Rate pressure product

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73724/1/j.1365-2044.1980.tb05005.x.pd

Surgical cyst decortication in autosomal dominant polycystic kidney disease

PURPOSE: To provide a summary of the relevant literature regarding the impact of surgical cyst decortication on hypertension, renal function, and pain management in patients with autosomal dominant polycystic kidney disease (ADPKD). METHODS: Data collection was conducted via a Medline search using the subject headings autosomal dominant polycystic kidney disease, surgery, decortication, and marsupialization. Additional reports were derived from references included within these articles. RESULTS: Despite a trend for improved blood pressure control after cyst decortication in some studies, this cumulative review of the literature did not provide consistent evidence supporting the role of this procedure in blood pressure management in patients with ADPKD. Surgical cyst decortication was associated with renal deterioration in a subset of patients with compromised baseline renal function but did not otherwise appear to have a significant impact on renal function in the majority of studies reviewed. Improvement in chronic pain after this procedure was ubiquitously reported across all studies examined. CONCLUSIONS: Despite a potential role in blood pressure management in the setting of ADPKD, surgical cyst decortication has not been definitively shown to alleviate hypertension in this clinical setting. Renal function does not appear to improve following this surgery. Patients with compromised baseline renal function appear to be at increased risk for further deterioration in renal function after cyst decortication, although the role of this procedure in altering the natural trajectory of renal failure in this patient subset needs further investigation. Cyst decortication is highly effective in the management of disease-related chronic pain for the majority of patients with ADPKD, providing durable pain relief in this patient population

The dynamics of power and resistance in police interview discourse

This is a study of police interviewing using an integrated approach, drawing on CA, CDA and pragmatics. The study focuses on the balance of power and control, finding that in particular the institutional status of the participants, the discursive roles assigned to them by the context, and their relative knowledge, are significant factors affecting the dynamics of the discourse. Four discursive features are identified as particularly significant, and a detailed analysis of the complex interplay of these features shows that power and control are constantly under negotiation, and are always open to challenge and resistance. Further it is shown that discursive dominance is not necessarily advantageous to participants, due to the specific goals and purposes of the police interview context. A wider consideration of the context illustrates the contribution that linguistics can make to the use of police interview data as evidence in the UK criminal justice system

Multi-institutional Evaluation of Producing and Testing a Novel 3D-Printed Laparoscopic Trainer

To create, distribute, and evaluate the efficacy of a portable, cost effective 3D-printed laparoscopic trainer for surgical skills development.Objective: To create, distribute, and evaluate the efficacy of a portable, cost-effective 3D-printed laparoscopic trainer for surgical skills development. Methods: The UCI Trainer (UCiT) laparoscopic simulator was developed via computer-aided designs (CAD), which were used to 3D-print the UCiT. Once assembled, a tablet computer with a rear-facing camera was attached for video and optics. Four institutions were sent the UCiT CAD files with a 3D-printer and instructions for UCiT assembly. For a comparison of the UCiT to a standard trainer, peg transfer and intracorporeal knot tying skills were accessed. These tasks were scored, and participants were asked to rate their experience with the trainers. Lastly, a questionnaire was given to individuals who 3D-printed and assembled the UCiT. Results: We recruited 25 urologists; none had any 3D-printing experience. The cost of printing each trainer was $26.50 USD. Each institution used the Apple iPad for optics. Six of eight participants assembled the UCiT in < 45 minutes, and rated assembly as somewhat easy. On objective scoring, participants performed tasks equally well on the UCiT vs the conventional trainer. On subjective scoring, the conventional trainer provided a significantly better experience vs the UCiT; however, all reported that the UCiT was useful for surgical education. Conclusion: The UCiT is a low cost, portable training tool that is easy to assemble and use. UCiT provided a platform whereby participants performed laparoscopic tasks equal to performing the same tasks on the more expensive, nonportable standard trainer

The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism.</p> <p>Case presentation</p> <p>We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma.</p> <p>Conclusion</p> <p>In patients with parathyroid carcinoma, the optimal surgical treatment is <it>en bloc </it>resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.</p

Timescales of Massive Human Entrainment

The past two decades have seen an upsurge of interest in the collective behaviors of complex systems composed of many agents entrained to each other and to external events. In this paper, we extend concepts of entrainment to the dynamics of human collective attention. We conducted a detailed investigation of the unfolding of human entrainment - as expressed by the content and patterns of hundreds of thousands of messages on Twitter - during the 2012 US presidential debates. By time locking these data sources, we quantify the impact of the unfolding debate on human attention. We show that collective social behavior covaries second-by-second to the interactional dynamics of the debates: A candidate speaking induces rapid increases in mentions of his name on social media and decreases in mentions of the other candidate. Moreover, interruptions by an interlocutor increase the attention received. We also highlight a distinct time scale for the impact of salient moments in the debate: Mentions in social media start within 5-10 seconds after the moment; peak at approximately one minute; and slowly decay in a consistent fashion across well-known events during the debates. Finally, we show that public attention after an initial burst slowly decays through the course of the debates. Thus we demonstrate that large-scale human entrainment may hold across a number of distinct scales, in an exquisitely time-locked fashion. The methods and results pave the way for careful study of the dynamics and mechanisms of large-scale human entrainment.Comment: 20 pages, 7 figures, 6 tables, 4 supplementary figures. 2nd version revised according to peer reviewers' comments: more detailed explanation of the methods, and grounding of the hypothese

Theory of de Haas-van Alphen Effect in Type-II Superconductors

Theory of quasiparticle spectra and the de Haas-van Alphen (dHvA) oscillation in type-II superconductors are developed based on the Bogoliubov-de Gennes equations for vortex-lattice states. As the pair potential grows through the superconducting transition, each degenerate Landau level in the normal state splits into quasiparticle bands in the magnetic Brillouin zone. This brings Landau-level broadening, which in turn leads to the extra dHvA oscillation damping in the vortex state. We perform extensive numerical calculations for three-dimensional systems with various gap structures. It is thereby shown that (i) this Landau-level broadening is directly connected with the average gap at H=0 along each Fermi-surface orbit perpendicular to the field H; (ii) the extra dHvA oscillation attenuation is caused by the broadening around each extremal orbit. These results imply that the dHvA experiment can be a unique probe to detect band- and/or angle-dependent gap amplitudes. We derive an analytic expression for the extra damping based on the second-order perturbation with respect to the pair potential for the Luttinger-Ward thermodynamic potential. This formula reproduces all our numerical results excellently, and is used to estimate band-specific gap amplitudes from available data on NbSe_2, Nb_3Sn, and YNi_2B_2C. The obtained value for YNi_2B_2C is fairly different from the one through a specific-heat measurement, indicating presence of gap anisotropy in this material. C programs to solve the two-dimensional Bogoliubov-de Gennes equations are available at http://phys.sci.hokudai.ac.jp/~kita/index-e.html .Comment: 16 pages, 11 figure

The feasibility of gene therapy in the treatment of head and neck cancer

Standard approach to the treatment of head and neck cancer include surgery, chemotherapy, and radiation. More recently, dramatic increases in our knowledge of the molecular and genetic basis of cancer combined with advances in technology have resulted in novel molecular therapies for this disease. In particular, gene therapy, which involves the transfer of genetic material to cells to produce a therapeutic effect, has become a promising approach. Clinical trials concerning gene therapy strategies in head and neck cancer as well as combination of these strategies with chemotherapy and radiation therapy will be discussed

How 911 callers and call‐takers impact police encounters with the public: The case of the Henry Louis Gates Jr. arrest

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156456/2/capp12508_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156456/1/capp12508.pd