“A Cosmic Wirtschaft”: Mood, Materiality and “Metacommunication” in the Cinema of Béla Tarr [Ágnes Hranitzky, Míhaly Víg, and Laszlo Krasznahorkai] (1987-2011).

This dissertation is a thematic response to the films of Bela Tarr’s “second-period”, from Damnation to The Turin Horse; and to claims made in the director’s discourse concerning the departure of his cinema from “story” and toward “metacommunication.” By this, Tarr refers to a motion away from the exigency of conventional narrative economy and toward an expressive realisation of the materiality of time, atmosphere and milieu. With reference to the philosophical discourse on Stimmung, or “mood,” I will argue that the disposition toward these paranarrative elements constitutes a medium of experience that conditions an attunement to the affective presence of the world. The appeal of Stimmung - which displaces the difference between “subject” and “object” - will orient our engagement with the “cosmic perspective” of these films and the “poetic experience” it implies. This displacement takes place with regard to a “free-indirect subjectivity,” an autonomous camera-consciousness that draws together subjects and environment into an experiential “state of being”, or “being-with”. Paradoxically, this inclination away from “story” becomes more profound with the entry of the writer Krasznahorkai into the circle of Tarr’s collaborators. The writer’s work represents a pretext and philosophical background to these films, which will be explicated with particular reference to Benjamin and Heidegger. Meanwhile, Tarr’s medium essentialist view rejects interpretation, situating his antipathy to “story” with reference to “metaphysical things” – theory and ideology, symbol and allegory – and suggesting that our “dignity” has been progressively diminished by the being-in-language of historical man. Accordingly, corruption by language is a thematic element of these films, in which the breakdown of meaning and its communicability takes on the apocalyptic dimensions of a cosmic disharmony. This will be read through Agamben’s discourse on gesture, ethics, and “messianic” time

Obesity and cardiovascular disease in the United States: nutritional and lifestyle strategies for prevention

Obesity and cardiovascular disease are growing epidemics in the United States, affecting all age groups and ethnicities. With their heavy financial and psychological burden on families and the healthcare system, there is an urgent need for new strategies for prevention and treatment of patients. Herein, I explore the burden that this epidemic has had in the United States, who is affected, and the history of how these diseases have become prevalent. I will focus on some of the potential factors that are associated with disease onset, and consider the best options are available for treatment and prevention. The primary objective of this review is to present underlying issues associated with obesity and cardiovascular disease, an overview on available treatments, and present contemporary evidence-based recommendations for patients

An application of principal component analysis to the clavicle and clavicle fixation devices

BACKGROUND: Principal component analysis (PCA) enables the building of statistical shape models of bones and joints. This has been used in conjunction with computer assisted surgery in the past. However, PCA of the clavicle has not been performed. Using PCA, we present a novel method that examines the major modes of size and three-dimensional shape variation in male and female clavicles and suggests a method of grouping the clavicle into size and shape categories. MATERIALS AND METHODS: Twenty-one high-resolution computerized tomography scans of the clavicle were reconstructed and analyzed using a specifically developed statistical software package. After performing statistical shape analysis, PCA was applied to study the factors that account for anatomical variation. RESULTS: The first principal component representing size accounted for 70.5 percent of anatomical variation. The addition of a further three principal components accounted for almost 87 percent. Using statistical shape analysis, clavicles in males have a greater lateral depth and are longer, wider and thicker than in females. However, the sternal angle in females is larger than in males. PCA confirmed these differences between genders but also noted that men exhibit greater variance and classified clavicles into five morphological groups. DISCUSSION AND CONCLUSIONS: This unique approach is the first that standardizes a clavicular orientation. It provides information that is useful to both, the biomedical engineer and clinician. Other applications include implant design with regard to modifying current or designing future clavicle fixation devices. Our findings support the need for further development of clavicle fixation devices and the questioning of whether gender-specific devices are necessary

Flight Testing of Guidance, Navigation and Control Systems on the Mighty Eagle Robotic Lander Testbed

During 2011 a series of progressively more challenging flight tests of the Mighty Eagle autonomous terrestrial lander testbed were conducted primarily to validate the GNC system for a proposed lunar lander. With the successful completion of this GNC validation objective the opportunity existed to utilize the Mighty Eagle as a flying testbed for a variety of technologies. In 2012 an Autonomous Rendezvous and Capture (AR&C) algorithm was implemented in flight software and demonstrated in a series of flight tests. In 2012 a hazard avoidance system was developed and flight tested on the Mighty Eagle. Additionally, GNC algorithms from Moon Express and a MEMs IMU were tested in 2012. All of the testing described herein was above and beyond the original charter for the Mighty Eagle. In addition to being an excellent testbed for a wide variety of systems the Mighty Eagle also provided a great learning opportunity for many engineers and technicians to work a flight program

The effect of age on outcomes of coronary artery bypass surgery compared with balloon angioplasty or bare-metal stent implantation among patients with multivessel coronary disease. A collaborative analysis of individual patient data from 10 randomized trials.

