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In this contribution, we achieve the primary goal of the active galactic nucleus (AGN) STORM campaign by recovering velocity-delay maps for the prominent broad emission lines (Lyα, C iv, He ii, and Hβ) in the spectrum of NGC 5548. These are the most detailed velocity-delay maps ever obtained for an AGN, providing unprecedented information on the geometry, ionization structure, and kinematics of the broad-line region. Virial envelopes enclosing the emission-line responses show that the reverberating gas is bound to the black hole. A stratified ionization structure is evident. The He ii response inside 5-10 lt-day has a broad single-peaked velocity profile. The Lyα, C iv, and Hβ responses extend from inside 2 to outside 20 lt-day, with double peaks at ±2500 km s-1 in the 10-20 lt-day delay range. An incomplete ellipse in the velocity-delay plane is evident in Hβ. We interpret the maps in terms of a Keplerian disk with a well-defined outer rim at R = 20 lt-day. The far-side response is weaker than that from the near side. The line-center delay days gives the inclination i ≈ 45°. The inferred black hole mass is M BH ≈ 7 × 107 M o˙. In addition to reverberations, the fit residuals confirm that emission-line fluxes are depressed during the "BLR Holiday"identified in previous work. Moreover, a helical "Barber-Pole"pattern, with stripes moving from red to blue across the C iv and Lyα line profiles, suggests azimuthal structure rotating with a 2 yr period that may represent precession or orbital motion of inner-disk structures casting shadows on the emission-line region farther out.

We present geometric and dynamical modeling of the broad line region (BLR) for the multi-wavelength reverberation mapping campaign focused on NGC 5548 in 2014. The data set includes photometric and spectroscopic monitoring in the optical and ultraviolet, covering the Hβ, C iv, and Ly broad emission lines. We find an extended disk-like Hβ BLR with a mixture of near-circular and outflowing gas trajectories, while the C iv and Ly BLRs are much less extended and resemble shell-like structures. There is clear radial structure in the BLR, with C iv and Ly emission arising at smaller radii than the Hβ emission. Using the three lines, we make three independent black hole mass measurements, all of which are consistent. Combining these results gives a joint inference of . We examine the effect of using the V band instead of the UV continuum light curve on the results and find a size difference that is consistent with the measured UV-optical time lag, but the other structural and kinematic parameters remain unchanged, suggesting that the V band is a suitable proxy for the ionizing continuum when exploring the BLR structure and kinematics. Finally, we compare the Hβ results to similar models of data obtained in 2008 when the active galactic nucleus was at a lower luminosity state. We find that the size of the emitting region increased during this time period, but the geometry and black hole mass remained unchanged, which confirms that the BLR kinematics suitably gauge the gravitational field of the central black hole.

We model the ultraviolet spectra of the Seyfert 1 galaxy NGC 5548 obtained with the Hubble Space Telescope during the 6 month reverberation mapping campaign in 2014. Our model of the emission from NGC 5548 corrects for overlying absorption and deblends the individual emission lines. Using the modeled spectra, we measure the response to continuum variations for the deblended and absorption-corrected individual broad emission lines, the velocity-dependent profiles of Ly and C iv, and the narrow and broad intrinsic absorption features. We find that the time lags for the corrected emission lines are comparable to those for the original data. The velocity-binned lag profiles of Ly and C iv have a double-peaked structure indicative of a truncated Keplerian disk. The narrow absorption lines show a delayed response to continuum variations corresponding to recombination in gas with a density of ∼105 cm-3. The high-ionization narrow absorption lines decorrelate from continuum variations during the same period as the broad emission lines. Analyzing the response of these absorption lines during this period shows that the ionizing flux is diminished in strength relative to the far-ultraviolet continuum. The broad absorption lines associated with the X-ray obscurer decrease in strength during this same time interval. The appearance of X-ray obscuration in ∼2012 corresponds with an increase in the luminosity of NGC 5548 following an extended low state. We suggest that the obscurer is a disk wind triggered by the brightening of NGC 5548 following the decrease in size of the broad-line region during the preceding low-luminosity state.

