Intradepartmental System of Allocating Operating Room Block Time and its Financial Impact at The University of New Mexico Department of Orthopaedics & Rehabilitation: A Preliminary Report

Background: Within a hospital, the operating room (OR) is one of the most critical and expensive resources. Labor productivity is maximized by filling allocated surgical block time with as many hours of cases as possible. We have found that the intradepartmental block time release system at our institution has improved access to operating time, resulting in a substantial financial advantage within the department. Methods: The annual charges and collections produced by the pick-up of intradepartmental released block time during the past 4 fiscal years (July 1-June 30) was assessed at both the main hospital and an outpatient surgical center. Results: There is a general, year-over-year trend of increasing charges and collections from the intradepartmental release of OR time. The average gross collection rate for OR pick-up time is 30%, which matches the average collection rate of about 30% for our department. At the main inpatient hospital, the orthopaedic spine service typically comprises the mostreleased OR block time. In the outpatient setting, typically the orthopaedic hand service captures the most released OR block time. Conclusions: The early release of allocated block time on an internal level may help schedule patients in an easier manner, with decreased patient wait times than other methods, and maintain the overall revenue within the department. Further studies that quantify surgeon satisfaction would help strengthen the use and validation of this system

Privileged Structure: Novel Indane Scaffolds as Potential Anticancer and Anti-Inflammatory Agents

The identification and use of “privileged structures” can increase the reliability and shorten the process in the drug discovery and drug design (a-b). Indane scaffolds occur in various natural products and they constitute the privileged structure that is ubiquitous in many biologically and pharmaceutically active molecules (c-e). Our research group has been working on the synthesis and pharmacological activity of nature identical and synthetically modified indanes and indanones for 20 years. In the current study, the molecular design is centred on elaboration of a fern derived bioactive pharmacophore. The fern is used in traditional Taiwanese medicine to treat inflammation, allergy, stomach cramps and fever (f). Using a synthetic approach we have designed a novel chemical scaffold which can be modified to inhibit angiogenesis and 5-lipoxygenase activity. The parent scaffold and a number of strategically modified derivatives were initially screened using the Zebra fish (Danio rerio) model of tumour angiogenesis (g). This screen led to the identification of two lead molecules, which were then further evaluated in in vitro cell lines and colorectal explants. Results from these experiments establish that the lead compounds affect inter-segmental vessel formation. These molecules also inhibit cell invasion and tube formation. When evaluated in ex vivo colorectal cancer explants where the molecules significantly affected angiogenic and inflammatory protein secretions. These small molecules also alter gene expression. Modification of the scaffold can inhibit 5-lipoxygenase activity. These data suggest that the new scaffold may have significant potential in the treatment of angiogenesis and inflammatory related diseases

LC3B globular structures correlate with survival in esophageal adenocarcinoma

Background: Esophageal adenocarcinoma has the fastest growing incidence of any solid tumor in the Western world. Prognosis remains poor with overall five-year survival rates under 25 %. Only a limited number of patients benefit from chemotherapy and there are no biomarkers that can predict outcome. Previous studies have indicated that induction of autophagy can influence various aspects of tumor cell biology, including chemosensitivity. The objective of this study was to assess whether expression of the autophagy marker (LC3B) correlated with patient outcome. Methods: Esophageal adenocarcinoma tumor tissue from two independent sites, was examined retrospectively. Tumors from 104 neoadjuvant naïve patients and 48 patients post neoadjuvant therapy were assembled into tissue microarrays prior to immunohistochemical analysis. Kaplan-Meier survival curves and log-rank tests were used to assess impact of LC3B expression on survival. Cox regression was used to examine association with clinical risk factors. Results: A distinct globular pattern of LC3B expression was found to be predictive of outcome in both patient groups, irrespective of treatment (p < 0.001). Multivariate analysis found that this was a strong independent predictor of poor prognosis (p < 0.001). Conclusions: This distinctive staining pattern of LC3B represents a novel prognostic marker for resectable esophageal adenocarcinoma

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale

Oscillation Results for a Class of Nonlinear Fractional Order Difference Equations with Damping Term

The paper studies the oscillation of a class of nonlinear fractional order difference equations with damping term of the form Δψλzηλ+pλzηλ+qλF∑s=λ0λ−1+μ λ−s−1−μys=0, where zλ=aλ+bλΔμyλ, Δμ stands for the fractional difference operator in Riemann-Liouville settings and of order μ, 0<μ≤1, and η≥1 is a quotient of odd positive integers and λ∈ℕλ0+1−μ. New oscillation results are established by the help of certain inequalities, features of fractional operators, and the generalized Riccati technique. We verify the theoretical outcomes by presenting two numerical examples

COX-derived prostanoid pathways in gastrointestinal cancer development and progression: Novel targets for prevention and intervention

Arachidonic acid metabolism through cyclooxygenase (COX) pathways leads to the generation of biologically active eicosanoids. Eicosanoid expression levels vary during development and progression of gastrointestinal (GI) malignancies. COX-2 is the major COX-isoform responsible for G.I. cancer development/progression. COX-2 expression increases during progression from a normal to cancerous state. Evidence from observational studies has demonstrated that chronic NSAID use reduces the risk of cancer development, while both incidence and risk of death due to G.I. cancers were significantly reduced by daily aspirin intake. A number of randomized controlled trials (APC trial, Prevention of Sporadic Adenomatous Polyps trial, APPROVe trial) have also shown a significant protective effect in patients receiving selective COX-2 inhibitors. However, chronic use of selective COX-2 inhibitors at high doses was associated with increased cardiovascular risk, while NSAIDs have also been associated with increased risk. More recently, downstream effectors of COX-signaling have been investigated in cancer development/progression. PGE 2, which binds to both EP and PPAR receptors, is the major prostanoid implicated in the carcinogenesis of G.I. cancers. The role of TXA 2 in G.I. cancers has also been examined, although further studies are required to uncover its role in carcinogenesis. Other prostanoids investigated include PGD 2 and its metabolite 15d-PGJ2, PGF 1α and PGI 2. Targeting these prostanoids in G.I. cancers has the promise of avoiding cardiovascular toxicity associated with chronic selective COX-2 inhibition, while maintaining anti-tumor reactivity.A progressive sequence from normal to pre-malignant to a malignant state has been identified in G.I. cancers. In this review, we will discuss the role of the COX-derived prostanoids in G.I. cancer development and progression. Targeting these downstream prostanoids for chemoprevention and/or treatment of G.I. cancers will also be discussed. Finally, we will highlight the latest pre-clinical technologies as well as avenues for future investigation in this highly topical research field. © 2011 Elsevier B.V

Modeling and stability analysis of the spread of novel coronavirus disease COVID-19

© 2021 World Scientific Publishing Company.Towards the end of 2019, the world witnessed the outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (COVID-19), a new strain of coronavirus that was unidentified in humans previously. In this paper, a new fractional-order Susceptible-Exposed-Infected-Hospitalized-Recovered (SEIHR) model is formulated for COVID-19, where the population is infected due to human transmission. The fractional-order discrete version of the model is obtained by the process of discretization and the basic reproductive number is calculated with the next-generation matrix approach. All equilibrium points related to the disease transmission model are then computed. Further, sufficient conditions to investigate all possible equilibria of the model are established in terms of the basic reproduction number (local stability) and are supported with time series, phase portraits and bifurcation diagrams. Finally, numerical simulations are provided to demonstrate the theoretical findings