OBJECTIVES: This study sought to assess whether patient age modifies the comparative effectiveness of coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). BACKGROUND: Increasingly, CABG and PCI are performed in older patients to treat multivessel disease, but their comparative effectiveness is uncertain. METHODS: Individual data from 7,812 patients randomized in 1 of 10 clinical trials of CABG or PCI were pooled. Age was analyzed as a continuous variable in the primary analysis and was divided into tertiles for descriptive purposes (≤56.2 years, 56.3 to 65.1 years, ≥65.2 years). The outcomes assessed were death, myocardial infarction and repeat revascularization over complete follow-up, and angina at 1 year. RESULTS: Older patients were more likely to have hypertension, diabetes, and 3-vessel disease compared with younger patients (p < 0.001 for trend). Over a median follow-up of 5.9 years, the effect of CABG versus PCI on mortality varied according to age (interaction p < 0.01), with adjusted CABG-to-PCI hazard ratios and 95% confidence intervals (CI) of 1.23 (95% CI: 0.95 to 1.59) in the youngest tertile; 0.89 (95% CI: 0.73 to 1.10) in the middle tertile; and 0.79 (95% CI: 0.67 to 0.94) in the oldest tertile. The CABG-to-PCI hazard ratio of less than 1 for patients 59 years of age and older. A similar interaction of age with treatment was present for the composite outcome of death or myocardial infarction. In contrast, patient age did not alter the comparative effectiveness of CABG and PCI on the outcomes of repeat revascularization or angina. CONCLUSIONS: Patient age modifies the comparative effectiveness of CABG and PCI on hard cardiac events, with CABG favored at older ages and PCI favored at younger ages

Improving Diabetes Care in Practice: Findings from the TRANSLATE trial

OBJECTIVE—The purpose of this study was to determine whether implementation of a multicomponent organizational intervention can produce significant change in diabetes care and outcomes in community primary care practices

PGRMC1 phosphorylation affects cell shape, motility, glycolysis, mitochondrial form and function, and tumor growth.

BackgroundProgesterone Receptor Membrane Component 1 (PGRMC1) is expressed in many cancer cells, where it is associated with detrimental patient outcomes. It contains phosphorylated tyrosines which evolutionarily preceded deuterostome gastrulation and tissue differentiation mechanisms.ResultsWe demonstrate that manipulating PGRMC1 phosphorylation status in MIA PaCa-2 (MP) cells imposes broad pleiotropic effects. Relative to parental cells over-expressing hemagglutinin-tagged wild-type (WT) PGRMC1-HA, cells expressing a PGRMC1-HA-S57A/S181A double mutant (DM) exhibited reduced levels of proteins involved in energy metabolism and mitochondrial function, and altered glucose metabolism suggesting modulation of the Warburg effect. This was associated with increased PI3K/AKT activity, altered cell shape, actin cytoskeleton, motility, and mitochondrial properties. An S57A/Y180F/S181A triple mutant (TM) indicated the involvement of Y180 in PI3K/AKT activation. Mutation of Y180F strongly attenuated subcutaneous xenograft tumor growth in NOD-SCID gamma mice. Elsewhere we demonstrate altered metabolism, mutation incidence, and epigenetic status in these cells.ConclusionsAltogether, these results indicate that mutational manipulation of PGRMC1 phosphorylation status exerts broad pleiotropic effects relevant to cancer and other cell biology

More questions than answers to the diagnosis and management of cauda equina syndrome-Authors' reply

No abstract available

Survival enhancing indications for coronary artery bypass graft surgery in California

<p>Abstract</p> <p>Background</p> <p>Coronary artery bypass graft (CABG) surgery is performed because of anticipated survival benefit, improvement in quality of life, or both. We performed this study to explore variations in clinical indications for CABG surgery among California hospitals and surgeons.</p> <p>Methods</p> <p>Using California CABG Outcomes Reporting Program data, we classified all isolated CABG cases in 2003–2004 as having "probable survival enhancing indications (SEIs)", "possible SEIs" or "non-SEIs." Patient and hospital characteristics associated with SEIs were examined.</p> <p>Results</p> <p>While 82.9% of CABG were performed for probable SEIs, the range extended from 68% to 96% among hospitals and 51% to 100% among surgeons. SEI rates were higher among patients aged ≥ 65 compared with those aged 18–64 (Adjusted Odds Ratio [AOR] > 1.29 for age groups 65–69, 70–74 and ≥ 75; all p < 0.001), among Asians and Native Americans compared with Caucasians (AOR 1.22 and 1.15, p < 0.001); and among patients with hypertension, peripheral vascular disease, diabetes, cerebrovascular disease and congestive heart failure compared to patients without these conditions (AOR > 1.09, all p < 0.001). Variations in indications for surgery were more strongly related to patient mix than to surgeon or hospital effects (intraclass correlation [ICC] = 0.04 for hospital; ICC = 0.01 for surgeon).</p> <p>Conclusion</p> <p>California hospitals and surgeons vary in their distribution of indications for CABG surgery. Further research is required to identify the roles of market factors, referral patterns, patient preferences, and local clinical culture in producing the observed variations.</p