Minority Women in Adminitstrative Professional Positions in Higher Education

This thesis is about minority women who hold professional positions in higher education. The study goes on to explore the personal and professional lives of this women through intimate stories of their lives

Obliterative surgery for the treatment of pelvic organ prolapse: A patient survey on reasons for surgery selection and post-operative decision regret and satisfaction

Objectives: To identify patient-reported reasons for selecting obliterative surgery for the purpose of predicting decision regret and satisfaction. Methods: We created a deidentified database of patients who underwent an obliterative procedure for prolapse from 2006 to 2013. Patients were excluded if they declined study participation, were deceased, or had dementia. Participants completed a survey regarding reasons for selecting obliterative surgery and a modified version of validated questionnaires on decision regret (Decision Regret Scale-Pelvic Floor Disorder) and satisfaction (Satisfaction with Decision Scale-Pelvic Floor Disorder). Parsimonious multivariate linear regression models were constructed to determine if any of the reasons given for choosing obliterative surgery were independent predictors of decision regret and satisfaction after controlling for significant sociodemographic, clinical, and surgical outcome data identified by bivariate analysis. Results: Seventy-seven women completed the surveys. "To follow my doctor's recommendations" and "no longer sexually active," and/or "did not plan to be" as reasons for selecting obliterative surgery made the most difference; however, these reasons were not identified as independent predictors of decision regret or satisfaction after controlling for confounders. The regret linear regression models identified preoperative sexual activity rather than the patient-reported reason "no longer sexually active and/or did not plan to be," as the only independent predictor of more decision regret after obliterative surgery (B coefficient 1.68, P < 0.01). The satisfaction linear regression models identified reoperation for any reason as an independent predictor of lower satisfaction ([beta], -0.24; P = 0.04) and the patient-reported reason for choosing obliterative surgery "not interested in pessary" as a predictor of higher satisfaction ([beta], 0.30, P = 0.01). Conclusions: This study advances our knowledge about the obliterative surgical decision making process. Behavioral and educational interventions directed at improving patient and physician communications concerning the dynamics of sexual health issues in an aging population will likely decrease regret when obliterative surgery is chosen. Minimizing reoperation after obliterative surgery through increased experience, knowledge, and improved surgical skills and patient validation when pessary is declined will likely improve satisfaction when obliterative surgery is chosen

Surgically cured hypoglycemia secondary to pleural solitary fibrous tumour: case report and update review on the Doege-Potter syndrome

The association of paraneoplastic hypoglycemia [Doege-Potter syndrome] and finger clubbing [Pierre-Marie-Bamberg syndrome] with pleural solitary fibrous tumour is rare. We present a previously unpublished but typical example of this rare occurrence together with a detailed updated literature review of previously published cases of pleural SFT discussing the histopathology of SFT; pathophysiology of the hypoglycemia and finger clubbing; treatment and outcome of pleural SFT. The patient, a 57-year-old African male was admitted at our hospital with recurrent episodes of hypoglycemia. He was found to have digital clubbing and decreased breath sounds in the right lower chest but no other significant clinical findings. His insulin level measured during an episode of hypoglycemia was undetectable. Chest radiograph and CT-scan revealed a lobulated mass in the right chest which was diagnosed to be SFT on histology. Surgical excision of the mass resulted in cure of the hypoglycemic episodes and rapid regression of the clubbing. Less than 65 cases of pleural SFT manifesting with hypoglycemia with or without finger-clubbing have been published in the English literature. The mean diameter of these tumours manifesting with hypoglycemia is 20 cm, 54% being benign while 42% were malignant. They predominantly present in the 6th-8th decade, average age of 64 years and a slight male preponderance at 58%. Complete surgical resection remains the most important predictor of clinical outcome in terms of recurrence and metastases, while providing instant cure for the hypoglycemia and rapid resolution of the finger clubbing

If you could see what we see, would it bother you?

Objective The purpose of our study was to determine whether the anatomic threshold for pelvic organ prolapse (POP) diagnosis and surgical success remains valid when the patient sees what we see on exam. Methods Two hundred participants were assigned, by computer-generated block randomization, to see one of four videos. Each video contained the same six clips representative of various degrees of anterior vaginal wall support. Participants were asked questions immediately after each clip. They were asked: “In your opinion, does this patient have a bulge or something falling out that she can see or feel in the vaginal area?” Similarly, they were asked to give their opinion on surgical outcome on a 4-point Likert scale. Results The proportion of participants who identified the presence of a vaginal bulge increased substantially at the level of early stage 2 prolapse (1 cm above the hymen), with 67 % answering yes to the question regarding bulge. The proportion of participants who felt that surgical outcome was less desirable also increased substantially at early stage 2 prolapse (1 cm above the hymen), with 52 % describing that outcome as “not at all” or “somewhat” successful. Conclusion Early stage 2 POP (1 cm above the hymen) is the anatomic threshold at which women identify both a vaginal bulge and a less desirable surgical outcome when they see what we see on examination

