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Objects are inert, passive, devoid of will, and as such bear no intrinsic value or moral worth. This claim is supported by the argument that to be considered a moral agent one must have a conscious will and be sufficiently free to act in accordance with that will. Since material objects, it is assumed, have no active will nor freedom, they should not be considered moral agents nor bearers of intrinsic ethical vale. Thus, the apparent “moral neutrality” of objects rests upon a kind of subject/object or mind/body dualism. The aim of this paper is to explore two paths by which western thought can escape this dualism, re-valuate the alleged “moral neutrality” of material objects, and initiate a sort of “object oriented ethics,” albeit with surprising results. To do so, this paper explores the work of Arthur Schopenhauer and Baruch Spinoza to interrogate both the claim that material objects have no will and that freedom is the necessary condition for ethical responsibility. This paper concludes by arguing that not only should objects been seen as bearers of their own ethical value, a determinate judgement can be made regarding that value through a basic understanding of the laws of physics.

Introduction: Patients within the US Veterans Health Administration (VA) system have higher rates of comorbidities and chronic pain, increasing risks of complications/poor outcomes following spine surgery. Although the use of bone morphogenetic protein 2 (BMP-2) is established for anterior lumbar interbody fusion, its indications for off-label use in posterolateral fusion are unclear. The objective of this study was to evaluate safety and utility of BMP-2 in posterolateral fusion through a 15-year experience at the VA., Methods: Patients underwent posterolateral lumbosacral fusions with BMP-2 by a single VA surgeon from January 1, 2005, to January 1, 2020. The primary outcome was fusion assessed through postoperative radiographs. Secondary outcomes included adjacent segment disease (ASD) and postoperative pain clinic utilization., Results: Sixty-eight patients underwent lumbosacral posterolateral fusion with BMP-2; 77.9% were discharged home and had no postoperative complications. All patients achieved bony fusion at a mean of 113.3 ± 59.9 days postoperatively. Five patients were diagnosed with cancer postoperatively, and eight patients required revision for ASD. No notable predictors of ASD exist. Preoperative opioid use predicted postoperative pain clinic utilization., Discussion: Posterolateral lumbar fusion with BMP-2 in veterans yields high fusion rates and favorable complication profiles and should be considered in multimorbid hosts., Study Design: Retrospective review of prospectively collected data., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Hemophilia A and B are chronic inherited bleeding disorders that together rank as one of the most expensive chronic diseases in the United States. Factor replacement products, which are the mainstay of treatment, are among the most expensive therapies, with a total annual cost of more than $250,000 per adult patient in the United States. Indirect costs also contribute to the economic burden and include lost productivity, caregivers' unpaid costs, and hemophiliarelated disability. Advances in hemophilia care have resulted in longer survival and a growing patient population, greater complexity in management of the disorder, and rising treatment costs. The establishment of federally recognized Hemophilia Treatment Centers has decreased costs and improved patient outcomes and quality of life by promoting outpatient, preventive, and homebased care. Successful collaboration among providers and managed care programs can improve outcomes and decrease costs for the delivery of hemophilia services.

A study of the reaction between gaseous aldehydes and amines has implicated proton transfer from wall-associated water. Carbinolamine formation and subsequent dehydration to imine with assistance by wall associated hydroxyl bearing species has not previously been specifically suggested to obtain in the multitude of enzyme processes using pyridoxal cofactor. However, the data now available make it clear that imine formation in the active site of those systems requires at least one water or hydroxyl bearing amino acid for proton transfer.

The reaction that occurs when vapors of 2,2-dimethylpropanal and methanamine are allowed to mix in an infrared gas cell has been examined. The disappearance of starting materials and formation of E-imine product, monitored simultaneously, is best fit by a process involving wall-associated water. The same or closely related processes have been successfully modeled; such processes may also be common to pyridoxal-catalyzed transamination and related reactions in biological systems.

Although meditation has been practiced worldwide for centuries, there are no reports that it causes epilepsy or increases the predisposition to it. Medical care utilization statistics and clinical studies indicate that individuals who regularly practice the Transcendental Meditation technique have fewer problems of the nervous system and specifically show decreased symptoms of epilepsy. The frequency, amplitude, areas of activation, and effects of the EEG during the Transcendental Meditation technique are completely different from those of epilepsy. There is no evidence that the Transcendental Meditation technique increases glutamate, which has been associated with epilepsy. With regard to serotonin, the relationship of serotonin to epilepsy has to be viewed in the context of the abnormal brain tissue that causes epilepsy. The serotonin increases that may occur through meditation have been associated with only beneficial effects.

