Investigating Student Perceptions of a Dissection‐Based Undergraduate Gross Anatomy Course Using Q Methodology

The demand for upper‐level undergraduate dissection‐based anatomy courses is growing, as professional programs require more advanced anatomy training prior to matriculation. To address this need, Indiana University School of Medicine (IUSM) partnered with Indiana University‐Purdue University Indianapolis—a large, urban, life science‐focused campus nearby to IUSM—to offer an undergraduate, dissection‐based course in regional gross anatomy. Because this is a new course, a deeper post‐course evaluation of student perceptions was conducted using Q methodology. In this study, Q methodology was used to evaluate student views of the overall course structure, pre‐laboratory materials and activities, assessments, and quality of instruction. Of the 15 students in the spring semester 2018 cohort, 80% (n = 12) participated in the evaluation, and 10 of those students followed up with written explanations for their rationale in selecting the four statements with which they most strongly agreed and disagreed. The Q methodology sorted the students into one of three statistically significant groups: Motivated Dissectors (n = 6), Traditional Students (n = 3), and Inspired Learners (n = 3). Motivated Dissectors and Inspired Learners felt strongly that the course did not encourage self‐directed learning and that the pre‐laboratory materials were not adequate to prepare them for quizzes. Traditional Students, however, disagreed, having a favorable opinion of the pre‐laboratory materials, even though this group felt most strongly that the amount of material covered in the course was overwhelming. This study demonstrates the utility of Q methodology to evaluate courses to elucidate student perspectives and inform future course modifications

Caudal Vertebral Body Articular Surface Morphology Correlates with Functional Tail Use in Anthropoid Primates

Prehensile tails, capable of suspending the entire body weight of an animal, have evolved in parallel in New World monkeys (Platyrrhini): once in the Atelinae (Alouatta, Ateles, Brachyteles, Lagothrix), and once in the Cebinae (Cebus, Sapajus). Structurally, the prehensile tails of atelines and cebines share morphological features that distinguish them from non-prehensile tails, including longer proximal tail regions, well-developed hemal processes, robust caudal vertebrae resistant to higher torsional and bending stresses, and caudal musculature capable of producing higher contractile forces. The functional significance of shape variation in the articular surfaces of caudal vertebral bodies, however, is relatively less well understood. Given that tail use differs considerably among prehensile and non-prehensile anthropoids, it is reasonable to predict that caudal vertebral body articular surface area and shape will respond to use-specific patterns of mechanical loading. We examine the potential for intervertebral articular surface contour curvature and relative surface area to discriminate between prehensile- and nonprehensile-tailed platyrrhines and cercopithecoids. The proximal and distal intervertebral articular surfaces of the first (Ca1), transitional (TV) and longest (LV) caudal vertebrae were examined for individuals representing 10 anthropoid taxa with differential patterns of tail-use. Study results reveal significant morphological differences consistent with the functional demands of unique patterns of tail use for all vertebral elements sampled. Prehensile-tailed platyrrhines that more frequently use their tails in suspension (atelines) had significantly larger and more convex intervertebral articular surfaces than all nonprehensile-tailed anthropoids examined here, although the intervertebral articular surface contour curvatures of large, terrestrial cercopithecoids (i.e. Papio) converge on the ateline condition. Prehensile-tailed platyrrhines that more often use their tails in tripodal bracing postures (cebines) are morphologically intermediate between atelines and nonprehensile tailed anthropoids.The authors would like to thank Bill Stanley, the Field Museum and the University of Texas at Austin for access to specimens and curatorial assistance as well as the Louisville Zoo and Dr. Roy Burns for their generous donation of Lagothrix lagotricha cadavers. Thanks also to Matthew Tocheri for access to curve fitting software and technical guidance, John Kappelman for the use of his desktop laser scanner and Brett Nachman for technical assistance

International Collaboration with the Shutdown of the BN-350 Reactor

Representatives from the United States and the United Kingdom discussed areas where collaboration on the shutdown of the BN-350 Reactor in Aktau, Kazakhstan would benefit not only Kazakhstan, but would also help to assure the successful shutdown of the reactor. A fundamental understanding of the basis for collaboration has been for each side to ‘add value’ to each of the project areas, rather than simply substitute for each other’s experience. This approach has brought distinct technical and management benefits to the decommissioning activities in Kazakhstan

