Keeper Of The Seal: The Art Of Henry Wood Elliott And The Salvation Of The Alaska Fur Seals

Thesis (Ph.D.) University of Alaska Fairbanks, 2001This thesis examines the art of Henry Wood Elliott (1846--1930) and its role in Elliott's successful crusade to save the Pribilof Island fur seals from probable extinction, its importance as a visual record of the nineteenth-century Pribilof Aleut people during a time of societal transition, and how the art reveals the guiding aspirations of the artist. Elliott was one of the first American artists to work in Alaska. An experienced field artist who had served on two prior government expeditions before his assignment to the Pribilof Islands, Elliott used his watercolors of the fur seals in a successful nationwide campaign to reverse the depletion of the herds. Less well known are Elliott's ethnographic watercolors of the Pribilof Aleut people. Created only a few short years after the 1867 Alaska Purchase, these works show the Native people accommodating their Aleut-Russian culture to American societal expectations. These images, then, are a significant visual record for safeguarding the Aleut people's past. Nettled by scientific opponents, Elliott also turned his artistic talents to retaliation. Just as William Hogarth (1697--1764) and Honore Daumier (1808--1879) used caricature to comment on society, Elliott created hundreds of cartoons (ca. 1910--1926) to ridicule his opponents and promote his own point of view. It is in these previously unexamined works that Henry Elliott achieved a synthesis of art and documentation. Elliott's art also reveals his own thwarted aspirations to achieve recognition as a serious artist. His experiences as an expedition artist encouraged both his enthusiasm for science and talent for documentation. Elliott's desire to pair his watercolors with descriptive written details and snippets of government documents, however, transformed them into visual record. Elliott may not have realized his dream of winning respect as an artist, but his documentary images aroused more interest in the declining fur seal herds than the thousands of pages of dry testimony documenting the controversy. The attention generated by his artwork was a major contributor to the successful resolution of the Pribilof Island fur seal debate

Do Schwartz Center Rounds® Hold Transformational Power? An Investigation into the Subjective Experiences of Panellists in Devon.

Systematic Review: The Impact of Schwartz Center® Rounds and Reflective Practice Groups on Healthcare Teams: A Systematic Literature Review. Abstract. Background: Schwartz Center Rounds® (SCRs) are multidisciplinary reflective forums where healthcare staff can discuss the psychological and emotional impact of work. Two NHS trusts piloted SCRs in 2009. They now run in 150 UK sites to support staff and enable compassionate care. The investment into SCRs has not been evidence-based. Early studies indicating positive outcomes for healthcare teams at individual, relational, and organizational levels were criticized for lacking rigour. Reflective practice groups (RPGs) share similarities with SCRs but pose a lighter burden on resources. No systematic reviews have investigated the outcomes of these interventions. Therefore, it was important to consider the evidence for both. Objective: To investigate the impact of SCRs and/or multidisciplinary RPGs on healthcare teams on individual, relational, and organizational levels. Method: Qualitative, quantitative, and mixed-methodology empirical studies and autoethnographic evidence on SCRs and/or multidisciplinary RPGs were sought via PsycINFO, Scopus, and Web of Science, The Point of Care Foundation evidence library, the Journal of Compassionate Health Care, and from two recent SCRs studies’ investigators. Results: The search yielded 863 records; 83 were fully accessed and 21 included. The studies’ quality was variable. All matched PICOS criteria and were maintained. Discussion: Four themes were identified: 1. Reflection, learning, and development; 2. Emotional and psychological impact; 3. Storytelling: Connecting humans through narrative communication; 4. Leadership and culture: Openness and honesty. Enablers and barriers, specifically, resources and safety, were connected to, and discussed within, theme four. Conclusions: SCRs and RPGs showed positive effects on healthcare teams at all levels. RPGs may be more conducive to establishing safety; SCRs held greater potential for staff to develop more holistic perspectives with opportunities for dialogue to effect organizational changes. The findings should be treated with caution given the potential bias of many participants and authors and the dearth of SCRs/RPGs’ non-participants’ perspectives. Whether SCRs have the power to effect sustained organizational change has yet to be established. Keywords: Schwartz Center Rounds, Reflective Practice Groups, healthcare teams, compassion Empirical Paper: Do Schwartz Center Rounds® Hold Transformational Power? An Investigation into the Subjective Experiences of Panellists in Devon. Abstract. Objective: To investigate the subjective experiences of NHS Schwartz Center® Rounds (SCRs) panellists in Devon. To explore whether SCRs hold transformational power on three levels: individual, (group/self-other) relational, and organizational, within an overarching systemic approach. Data sources/study setting: Twelve panellists who had presented at the Royal Devon and Exeter NHS Foundation Trust-Devon Partnership NHS Trust (RD&E-DPT) SCRs in South West England, the first joint SCRs initiative between an acute NHS trust (RD&E) and a mental health NHS trust (DPT). Six RD&E and six DPT panellists took part between May and November 2016, who were also regular attendees (N=4), non-regular attendees (N=5), and non-attendees (N=3) of SCRs. Study design: Twelve individual semi-structured qualitative interviews. Data analysis: Thematic analysis from a social constructionist position was employed to identify patterns across the data set. Key findings: The analysis identified three overarching themes: 1. Psychological safety, culture/s, and leadership; 2. Reflection, learning, and development; 3. Storytelling, connection, and compassion. Reciprocal relationships appeared mutually reinforcing amongst these interacting themes. SCRs in this context appeared to effect transformation at individual and relational levels, with limited impact at the organizational level. For most participants, relational changes were around increased human connection, compassion, and empathy towards colleagues rather than patients. Conclusions: SCRs’ transformational power may be constrained if organizations are solely focused on achieving external goals and if barriers, particularly related to psychological safety, cultural assumptions, norms, and values, are not addressed. Possible SCRs’ mechanisms cited by previous research were supported and a new theoretical model proposed. Key words: Schwartz Center Rounds, compassion, empathy, staff support, human

Discovery Elbow System arthroplasty polyethylene bearing exchange: outcomes and experience

Background The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107° (±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence IV

The diagnosis and management of systemic autoimmune rheumatic disease-related interstitial lung disease: British Society for Rheumatology guideline scope

Interstitial lung disease (ILD) is a significant complication of many systemic autoimmune rheumatic diseases (SARDs), although the clinical presentation, severity and outlook may vary widely between individuals. Despite the prevalence, there are no specific guidelines addressing the issue of screening, diagnosis and management of ILD across this diverse group. Guidelines from the ACR and EULAR are expected, but there is a need for UK-specific guidelines that consider the framework of the UK National Health Service, local licensing and funding strategies. This article outlines the intended scope for the British Society for Rheumatology guideline on the diagnosis and management of SARD-ILD developed by the guideline working group. It specifically identifies the SARDs for consideration, alongside the overarching principles for which systematic review will be conducted. Expert consensus will be produced based on the most up-to-date available evidence for inclusion within the final guideline. Key issues to be addressed include recommendations for screening of ILD, identifying the methodology and frequency of monitoring and pharmacological and non-pharmacological management. The guideline will be developed according to methods and processes outlined in Creating Clinical Guidelines: British Society for Rheumatology Protocol version 5.1.</p

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

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

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

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

AIDS-related mycoses: the way forward.

The contribution of fungal infections to the morbidity and mortality of HIV-infected individuals is largely unrecognized. A recent meeting highlighted several priorities that need to be urgently addressed, including improved epidemiological surveillance, increased availability of existing diagnostics and drugs, more training in the field of medical mycology, and better funding for research and provision of treatment, particularly in developing countries