Optimising sample preparation for FTIR-based microplastic analysis in wastewater and sludge samples: multiple digestions

The lack of standardised methodologies in microplastic research has been addressed in recent years as it hampers the comparison of results across studies. The quantification of microplastics in the environment is key to the assessment of the potential eco-toxicological impacts that this new category of emerging pollutants could have on terrestrial and aquatic species. Therefore, the need for protocols that are robust, simple and reliable together with their standardisation are of crucial importance. This study has focused on removal of organic matter with Fenton reagent from wastewater and sludge samples. This step of analysis was optimised by implementing a multi-digestion treatment on these samples that have high concentration of complex mixtures of organic matter, which interfere with microplastic enumeration. Moreover, this study targeted the detection of microplastics in the sub-hundred-micron size range due to the potential higher risks associated with smaller-sized particles and the limited data available from previous wastewater research. To show the validity of the method, triplicate samples of raw sewage, final effluent and sludge were independently spiked with two different sizes and types of microplastic polymers. Due to the various analytical stages required for the isolation of microplastics, time is a limiting factor in sample processing. The sequential digestion with Fenton reagent represents an inexpensive and time-efficient procedure for wastewater research providing effective degradation of organic material. These advantages over other currently available methods mean the method is suitable for analysis of large numbers of samples allowing robust monitoring data sets to be generated

The Use of Tissue Engineering to Fabricate Perfusable 3D Brain Microvessels

Tissue engineering of the blood-brain barrier (BBB) in vitro has been rapidly expanding to address the challenges of mimicking the native structure and function of the BBB. Most of these models utilize 2D conventional microfluidic techniques. However, 3D microvascular models offer the potential to more closely recapitulate the cytoarchitecture and multicellular arrangement of in vivo microvasculature, and also can recreate branching and network topologies of the vascular bed. In this perspective, we discuss current 3D brain microvessel modeling techniques including templating, printing, and self-assembling capillary networks. Furthermore, we address the use of biological matrices and fluid dynamics. Finally, key challenges are identified along with future directions that will improve development of next generation of brain microvasculature models

Riparian Plant Isotopes Reflect Anthropogenic Nitrogen Perturbations: Robust Patterns Across Land Use Gradients

Riparian plants incorporate nitrogen (N) from aquatic, terrestrial, and atmospheric sources, and their stable isotope compositions (δ15 N) may reflect land use impacts on N sources and transformations over scales of sites to watersheds. We surveyed leaf δ15 N values of 11 common riparian tree, shrub, and herbaceous species from 20 streams and rivers spanning three fifth-order watersheds in northern Utah, USA (n - 255 sites and 819 leaf samples). Streams spanned undeveloped montane forests to suburban, urban, and agricultural lands. Mean species-specific differences in leaf δ15N values were relatively small within sites (1.2 ± 2.2‰), although emergent aquatic macrophytes had higher within-site δ15 N values than other growth forms. Leaf δ15 N values varied significantly across land-use categories, and were lowest in undeveloped montane reaches (0.5 ± 1.9‰; mean and standard deviation), intermediate in suburban and urban reaches (2.3 ± 2.6 and 3.2 ± 3.4‰), and greatest in agricultural reaches (4.1 ± 3.1‰). The substantial variation in leaf δ15N values within a land use category often corresponded with local management differences. In an undeveloped montane canyon permitting off-leash dogs, leaf δ15N values (1.5 ± 1.3‰) exceeded similar canyons that strictly prohibited dogs (δ15 N = - 0.7 ± 1.1‰). Canyons with cattle grazing had leaf δ15 N values enriched by 1.4 and 2.8‰ relative to similar, but un-grazed canyons. Variation in traffic between 0 and 5000 vehicles per day did not significantly affect leaf δ15N values, although a canyon with 50,000 vehicles per day showed a 5.7‰ increase relative to low-trafficked canyons. Urban leaf δ15N values were consistently enriched by 2.5 ± 0.6‰ relative to leaves in un-grazed montane reaches, and leaves in a septic-impacted suburban reach were enriched by 4.6‰ relative to upstream samples. Samples from a sewage-impacted urban river averaged 8.0 ± 4.1‰ and reached 22‰ adjacent to publicly owned treatment works (POTW). Another urban river displayed similar values in the absence of POTWs, implicating leaky sewers. Our results demonstrate the capacity of N isotopes from a diverse riparian plant community to inform our spatial understanding of watershed N-cycling perturbations, and illustrate the impact of human activities on N cycling even within protected watersheds. © 2015 Hall et al