Artificial Intelligence and Liver Transplant:Predicting Survival of Individual Grafts

The demand for liver transplantation far outstrips the supply of deceased donor organs, and so, listing and allocation decisions aim to maximize utility. Most existing methods for predicting transplant outcomes use basic methods, such as regression modeling, but newer artificial intelligence (AI) techniques have the potential to improve predictive accuracy. The aim was to perform a systematic review of studies predicting graft outcomes following deceased donor liver transplantation using AI techniques and to compare these findings to linear regression and standard predictive modeling: donor risk index (DRI), Model for End‐Stage Liver Disease (MELD), and Survival Outcome Following Liver Transplantation (SOFT). After reviewing available article databases, a total of 52 articles were reviewed for inclusion. Of these articles, 9 met the inclusion criteria, which reported outcomes from 18,771 liver transplants. Artificial neural networks (ANNs) were the most commonly used methodology, being reported in 7 studies. Only 2 studies directly compared machine learning (ML) techniques to liver scoring modalities (i.e., DRI, SOFT, and balance of risk [BAR]). Both studies showed better prediction of individual organ survival with the optimal ANN model, reporting an area under the receiver operating characteristic curve (AUROC) 0.82 compared with BAR (0.62) and SOFT (0.57), and the other ANN model gave an AUC ROC of 0.84 compared with a DRI (0.68) and SOFT (0.64). AI techniques can provide high accuracy in predicting graft survival based on donors and recipient variables. When compared with the standard techniques, AI methods are dynamic and are able to be trained and validated within every population. However, the high accuracy of AI may come at a cost of losing explainability (to patients and clinicians) on how the technology works

Solid-state structure, solution-state behaviour and catalytic activity of electronically divergent C, N-chelating palladium-N-heterocyclic carbene complexes

A family of electronically diverse pyridyl- and picolyl-substituted imidazolium salts have been prepared and coordinated to palladium in a single step, to deliver a variety of palladium(II)–N-heterocyclic carbene (NHC) complexes. Neutral Pd(NHC)X2, cationic [Pd(NHC)2X]X and dicationic [Pd(NHC)2]X2-type complexes have been isolated and fully characterised, with single-crystal X-ray analysis revealing a variety of coordination environments around the palladium centres. The pre-formed complexes have been employed in a model Suzuki–Miyaura cross-coupling reaction to yield a sterically congested tetra-ortho-substituted biaryl product, showcasing turnover numbers comparable to Pd-PEPPSI-IPr catalyst

Willing and able: action-state orientation and the relation between procedural justice and employee cooperation

Existing justice theory explains why fair procedures motivate employees to adopt cooperative goals, but it fails to explain how employees strive towards these goals. We study self-regulatory abilities that underlie goal striving; abilities that should thus affect employees’ display of cooperative behavior in response to procedural justice. Building on action control theory, we argue that employees who display effective self-regulatory strategies (action oriented employees) display relatively strong cooperative behavioral responses to fair procedures. A multisource field study and a laboratory experiment support this prediction. A subsequent experiment addresses the process underlying this effect by explicitly showing that action orientation facilitates attainment of the cooperative goals that people adopt in response to fair procedures, thus facilitating the display of actual cooperative behavior. This goal striving approach better integrates research on the relationship between procedural justice and employee cooperation in the self-regulation and the work motivation literature. It also offers organizations a new perspective on making procedural justice effective in stimulating employee cooperation by suggesting factors that help employees reach their adopted goals

Longterm Outcomes of Patients Undergoing Liver Transplantation for Acute-on-Chronic Liver Failure