During the Space Telescope and Optical Reverberation Mapping Project observations of NGC 5548, the continuum and emission-line variability became decorrelated during the second half of the six-month-long observing campaign. Here we present Swift and Chandra X-ray spectra of NGC 5548 obtained as part of the campaign. The Swift spectra show that excess flux (relative to a power-law continuum) in the soft X-ray band appears before the start of the anomalous emission-line behavior, peaks during the period of the anomaly, and then declines. This is a model-independent result suggesting that the soft excess is related to the anomaly. We divide the Swift data into on- and off-anomaly spectra to characterize the soft excess via spectral fitting. The cause of the spectral differences is likely due to a change in the intrinsic spectrum rather than to variable obscuration or partial covering. The Chandra spectra have lower signal-to-noise ratios, but are consistent with the Swift data. Our preferred model of the soft excess is emission from an optically thick, warm Comptonizing corona, the effective optical depth of which increases during the anomaly. This model simultaneously explains all three observations: the UV emission-line flux decrease, the soft-excess increase, and the emission-line anomaly.

We conduct a multiwavelength continuum variability study of the Seyfert 1 galaxy NGC 5548 to investigate the temperature structure of its accretion disk. The 19 overlapping continuum light curves (1158 A oto 9157 A o) combine simultaneous Hubble Space Telescope, Swift, and ground-based observations over a 180 day period from 2014 January to July. Light-curve variability is interpreted as the reverberation response of the accretion disk to irradiation by a central time-varying point source. Our model yields the disk inclination i = 36° ±10° temperature T1 = 44 ±6 ) × 10 3 K at 1 light day from the black hole, and a temperatureradius slope (T ∞r-a) of a = 0.99 ±0.03. We also infer the driving light curve and find that it correlates poorly with both the hard and soft X-ray light curves, suggesting that the X-rays alone may not drive the ultraviolet and optical variability over the observing period. We also decompose the light curves into bright, faint, and mean accretion-disk spectra. These spectra lie below that expected for a standard blackbody accretion disk accreting at L LEdd = 0.1.

We present the Data Release 12 Quasar catalog (DR12Q) from the Baryon Oscillation Spectroscopic Survey (BOSS) of the Sloan Digital Sky Survey III. This catalog includes all SDSS-III/BOSS objects that were spectroscopically targeted as quasar candidates during the full survey and that are confirmed as quasars via visual inspection of the spectra, have luminosities Mi [z = 2] 2.15 (184 101, of which 167 742 are new discoveries) is about an order of magnitude greater than the number of z > 2.15 quasars known prior to BOSS. Redshifts and FWHMs are provided for the strongest emission lines (C iv, C iii], Mg ii). The catalog identifies 29 580 broad absorption line quasars and lists their characteristics. For each object, the catalog presents five-band (u, g, r, i, z) CCD-based photometry with typical accuracy of 0.03 mag together with some information on the optical morphology and the selection criteria. When available, the catalog also provides information on the optical variability of quasars using SDSS and Palomar Transient Factory multi-epoch photometry. The catalog also contains X-ray, ultraviolet, near-infrared, and radio emission properties of the quasars, when available, from other large-area surveys. The calibrated digital spectra, covering the wavelength region 3600-10 500 Å at a spectral resolution in the range 1300 < R < 2500, can be retrieved from the SDSS Catalog Archive Server. We also provide a supplemental list of an additional 4841 quasars that have been identified serendipitously outside of the superset defined to derive the main quasar catalog.

During an intensive Hubble Space Telescope (HST) Cosmic Origins Spectrograph (COS) UV monitoring campaign of the Seyfert 1 galaxy NGC 5548 performed from 2014 February to July, the normally highly correlated far UV continuum and broad emission line variations decorrelated for ∼60-70 days, starting ∼75 days after the first HST/COS observation. Following this anomalous state, the flux and variability of the broad emission lines returned to a more normal state. This transient behavior, characterized by significant deficits in flux and equivalent width of the strong broad UV emission lines, is the first of its kind to be unambiguously identified in an active galactic nucleus reverberation mapping campaign. The largest corresponding emission line flux deficits occurred for the high ionization, collisionally excited lines C iv and Si iv(+O iv]), and also He ii(+O iii]), while the anomaly in Lywas substantially smaller. This pattern of behavior indicates a depletion in the flux of photons with relative to those near 13.6 eV. We suggest two plausible mechanisms for the observed behavior: (i) temporary obscuration of the ionizing continuum incident upon broad line region (BLR) clouds by a moving veil of material lying between the inner accretion disk and inner (BLR), perhaps resulting from an episodic ejection of material from the disk, or (ii) a temporary change in the intrinsic ionizing continuum spectral energy distribution resulting in a deficit of ionizing photons with energies >54 eV, possibly due to a transient restructuring of the Comptonizing atmosphere above the disk. Current evidence appears to favor the latter explanation.

