Concomitant rotator cuff repair and instability surgery provide good patient-reported functional outcomes in patients aged 40 years or older with shoulder dislocation

Background: Recurrent anterior shoulder dislocation in patients aged \u3e /= 40 years is not as rare as once thought. The mechanism of instability in this patient population is different-more likely to be attributed to rotator cuff pathology-compared with that in younger individuals. With an increasingly aging active population, surgical management has a rising role in preventing morbidity associated with recurrent instability. Our purpose was to evaluate outcomes of anterior shoulder instability repair (ie, Bankart or bony Bankart repair) with and without rotator cuff repair (RCR) in patients aged \u3e /= 40 years. Methods: We conducted a retrospective chart review of all patients aged \u3e /= 40 years who underwent surgical repair for anterior shoulder instability from 2008-2016. Patients were categorized into 4 cohorts: Bankart repair only, bony Bankart repair only, Bankart repair with concomitant RCR, and bony Bankart repair with concomitant RCR. Demographic and history-of-instability data were collected. Clinical and functional outcomes assessed included the Single Assessment Numeric Evaluation score, American Shoulder and Elbow Surgeons score, Penn Shoulder Score, visual analog scale score for pain, Western Ontario Shoulder Instability Index score, and patient satisfaction score. Results: A total of 146 patients were included in this study, with 103 patients (71%) having \u3e /=2-year outcome scores. Outcome scores were not significantly different among groups. For patients who underwent Bankart repair only, bony Bankart repair only, Bankart repair with RCR, and bony Bankart repair with RCR, the Single Assessment Numeric Evaluation scores were 80.8 +/- 19.7, 90.0 +/- 10.7, 79.3 +/- 29.4, and 87.2 +/- 10.6, respectively (P = .284); American Shoulder and Elbow Surgeons scores, 83.8 +/- 19.7, 92.4 +/- 17.4, 82.5 +/- 25.6, and 85.6 +/- 12.7, respectively (P = .114); Penn Shoulder Scores for function, 84.5 +/- 17.9, 90.9 +/- 15.3, 83.6 +/- 25.1, and 95.7 +/- 13.0, respectively (P = .286); and Western Ontario Shoulder Instability Index scores, 481.0 +/- 519.5, 292.1 +/- 414.3, 548.9 +/- 690.5, and 320.6 +/- 258.7, respectively (P = .713). Age at the time of surgery significantly differed between cohorts (P \u3c .001). No patients had recurrence of instability during the study period. Conclusion: Similar functional outcomes can be achieved in the surgical management of anterior instability in patients aged \u3e /= 40 years. Rotator cuff tears should be suspected and repaired in patients with anterior instability, especially those aged \u3e /= 50 years

A Review of Web-Based Job Advertisements for Australian Event Management Positions

Strong growths in the Australian event management industry, ongoing technological changes and the internationalisation of the market place has spurred the need for appropriately educated and trained event managers and for a re-evaluation of educational and job training curriculum to meet these new challenges. In order for Australia to position itself as a world leader in event management, it is important to provide consistent high professional standards and event managers that not only meet, but exceed the demands of the industry. While there is some literature that focuses on the tourism and leisure job market (Crossley, 1992; Keung & Pine, 2000), and a small but developing literature base that focuses on event management training (Harris & Jago, 1999; Hawkins & Goldbatt, 1995) relatively little consideration has been given to a national agenda for event management skilling. To provide an indication of current employer requirements, a nationwide study of job advertisements in event management has commenced. The aims of the study are to further the understanding of the educational needs and training requirements of the industry; to ascertain the learned skills and personal attributes sought from event managers; to determine the compatibility of industry demands with current educational and vocational provisions; and to suggest post-secondary institutional avenues through which event management education and training needs can be pursued. This is an ongoing study and it is hoped that it will contribute towards a broad scale understanding of the event management job market. More importantly however, it can be used as the basis for curriculum evaluation and training needs, and create a better understanding and compatibility between event management education and industry practice. This paper reports the preliminary results from a content analysis of approximately 100 web-based job advertisements. Email alert accounts were established with several search engines to gather a sample of event management related job advertisements from around Australia. An analytical framework was devised for the analysis of the advertisements themselves. The results reveal several interesting trends including the geographical concentration of the event management job market, the range of industries that require event management specialists or event management skills, and a series of required skills and key attributes of event managers. The results of this study establish a platform from which to develop a classification of event management skills required by the industry

