Evolution of the fish sorting and debris handling system at the Swift Hydroelectric Project Floating Surface Collector for juvenile salmonids

The Swift Floating Surface Collector (FSC) began operation in 2012 and was the third of eight large scale surface collectors installed in the Pacific Northwest region of the United States since 2008. Downstream fish collection and sorting at Swift Dam was a key component of the Lewis River reintroduction program that reestablished passage of anadromous salmonids past PacifiCorp’s three large hydropower dams (510 MW Lewis River Hydroelectric Project) that blocked fish passage beginning in 1931. The Swift FSC floats to accommodate reservoir fluctuation of 90 feet and attracts fish with pumped surface flows of 600 cfs. After passing through a large V-screen, fish and debris enter a fish separator system designed to separate fish by girth into fry (≤3” long), smolts (≤10” long), and adult fish (\u3e10”). The separator system was designed as an evolution of similar systems studied on the Snake, Columbia, Yakima, and Cowlitz Rivers, and was optimized on lessons learned and to accommodate space constraints on the floating structure. Swift dam is the most upstream project on the Lewis river, so all flow entering the collector is unregulated and carries a heavy debris load. Operations staff are finding this system collects more debris than any of the other new FSC’s in the region. Several modifications to provide better debris exclusion, handling, and processing have been made and others are currently under design. These modifications also improve fish attraction, sorting, collection, and safety conditions for the operational staff. This presentation will review the original design goals and details, improvements made through 2017, highlight a new system currently under design planned to be operational in late 2018, and describe other ideas under consideration for adaptive management implementation. Lessons learned can be utilized at other downstream fish collectors with high debris loading

‘“For Without Vanity I’m Better Known”: Restoration Actors and Metatheatre on the London Stage.’

Published version of article deposited in accordance with SHERPA Romeo guidelines. © Cambridge University Press, 2011

Clipping the Positive Lymph Node in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial.

BACKGROUND: For patients with clinically node-positive (cN+) breast cancer undergoing neoadjuvant chemotherapy (NAC), retrieving previously clipped, biopsy-proven positive lymph nodes during sentinel lymph node biopsy [i.e., targeted axillary dissection (TAD)] may reduce false negative rates. However, the overall utilization and impact of clipping positive nodes remains uncertain. PATIENTS AND METHODS: We retrospectively analyzed cN+ ISPY-2 patients (2011-2022) undergoing axillary surgery after NAC. We evaluated trends in node clipping and associations with type of axillary surgery [sentinel lymph node (SLN) only, SLN and axillary lymph node dissection (ALND), or ALND only] and event-free survival (EFS) in patients that were cN+ on a NAC trial. RESULTS: Among 801 cN+ patients, 161 (20.1%) had pre-NAC clip placement in the positive node. The proportion of patients that were cN+ undergoing clip placement increased from 2.4 to 36.2% between 2011 and 2021. Multivariable logistic regression showed nodal clipping was independently associated with higher odds of SLN-only surgery [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.8-6.8, p < 0.001]. This was also true among patients with residual pathologically node-positive (pN+) disease. Completion ALND rate did not differ based on clip retrieval success. No significant differences in EFS were observed in those with or without clip placement, both with or without successful clip retrieval [hazard ratio (HR) 0.85, 95% CI 0.4-1.7, p = 0.7; HR 1.8, 95% CI 0.5-6.0, p = 0.3, respectively]. CONCLUSION: Clip placement in the positive lymph node before NAC is increasingly common. The significant association between clip placement and omission of axillary dissection, even among patients with pN+ disease, suggests a paradigm shift toward TAD as a definitive surgical management strategy in patients with pN+ disease after NAC

The diagnosis of pancreatic mucinous cystic neoplasm and associated adenocarcinoma in males: An eight‐institution study of 349 patients over 15 years

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137278/1/jso24582_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137278/2/jso24582.pd

Association of Preoperative Risk Factors With Malignancy in Pancreatic Mucinous Cystic Neoplasms: A Multicenter Study

Pancreatic mucinous cystic neoplasms (MCNs) harbor malignant potential, and current guidelines recommend resection. However, data are limited on preoperative risk factors for malignancy (adenocarcinoma or high-grade dysplasia) occurring in the setting of an MCN