We present ground-based optical photometric monitoring data for NGC 5548, part of an extended multiwavelength reverberation mapping campaign. The light curves have nearly daily cadence from 2014 January to July in nine filters (BVRI and ugriz). Combined with ultraviolet data from the Hubble Space Telescope and Swift, we confirm significant time delays between the continuum bands as a function of wavelength, extending the wavelength coverage from 1158 Å to the z band (∼9160 Å). We find that the lags at wavelengths longer than the V band are equal to or greater than the lags of high-ionization-state emission lines (such as He ii and λ1640 and λ4686), suggesting that the continuum-emitting source is of a physical size comparable to the inner broad-line region (BLR). The trend of lag with wavelength is broadly consistent with the prediction for continuum reprocessing by an accretion disk with τ ∝ λ 4 . However, the lags also imply a disk radius that is 3 times larger than the prediction from standard thin-disk theory, assuming that the bolometric luminosity is 10% of the Eddington luminosity (L = 0.1 L Edd ). Using optical spectra from the Large Binocular Telescope, we estimate the bias of the interband continuum lags due to BLR emission observed in the filters. We find that the bias for filters with high levels of BLR contamination (∼20%) can be important for the shortest continuum lags and likely has a significant impact on the u and U bands owing to Balmer continuum emission.

Recent intensive Swift monitoring of the Seyfert 1 galaxy NGC 5548 yielded 282 usable epochs over 125 days across six UV/optical bands and the X-rays. This is the densest extended active galactic nucleus (AGN) UV/optical continuum sampling ever obtained, with a mean sampling rate

We describe the first results from a six-month long reverberation-mapping experiment in the ultraviolet based on 171 observations of the Seyfert 1 galaxy NGC 5548 with the Cosmic Origins Spectrograph on the Hubble Space Telescope. Significant correlated variability is found in the continuum and broad emission lines, with amplitudes ranging from ∼30% to a factor of two in the emission lines and a factor of three in the continuum. The variations of all the strong emission lines lag behind those of the continuum, with He ii lagging behind the continuum by ∼2.5 days and Ly , C iv , and Si iv lagging by ∼5-6 days. The relationship between the continuum and emission lines is complex. In particular, during the second half of the campaign, all emission-line lags increased by a factor of 1.3-2 and differences appear in the detailed structure of the continuum and emission-line light curves. Velocity-resolved cross-correlation analysis shows coherent structure in lag versus line of sight velocity for the emission lines; the high-velocity wings of C iv respond to continuum variations more rapidly than the line core, probably indicating higher velocity broad-line region clouds at smaller distances from the central engine. The velocity-dependent response of Ly, however, is more complex and will require further analysis.

We present the Data Release 10 Quasar (DR10Q) catalog from the Baryon Oscillation Spectroscopic Survey (BOSS) of the Sloan Digital Sky Survey III. The catalog includes all BOSS objects that were targeted as quasar candidates during the first 2.5 years of the survey and that are confirmed as quasars via visual inspection of the spectra, have luminosities Mi[z = 2] 2.15 (117 668) is ~5 times greater than the number of z > 2.15 quasars known prior to BOSS. Redshifts and FWHMs are provided for the strongest emission lines (C iv, C iii, Mg ii). The catalog identifies 16 461 broad absorption line quasars and gives their characteristics. For each object, the catalog presents five-band (u, g, r, i, z) CCD-based photometry with typical accuracy of 0.03 mag and information on the optical morphology and selection method. The catalog also contains X-ray, ultraviolet, near-infrared, and radio emission properties of the quasars, when available, from other large-area surveys. The calibrated digital spectra cover the wavelength region 3600-10 500 Å at a spectral resolution in the range 1300 < R < 2500; the spectra can be retrieved from the SDSS Catalog Archive Server. We also provide a supplemental list of an additional 2376 quasars that have been identified among the galaxy targets of the SDSS-III/BOSS. © 2014 ESO.

