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High levels of dissolved SO4 in drinking water can adversely affect livestock performance. Some plant species may help to remove SO4 and cleanse drinking water, especially S-hyperaccumulators. However, little is known about the capacity of S-hyperaccumulators to grow in rangeland wetland environments. Here we measured plant properties, S concentration, and S mass of nine plant species. Plants were grown in a wetland environment on an artificial floating island (AFI) in a mesocosm supplied with high SO4 water (2 430−4 730 parts per million [PPM]) from a rangeland reservoir. Water properties were measured throughout the experiment. We also used our data and data from the literature to parameterize simulations and estimate the number of plants (per L) needed to reduce the SO4 concentration from 2 000 PPM to a recommended limit of 1 000 PPM. The average sulfur concentration of the nine species was 3.8 times greater than the average of 39 species from the literature. Among the nine species, Brassica napus L., B. napus var. pabularia (DC.) Rchb., and Brassica septiceps (L. H. Bailey) L. H. Bailey tended to have the greatest shoot S concentrations. The total S mass per plant was 5 times greater for B. septiceps (44 mg × plant−1) than B. juncea (L.) Czern. We found no other appreciable differences in total S mass among species. The simulations suggest that ≥ 1.9 plants × L−1 of B. septiceps or ≥ 0.6 plants × L−1 of B. oleracea L. would be needed to reduce the water's SO4 concentration from 2 000 PPM to the recommended limit. Given the small amount of S removed (per plant) relative to the vast amount of dissolved SO4 possible in rangeland water sources, planted AFIs are not likely to be a practical tool for reducing SO4 in livestock drinking water. Conversely, water treatment systems may be justified in some cases.

Dissolved solids can negatively impact livestock drinking water. To characterize dissolved solid concentrations in the northern Great Plains, we studied 45 water sources over 11 yr. Ca, F, Mg, Na, and total solids sometimes exceeded recommended levels but rarely reached levels empirically shown to negatively impact livestock. Fe often attained concentrations that reduce water consumption, which can reduce feed intake and weight gain. Excessive Fe was likeliest in creeks and reservoirs. SO4 sometimes reached concentrations that reduce weight gain but rarely reached concentrations causing health problems. Excessive SO4 was least likely in reservoirs. A safeguard against water quality problems is ensuring livestock can access multiple water source types (e.g., wells and reservoirs) so that they can use taste and smell to choose acceptable water. Where this is impossible, water quality monitoring is of greater importance. Inexpensive electrical conductivity meters roughly estimate water quality and can identify watering locations requiring more detailed monitoring.

Risk of complications following hernia repair is the key parameter to assess risk/benefit ratio of a technique. As mesh devices are permanent, their risks are life-long. Too many reports in the past assessed mesh safety prematurely after short follow-ups. We aimed to explore what length of follow up would reveal the full extent of complications. Time lapses between implantation and excision were analyzed in 460 cases of meshes excised for complications after hernia repair. Patterns of percentage growth and time lapses at 50th and 95th percentiles were used to compare groups of different hernia type, age, gender and reason for excision. The 50th and 95th case percentiles in the dataset were at 3.75 and 15.0 years between mesh implantation and excision. For hernia types, the longest time lapses were for groin hernias (4.0 and 16.11 years at 50th and 95th percentiles). The shortest were for umbilical hernias (2.16 and 9.68 years). Males had later excisions than females (4.11 and 16.1 vs. 2.47 and 9.79 years). Younger patients (

With the emergence of industry 4.0, the oil and gas (O&G) industry is now considering a range of digital technologies to enhance productivity, efficiency, and safety of their operations while minimizing capital and operating costs, health and environment risks, and variability in the O&G project life cycles. The deployment of emerging technologies allows O&G companies to construct digital twins (DT) of their assets. Considering DT adoption, the O&G industry is still at an early stage with implementations limited to isolated and selective applications instead of industry-wide implementation, limiting the benefits from DT implementation. To gain the full potential of DT and related technological adoption, a comprehensive understanding of DT technology, the current status of O&G-related DT research activities, and the opportunities and challenges associated with the deployment of DT in the O&G industry are of paramount importance. In order to develop this understanding, this paper presents a literature review of DT within the context of the O&G industry. The paper follows a systematic approach to select articles for the literature review. First, a keywords-based publication search was performed on the scientific databases such as Elsevier, IEEE Xplore, OnePetro, Scopus, and Springer. The filtered articles were then analyzed using online text analytic software (Voyant Tools) followed by a manual review of the abstract, introduction and conclusion sections to select the most relevant articles for our study. These articles and the industrial publications cited by them were thoroughly reviewed to present a comprehensive overview of DT technology and to identify current research status, opportunities and challenges of DT deployment in the O&G industry. From this literature review, it was found that asset integrity monitoring, project planning, and life cycle management are the key application areas of digital twin in the O&G industry while cyber security, lack of standardization, and uncertainty in scope and focus are the key challenges of DT deployment in the O&G industry. When considering the geographical distribution for the DT related research in the O&G industry, the United States (US) is the leading country, followed by Norway, United Kingdom (UK), Canada, China, Italy, Netherland, Brazil, Germany, and Saudi Arabia. The overall publication rate was less than ten articles (approximately) per year until 2017, and a significant increase occurred in 2018 and 2019. The number of journal publications was noticeably lower than the number of conference publications, and the majority of the publications presented theoretical concepts rather than the industrial implementations. Both these observations suggest that the DT implementation in the O&G industry is still at an early stage.

The Agricultural Research Service (ARS) Beef Grand Challenge is a cooperative, multidisciplinary effort evaluating differences in performance of genetic lines across production environments representative of different geographical regions. Weaned spring-born calves (n = 120 per location), representing natural service matings to Angus, Hereford, Simmental, Charolais, or indicus-composite (Beefmaster or Brangus) bulls from the U.S. Meat Animal Research Center Germplasm Evaluation program in south central Nebraska, are sent to wheat pasture (central Oklahoma) and winter range (eastern Montana), and weaned fall-born calves (n=40 per location) are sent to summer grazing on shortgrass prairie (northeastern Colorado) and southern mixed-grass rangeland (western Oklahoma). All cattle are fed a finishing ration representative of the region that approximately matches energy content across locations. Each calving season has a matching counterpart of calves that remain in Nebraska on a calf-fed drylot program (receiving ration followed by longer finishing ration). Breeds and sires are represented equally, to the extent possible, at each location. To detect differences in breed effects at each location and average over yearly variation, the study is being replicated for 4 years. Weights, stress measures, carcass composition (marbling, yield grade, quality grade, etc.), steak tenderness and steak fatty acid composition are collected from each location. Additionally, rumen metagenomic composition, metagenomic samples, preharvest food safety samples, and feed intake measures are collected at some locations. Grazing impacts and supplemental range feeding are also being evaluated. One year of sampling has been completed, with numeric differences observed for marbling and tenderness as well as growth performance among locations. Statistical differences will be evaluated when replicate years are collected. The USDA is an equal opportunity provider and employer.

