364 research outputs found

    Next Year in Juarez: Stories

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    This creative dissertation comprises a collection of short fiction and a critical preface. The preface explores the concept of variousness as it affects the contemporary production of literary fiction. Reference is made to a range of twentieth century writers in order to position the dissertation in a context of literary history. The piece titled “The Essay on Longing” is the first chapter of a novel-in-stories

    Propensity Score-Matched Analysis of Open Surgical and Endovascular Repair for Type B Aortic Dissection

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    Objective. To identify national outcomes of thoracic endovascular aortic repair (TEVAR) for type B aortic dissections (TBADs). Methods. The Nationwide Inpatient Sample database was examined from 2005 to 2008 using ICD-9 codes to identify patients with TBAD who underwent TEVAR or open surgical repair. We constructed separate propensity models for emergently and electively admitted patients and calculated mortality and complication rates for propensity score-matched cohorts of TEVAR and open repair patients. Results. In-hospital mortality was significantly higher following open repair than TEVAR (17.5% versus 10.8%, P = .045) in emergently admitted TBAD. There was no in-hospital mortality difference between open repair and TEVAR (5.6% versus 3.3%, P = .464) for elective admissions. Hospitals performing thirty or more TEVAR procedures annually had lower mortality for emergent TBAD than hospitals with fewer than thirty procedures. Conclusions. TEVAR produces better in-hospital outcomes in emergent TBAD than open repair, but further longitudinal analysis is required

    Development of a multimedia tutorial to educate how to assess the critical view of safety in laparoscopic cholecystectomy using expert review and crowd-sourcing

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    We sought to determine the feasibility of developing a multimedia educational tutorial to teach learners to assess the critical view of safety using input from expert surgeons, non-surgeons and crowd-sourcing. We intended to develop a tutorial that would teach learners how to identify the basic anatomy and physiology of the gallbladder, identify the components of the critical view of safety criteria, and understand its significance for performing a safe gallbladder removal. Using rounds of assessment with experts, laypersons and crowd-workers we developed an educational video with improving comprehension after each round of revision. We demonstrate that the development of a multimedia educational tool to educate learners of various backgrounds is feasible using an iterative review process that incorporates the input of experts and crowd sourcing. When planning the development of an educational tutorial, a step-wise approach as described herein should be considered

    Assessment of NASA Airborne Laser Altimetry Data Using Ground-Based GPS Data Near Summit Station, Greenland

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    A series of NASA airborne lidars have been used in support of satellite laser altimetry missions. These airborne laser altimeters have been deployed for satellite instrument development, for spaceborne data validation, and to bridge the data gap between satellite missions. We used data from ground-based Global Positioning System (GPS) surveys of an 11 km long track near Summit Station, Greenland, to assess the surface–elevation bias and measurement precision of three airborne laser altimeters including the Airborne Topographic Mapper (ATM), the Land, Vegetation, and Ice Sensor (LVIS), and the Multiple Altimeter Beam Experimental Lidar (MABEL). Ground-based GPS data from the monthly ground-based traverses, which commenced in 2006, allowed for the assessment of nine airborne lidar surveys associated with ATM and LVIS between 2007 and 2016. Surface–elevation biases for these altimeters – over the flat, ice-sheet interior – are less than 0.12 m, while assessments of measurement precision are 0.09 m or better. Ground-based GPS positions determined both with and without differential post-processing techniques provided internally consistent solutions. Results from the analyses of ground-based and airborne data provide validation strategy guidance for the Ice, Cloud, and land Elevation Satellite 2 (ICESat-2) elevation and elevation-change data products

    Adrenal myelolipoma: Operative indications and outcomes

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    Background: Adrenal myelolipoma (AM) is a benign lesion for which adrenalectomy is infrequently indicated. We investigated operative indications and outcomes for AM in a large single-institution series. Subjects and Methods: A retrospective cohort study of prospectively collected data was conducted. Patients (≥16 years of age) who underwent adrenalectomy in the Division of General Surgery at Barnes-Jewish Hospital (1993–2010) were grouped by operative indication (myelolipoma versus other pathology) and compared using nonparametric tests (α<0.05). Results: Sixteen patients (4.0%) had myelolipomas resected out of 402 patients who underwent adrenalectomy. Fourteen patients with suspected AM underwent adrenalectomy, 13 (93%) of whom had AM confirmed on pathology. Indications for adrenalectomy were abdominal or flank pain, large tumor size (>8 cm), atypical radiologic appearance, and/or inferior vena cava compression. Three patients with suspected other adrenal lesions had AM confirmed on final pathology. Operative approach was laparoscopic in 15 cases and open in 1 case of a 21-cm lesion. Patients who underwent laparoscopic adrenalectomy for AM (n=15) or other adrenal pathology (n=343) were similar with respect to age, gender, American Society of Anesthesiologists classification, prior abdominal operation, tumor side, operative time, conversion rate, estimated blood loss, intraoperative complications, hospital length of stay, and 30-day morbidity. However, patients with resected AM had a higher body mass index (36.5±8.1 kg/m(2) versus 30.1±7.5 kg/m(2); P<.01) and a larger preoperative tumor size (8.4±3.0 cm versus 3.1±1.7 cm; P<.01). Conclusions: Laparoscopic adrenalectomy may be appropriate for patients with a presumptive diagnosis of AM and abdominal or flank pain, large tumor size, and/or uncertain diagnosis after imaging. Outcomes and morbidity following LA for AM and other adrenal pathology appear comparable