Improved protocols for the preparation of 1-bromodihydrocodeinone (1-bromohydrocodone) and 1-bromo-14-hydroxydihydrocodeinone (1-bromooxycodone) and synthesis of the corresponding 1-chloro and 1-iodo derivatives have been achieved using the corresponding N-halosuccinimides in acidic milieu. The corresponding 1-carboethoxy derivative of 14-hydroxydihydrocodeinone (1-carboethoxyoxycodone) has been prepared by Pd-catalyzed reaction with carbon monoxide in ethanol. The ester was hydrolyzed to the corresponding zwitterionic amino acid.

Beginning with (+)-serine or (-)-serine, as appropriate, convenient, high-yield, enantioselective synthesis of all eight stereoisomeric 2-hydroxymethyl-3,4-dihydroxypyrrolidines (the enantiomeric pairs of iminoribitol, -arabinitol, -xylitol, and -lyxitol) can be effected. The absolute configuration of the starting amino acid defines the set of azasugars produced.

The previously reported reaction of tolazamide with nitrite, under physiological conditions, to form N-nitrosohexamethyleneimine and surprisingly, N-nitrosopiperidine was confirmed. By using the six-membered ring analogue of tolazamide, 1-(piperidyl)-3-(p-tolylsulfonyl)urea, which yields the corresponding N-nitrosopiperidine and N-nitrosopyrrolidine, the present study shows that an unusual ring contraction occurs, excising the carbon alpha to the nitrogen.

The amount of tin(II) required for adequate reduction, complexation, and stability of technetium Tc 99m pertechnetate in radiopharmaceutical kits, and methods of preventing the loss of tin(II) during formulation of these lyophilized kits are investigated. Tin(II) loss from stannous chloride solutions was studied under several conditions, including room air versus nitrogen atmospheres, during vial filling in a laminar-flow hood with samples frozen on dry ice versus samples at room temperature, during lyophilization, and during storage under refrigerated, ambient, and elevated temperatures. Various amounts of stannous chloride, ranging from 5 to 1000 microgram/ml, were used in formulating sodium pertechnetate Tc 99m kits containing 100 mCi technetium Tc 99m and 0.4 microgram total technetium. Samples were removed at various times; hydrolyzed technetium, pertechnetate, and technetium Tc 99m pyrophosphate were isolated on instant thin-layer chromatography-silica gel and quantified with a scintillation counter. The time necessary to deoxygenate distilled water by nitrogen purging was measured. Several sources of stannous chloride were assayed for tin(II) content. Tin(II) loss occurs rapidly in solution (15% in one hour) unless continuously protected with nitrogen, and during vial filling in a laminar-flow hood unless frozen with dry ice. No substantial loss of tin(II) was detected during lyophilization or during storage of lyophilized product at any of the three temperatures. A minimum of 400 microgram tin(II) was required to provide 90% technetium Tc 99m pyrophosphate at six hours after preparation. Adequate deoxygenation of small quantities (450 ml) of water was accomplished in less than one hour. Some stannous chloride salts were highly oxidized in the dry state, and only high-purity elemental tin wire gave acceptable yields of tin(II).

The negative impact of turnover is well documented in the literature. This paper examines turnover with a unique, positive focus. Turnover is reviewed, not only from the standpoint of the organizational theorist, but with economic, sociological, and psychological/social psychological perspectives. Often ignored benefits of turnover are noted.

The grievance procedure can be a very expensive proposition. Here's a listing of the most commonly filed grievances and what to expect when you're confronted by them.

An inexpensive system has been devised for the efficient transfer of Xe-127 gas from the manufacturer's ampule into individual dose vials for patient use. By displacing the gas with an aqueous solution, the initial transfer is made from an ampule of known activity into an evacuated serum vial of predetermined volume with transfer efficiency greater than 99%. A similar principle is used to transfer Xe-127 from the stock serum vial into individual dose vials, with total xenon recovery exceeding 98%. Ability to deliver the desired activity to each vial is within 90-110% of that predicted by calculation. Reproducibility in delivering a given activity was excellent, with all vials falling between 95 and 105% of the mean activity. Stability studies showed that 94% of the Xe-127 activity can be removed from the vials with only 6% absorbed in the rubber stopper after 5 wk of storage. The device costs less than $25.00 and can be constructed easily from common laboratory materials.

High levels of turnover have traditionally been viewed by human resources managers as having a negative effect on the organization. But the authors--Idalene F. Kesner, associate instructor in business policy, and Dan R. Dalton, assistant professor of administrative and behavioral studies, both at the Graduate School of Business, Indiana University--maintain that responsible levels of employee turnover may have both direct and indirect benefits for the organization. Such benefits include displacement of poor performers, an infusion of new knowledge in the organization, and the stimulation of changes in policies and practices. In addition, of course, there are opportunities for cost reduction and consolidation. Using data compiled from the experience of a California public utility, the authors show how to calculate the direct, hard-dollar value of the savings that can be realized in regular pay, overtime pay, pension contributions, earned but unused sick leave, and other areas.