This study identifies the relationship between local stakeholder pressures and Korean foreign subsidiaries’ corporate social responsibility (CSR). Analyzing the survey data of 177 Korean foreign subsidiaries yielded two important findings. First, local primary stakeholders have a positive impact on responsive CSR activities, but have no influence on strategic CSR activities. Second, local secondary stakeholders in host countries have a strong influence on both responsive and strategic CSR activities. Secondary stakeholders have more influence on strategic than on responsive CSR activities. This article suggests a change in managerial philosophy toward primary and secondary stakeholders, which may have important implications for multinational enterprises (MNEs) in achieving greater success with the design of their CSR activities.

Treatment-resistant depression, a chronic condition that affects 30% of depressed patients on antidepressants, is highly linked to suicidal behavior. Chronic hypoxia exposure via living at altitude (hypobaric hypoxia) or with chronic hypoxic diseases is demographically linked to increased risk for depression and suicide. We previously demonstrated that housing rats at altitude for a week incrementally increases depression-like behavior in the forced swim test (FST) in females, but not males. In animal models, high altitude exposure reduces brain serotonin, and selective serotonin reuptake inhibitors (SSRIs) can lose efficacy when brain serotonin levels are low. To address whether residence at moderate altitude is detrimental to SSRI function, we examined SSRI efficacy in the FST after a week of housing rats at altitudes of 4500 ft. or 10,000 ft. as compared to at sea level. In females, the tricyclic antidepressant desipramine (positive control) functioned well in all groups, increasing latency to immobility and decreasing immobility, by increasing climbing. However, the SSRIs fluoxetine, paroxetine and escitalopram were ineffective in females in all groups: only paroxetine improved swimming in the FST as expected of a SSRI, while all three unexpectedly reduced climbing. Fluoxetine was also ineffective in male rats. Sertraline was the only SSRI with antidepressant efficacy at altitude in both females and males, increasing swimming, climbing and latency to immobility, and reducing immobility. Hypobaric hypoxia thus appears to be detrimental to efficacy of the SSRIs fluoxetine, paroxetine and escitalopram, but not of sertraline. Unlike the other SSRIs, sertraline can improve both serotonergic and dopaminergic transmission, and may be less impacted by a hypoxia-induced serotonin deficit. A targeted approach may thus be necessary for successful antidepressant treatment in patients with depression who live at altitude or with chronic hypoxic diseases, and that sertraline may be the SSRI of choice for prescription for this population.

Objective: The attainment of specific identifiable competencies is the primary measure of progress in the modern medical education system. The system, therefore, requires a method for accurately assessing competence to be feasible. Evidence of validity needs to be gathered before an assessment tool can be implemented in the training and assessment of physicians. This evidence of validity must according to the contemporary theory on validity be gathered from specific sources in a structured and rigorous manner. The flexible pharyngo-laryngoscopy (FPL) is central to the otorhinolaryngologist. We aim to evaluate the flexible pharyngo-laryngoscopy assessment tool (FLEXPAT) created in a previous study and to establish a pass–fail level for proficiency. Methods: Eighteen physicians with different levels of experience (novices, intermediates, and experienced) were recruited to the study. Each performed an FPL on two patients. These procedures were video recorded, blinded, and assessed by two specialists. The score was expressed as the percentage of a possible max score. Cronbach’s α was used to analyze internal consistency of the data, and a generalizability analysis was performed. The scores of the three different groups were explored, and a pass–fail level was determined using the contrasting groups’ standard setting method. Results: Internal consistency was strong with a Cronbach’s α of 0.86. We found a generalizability coefficient of 0.72 sufficient for moderate stakes assessment. We found a significant difference between the novice and experienced groups (p < 0.001) and strong correlation between experience and score (Pearson’s r = 0.75). The pass/fail level was established at 72% of the maximum score. Applying this pass–fail level in the test population resulted in half of the intermediary group receiving a failing score. Discussion: We gathered validity evidence for the FLEXPAT according to the contemporary framework as described by Messick. Our results support a claim of validity and are comparable to other studies exploring clinical assessment tools. The high rate of physicians underperforming in the intermediary group demonstrates the need for continued educational intervention. Conclusion: Based on our work, we recommend the use of the FLEXPAT in clinical assessment of FPL and the application of a pass–fail level of 72% for proficiency.

Lowering production costs while maintaining an optimal level of production is important to producers in extensive environments. Efforts that strive to match the environment to the nutritional requirements of the grazing animal will substantially improve economic returns to the producer. Therefore, a 3-yr study was implemented that evaluated glucose clearance and serum metabolites in primiparous beef heifers (n = 48; 16/yr) from two different feeding regimes. Serum metabolites and glucose clearance measures were analyzed by fitting a repeated measure mixed model using the MIXED procedure of SAS 9.4 (SAS Inst., Inc., Cary, NC). Heifers dams received adequate 1.8 (ADEQ) or marginal 1.2 (MARG) kg/d winter supplementation for approximately 80 d prior to parturition and their heifer calves were then randomly assigned to heifer development treatments that provided ad-libitum (AL) or 80% of ad-libitum (LAL) feed post weaning. Heifers that received the AL treatment during the developmental period were then assigned the 1.8 kg/d winter supplementation for life, whereas heifers that received the LAL treatment during development were assigned the 1.2 kg/d winter supplementation for life. Peak glucose concentrations in response to a bolus dose of glucose changed in magnitude between ADEQ and MARG in utero treatments and decreased further removed from parturition (P = 0.05). However, these changes did not manifest along with other glucose clearance measures (P > 0.17) indicating that regardless of in utero treatment or heifer development treatment the reduction in feed input did not greatly influence glucose clearance measures or baseline serum metabolites throughout postpartum, first parity period.