We present the second edition of the Sloan Digital Sky Survey (SDSS) Quasar Catalog. The catalog consists of the 16,713 objects in the SDSS First Data Release that have luminosities larger than Mi = -22 (in a cosmology with H0 = 70 km s-1 Mpc-1, ΩM= 0.3, and Ω∇ = 0.7), have at least one emission line with FWHM larger than 1000 km s-1, and have highly reliable redshifts. The area covered by the catalog is ≈ 1360 deg 2. The quasar redshifts range from 0.08 to 5.41, with a median value of 1.43. For each object, the catalog presents positions accurate to better than 0.′2 rms per coordinate, five-band (ugriz) CCD-based photometry with typical accuracy of 0.03 mag, and information on the morphology and selection method. The catalog also contains some radio, near-infrared, and X-ray emission properties of the quasars, when available, from other large-area surveys. Calibrated digital spectra of all objects in the catalog, covering the wavelength region 3800-9200 Å at a spectral resolution of 1800-2100, are available. This publication supersedes the first SDSS Quasar Catalog, which was based on material from the SDSS Early Data Release. A summary of corrections to current quasar databases is also provided. The majority of the objects were found in SDSS commissioning data using a multicolor selection technique. Since the quasar selection algorithm was undergoing testing during the entire observational period covered by this catalog, care must be taken when assembling samples from the catalog for use in statistical studies. A total of 15,786 objects (94%) in the catalog were discovered by the SDSS; 12,173 of the SDSS discoveries are reported here for the first time. Included in the new discoveries are five quasars brighter than i= 16.0 and 17 quasars with redshifts larger than 4.5.

The purpose of this study was to evaluate the radiographic and clinical outcomes of isolated talonavicular arthrodesis in the treatment of the flexible pes valgus foot type. Retrospectively, 51 consecutive isolated talonavicular arthrodeses in 41 patients were evaluated. The mean patient age was 47 (range 9 to 72) years, and the mean follow-up duration was 43.3 (range 11 to 113) months. The mean 10-cm categorical pain score before the surgery was 7.60 +/- 2.37, and this improved to 1.90 +/- 2.38 postoperatively, and this difference was statistically significant (P < .001). We also measured the preoperative and postoperative percent of talar uncovering, calcaneocuboid angle, Kite's angle, talar dome height, calcaneal inclination angle, and Meary's angle, and observed statistically significant (P < .001) improvements in all of these. Fifty-one (100%) of the cases progressed to radiographic osseous union, although 2 (3.92%) of the cases were considered delayed unions. Moreover, 4 (7.84%) of the cases displayed juxta-articular arthrosis postoperatively, and 2 (3.9%) cases developed transfer pain to the lateral column. The authors concluded that isolated talonavicular arthrodesis is a safe and effective procedure for the treatment of painful pes valgus deformity. [ABSTRACT FROM AUTHOR]

