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223 Surgical Management of Degenerative Cervical Myelopathy: Comparing Outcomes Between Patients Admitted Through Clinic Versus Emergency Department
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- Dagoberto Pina, Jared Watson, Alex Villegas, Zachary Booz, Joseph Holland, Micaela White, Gabriel Santamaria, Joseph Wick, Wyatt Vander Voort, Brandon Ortega, Keegan Conry, Yashar Javidan, Rolando Roberto, Eric Klineberg, Shaina Lipa, Hai Le
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue s1 / April 2023
- Published online by Cambridge University Press:
- 24 April 2023, pp. 68-69
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OBJECTIVES/GOALS: Degenerative cervical myelopathy (DCM) can lead to pain, disability, and permanent spinal cord impairment. Timely diagnosis and surgical intervention is essential to optimize functional outcomes for patients with CSM. Here, we compared patients who were admitted through clinic versus the emergency department (ED) for surgical management of DCM. METHODS/STUDY POPULATION: Patients aged ≥18 years admitted for surgery for DCM through clinic (elective cohort) were compared to a surgical cohort who were evaluated through the ED (call cohort). Basic demographics included age, gender, race, ethnicity, and insurance payor. Sociodemographic characteristics were estimated using the Social Deprivation Index (SDI) and the Area Deprivation Index (ADI) for the state of California, which were obtained through aggregated Zip Code Tabulation Area (ZCTA). Cervical MRI was reviewed to assess severity of spinal cord compression. Other outcomes included number of motion segments operated on, functional outcome using the Nurick classification, length of stay (LOS), disposition, and 30-day reoperation and readmission rates. RESULTS/ANTICIPATED RESULTS: From 2015 to 2021, 327 DCM patients received surgery (227 Elective Cohort, 100 Call Cohort). Elective cohort was mainly female (48.0 vs 30.0%, p=0.002) and white (72.7 vs 51.0%, p=0.0001). Call cohort was mainly uninsured/covered by Medicare/Medicaid (78.0 vs 67.0%, p=0.04), had higher SDI (68.0 vs 56.2, p=0.0003), ADI (7.9 vs 7.2, p=0.009), and cervical cord compression on MRI (78.0 vs 42.3% Grade III, p DISCUSSION/SIGNIFICANCE: Compared to DCM patients undergoing elective surgery, those admitted through the ED were more likely to be male, non-White, and socioeconomically disadvantaged, as measured by SDI and ADI. Postoperative outcomes were less favorable for these patients, including longer hospital stay, discharge disposition, and less Nurick grading improvement.
Super-Hydrophilic, Bio-compatible Anti-Fog Coating for Lenses in Closed Body Cavity Surgery: VitreOxTM – Scientific Model, In Vitro Experiments and In Vivo Animal Trials
- Nicole Herbots, Clarizza F. Watson, Eric J. Culbertson, Ajjya J. Acharya, Pierre R. Thilmany, Steven Marsh, Raymond T. Marsh, Igor P.O. Martins, Gabriel P.K. Watson, A.M. Mascareno, Saloni Sinha, Mayuri Gupta, Nehal Gupta, Abijith Krishnan
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- Journal:
- MRS Advances / Volume 1 / Issue 29 / 2016
- Published online by Cambridge University Press:
- 22 June 2016, pp. 2141-2146
- Print publication:
- 2016
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Lenses in laparoscopes, arthroscopes, and laryngoscopes fog during closed body surgery due to humidity from bodily fluids and differences between body and operating room temperatures.1,2 Surgeons must repeatedly remove, clean, and reinsert scopes that are obscured by fog. As a result, surgery duration, infection risks, and scarring from air exposure increase.3,4 Current methods to address fogging introduce other complications. Acidic alcohol-based coatings scar tissue and quickly evaporate, and heated lenses require reheating every 5 to 20 minutes.3,4 This paper presents a new super-hydrophilic, biocompatible, non-toxic, pH neutral (7.2-7.4), and long-lasting anti-fog coating called VitreOx™.5-7 VitreOx™ can be used wet or dry, without use of alcohol, heat, or fluid evacuation. When applied as a liquid, it easily espouses lenses’ surfaces and edges, and dries within seconds to form a permanently super-hydrophilic surface on silica and polymer surfaces. VitreOx™ avoids current shortfalls by eliminating frequent reapplications, avoiding reapplication for surgeries lasting up to 72 hours.
VitreOx™'s anti-fog properties can be explained by nucleation and growth theory for thin films condensation: 1) 3-D droplets, resulting in fogging; 2) 2-D sheets resulting in a flat transparent film; or 3) mixed 3-D on 2-D, resulting in optical distortion. On hydrophobic surfaces (e.g. lenses), condensation occurs with fogging via spherical 3-D droplets, as in the Volmer-Weber model. 3-D droplets scatter light in all directions through refraction yielding opaque or translucent films (fog). VitreOx™ applied to hydrophobic lenses renders them super-hydrophilic. Similar to the 2-D Frank Van-der-Merwe Growth Mode, condensation with uniform wetting yields transparent 2-D films that do not distort optical images transmission.