Comparison of Asymmetric Reaming versus a Posteriorly Augmented Component for Posterior Glenoid Wear and Retroversion: A Radiographic Study.

Background: Managing posterior glenoid wear and retroversion remains a challenge in shoulder arthroplasty. Correcting glenoid version through asymmetric reaming (AR) with placement of a standard glenoid component and the use of posteriorly augmented glenoid (PAG) components are two methods used to address this problem. Our objective is to report the radiographic outcomes of patients with posterior glenoid wear and/or retroversion treated with either approach. Methods: Patients with posterior glenoid wear and a minimum of 15 degrees of retroversion, treated with AR and standard glenoid component or with a PAG component (3 mm, 5 mm, or 7 mm posterior augmentation), were consecutively identified through retrospective chart review. Pre-operative axillary views were evaluated for version, humeral head subluxation in relation to scapular axis and to mid-glenoid face. Post-operative axillary views were reviewed to measure corrected inversion and humeral head subluxation. Results: There were 48 patients in the AR group and 49 patients in the PAG group. Version improved 6.8 degrees in the AR group. In the PAG group, version improved 8.8 degrees with 3 mm augment, 13.4 degrees with 5 mm augment, and 12.8 with 7 mm augments. There were significantly more central peg perforations in the 5 mm PAG group compared to other groups. The humeral head was re-centered within 6.1% of normal in all groups except 7 mm augments. Conclusion: This study demonstrates that AR and PAGs have the ability to re-center the humeral head when utilized in patients with retroversion and posterior wear. Use of a PAG component may allow for greater correction of glenoid retroversion, however, there is an increased risk for central peg perforation with the specific implant utilized in this study. Long-term follow-up is ongoing and needed to understand the clinical implications of these findings

Dimensions of Liberal Education at Brockport

Editor: H. Larry Humm (College at Brockport emeritus). Editorial board: Robert W. Strayer (professor emeritus, College at Brockport) ; W. Bruce Leslie, (College at Brockport faculty member) ; Robert S. Getz (professor emeritus, College at Brockport) ; J. Douglas Hickerson (former Director of Student Affairs, College at Brockport), Kenneth L. Jones (former College at Brockport faculty member) ; Charles R. Edwards (professor emeritus, College at Brockport). Also includes chapters by the following emeriti and former faculty members and professionals of The College at Brockport: Donald S. Douglas (former provost), Harold L. Rakov (emeritus), Roger M. Weir (emeritus), Owen S. Ireland (current), Edward J. Gucker (emeritus), Warren Fraleigh (emeritus), Lynn H. Parsons (emeritus), Ian H. Henderson (emeritus), Robert J. Gemmett (emeritus), J. Emory Morris (emeritus), Beth E. VanFossen (former faculty member), Peter L. Marchant (emeritus), Gladdys W. Church (former Director of the Learning Skills Center). An instructional development project of the Educational Communications Center, State University College at Brockport, Brockport, New York. Contents: On coming to college for the first time : Great expectations, yours and ours / Donald S. Douglas -- High school and college, what’s the difference? / Harold L. Rakov -- Living in a college community / Roger M. Weir -- A liberal arts education: what, why and how: The liberating arts and personal freedom / J. Douglas Hickerson -- The liberal arts, preparation for a career / Roger M. Weir -- Liberally educated people, knowing them when you see them: Perspective 1, Gaining knowledge, discipline, and values / Owen S. Ireland -- Perspective 2, Nurturing curiosity, creativity, and commitment / Edward J. Gucker -- Perspective 3, Cultivating freedom / Warren Fraleigh -- Democracy and the liberal arts, Is there a connection? / Lynn H. Parsons -- From Socrates to Brockport, your place in a long tradition / W. Bruce Leslie -- Why study the fine arts? / Ian H. Henderson -- Why study the humanities? / Robert J. Gemmett -- Why study the sciences? / J. Emory Morris -- Why study the social sciences? / Beth E. VanFossen -- More than making it: getting the most out of college : Where am I going? How do I get there? Some thoughts on academic planning / Robert S. Getz -- Thinking about thinking / H. Larry Humm -- How not to be a victim of time, a first letter to an anxious student / Peter L. Marchant -- Reading in college, more than turning pages / Charles R. Edwards -- Going to class-- being there is not enough / H. Larry Humm -- How not to be a victim of essay assignments, a second letter to an anxious student / Peter L. Marchant -- Making the most of tests / Gladdys W. Church.https://digitalcommons.brockport.edu/bookshelf/1328/thumbnail.jp