    Pan-Genomic Analysis of Clostridium botulinum Group II (Non-Proteolytic C. botulinum) Associated with Foodborne Botulism and Isolated from the Environment

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    The neurotoxin formed by Clostridium botulinum Group II is a major cause of foodborne botulism, a deadly intoxication. This study aims to understand the genetic diversity and spread of C. botulinum Group II strains and their neurotoxin genes. A comparative genomic study has been conducted with 208 highly diverse C. botulinum Group II strains (180 newly sequenced strains isolated from 16 countries over 80 years, 28 sequences from Genbank). Strains possessed a single type B, E, or F neurotoxin gene or were closely related strains with no neurotoxin gene. Botulinum neurotoxin subtype variants (including novel variants) with a unique amino acid sequence were identified. Core genome single-nucleotide polymorphism (SNP) analysis identified two major lineages—one with type E strains, and the second dominated by subtype B4 strains with subtype F6 strains. This study revealed novel details of population structure/diversity and established relationships between whole-genome lineage, botulinum neurotoxin subtype variant, association with foodborne botulism, epidemiology, and geographical source. Additionally, the genome sequences represent a valuable resource for the research community (e.g., understanding evolution of C. botulinum and its neurotoxin genes, dissecting key aspects of C. botulinum Group II biology). This may contribute to improved risk assessments and the prevention of foodborne botulism

    Perceived role of the veterinarian in promoting dairy cattle welfare

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    Improving the lives of animals in agricultural systems has primarily focused on minimizing negative experiences. Research is needed on the promotion of positive experiences (pleasure, enjoyment, play, choice, happiness) for animals and the role of veterinarians in their promotion. Our aims were to describe how Canadian bovine veterinarians and veterinary students perceive the role of a veterinarian in positive vs. negative experiences for dairy cows and to analyze the rationale provided to explain their answers. Canadian veterinary practitioners (n = 78) and veterinary students (n = 148) responded to an online cross-sectional survey and were asked, on a 7-point scale, how important the role of a veterinarian is to promote practices that influence the experience of dairy cows. We used qualitative description to analyse participants’ open-ended text responses. Practices to minimize negative experiences were most important (mean ± SE; 6.8 ± 0.03), a balance of positive and negative experiences was less important (6.4 ± 0.05), and encouragement of positive experiences scored lowest (6.0 ± 0.06), although all scored highly. Four themes were identified to explain participants’ reasoning regarding their perceived role of a veterinarian in the promotion of dairy cattle welfare, centered on: the animal, the producer, the veterinarian, and society. Participants indicated that promoting positive experiences was less important than decreasing negative experiences (5.9 ± 0.09). There were four themes identified to explain participants’ reasoning regarding the relative importance of promotion of positive experiences versus decreasing negative experiences which centered on: frameworks to compare positive and negative experiences, impacts on the animal, the participant’s view of their role, and the practicality of implementation. These results indicate modest differences in valuing avoidance of negative vs. promotion of positive welfare. There were no differences in the quantitative analyses between veterinarians and veterinary students. We conclude that veterinarians are favorably disposed to positive aspects of welfare for dairy cows but may be more focussed on avoidance of negative aspects of welfare

    The Genetic Analysis Workshop 16 Problem 3: simulation of heritable longitudinal cardiovascular phenotypes based on actual genome-wide single-nucleotide polymorphisms in the Framingham Heart Study

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    The Genetic Analysis Workshop (GAW) 16 Problem 3 comprises simulated phenotypes emulating the lipid domain and its contribution to cardiovascular disease risk. For each replication there were 6,476 subjects in families from the Framingham Heart Study (FHS), with their actual genotypes for Affymetrix 550 k single-nucleotide polymorphisms (SNPs) and simulated phenotypes. Phenotypes are simulated at three visits, 10 years apart. There are up to 6 "major" genes influencing variation in high- and low-density lipoprotein cholesterol (HDL, LDL), and triglycerides (TG), and 1,000 "polygenes" simulated for each trait. Some polygenes have pleiotropic effects. The locus-specific heritabilities of the major genes range from 0.1 to 1.0%, under additive, dominant, or overdominant modes of inheritance. The locus-specific effects of the polygenes ranged from 0.002 to 0.15%, with effect sizes selected from negative exponential distributions. All polygenes act independently and have additive effects. Individuals in the LDL upper tail were designated medicated. Subjects medicated increased across visits at 2%, 5%, and 15%. Coronary artery calcification (CAC) was simulated using age, lipid levels, and CAC-specific polymorphisms. The risk of myocardial infarction before each visit was determined by CAC and its interactions with smoking and two genetic loci. Smoking was simulated to be commensurate with rates reported by the Centers for Disease Control. Two hundred replications were simulated
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