Background: Mitigating attrition is a key component to reduce selection bias in longitudinal randomized controlled trials (RCTs). Few studies of electronic nicotine delivery systems (ENDS) allow for the examination of long-term retention. This analysis explores the relationship between attrition, baseline measures, and condition assigned for a RCT involving ENDS differing in nicotine delivery over a 24-week intervention period., Methods: Participants (N = 520) who smoked ≥10 cigarettes per day [CPD] for ≥1 year and reported interest in reducing but not quitting were randomized to 1 of 4 conditions: an ENDS containing 0, 8, or 36 mg/ml liquid nicotine (administered double-blind) or a cigarette-shaped plastic tube. Cox proportional hazards regression models were fit to examine attrition over time and predictors of attrition including baseline characteristics and condition. A stepwise approach was used to determine the final model; alpha was set at 0.05., Results: Attrition did not differ significantly by condition (223/520), and most (69%) were lost-to-follow-up. Only age, education level, and household income were significantly predictive of attrition. For every additional year of age, attrition risk fell by 3%. Holding a bachelor's degree or higher was associated with reduced attrition risk. Those with the lowest income (<$10 K) were more likely to be withdrawn compared to those earning $10 K-39 K, and those with the highest income ($100 K+) were more likely to be withdrawn compared with the latter bracket and those earning $70-99 K., Conclusion: ENDS nicotine content did not drive differential attrition in this trial, and targeted retention efforts are needed for specific subgroups. Trial Registration #: NCT02342795., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: JF has done paid consulting for pharmaceutical companies involved in producing smoking cessation medications, including Johnson & Johnson in the past 3 years, and has received a research grant and study drug (varenicline) from Pfizer prior to that, all of which are unrelated to the current study., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Siblings of youth with cancer have heightened risk for poor long-term psychosocial outcomes. Although sibling psychosocial care is a standard in pediatric oncology, this standard is among those least likely to be met. To address barriers to providing sibling services, a blueprint for systematic psychosocial screening and support of siblings was developed based on feedback from a national sample of psychosocial providers., Procedure: Semi-structured interviews were conducted with a purposive sample of psychosocial care providers (N = 27) of various disciplines working in US pediatric cancer centers, varied in size, type, and extent of sibling support. Interviews queried providers' suggestions for the future of sibling psychosocial care and impressions of a blueprint for sibling service delivery, which was iteratively refined based on respondents' feedback. Interviews were analyzed using applied thematic analysis., Results: Based on existing literature and refined according to providers' recommendations, the Sibling Services Blueprint was developed to provide a comprehensive guide for systematizing sibling psychosocial care. The blueprint content includes: (i) a timeline for repeated sibling screening and assessment; (ii) a stepped model of psychosocial support; (iii) strategies for circumventing barriers to sibling care; and (iv) recommendations for how centers with varying resources might accomplish sibling-focused care. The blueprint is available online, allowing providers to easily access and individualize the content. Providers indicated enthusiasm and high potential utility and usability of the blueprint., Conclusions: The Sibling Services Blueprint may be a useful tool for systematizing sibling psychosocial care, promoting wider availability of sibling-focused services, and addressing siblings' unmet needs., (© 2024 Wiley Periodicals LLC.)

The incidence of human papillomavirus (HPV)-related oropharynx cancer has steadily increased over the past two decades and now represents a majority of oropharyngeal cancer cases. Integration of the HPV genome into the host genome is a common event during carcinogenesis that has clinically relevant effects if the viral early genes are transcribed. Understanding the impact of HPV integration on clinical outcomes of head and neck squamous cell carcinoma (HNSCC) is critical for implementing deescalated treatment approaches for HPV + HNSCC patients. RNA sequencing (RNA-seq) data from HNSCC tumors ( n = 84) were used to identify and characterize expressed integration events, which were overrepresented near known head and neck, lung, and urogenital cancer genes. Five genes were recurrent, including CD274 (PD-L1) A significant number of genes detected to have integration events were found to interact with Tp63, ETS, and/or FOX1A. Patients with no detected integration had better survival than integration-positive and HPV - patients. Furthermore, integration-negative tumors were characterized by strongly heightened signatures for immune cells, including CD4 + , CD3 + , regulatory, CD8 + T cells, NK cells, and B cells, compared with integration-positive tumors. Finally, genes with elevated expression in integration-negative specimens were strongly enriched with immune-related gene ontology terms, while upregulated genes in integration-positive tumors were enriched for keratinization, RNA metabolism, and translation. Implications: These findings demonstrate the clinical relevancy of expressed HPV integration, which is characterized by a change in immune response and/or aberrant expression of the integration-harboring cancer-related genes, and suggest strong natural selection for tumor cells with expressed integration events in key carcinogenic genes. Mol Cancer Res; 16(1); 90-102. ©2017 AACR ., (©2017 American Association for Cancer Research.)

Purpose: There is substantial heterogeneity within human papillomavirus (HPV)-associated head and neck cancer (HNC) tumors that predispose them to different outcomes; however, the molecular heterogeneity in this subgroup is poorly characterized due to various historical reasons., Experimental Design: We performed unsupervised gene expression clustering on deeply annotated (transcriptome and genome) HPV(+) HNC samples from two cohorts (84 total primary tumors), including 18 HPV(-) HNC samples, to discover subtypes and characterize the differences between subgroups in terms of their HPV characteristics, pathway activity, whole-genome somatic copy number alterations, and mutation frequencies., Results: We identified two distinct HPV(+) subtypes (namely HPV-KRT and HPV-IMU). HPV-KRT is characterized by elevated expression of genes in keratinocyte differentiation and oxidation-reduction process, whereas HPV-IMU has strong immune response and mesenchymal differentiation. The differences in expression are likely connected to the differences in HPV characteristics and genomic changes. HPV-KRT has more genic viral integration, lower E2/E4/E5 expression levels, and higher ratio of spliced to full-length HPV oncogene E6 than HPV-IMU; the subgroups also show differences in copy number alterations and mutations, in particular the loss of chr16q in HPV-IMU and gain of chr3q and PIK3CA mutation in HPV-KRT., Conclusions: Our characterization of two subtypes of HPV(+) HNC tumors provides valuable molecular level information that point to two main carcinogenic paths. Together, these results shed light on stratifications of the HPV(+) HNCs and will help to guide personalized care for HPV(+) HNC patients. Clin Cancer Res; 22(18); 4735-45. ©2016 AACR., Competing Interests: The authors declare there are no potential conflicts of interest., (©2016 American Association for Cancer Research.)