AIMS: Recent data have demonstrated greater than 80% one-year survival probability after liver transplantation (LT) for patients with severe acute on chronic liver failure (ACLF). However, long term outcomes and complications are still unknown for this population. Our aim was to compare long-term patient and graft survival among patients transplanted across all grades of ACLF. METHODS: We analyzed the UNOS database, years 2004-2017. Patients with ACLF were identified using the EASL-CLIF criteria. Kaplan-Meier and Cox regression methods were used to determine patient and graft survival and associated predictors of mortality in adjusted models. RESULTS: A total of 75,844 patients were transplanted of which 48,854 (64.4%) had no ACLF, 9,337 (12.3%) had ACLF-1, 9,386 (12.4%) had ACLF-2 and 8,267 (10.9%) had ACLF-3. Patients transplanted without ACLF had a greater proportion of hepatocellular carcinoma within (23.8%) and outside (12.7%) Milan criteria. Five-year patient survival after LT was lower in the ACLF-3 patients compared with the other groups (67.7%, p<0.001), although after year 1, the percentage decrease in survival was similar among all groups. Infection was the primary cause of death among all patient groups in the first year. After the first year, infection was the main cause of death in patients transplanted with ACLF-1 (31.1%), ACLF-2 (33.3%) and ACLF-3 (36.7%), whereas malignancy was the predominant cause of death in those transplanted with no ACLF (38.5%). Graft survival probability at 5 years was above 90% among all patient groups. CONCLUSION: Patients transplanted with ACLF-3 have lower 5-year survival as compared to ACLF 0-2 but mortality rates were not significantly different after the first year following LT. Graft survival was excellent across all ACLF groups

Organizational Support and Contract Fulfillment as Moderators of the Relationship Between Preferred Work Status and Performance

Purpose The purpose of this study was to examine organizational context variables as moderators of the relationship between preferred work status and job performance. The moderators were perceived organizational support (POS) and psychological contract fulfillment. Design/Methodology/Approach Survey data was collected from 164 participants working in a health and fitness organization. These participants ranged in age from 18 to 79 years old (M = 40, SD = 12.5) and held various positions including middle managers, clerical workers, maintenance workers, and sports trainers. Findings The relationship between preferred work status and extra-role performance was negative when POS was higher but not when POS was lower. Also, the relationship between preferred work status and extra-role performance was positive when contract fulfillment was lower but not when it was higher. No moderating effects were found when examining in-role performance. Implications Given the large and growing use of part-time workers it is important to understand differences across various subgroups of them in order to better inform human resource policies and practices. Specifically, the results highlight a key role for the management of reciprocity perceptions. Originality/Value The literature on part-time workers suggests there are important differences between employees who work part-time because they prefer it and those who work part-time but prefer to work full-time. Research regarding the relationship between preferred work status and performance has produced mixed results. This study helps reconcile conflicting results regarding the relationship between preferred work status and performance by examining the moderating effects of theoretically relevant variables

Problems and Prospects: Public Health Regulation of Dietary Supplements

Dietary supplements are a global business worth more than US$100 billion annually. These supplements are taken by up to 50% of adults and perhaps one-third of children in economically advanced economies. Definitions of dietary supplements differ from country to country, and regulation is generally lax and often seems to be directed more toward promoting commerce than protecting public health. Supplements may directly cause toxic reactions or may interact with other supplements or pharmaceuticals. Some supplements are found to have been contaminated with heavy metals, and others do not contain the expected quantities of active ingredients. In general, supplements are not needed except in cases of established deficiencies, and excess of some nutrients can increase cancer rates. There are important public health reasons for taking some supplements, including folate and iodine in pregnancy. This review discusses the public health concerns associated with dietary supplements and suggests directions for further regulation

An evaluation of POSSUM and P-POSSUM scoring in predicting post-operative mortality in a level 1 critical care setting

Background POSSUM and P-POSSUM are used in the assessment of outcomes in surgical patients. Neither scoring systems’ accuracy has been established where a level 1 critical care facility (level 1 care ward) is available for perioperative care. We compared POSSUM and P-POSSUM predicted with observed mortality on a level 1 care ward. Methods A prospective, observational study was performed between May 2000 and June 2008. POSSUM and P-POSSUM scores were calculated for all postoperative patients who were admitted to the level 1 care ward. Data for post-operative mortality were obtained from hospital records for 2552 episodes of patient care. Observed vs expected mortality was compared using receiver operating characteristic (ROC) curves and the goodness of fit assessed using the Hosmer-Lemeshow equation. Results ROC curves show good discriminative ability between survivors and non-survivors for POSSUM and P-POSSUM. Physiological score had far higher discrimination than operative score. Both models showed poor calibration and poor goodness of fit (Hosmer-Lemeshow). Observed to expected (O:E) mortality ratio for POSSUM and P-POSSUM indicated significantly fewer than expected deaths in all deciles of risk. Conclusions Our data suggest a 30-60% reduction in O:E mortality. We suggest that the use of POSSUM models to predict mortality in patients admitted to level 1 care ward is inappropriate or that a recalibration of POSSUM is required to make it useful in a level 1 care ward setting