Heterozygous mutations in KMT2B are associated with an early-onset, progressive and often complex dystonia (DYT28). Key characteristics of typical disease include focal motor features at disease presentation, evolving through a caudocranial pattern into generalized dystonia, with prominent oromandibular, laryngeal and cervical involvement. Although KMT2B-related disease is emerging as one of the most common causes of early-onset genetic dystonia, much remains to be understood about the full spectrum of the disease. We describe a cohort of 53 patients with KMT2B mutations, with detailed delineation of their clinical phenotype and molecular genetic features. We report new disease presentations, including atypical patterns of dystonia evolution and a subgroup of patients with a non-dystonic neurodevelopmental phenotype. In addition to the previously reported systemic features, our study has identified co-morbidities, including the risk of status dystonicus, intrauterine growth retardation, and endocrinopathies. Analysis of this study cohort (n = 53) in tandem with published cases (n = 80) revealed that patients with chromosomal deletions and protein truncating variants had a significantly higher burden of systemic disease (with earlier onset of dystonia) than those with missense variants. Eighteen individuals had detailed longitudinal data available after insertion of deep brain stimulation for medically refractory dystonia. Median age at deep brain stimulation was 11.5 years (range: 4.5–37.0 years). Follow-up after deep brain stimulation ranged from 0.25 to 22 years. Significant improvement of motor function and disability (as assessed by the Burke Fahn Marsden’s Dystonia Rating Scales, BFMDRS-M and BFMDRS-D) was evident at 6 months, 1 year and last follow-up (motor, P = 0.001, P = 0.004, and P = 0.012; disability, P = 0.009, P = 0.002 and P = 0.012). At 1 year post-deep brain stimulation, >50% of subjects showed BFMDRS-M and BFMDRS-D improvements of >30%. In the long-term deep brain stimulation cohort (deep brain stimulation inserted for >5 years, n = 8), improvement of >30% was maintained in 5/8 and 3/8 subjects for the BFMDRS-M and BFMDRS-D, respectively. The greatest BFMDRS-M improvements were observed for trunk (53.2%) and cervical (50.5%) dystonia, with less clinical impact on laryngeal dystonia. Improvements in gait dystonia decreased from 20.9% at 1 year to 16.2% at last assessment; no patient maintained a fully independent gait. Reduction of BFMDRS-D was maintained for swallowing (52.9%). Five patients developed mild parkinsonism following deep brain stimulation. KMT2B-related disease comprises an expanding continuum from infancy to adulthood, with early evidence of genotype-phenotype correlations. Except for laryngeal dysphonia, deep brain stimulation provides a significant improvement in quality of life and function with sustained clinical benefit depending on symptoms distribution.

Current research has emphasized the role that industry characteristics play in MNEs knowledge sourcing decisions. However, much remains to be understood regarding the specific circumstances uncerta...

In response to recent exponential advancements in computer technology (such as artificial intelligence, machine learning, and robotics), there have been several recent studies trying to assess the ...

Several targeted therapeutic options exist for non-small cell lung cancer (NSCLC) patients whose tumors harbor mutations of EGFR, including L858R, exon 19 deletions, and the acquired resistance mutation, T790M. However, there is no approved targeted therapy for patients with EGFR exon 20 insertions, highlighting an ongoing unmet medical need. Here, we describe a potent and selective inhibitor of EGFR exon 20 insertion mutants with decreased activity on the wild-type EGFR for an improved therapeutic window. Our compound, BAY-568, exhibits greater than 20-fold selectivity for EGFR exon 20 insertions compared to wild-type EGFR in isogenic Ba/F3 models and in cancer cell lines endogenously expressing EGFR exon 20 insertions. This activity is also observed in xenograft models in vivo, correlating with reductions in phospho-EGFR and phospho-Erk in tumors but not skin samples from treated mice. BAY-568 furthermore has even greater activity towards the “classical” erlotinib-sensitive mutations, L858R and exon 19 deletions. Importantly, our compound is reversible, differentiating it from other investigational compounds currently in clinical trials. Consistent with this, the presence of a C797S mutation, typically found in patients with acquired resistance to osimertinib, has no effect on the activity of BAY-568. Taken together, these results demonstrate the ability of BAY-568 to kill cancer cells harboring exon 20 insertions and other EGFR mutations with decreased activity on wild-type EGFR, irrespective of C797S mutation status. Citation Format: Franziska Siegel, Stephan Siegel, Keith Graham, Bethany Kaplan, Kirstin Petersen, Ulf Boemer, Uwe Eberspaecher, Daniel Korr, Ursula Moenning, Detlev Suelzle, Jens Schroeder, Florian Prinz, Sabine Zitzmann-Kolbe, Gizem Karsli-Uzunbas, Timothy Lewis, Mario Hermsen, Andrew Cherniack, Franz von Nussbaum, Knut Eis, Matthew Meyerson, Heidi Greulich. Preclinical activity of the first reversible, potent and selective inhibitor of EGFR exon 20 insertions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1470.

Background Accurate identification of patients at risk of early postoperative deterioration allows needs-based allocation of patients to appropriate levels of care. This study aimed to record the incidence of early postoperative deterioration and identify factors predictive of at-risk patients. Doing so may assist future evidence-based perioperative planning and allocation of patients to high-acuity facilities. Methods With ethical approval, data from elective non-cardiac surgical patients were collected between May and August 2013. Patient and surgical factors potentially related to postoperative deterioration were collected from preoperative assessment records. Data on deterioration in the postanaesthesia care unit (PACU), and on the wards were collected prospectively for a period of 72 h postoperatively. Patient factors, surgical factors and PACU events were compared with ward events using binomial logistic regression analysis. Results Of the 747 patients, postoperative deterioration was common both in PACU (155 (20.1%) patients) and on the wards (125 (16.7%)). Common ward events included hypotension (64 (8.2%)) and desaturation (59 (6.2%)). A rapid response team call occurred for 33 (4.4%) patients and an unplanned ICU admission for seven (0.9%) patients. A history of atrial fibrillation and chronic liver disease, duration of surgery and excessive sedation in PACU, among others, were strongly associated with subsequent ward deterioration. However, measures of surgical complexity were not. Conclusions Patient factors, duration of surgery and events in PACU can be predictive of subsequent early postoperative ward clinical deterioration. Such information may aid appropriate perioperative decision-making with respect to postoperative utilization of high-acuity facilities.

Summary Introduction: Various health-related data, subsequently called Person Generated Health Data (PGHD), is being collected by patients or presumably healthy individuals as well as about them as much as they become available as measurable properties in their work, home, and other environments. Despite that such data was originally just collected and used for dedicated predefined purposes, more recently it is regarded as untapped resources that call for secondary use. Method: Since the secondary use of PGHD is still at its early evolving stage, we have chosen, in this paper, to produce an outline of best practices, as opposed to a systematic review. To this end, we identified key directions of secondary use and invited protagonists of each of these directions to present their takes on the primary and secondary use of PGHD in their sub-fields. We then put secondary use in a wider perspective of overarching themes such as privacy, interpretability, interoperability, utility, and ethics. Results: We present the primary and secondary use of PGHD in four focus areas: (1) making sense of PGHD in augmented Shared Care Plans for care coordination across multiple conditions; (2) making sense of PGHD from patient-held sensors to inform cancer care; (3) fitting situational use of PGHD to evaluate personal informatics tools in adaptive concurrent trials; (4) making sense of environment risk exposure data in an integrated context with clinical and omics-data for biomedical research. Discussion: Fast technological progress in all the four focus areas calls for a societal debate and decision-making process on a multitude of challenges: how emerging or foreseeable results transform privacy; how new data modalities can be interpreted in light of clinical data and vice versa; how the sheer mass and partially abstract mathematical properties of the achieved insights can be interpreted to a broad public and can consequently facilitate the development of patient-centered services; and how the remaining risks and uncertainties can be evaluated against new benefits. This paper is an initial summary of the status quo of the challenges and proposals that address these issues. The opportunities and barriers identified can serve as action items individuals can bring to their organizations when facing challenges to add value from the secondary use of patient-generated health data.

We determined the effects of two forage allowance levels (LOW vs. HIGH) and weather conditions on daytime and nighttime movement patterns of young rangeland-raised cows. We also investigated whether calf weaning weights (n = 42) were significantly related to postcalving movement patterns of the dam. Global positioning system data were collected over 4 years by recording 5-min interval locations of 52 crossbred cows grazing a 146-ha woodland/grassland pasture for approximately 20 days. The pasture was stocked moderately in 2004 (73 AUMs) and 2005 (78 AUMs) and lightly in 2006 (34 AUMs) and 2007 (32 AUMs). Estimated forage allowance was lowin 2004 and 2005 (347 and 438 kg herbage · cow-1, respectively) and high in 2006 and 2007 (1104 and 1884 kg herbage · cow-1, respectively). We calculated distance traveled, path sinuosity, woodland preference, and area explored for each cow during 24 h (D + N), daytime (DAY), and nighttime (PRE dawn and POST sunset) periods. Cows in LOW traveled farther than coun...

ALPHABETIC LISTINGS NUMERALS APPENDICES Telecommunications Timeline Asynchronous Transfer Mode (ATM) ITU-T Series Recommendations List of World Wide Web Search Engines List of Internet Domain Name Extensions List of Request for Comments (RFC) Bibliography Acronyms and Abbreviations Telephone Area Codes Dial Equivalents, Radio Alphabet, Morse Code, Metric Prefixes/Values ASCII Character and Control Codes

The objective is to compare nerve densities in explanted polypropylene meshes in patients with or without chronic pain. Pain has supplanted recurrences as a complication of hernia surgery. The increased incidence of pain mirrors a parallel increase in the use of polypropylene meshes. Neither triple neurectomy nor careful nerve preservation has brought relief. Perhaps because we have forgotten that nerves, in response to some evolutionary mechanism, tend to regenerate, undergo changes imposed by prosthetic elements and architecture, mimicking entrapment and compartment syndromes. A total of 33 hernia meshes have been analyzed: 17 excised due to severe pain, two for combined pain and recurrence, 14 sampled during revision for recurrence without pain. Each mesh had standardized sampling for histology and the nerves were highlighted by S100 stain. Nerve densities were assessed within the mesh spaces and in tissue outside the mesh. The density of nerves present in the standardized mesh samples of patients complaining of pain was much more elevated than in the mesh of those patients who had a recurrence but no pain. The difference was statistically significant (p

Concentrated dissolved minerals in naturally occurring water accessible to livestock grazing semiarid landscapes can negatively influence animal productivity and well-being. Twelve indicators of water quality (Ca, Cl, Fe, F, Mg, Mn, Na, nitrate N, pH, SO 4 , total dissolved solids (TDS), and temperature) were measured at 45 livestock water sites over 5 yr from 2009 through 2013 at the 22,257- ha USDA-ARS Fort Keogh Livestock and Range Research Laboratory (Miles City, MT) to estimate variation. Water was sampled from 4 sources: 1) flowing surface water, 2) groundwater, 3) reservoirs, and 4) springs. The sampled area was classified by 3 cardinal compass bearings (locations): 1) north, 2) southeast, and 3) southwest of the Yellowstone River. Samples were collected twice yearly in 2 seasons, May (wet) and September (dry). Year, location, source, and season and their interactions were analyzed as a 5 × 3 × 4 × 2 factorial arrangement of treatments. A location × year interaction (P < 0.04) was found for Mg, Na, SO 4 , and TDS. The southwest location had the greatest concentrations in 2012 of Na, SO 4 , and TDS. A source × year interaction (P < 0.02) was found for Ca, Fe, F, Mg, Mn, Na, SO 4 , TDS, and temperature. Iron, Mg, and Mn had the greatest concentrations in flowing surface water in 2012. Greater and then lower precipitation in 2011 followed by below-average precipitation in 2012 was associated with elevated mineral concentrations in sources in the southwest location and flowing surface water sources demonstrating sources of water quality variability within time and space at the study site. Average concentrations of Ca, Cl, Mg, and nitrate N and pH levels across sources and locations did not exceed the upper maximum intake level for beef cattle. In contrast, concentrations of F, Fe, Na, SO 4 , and TDS at times exceeded the upper maximum level for beef cattle, indicating these minerals may negatively impact range beef cattle performance.

“Indications for pure tissue repairs” is a timely and relevant chapter in a modern textbook on the art of hernia surgery. While the introduction of synthetic polypropylene meshes seemed a boon at first in the management of the tenacious hernia recurrence, it fell short as a panacea. Mesh in any shape, form, weight, configuration, and combination with resorbable and non-resorbable addenda is still a foreign body with its expected flaws and limitations. Unfortunately, the most germane predicament has been the chronic post-herniorrhaphy pain syndrome which has become a major obstacle to a patient’s well-being.

Like most liberal arts colleges in the country, that at Middle Tennessee State University has experienced a substantial drop in enrollment over the past six years. Declining enrollments, a state mandate to improve retention and persistence, and a national climate that undervalues the liberal arts have created a need to ensure that students recognize the importance and value of their liberal arts experiences. Using a pre-test/post-test survey, we seek to determine student habit and perception changes concerning liberal arts that result from participation in Reacting to the Past (RTTP) experiences. Since RTTP is a cost-effective high-impact practice, it is a viable tool to engage students, allowing them to see firsthand why liberal arts are important for their educational experience.

The widespread adoption of electronic medical records (EMRs) in healthcare has provided vast new amounts of data for statistical machine learning researchers in their efforts to model and predict patient health status, potentially enabling novel advances in treatment. In the case of sepsis, a debilitating, dysregulated host response to infection, extracting subtle, uncataloged clinical phenotypes from the EMR with statistical machine learning methods has the potential to impact patient diagnosis and treatment early in the course of their hospitalization. However, there are significant barriers that must be overcome to extract these insights from EMR data. First, EMR datasets consist of both static and dynamic observations of discrete and continuous-valued variables, many of which may be missing, precluding the application of standard multivariate analysis techniques. Second, clinical populations observed via EMRs and relevant to the study and management of conditions like sepsis are often heterogeneous; properly accounting for this heterogeneity is critical. Here, we describe an unsupervised, probabilistic framework called a composite mixture model that can simultaneously accommodate the wide variety of observations frequently observed in EMR datasets, characterize heterogeneous clinical populations, and handle missing observations. We demonstrate the efficacy of our approach on a large-scale sepsis cohort, developing novel techniques built on our model-based clusters to track patient mortality risk over time and identify physiological trends and distinct subgroups of the dataset associated with elevated risk of mortality during hospitalization.AbbreviationsEMRelectronic medical recordCMMcomposite mixture modelKPNCKaiser Permanente Northern CaliforniaBICBayesian information criterionAICAkaike information criterionPAMpartitioning around medoidsMICEmultivariate imputation using chained equations

PURPOSE: To compare the ability of three different anterior cruciate ligament (ACL) reconstruction techniques to normalize rotational knee stability 1 year after ACL reconstruction. Two of these techniques are so-called anatomic techniques.METHODS: Three different ACL reconstruction techniques were tested for their ability to normalize rotational knee stability in a prospective randomized study. Forty-seven ACL-deficient (ACLD) patients were randomized to transtibial single-bundle (SB), anatomic SB, and double-bundle ACL reconstruction. Three-dimensional motion analysis was performed preoperatively and at 1-year follow-up to evaluate tibial rotation and rotational stiffness. Motion data were captured using an eight-camera motion analysis system. Tibial rotation was determined during walking, running, and a pivoting task. Other outcome parameters were KT-1000 knee laxity measurements and the subjective outcome scores KOOS and IKDC.RESULTS: Three-dimensional motion analysis demonstrated that the tibial internal rotation and the rotational stiffness did not differ between the ACL reconstruction techniques during walking, running, and pivoting at 1-year follow-up. Objective knee stability and subjective outcome scores did not differ between the reconstruction groups.CONCLUSION: No significant difference in rotational stability walking, running, and pivoting was seen between anatomic and nonanatomic ACL reconstruction techniques at 1-year follow-up.LEVEL OF EVIDENCE: Therapeutic study, Level I.

Interannual variation of forage quantity and quality driven by precipitation events influence beef livestock production systems within the Southern and Northern Plains and Pacific West, which combined represent 60% (approximately 17.5 million) of the total beef cows in the United States. The beef cattle requirements published by the NRC are an important tool and excellent resource for both professionals and producers to use when implementing feeding practices and nutritional programs within the various production systems. The objectives of this paper include evaluation of the 1996 Beef NRC model in terms of effectiveness in predicting extensive range beef cow performance within arid and semiarid environments using available data sets, identifying model inefficiencies that could be refined to improve the precision of predicting protein supply and demand for range beef cows, and last, providing recommendations for future areas of research. An important addition to the current Beef NRC model would be to allow users to provide region-specific forage characteristics and the ability to describe supplement composition, amount, and delivery frequency. Beef NRC models would then need to be modified to account for the N recycling that occurs throughout a supplementation interval and the impact that this would have on microbial efficiency and microbial protein supply. The Beef NRC should also consider the role of ruminal and postruminal supply and demand of specific limiting AA. Additional considerations should include the partitioning effects of nitrogenous compounds under different physiological production stages (e.g., lactation, pregnancy, and periods of BW loss). The intent of information provided is to aid revision of the Beef NRC by providing supporting material for changes and identifying gaps in existing scientific literature where future research is needed to enhance the predictive precision and application of the Beef NRC models.

While compensation is a central component in the relationship between employees and employers, it is a relatively under-researched area within human resource management and industrial-organisational psychology. Instead, where much of the compensation research has occurred is within the disciplines of economics and finance, areas where agency theory dominates. This article explores the relationship between culture and compensation practices through the lens of organisational justice theory and contrasts the role of distributive justice with the more recent procedural and interactional justice theories. The article articulates how fairness perceptions are instrumental in determining which compensation practices fit different cultures. The consideration of individual perception is important as there is considerable variability within cultures and many organisations have to deal with increasingly multicultural workforces. A particular contribution of this paper is that it explicitly discusses justice perceptions as an explanatory variable of the relationship between culture and compensation practices, something that frequently has been omitted in prior scholarship. The article further explores the extent to which employee participation in compensation decisions may modify perceptions of fairness, and subsequently how this participation effect may be modified by culture.

a b s t r a c t Implementation of minimal supplemental strategies during late gestation has been reported to potentially increase post-weaning progeny health in the feedlot. Therefore, to investigate the effects of nutritional management strategies during late gestation on cow and subsequent steer progeny performance, 103 gestating cows grazing dormant win- ter range were utilized at Corona Range and Livestock Research Center, Corona, NM. Cows were supplemented with (1) a 36% crude protein (CP) supplement (CSM) fed 3×/wk at a rate of 454 g cow−1 d−1, (2) self-fed supplement comprised of 50% corn gluten meal and 50% mineral (SMP; 28% CP), or (3) cows fed no protein supplement during late gestation (NS). Cows were supplemented for 60 d from December until 2 wk prior to calving. Supplement consumption was 0.45, 0.17, and 0.00 kg/d for CSM, SMP, and NS. After weaning, steers were preconditioned for 45 d and were received and treated as custom-fed commercial cattle at a feedlot in mid-November. Cow BW and BCS were not influenced (P≥0.55) by late gestation management strategy throughout the study. Prepartum supplementation strate- gies did not influence (P=0.75) subsequent pregnancy rates. Calf BW at weaning, during the feedlot phase, and HCW were not different (P≥0.52) among dam prepartum treatments. A

Nitrate (NO3−) supplementation resulting in higher plasma nitrite (NO2−) is reported to lower resting mean arterial blood pressure (MAP) and oxygen uptake (VO2) during submaximal exercise in non-athletic populations, whereas effects in general are absent in endurance-trained individuals. To test whether physiologic effects of NO3− supplementation depend on local muscular training status or cardiovascular fitness, male endurance-trained cyclists (CYC, n=9, VO2-max: 64±3 mL/min/kg; mean±SD) and recreational active subjects serving as a control group (CON, n=8, 46±3 mL/min/kg), acutely consumed nitrate-rich beetroot juice ([NO3−] ~9 mmol) (NIT) or placebo (PLA) with assessment of resting MAP and energy expenditure during moderate intensity (~50% VO2-max) and incremental leg cycling (LEG-ex) and arm-cranking exercise (ARM-ex). NIT increased (P

Introduction: Great investments are made in new hospital buildings all in favour of single bedrooms for patients. Conclusions regarding the impact of single bedrooms versus multi bedrooms vary. Method: We performed semi-structured interviews with patients undergoing surgery for rectal cancer about their preferences and experiences regarding hospitalization in a single bedroom or a multi bedroom. The data were collected during 2016. Results: The company of fellow patients seems to be of great importance. Patients find the company healing and it contributed to feeling safer. Disturbances like sound and too much activity in a four bedroom is a problem. Most patients preferred single bedrooms when talking to visitors and when they felt very sick. Conclusion: Many patients preferred four bedrooms over single bedrooms because of the company from fellow patients. This conflicts with the tendency in modern hospital design which favors all single bedrooms.

Microwave energy has inherent advantages for heat treatment of foods due to the ability to penetrate food and microwave permeable materials to volumetrically heat the contents rather than rely solely on thermal conduction. It can be applied to both flow-through heat exchange systems for pumpable foods and to prepackaged foods. However, successful commercialization of continuous microwave-assisted pasteurization and sterilization of meals and meal components has only been slowly progressing since the 1970s. The first successful development was the Multitherm hot air and microwave energy based system out of Alpha-Laval. It was subsequently abandoned commercially, but other technology manufacturers in Europe included, e.g., Officine Meccaniche Attrezzature per Ceramiche (OMAC). They sold over 200 machines in the period circa. 1980–2000, which were based on a 2.45 GHz continuous microwave sterilization process. Products such as pasta meals became common in Italy in the 1990s and in other parts of the world excluding the United States. Also in Europe, an industrial continuous in-pack meal pasteurization system by MicVac uses 2.45 GHz microwaves. This system utilizes a one-way steam valve on the food package, which releases excess energy as steam allowing rapid heating and vacuum sealing when the product cools below boiling point. Other current reported systems include a 2.45 GHz continuous pressurized microwave sterilization system manufactured by Gustosi, and 915 MHz pressured pasteurization and sterilization systems developed out of Washington State University for US Defense and commercial consortia backers. These systems are finding growing markets enabled by many factors. The development of improved heat- and oxygen-resistant packaging allows better quality preservation. The rise of meals not prepared at home and the developments of centralized institutional catering systems has greatly expanded the range of applications. Improvements in technology, such as computer controlled processing, allow dynamic control of microwave energy to minimize any overprocessing during sterilization with consequential loss of organoleptic qualities.

Background Numerous rehabilitation protocols exist for postoperative rotator cuff repairs. Because the goal of early rehabilitation is to prevent postoperative adhesions while protecting the repaired tendons, it would be advantageous to know which range-of-motion exercises allow the rotator cuff to remain the most passive in a painful, guarded, postsurgical shoulder. Methods Twenty-six subjects who had undergone subacromial decompression, distal clavicle resection, or a combination of both procedures volunteered to participate within the first 4 days after surgery. Fine-wire electrodes were inserted into the subject's supraspinatus (SS) and infraspinatus (IS). Muscle activity was recorded at resting baseline (BL) and during 14 exercises that have been found in the passive phase of rotator cuff protocols and tested in healthy subjects. Each exercise was compared with BL activity as well as with other exercises in the same movement group. Results The SS remained as passive as BL during therapist- and self-assisted external rotation, therapist-assisted elevation, pendulums, and isometric internal rotation and adduction. The IS was activated greater than BL for all 14 exercises studied. Conclusion Of the 14 exercises studied, 6 allowed the SS and 0 allowed the IS to remain as passive as quiet-stance BL in postsurgical subacromial decompression/distal clavicle resection patients.

ABAT deficiency (OMIM 613163) is a rare inborn error of metabolism caused by recessive variants in the gene 4-aminobutyric acid transaminase (ABAT), which is responsible for both the catalysis of GABA and maintenance of nucleoside pools in the mitochondria. To date, only a few patients have been reported worldwide. Their clinical presentation has been remarkably consistent with primary features of severe psychomotor retardation, encephalopathy, hypotonia, and infantile-onset refractory epilepsy. We report a new case of ABAT deficiency that marks an important departure from previous clinical findings. The patient presented at age 6 months with global developmental delay, hypotonia, hypersomnolence and mild choreiform movements. At age 18 months, the subject's clinical presentation was still milder than all previously reported patients and, most notably, did not include seizures. Clinical whole exome sequencing revealed two heterozygous ABAT missense variants that are rare and predicted damaging, but never before reported in a patient and were reported as variants of unknown significance. To test the potential pathogenicity of the variants identified in this patient we developed a cell-based system to test both functions of the ABAT protein via GABA transaminase enzyme activity and mtDNA copy number assays. This systematic approach was validated using vigabatrin, the irreversible inhibitor of ABAT, and leveraged to test the functionality of all ABAT variants in previously reported patients plus the variants in this new case. This work confirmed the novel variants compromised ABAT function to similar levels as variants in previously characterized cases with more severe clinical presentation, thereby confirming the molecular diagnosis of this patient. Additionally, functional studies conducted in cells from both mild and severe patient fibroblasts showed similar levels of compromise in mitochondrial membrane potential, respiratory capacity, ATP production and mtDNA depletion. These results illustrate how cell-based functional studies can aid in the diagnosis of a rare, neurological disorder. Importantly, this patient marks an expansion in the clinical phenotype for ABAT deficiency to a milder presentation that is more commonly seen in pediatric genetics and neurology clinics.

Objective Conventional scales may help with the identification of depression but are generally too lengthy for clinical practice and perform poorly against anxiety and distress. We therefore examined the value of a single item NCCN Distress Thermometer and an enhanced visual-analogue method (Emotion Thermometers, ET) that incorporates four emotion thermometers. Methods We examined 228 patients with mixed cardiovascular conditions of whom 200 completed questionnaires. 64.5% suffered from cardiomyopathy/congestive heart failure, 9.5% had coronary artery disease, 4.5% had multiple cardiac diagnoses, 3% suffered from hypertension, 2% had rhythm problem, 2% had valve problems and 1.5% were diagnosed with atrial fibrillation. We used DSM-IV criteria to define current depression, the GAD7 to define current anxiety and the HADS-T to define distress. 13% had DSM-IV MDD and 19.1% had major or minor depression using DSM-IV (any depression). There were also 59 people (29.6%) with clinically significant distress and 46 with clinically significant anxiety (23.1%). Results The optimal accuracy for major depression was either the Depression thermometer (DepT) or the Help thermometer (HelpT), as both performed well. They had a sensitivity and specificity of 73.1%, 89.7% and 84.6%, 85.6%, respectively. The DepT was also best for detecting any DSM-IV depression (sensitivity 68.4% and specificity 93.2%) and HAD-T based distress (sensitivity 79.7% and specificity 82.9%). The Anxiety thermometer (AnxT) performed best against the GAD7 (sensitivity 84.8% and specificity 83.7%). Conclusion Innovative visual-analogue screening tools for mood appear to perform well in cardiovascular settings.

Atmospheric mercury pollution related to gold mining activities is a matter of concern in the Republic of Suriname. The first measurements of total gaseous mercury (TGM) in ambient air in Suriname at different sites are presented in this study. Our study shows that Suriname has a TGM mercury background level of 1.45–1.52 ng/m3, with a mean of 1.4 ng/m3 which is in agreement with global background concentrations (1.5–2.0 ng/m3) (Feng et al. Sci Total Environ 304:61–72, 2003; Li et al. Sci Total Environ 395:72–79, 2008). Emissions of mercury from gold buy up shops in the City of Paramaribo result in TGM maximum concentrations of 109.4 ng/m3 (15 min average) and a mean concentration level of 5.6 ng/m3 at this urban measurement location. These levels are comparable with that of world cities in Asia and North America. However, per capita Paramaribo loads 3.5–6.5 times more TGM into the atmosphere than Changchun City (Fang et al. Sci Total Environ 330:159–170, 2004) and the occurring spikes are 5.3 times higher and much longer in duration then those in New York City (Carpi and Chen Water Air Soil Pollut 140:371–379, 2002). According to health standard institutions these concentrations represent no risk for the general public. However, a survey inside and in the close vicinity (

The year 2007 was a year for visionary change in the field of civil engi- neering in the United States. This vision did not go unnoticed in the Caribbean. At the Department of Civil and Environmental Engineering of the University of the West Indies, the M.Sc. programs have been restructured to meet the U.K. Joint Board of Moderators requirements for academic accreditation and to fulfill the mandate of the vice chancellor to develop 12 desired attributes, with leadership being among them. A model was devel- oped in a course, Practical Team Project, to measure the learning outcome of leadership by combining the Project Management Institute body of knowledge areas and the Insti- tute of Civil Engineers (ICE) development objectives. The course prepares students for professional review at the Incorporated Engineering (I.Eng.) level with the ICE and gives them similar standing in other Washington Accord signatory countries. This new initia- tive for the university required innovative assessment techniques, such as 360-degree feedback and zero tolerance, to evaluate the demonstrated leadership of the graduate students. Analytical tools such as ANOVA and t-test were used to justify the effectiveness of the chosen model.

Bedside placement of postpyloric feeding tubes in surgical intensive care patients: a pilot series to evaluate two methods. Early enteral feeding is thought to be a key factor in maintaining the integrity of the gastrointestinal tract mucosal barrier associated with less bacterial translocation and decreased stimulation of the systemic inflammatory response and subsequent improved outcome in intensive care patients. Thus enteral feeding by nasogastric tubes is the preferred route of nutritional support for most surgical intensive care patients. However, intensive care patients with delayed gastric emptying and poor intestinal motility may not tolerate gastric feeding and may therefore benefit from postpyloric feeding. Postpyloric feeding tube placement may be achieved by endoscopic procedures or different bedside techniques with variable success. In the present study two feeding tubes for bedside postpyloric placement without endoscopic assistance were compared. The time to successful positioning was compared for jejunal feeding tubes from the companies Cook (Tiger 2™) and PortaMedical (Corflo-Tube®). The description for the Tiger 2™ states that because of its design slight residual peristalsis can cause it to migrate from the stomach to the jejunum. The Corflo-Tube® is also positioned at the bedside with the help of a detector and a monitor which maps the movements of the magnetic tip of the mandrin as it is pushed forward. Patients receiving early enteral nutrition through a gastric tube and exhibiting enhanced reflux, in spite of the head of the bed being raised and the administration of prokinetics randomly received either a Tiger 2™ or a Corflo-Tube®. The study included 41 patients from an intensive care ward for surgical patients and 13 out of 20 Tiger 2™-Tubes (65%) and 16 out of 21 Corflo-Tubes® (76%) were successfully positioned (p>0.05). The median time to successful positioning with the Corflo-Tubes® was 0.83 h (range 0.06–2.5 h), which was significantly shorter than the 24 h (range 2–72 h) found with the Tiger 2™ (p

Fort Keogh Livestock and Range Research Laboratory's Historic Role in the Settlement of the West and Present Contributions to Range Ecology and Livestock Research DOI:10.2458/azu_rangelands_v32i5_petersen

The highest rate of accidents and injuries in British industries has been reported by the construction industry during the past decade. Since then stakeholders have recognised that a possible solution would be to inculcate a good attitude towards health and safety risk management in undergraduate civil engineering students and construction professionals. Consequently, the four accreditation bodies that accredit construction degrees have improved coverage of health and safety risk management. The key issue has now shifted to ensure that Higher Education Centres deliver these requirements. This paper demonstrates innovative assessment methods that have been used to inculcate a safety conscious attitude into undergraduate civil engineering students, and to improve their knowledge of health and safety risk management. Surveys were administered to the students before and after they were subjected to innovative assessment techniques over two semesters in the construction management units. The analyses of the re...

Bei einem Patienten mit erworbenem Immundefektsyndrom (AIDS) beherrschte eine schwere Zytomegalievirus-(CMV-)Infektion mit Manifestationen am Gastrointestinaltrakt und an der Retina das klinische Bild. Die gastrointestinale Symptomatik - Durchfälle und rezidivierendes Erbrechen - fand autoptisch in einer Zerstörung der Tunica muscularis des Digestionstraktes ihr Korrelat. Die CMV-Retinitis führte zu fast vollständigem Visusverlust; dies war die Folge einer weitgehenden Zerstörung der Retina. Außer der generalisierten CMV-Infektion und einem disseminierten Kaposi-Sarkom, das sich ebenfalls am Gastrointestinaltrakt manifestierte und dort vergleichsweise diskrete pathologisch-anatomische Veränderungen verursachte, war bei der Autopsie noch ein malignes Lymphom des Gehirns vorhanden., In a patient with AIDS, severe cytomegalovirus (CMV) infection dominated with gastro-intestinal and retinal involvement. The gastro-intestinal signs - diarrhoea and recurrent vomiting - correlated with the destruction of the tunica muscularis of the digestive tract seen at post-mortem. The CMV retinitis caused an almost complete loss of sight, the consequence of extensive destruction of the retina. In addition to the generalized CMV infection and disseminated Kaposi's sarcoma, which also involved the gastro-intestinal tract and caused discrete histopathological changes, post-mortem examination revealed a malignant lymphoma of the brain.

Based on circulating C-reactive protein (CRP) levels, some individuals develop slightly increased inflammation as they age. In elderly inflamed rats, the muscle response to protein feeding is impaired, whereas it can be maintained by treatment with non-steroidal anti-inflammatory drugs (NSAIDs). It is unknown whether this applies to elderly humans with increased inflammation. Thus, the muscle response to whey protein bolus ingestion with and without acute resistance exercise was compared between healthy elderly individuals and elderly individuals with slightly increased inflammation±NSAID treatment.Twenty-four elderly men (60years) were recruited. Of those, 14 displayed a slightly increased systemic inflammation (CRP2mg/l) and were randomly assigned to NSAID (Ibuprofen 1800mg/day) or placebo treatment for 1week. The remaining 10 elderly individuals served as healthy controls (CRP1mg/l). The muscle protein synthetic response was measured as the fractional synthetic rate (FSR) and p70S6K phosphorylation-to-total protein ratio.The basal myofibrillar FSR and the myofibrillar FSR responses to whey protein bolus ingestion with and without acute resistance exercise were maintained in inflamed elderly compared to healthy controls (p0.05) and so was p70S6K phosphorylation. Moreover, NSAID treatment did not significantly improve the myofibrillar and connective tissue FSR responses or reduce the plasma CRP level in inflamed, elderly individuals (p0.05).A slight increase in systemic inflammation does not affect the basal myofibrillar FSR or the myofibrillar FSR responses, which suggests that elderly individuals with slightly increased inflammation can benefit from protein ingestion and resistance exercise to stimulate muscle protein anabolism. Moreover, the NSAID treatment did not significantly affect the myofibrillar or connective tissue FSR responses to protein ingestion and acute resistance exercise.

Bacillary angiomatosis is a cutaneous or visceral infection with Bartonella henselae or Bartonella quintana. Cases usually occur in HIV infected individuals. We present a 60-year-old man with chronic lymphocytic leukemia and neutropenic fever caused by bacillary angiomatosis. The nine BA cases in oncology patients are reviewed.

BACKGROUND: Although the randomized controlled trial (RCT) is regarded as the gold standard for evaluation of the effect of an intervention, its external validity has been questioned. RCTs cannot be expected to produce results that are directly relevant to all patients and all settings, but they should at least allow patients and clinicians to judge to whom trial results can reasonably be applied. We assessed the external validity of an RCT investigating the efficacy of a fast-track program after total hip replacement. METHODS: 130 patients were identified as potential participants.18 patients were excluded, 33 enrolled patients declined to participate, and 79 patients were enrolled and randomized. We studied the distribution of preoperative characteristics and postoperative clinical variables in these 3 groups. RESULTS: A significant difference was found in both preoperative characteristics and clinical outcome variables. The non-consenters were older, less healthy, and needed more help from the home care system. Furthermore, they were hospitalized longer and were more often transferred to a rehabilitation ward. INTERPRETATION: Our findings demonstrate the importance of patient inclusion criteria in RCTs. Moreover, they may account for the lack of reproducibility of RCT results in clinical practice dealing with fast-track programs. Udgivelsesdato: 2007-Feb

Ranching is a challenging and sometimes risky business, with cattle production (and associated enterprise income) largely being dependent on seasonal weather patterns and corresponding forage production. To help reduce this risk, the USDA–Agricultural Research Service performed a multistate study of seasonal weather effects on cattle production across the Northern Great Plains (Wyoming, North Dakota, and Montana). Cool, wet springs and longer, cooler growing seasons increased cattle production across the Northern Great Plains. Knowledge of these seasonal weather influences on cattle production is important for management decision making, but practical application of this knowledge remains problematic. Increased enterprise flexibility to deal with variable forage production can be achieved by using seasonal weather forecasts, as well as reducing base cow-calf herd numbers to less than 100% of typical ranch carrying capacity. Yearlings or seasonal contract grazing can then be used to increase grazing to use additional forage in good years. Recently launched USDA Regional Climate Hubs will deliver science-based knowledge, practical information, management and conservation strategies, and decision tools to ranchers that will help them adapt to weather variability and changing climatic conditions. Fil: Reeves,Justin L.. US Dept of Agriculture. Agricultural Research Service. Rangeland Resources Research Unit; Estados Unidos Fil: Derner, Justin D.. US Dept of Agriculture. Agricultural Research Service. Rangeland Resources Research Unit; Estados Unidos Fil: Sanderson, Matt A.. US Dept of Agriculture. Agricultural Research Service. Northern Great Plains Research Laboratory; Estados Unidos Fil: Kronberg, Scott L.. US Dept of Agriculture. Agricultural Research Service. Northern Great Plains Research Laboratory; Estados Unidos Fil: Hendrickson, John R.. US Dept of Agriculture. Agricultural Research Service. Northern Great Plains Research Laboratory; Estados Unidos Fil: Vermeire, Lance T.. US Dept of Agriculture. Agricultural Research Service. Ft Keogh Livestock and Range Research Laboratory; Estados Unidos Fil: Petersen, Mark K.. US Dept of Agriculture. Agricultural Research Service. Ft Keogh Livestock and Range Research Laboratory; Estados Unidos Fil: Irisarri, Jorge Gonzalo Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; Argentina. University of Wyoming. Department of Agricultural and Applied Economics; Estados Unidos

The effective and efficient management of buildings necessitates, amongst other aspects, the ability to interrogate reliable data relating to condition, cost implications of that condition and the spend options available and appropriate. Most buildings have been subject to one or more surveys and data from these is often available to the building owner, manager or user. The form and value of such data is, however, variable in the extreme and is, not least, relevant mainly to the organization or person who commissioned that particular survey. This paper introduces a quantitative model for the repair and maintenance of buildings/properties. It is based on a coded system of observing, assessing, recording and appraising the condition of those elements of a building which would most influence the costs of repairing or maintaining elements of, or the whole of, buildings. Background information and criteria for the development of this model is detailed in this paper and also, the model matrix system defining the step-by-step calculation process of cost of repair and maintenance has been reported. A detailed report on a case-study (application of the model) consisting of the data collection and cost analysis of a property is also provided. The case-study includes a comparison between the predicted cost of repair and the real cost of repair (cost after completion of repair work) concerning a residential dwelling.

An empirical study of practitioners in the newSouth Africa found no evidence that respondents grouped public relations practices according to principles of symmetry or asymmetry, thus rejecting the notion of symmetry as a normative public relations approach in international settings. Instead, South African practitioners developed their ownculture-specific models of practice basedonthe economic, social, and political realities of their country. These included the conflict-based Western Dialogic model rooted in dissensus, the Activist model promoting change in organizations, theUbuntu model favoring harmony and reconciliation in theworkplace, and the Oral Communication model focusing on the use of oral media in the communication process. Practitioners' demographic characteristics did not influence their use of public relations models, most probably because of the similarity of their public relations education, which seemed to emphasize a focus on the characteristics of an organization's publics in the commu...

Introduction Rectal function following rectal resection for carcinoma was studied in 43 patients. Methods Sixteen women and 27 men with a median age of 66 years (range 41–79 years) were included. Twenty-three patients had a diverting ileostomy at the time of resection. Eight patients had a 6-cm colonic J-pouch. Ten patients had anastomotic leakage including two patients without diverting ileostomy. One patient had pre-operative radiation with 25 Gy. The patients were studied at a median 12 months (range 3–30) after rectal resection. Distance from anal verge to the anastomosis was a median 7 cm (range 3–12 cm). Clinical data, anal manometry and rectal compliance were analysed. Results Stool frequency was 3 per day (range 1–10). Twenty-two (51%) patients were continent, 11 (26%) were incontinent for flatus, and 10 (23%) were incontinent for faeces (three for liquid and seven for solid stool). Fourteen (33%) patients had constipation, two of whom also had incontinence for solid or liquid stool. The level of the anastomosis for patients with postoperative constipation was 5 cm (range 3–12 cm), while it was 7 cm (range 3–10 cm) for nonconstipated patients (NS). Anal manometry was normal. Rectal compliance was lower in patients with incontinence for liquid or solid faeces than in patients with flatus incontinence only (P