Fabric Philosophy: The “Texture” of Theatricality and Performativity

As metaphors of human existence, the idioms of theatricality and performativity both fluctuate between values of novelty and normativity: theatricality, between the essence of an art form and a cultural value variously opposed or embraced, performativity, between doing and dissimulation. To revert from drawing too sharp boundaries, either between the two phenomena or between their cognate art forms and everyday life, the article pursues to analyse them in “textural” terms specifically inspired by Tim Ingold’s ecological anthropology and Stephen C. Pepper’s philosophical pragmatism from the 1940s. Where Ingold’s ecology of lines admits to “no insides or outsides,” “trailing loose ends in every direction,” Pepper’s “contextualistic world” of events admits “no top nor bottom” to its strands and textures. After introducing Ingold’s networks of connected objects and meshworks of interwoven lines as shorthand terms for specifically theatrical and performative textures, their various dynamics are considered in terms of absorption and abstraction: on a global scale – I briefly consider the Anthropos(c)ene as theatrum mundi – seeing all the world as a stage indeed depends on something of a theatrical inversion of its lines of becoming. From the tensions of novelty and normativity, noted above, what emerges is a fabric philosophy of weaving and zooming between overlapping textures: if the performative names a dramaturgy of becoming, then the theatrical provides an optic for its analysis

Disparities in the Operative Experience Between Female and Male General Surgery Residents: A Multi-institutional Study From the US ROPE Consortium

OBJECTIVE: To examine differences in resident operative experience between male and female general surgery residents. BACKGROUND: Despite increasing female representation in surgery, sex and gender disparities in residency experience continue to exist. The operative volume of male and female general surgery residents has not been compared on a multi-institutional level. METHODS: Demographic characteristics and case logs were obtained for categorical general surgery graduates between 2010 and 2020 from the US Resident OPerative Experience Consortium database. Univariable, multivariable, and linear regression analyses were performed to compare differences in operative experience between male and female residents. RESULTS: There were 1343 graduates from 20 Accreditation Council for Graduate Medical Education-accredited programs, and 476 (35%) were females. There were no differences in age, race/ethnicity, or proportion pursuing fellowship between groups. Female graduates were less likely to be high-volume residents (27% vs 36%, P \u3c 0.01). On univariable analysis, female graduates performed fewer total cases than male graduates (1140 vs 1177, P \u3c 0.01), largely due to a diminished surgeon junior experience (829 vs 863, P \u3c 0.01). On adjusted multivariable analysis, female sex was negatively associated with being a high-volume resident (OR = 0.74, 95% CI: 0.56 to 0.98, P = 0.03). Over the 11-year study period, the annual total number of cases increased significantly for both groups, but female graduates (+16 cases/year) outpaced male graduates (+13 cases/year, P = 0.02). CONCLUSIONS: Female general surgery graduates performed significantly fewer cases than male graduates. Reassuringly, this gap in operative experience may be narrowing. Further interventions are warranted to promote equitable training opportunities that support and engage female residents

The Role of Liver-Directed Surgery in Patients With Hepatic Metastasis From Primary Breast Cancer: a Multi-Institutional Analysis

BACKGROUND: Data on surgical management of breast liver metastasis are limited. We sought to determine the safety and long-term outcome of patients undergoing hepatic resection of breast cancer liver metastases (BCLM). METHODS: Using a multi-institutional, international database, 131 patients who underwent surgery for BCLM between 1980 and 2014 were identified. Clinicopathologic and outcome data were collected and analyzed. RESULTS: Median tumor size of the primary breast cancer was 2.5 cm (IQR: 2.0-3.2); 58 (59.8%) patients had primary tumor nodal metastasis. The median time from diagnosis of breast cancer to metastasectomy was 34 months (IQR: 16.8-61.3). The mean size of the largest liver lesion was 3.0 cm (2.0-5.0); half of patients (52.0%) had a solitary metastasis. An R0 resection was achieved in most cases (90.8%). Postoperative morbidity and mortality were 22.8% and 0%, respectively. Median and 3-year overall-survival was 53.4 months and 75.2%, respectively. On multivariable analysis, positive surgical margin (HR 3.57, 95% CI 1.40-9.16; p = 0.008) and diameter of the BCLM (HR 1.03, 95% CI 1.01-1.06; p = 0.002) remained associated with worse OS. DISCUSSION: In selected patients, resection of breast cancer liver metastases can be done safely and a subset of patients may derive a relatively long survival, especially from a margin negative resection.info:eu-repo/semantics/publishedVersio