Opioid abuse, misuse and overdose is now a public health epidemic receiving political, medical, and media attention at all levels. Despite the fact that many people know someone suffering from addiction, there is very little research focusing on this issue in older adults. Chronic pain, a highly prevalent affliction for the aging population, has been accompanied by a significant increase in opioid use. This, along with some unique aspects of older adults (increased susceptibility to illness, higher likelihood of altered presentation of illness, and impaired recovery), means that great care needs to be taken when considering opioids for treatment. Prudent prescribing is possible, but universal precautions should be taken to reduce the risk of opioid abuse, misuse, and addiction. This review provides education, summarizes current literature, and gives guidance in universal precautions for prescribing opioids.

Through a recent (2003-2007) survey of ectoparasites on hoofed mammals in western North America, a literature review, and examination of archived museum specimens, we found that the exotic deer-chewing louse, Bovicola tibialis (Piaget), is a long-term, widespread resident in the region. The earliest known collection was from Salt Spring Island, Canada, in 1941. We found these lice on the typical host, that is, introduced European fallow deer (Dama dama L.), and on Asian chital (Axis axis [Erxleben] ), native Columbian black-tailed deer (Odocoileus hemionus columbianus [Richardson] ), and Rocky Mountain mule deer (O. h. hemionus [Rafinesque]) x black-tailed deer hybrids. Chital and the hybrid deer are new host records. All identified hosts were known to be or probably were exposed to fallow deer. Geographic records include southwestern British Columbia, Canada; Marin and Mendocino Counties, California; Deschutes, Lincoln, and Linn Counties, Oregon; Yakima and Kittitas Counties, Washington; Curry County, New Mexico; and circumstantially, at least, Kerr County, Texas. All but the Canadian and Mendocino County records are new. Bovicola tibialis displays a number of noteworthy similarities to another exotic deer-chewing louse already established in the region, that is, Damalinia (Cervicola) sp., which is associated with a severe hair-loss syndrome in black-tailed deer. We discuss longstanding problems with proper identification of B. tibialis, the probability that it occurs even more widely in the United States, and the prospects for it to cause health problems for North American deer. Additional information gathered since our active survey establishes further new distribution and host records for B. tibialis.

Prescription drug abuse has reached epidemic proportions in the United States and West Virginia is not immune. It is estimated that in 2009, the number of adolescents and adults with a substance abuse and/or dependence problem has reached 23.2 million in the US. There has been an alarming rate of increased sales of methadone, hydrocodone and oxycodone. This article addresses the scope of the problem of prescription drug abuse in West Virginia and the impact by and on the addicted individual. Addiction is a chronic relapsing neuropsychiatric illness manifested by compulsive drug seeking and use. It has created a substantive socioeconomic burden on our state. Prescription drug abuse and addiction increase medical expenses, drug related crime and unemployment. There are misconceptions regarding the etiology and treatment of addiction based on past clinical experience. The view of addiction as volitional misconduct alone has been disproven scientifically. A more current understanding of neurobiological alterations caused by this disease, current treatment strategies and future directions will be presented. This article provides an understanding of prescription drug abuse and addiction's contribution and impact on society's health and social policy. Addressing the problem of prescription drug abuse requires an understanding of the disease of addiction, thus enhancing the effectiveness in diminishing the associated health and social costs. It is the article's intent to illuminate the mutually symbiotic relationship of prescription drug abuse and the disease of addiction and subsequently provide recommendations toward the resolution of this most important issue.

Unlabelled: Heat is generated whenever osteotomies are created, Kirschner wires are inserted, holes are drilled, and when bone is reduced with a burr. Although previous investigators have determined the combination of time and temperature necessary to cause bone injury, to our knowledge, no one has yet specifically studied whether the heat generated when osteotomies are performed in the foot reaches sufficient levels to damage osseous tissue. Toward that end, the authors designed an experiment to measure the change in cadaveric first metatarsal temperature, and the time associated with the rise and fall of the bone temperature, in response to osteotomies performed with and without concomitant saline solution irrigation of the saw blade. The study was conducted on matched pairs (contralateral limbs) of cadaveric bone, with one side being irrigated with normal saline solution and the other side being osteotomized without saline solution irrigation. Osteotomies were created dorsally and plantarly at 3 sites in the first metatarsal specimens, specifically at the head, mid-diaphysis, and base; and a total of 112 osteotomies were included in the analyses. Regardless of whether saline solution irrigation was used, none of the bone specimens reached a temperature known to be associated with thermal injury during osteotomy. The use of saline solution irrigation did, however, provide a reduction in peak bone temperature during osteotomy, and the duration of sustained temperature elevation was also shortened with the use of irrigation., Level of Clinical Evidence: 5.

An eviscerated hunter-harvested female black-tailed deer (Odocoileus hemionus columbianus) was submitted to the Washington Department of Fish and Wildlife. The deer was emaciated, devoid of adipose tissue, and the parietal surface of the thoracic cavity contained multiple granulomas. Acid-fast bacteria were detected histologically from the granulomas and were isolated and identified as Mycobacterium kansasii, a nontuberculous mycobacterium sporadically reported to cause tuberculosis-like disease in a variety of vertebrates. This was the first report of symptomatic disease caused by M. kansasii in free-ranging deer. This case indicates that atypical mycobacteria can cause tuberculosis-like disease in free-ranging deer and illustrates the importance of identifying causative agents of tuberculosis-like disease in wildlife.

Overwinter fawn mortality associated with hair loss syndrome (HLS) is anecdotally thought to be important in declines of Columbian black-tailed deer (Odocoileus hemionus columbianus) populations in Washington and Oregon (USA). We determined prevalence of HLS in black-tailed deer, September and April fawn:doe ratios, and minimum overwinter survival rates of fawns for selected game management units (GMUs) in western Washington from 1999 to 2001. Prevalence of HLS ranged from 6% to 74% in fawns and 4% to 33% in does. Minimum fawn survival ranged from 0.56 to 0.83 and was unrelated to prevalence of HLS in either does (r=0.005, P=0.991) or fawns (r=-0.215, P=0.608). The prevalence of HLS in either does or fawns was also unrelated to either fall fawn:doe ratios (HLS does: r=-0.132, P=0.779; HLS fawns: r=0.130, P=0.760) or spring fawn:doe ratios (HLS does: r=-0.173, P=0.711; HLS fawns: r=-0.020, P=0.963). However, the prevalence of HLS in does and fawns was strongly related (r=0.942, P=0.002), and GMUs with high prevalence of HLS had lower deer population densities (fawns: r=-0.752, P=0.031; does: r=-0.813, P=0.026). Increased overwinter mortality of fawns because of HLS was not supported by our data. Decreased production of fawns, increased summer mortality of fawns, or both were seen in six of eight study GMU-year combinations. Observed rates of productivity and minimum fawn survival were inadequate to maintain population size in five of eight study GMU-year combinations, assuming an annual doe survival rate of 0.75. The influence of deer condition and population health on adult survival, fawn production, preweaning fawn survival, parasitism, and prevalence of HLS in both fawns and adults need to be clarified to identify what factors are limiting black-tailed deer productivity.