Epidermal Growth Factor Receptor Activation in Glioblastoma through Novel Missense Mutations in the Extracellular Domain

Background: Protein tyrosine kinases are important regulators of cellular homeostasis with tightly controlled catalytic activity. Mutations in kinase-encoding genes can relieve the autoinhibitory constraints on kinase activity, can promote malignant transformation, and appear to be a major determinant of response to kinase inhibitor therapy. Missense mutations in the EGFR kinase domain, for example, have recently been identified in patients who showed clinical responses to EGFR kinase inhibitor therapy. Methods and Findings: Encouraged by the promising clinical activity of epidermal growth factor receptor (EGFR) kinase inhibitors in treating glioblastoma in humans, we have sequenced the complete EGFR coding sequence in glioma tumor samples and cell lines. We identified novel missense mutations in the extracellular domain of EGFR in 13.6% (18/132) of glioblastomas and 12.5% (1/ 8) of glioblastoma cell lines. These EGFR mutations were associated with increased EGFR gene dosage and conferred anchorage-independent growth and tumorigenicity to NIH-3T3 cells. Cells transformed by expression of these EGFR mutants were sensitive to small-molecule EGFR kinase inhibitors. Conclusions: Our results suggest extracellular missense mutations as a novel mechanism for oncogenic EGFR activation and may help identify patients who can benefit from EGFR kinase inhibitors for treatment of glioblastoma

Unraveling the structural complexity in a single-stranded RNA tail: implications for efficient ligand binding in the prequeuosine riboswitch

Single-stranded RNAs (ssRNAs) are ubiquitous RNA elements that serve diverse functional roles. Much of our understanding of ssRNA conformational behavior is limited to structures in which ssRNA directly engages in tertiary interactions or is recognized by proteins. Little is known about the structural and dynamic behavior of free ssRNAs at atomic resolution. Here, we report the collaborative application of nuclear magnetic resonance (NMR) and replica exchange molecular dynamics (REMD) simulations to characterize the 12 nt ssRNA tail derived from the prequeuosine riboswitch. NMR carbon spin relaxation data and residual dipolar coupling measurements reveal a flexible yet stacked core adopting an A-form-like conformation, with the level of order decreasing toward the terminal ends. An A-to-C mutation within the polyadenine tract alters the observed dynamics consistent with the introduction of a dynamic kink. Pre-ordering of the tail may increase the efficacy of ligand binding above that achieved by a random-coil ssRNA. The REMD simulations recapitulate important trends in the NMR data, but suggest more internal motions than inferred from the NMR analysis. Our study unmasks a previously unappreciated level of complexity in ssRNA, which we believe will also serve as an excellent model system for testing and developing computational force fields

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment