the intersectionality that they experience when attempting to utilize technology. Because of the potential for instructors to use mediated communication in ways that are marginalizing, I will argue that instructors should examine the ways in which they use mediated communication in the classroom to ensure that their assignments do not (unintentionally) subjugate students.

An amendment to this paper has been published and can be accessed via the original article.

Critical communication pedagogy (CCP) scholarship is a relatively new and important area of research that evaluates how language is used to both empower and marginalize. It faces challenges in terms of recognition and publication outlets. In this essay, I argue that scholars face obstacles when attempting to publish pedagogical work that is critical in nature. I make the case that a major reason that CCP scholarship is not as widely recognized is that it is largely not considered to be applied work. By sharing my experiences, I argue that scholars working in CCP can help to overcome these barriers to recognition and publication by developing an applied language and focus for CCP, demonstrating how CCP can be used to recognize and respond to hegemony in the classroom and in society.

The elastic scattering of the weakly bound radioactive nuclei B8 and Be7 from a Pb208 target was measured for the first time in the energy range around the Coulomb barrier. The data were analyzed using the optical model and the continuum discretized coupled channels (CDCC) formalisms. The reaction cross sections extracted from the optical model fits clearly indicate a remarkably enhanced reaction probability for the very weakly bound B8 (Sp=137.5keV) compared to similar mass nuclei interacting with the same target nucleus. CDCC calculations assuming a He3+He4 cluster model well described the Be7 experimental elastic scattering angular distributions, whereas the use of a Be7+p cluster model of B8 with an inert Be7 core gave a relatively poor description of the corresponding experimental data, suggesting that this model may be too simplistic and the possibility of core excitation should not be ignored. © 2019 American Physical Society. UK.

We investigated the reaction dynamics induced by the Be-7, B-8+Pb-208 collisions at energies around the Coulomb barrier. Charged particles originated by both the collisions were detected by means of 6 Delta E-E-res telescopes of a newly developed detector array. Experimental data were analysed within the framework of the Optical Model and the total reaction cross-sections were compared together and with the Li-6,Li-7+Pb-208 collision data. According to the preliminary results, Be-7 nucleus reactivity is rather similar to the Li-7 one whereas the B-8+Pb-208 total reaction cross section appears to be much larger than those measured for reactions induced by the other weakly-bound projectiles on the same target.

this contribution we describe the first results obtained for the investigation of the elastic scattering process in the reactions induced by the Radioactive Ion Beams Be-7 and B-8 on a Pb-208 target at Coulomb barrier energies. The experimental data were analyzed within the framework of the optical model in order to extract the total reaction cross section. The comparison with data available in literature for reactions induced on Pb-208 by light ions in the mass range A = 6-8 shows that the loosely-bound( 8)B has the largest reactivity.

BACKGROUND: Radical local treatment of pulmonary metastases is practiced with increasing frequency due to acknowledgment and better understanding of oligo-metastatic disease. This study aimed to develop a nomogram predicting overall survival (OS) after stereotactic body radiotherapy (SBRT) for pulmonary metastases. PATIENTS AND METHODS: A multi-institutional database of 670 patients treated with SBRT for pulmonary metastases was used as training cohort. Cox regression analysis with bidirectional variable elimination was performed to identify factors to be included into the nomogram model to predict 2-year OS. The calibration rate of the nomogram was assessed by plotting the actual Kaplan-Meier 2-year OS against the nomogram predicted survival. The nomogram was externally validated using two separate monocentric databases of 145 and 92 patients treated with SBRT for pulmonary metastases. RESULTS: The median follow up of the trainings cohort was 14.3months, the 2-year and 5-year OS was 52.6% and 23.7%, respectively. Karnofsky performance index, type of the primary tumor, control of the primary tumor, maximum diameter of the largest treated metastasis and number of metastases (1 versus >1) were significant prognostic factors in the Cox model (all pBACKGROUND: Radical local treatment of pulmonary metastases is practiced with increasing frequency due to acknowledgment and better understanding of oligo-metastatic disease. This study aimed to develop a nomogram predicting overall survival (OS) after stereotactic body radiotherapy (SBRT) for pulmonary metastases.PATIENTS AND METHODS: A multi-institutional database of 670 patients treated with SBRT for pulmonary metastases was used as training cohort. Cox regression analysis with bidirectional variable elimination was performed to identify factors to be included into the nomogram model to predict 2-year OS. The calibration rate of the nomogram was assessed by plotting the actual Kaplan-Meier 2-year OS against the nomogram predicted survival. The nomogram was externally validated using two separate monocentric databases of 145 and 92 patients treated with SBRT for pulmonary metastases.RESULTS: The median follow up of the trainings cohort was 14.3months, the 2-year and 5-year OS was 52.6% and 23.7%, respectively. Karnofsky performance index, type of the primary tumor, control of the primary tumor, maximum diameter of the largest treated metastasis and number of metastases (1 versus >1) were significant prognostic factors in the Cox model (all pCONCLUSIONS: A nomogram for prediction of OS after SBRT for pulmonary metastases was generated and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting.KEY MESSAGE: A nomogram for prediction of overall survival after stereotactic body radiotherapy (SBRT) for pulmonary metastases was developed and externally validated. This tool might be helpful for interdisciplinary discussion and evaluation of local and systemic treatment options in the oligo-metastatic setting.