In 1994, we reported on a series of patients treated with T-cell therapy (Study #1). This paper (Study #2) is an update of our experience through 1999 in the production of tumor-derived activated cells (TDAC), also called tumor-infiltrating lymphocytes (TIL), from tumor biopsies. TDAC were successfully grown in medium containing Interleukin-2 from 75% of the 366 tumor biopsies tested. There was no significant difference in success (growth to 1 x 10(9) cells) comparing primary and metastatic tumors. Many of the tumors were shipped to the laboratory by overnight delivery from distant sites. Success rate did decrease with the length of time for tumor transport in excess of 24 hours. Certain additional cytokines were tested when cultures did not grow. Interleukin-4 was beneficial in the development of 1 of 4 TDAC cultures which did not grow with IL-2 alone. In order to produce TDAC to treat patients, cells were grown in gas permeable plastic bags or in artificial capillary bioreactor cultures. Approximately 1 x 10(9) were seeded from an initially successful "feasibility study" to bulk produce cells for treatment. Harvest was carried out after about 3 weeks. Sixty-three patients were treated at least once with a minimum of 1 x 10(10) TDAC given by intravenous infusion. On the average, the number of cells per treatment was 3 x 10(10) with a viability of 87%. TDAC cultures contained T cells with variable ratios of CD4 to CD8 cells. Secreted granulocyte-monocyte colony stimulating factor, interferon gamma and tumor necrosis factor alpha were measured in TDAC conditioned medium. Only 34 patients received the full course of 4 TDAC treatments. The cells were well tolerated with mild fever and dyspnea. Partial responses were observed in 8 patients, including the dramatic regression of scalp nodules in a patient with renal cancer. These results showed that therapeutic amounts of TDAC can be produced in cell culture in a reasonable and cost-effective manner. The cells were well tolerated and responses were seen in renal and melanoma patients resistant to IL-2 with bulky, advanced cancer.

We present adaptive optics imaging of the CLASS gravitational lens system B1359+154 obtained with the Canada-France-Hawaii Telescope (CFHT) in the infrared K band. The observations show at least three brightness peaks within the ring of lensed images, which we identify as emission from multiple lensing galaxies. The results confirm the suspected compound nature of the lens, as deduced from preliminary mass modeling. The detection of several additional nearby galaxies suggests that B1359+154 is lensed by the compact core of a small galaxy group. We attempted to produce an updated lens model based on the CFHT observations and new 5 GHz radio data obtained with the MERLIN array, but there are too few constraints to construct a realistic model at this time. The uncertainties inherent with modeling compound lenses make B1359+154 a challenging target for Hubble constant determination through the measurement of differential time delays. However, time delays will offer additional constraints to help pin down the mass model. This lens system therefore presents a unique opportunity to directly measure the mass distribution of a galaxy group at intermediate redshift.

The rate of mass accumulation due to galaxy merging depends on the mass, density, and velocity distribution of galaxies in the near neighborhood of a host galaxy. The fractional luminosity in kinematic pairs combines all of these effects in a single estimator that is relatively insensitive to population evolution. Here we use a k-corrected and evolution-compensated volume-limited sample having an R-band absolute magnitude of Mk,eR/=0.2M*) is 0.02+/-0.01&parl0;1+z&parr0;0.1+/-0.5M* Gyr-1. Present-day high-luminosity galaxies therefore have accreted approximately 0.15M* of their mass over the approximately 7 Gyr to redshift 1. Since merging is likely only weakly dependent on the host mass, the fractional effect, deltaM&solm0;M approximately 0.15M*&solm0;M, is dramatic for lower mass galaxies but is, on the average, effectively perturbative for galaxies above 1M*.

A dead elk (Cervus elaphus roosevelti) calf was diagnosed with bacillary hemoglobinuria, a toxemia caused by the bacterium Clostridium haemolyticum. The mortality occurred in southwest Washington, USA (46 degrees 13'N, 123 degrees 22'W), in an area in which several previous mortalities, suspected but not conclusively diagnosed to be either bacillary hemoglobinuria, enterotoxemia, or leptospirosis, occurred. This is the first reported incidence of mortality attributable to bacillary hemoglobinuria in free-ranging elk. Similar deaths of young elk in the area suggest that mortality from this disease may be common locally.

Exposure to one or more serovars of Leptospira interrogans was observed in five of six sampled elk (Cervus elaphus roosevelti) killed in November 1993, from an isolated herd in southwest Washington, USA (46 degrees 45'N, 123 degrees 6'W). In April 1994, exposure to L. interrogans serovars was documented in nine of 11 captured cow elk from the same herd. Leptospires were not isolated from any of the exposed elk, and 10 of the 11 cows were pregnant. The high seroprevalence is evidence that exposure is widespread in the herd. Local productivity of elk was high, however, and the surrounding topography was not conducive for transmission to other elk populations.