In vitro and in vivo studies of VitreOx™ were conducted to measure performance and duration of anti-fog effectiveness and bio-compatibility. In vitro tests spanned from 3 to 72 hours over a 3-year range. Side-by-side in vivo gastro-endoscopies were conducted on Yucatan™ swine for 90 minutes using 1) VitreOx™, 2) bare lens, and 3) Covidien Clearify™ surfactant with warmer. VitreOx™ coated lenses did not fog nor need reapplication for 90 minutes, while Covidien Clearify™ lasted 38 minutes without fogging, requiring retreatment. No adverse reaction was observed on swines exposed toVitreOx™, in surgery and 12 months thereafter.
Chapter 25 - Policies for Capacity Development
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- By Lynn Mytelka, United Nations University-MERIT, Francisco Aguayo, El Colegio de México, Grant Boyle, McCarthy Tétrault LLP, Sylvia Breukers, Duneworks, Gabriel de Scheemaker, Conduit Ventures Ltd., Ibrahim Abdel Gelil, Arabian Gulf University, René Kemp, United Nations University-MERIT, Joachim Monkelbaan, International Centre for Trade and Sustainable Development, Carolina Rossini, University of São Paulo, Jim Watson, University of Sussex, Rosemary Wolson, Council for Scientific and Industrial Research, Staffan Jacobsson, Chalmers University of Technology, Upendra Tripathy, Government of India, John T. Wilbanks, The Ewing Marro Kauffman Foundation, Youba Sokona, United Nations Economic Commission
- Global Energy Assessment Writing Team
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- Book:
- Global Energy Assessment
- Published online:
- 05 September 2012
- Print publication:
- 27 August 2012, pp 1745-1802
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Summary
Executive Summary
This chapter focuses on capacities and capacity development for energy transitions. The transitions put forward in GEA require a transformation of energy systems that demand significant changes in the way energy is supplied and used today, irrespective of whether the technologies involved are new to the world or to a country, its producers or users.
Energy transitions are, by definition, long-term, socially embedded processes in the course of which capacities at the individual, organizational, and systems levels, as well as the policies for capacity development themselves, will inevitably change. From this perspective, capacity development can no longer be seen as a simple aggregation of individual skills and competences or the introduction of a new “technology.” Rather, it is a broad process of change in production and consumption patterns, knowledge, skills, organizational forms, and – most importantly – in the established practices and norms of the actors involved, or what are called informal institutions. In other words, a host of new and enhanced capacities will be needed over time. Informal institutions are reflected in a range of beliefs and boundaries that shape choices about new energy technologies. These can include engineering beliefs about what is feasible or worth attempting and boundaries that shape the processes of choice, such as lines of research to pursue, kinds of products to produce, or practices of consultation and dialogue. They also emerge as “path dependence” in contexts where earlier investments result in high sunk costs, habits and practices are entrenched, and “expert views” are shaped by earlier thinking that narrows the range of choices to established technologies and evaluation techniques.
Contributors
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- By Ashok Agarwal, Carrie Bedient, Nick Brook, Michelle Catenacci, Ying Cheong, Francisco Domínguez, Thomas Elliott, Sandro C. Esteves, Tommaso Falcone, Gabriel de la Fuente, Eugene Galdones, Juan A. Garcia-Velasco, David K. Gardner, Tamara Garrido, Robert B. Gilchrist, Georg Griesinger, Roy Homburg, Jeanine Cieslak Janzen, Mark T. Johnson, Jennifer Kahn, David L. Keefe, Efstratios M Kolibianakis, Laurie J. McKenzie, Nick Macklon, David Meldrum, Ashley R. Mott, Tetsunori Mukaida, Zsolt Peter Nagy, Edurne Novella-Maestre, Chris O’Neill, Chikaharo Oka, Steven F. Palta, Lewis K. Pannell, Antonio Pellicer, Valeria Pugni, Botros R. M. B. Rizk, Christopher B. Rizk, Claude Robert, Denny Sakkas, Hassan N. Sallam, William B. Schoolcraft, Lonnie D. Shea, Carlos Simón, Manuela Simoni, Marc-Andre Sirard, Johan E. J. Smitz, Eric S. Surrey, Jan Tesarik, Raquel Mendoza Tesarik, Jeremy G. Thompson, Andrew J. Watson, Teresa K. Woodruff
- Edited by David K. Gardner, University of Melbourne, Botros R. M. B. Rizk, University of South Alabama, Tommaso Falcone
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- Book:
- Human Assisted Reproductive Technology
- Published online:
- 16 May 2011
- Print publication:
- 31 March 2011, pp ix-xii
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Personality as a risk factor in large bowel cancer: data from the Melbourne Colorectal Cancer Study
- Gabriel A. Kune, Susan Kune, Lyndsey F. Watson, Claus Bahne Bahnson
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- Journal:
- Psychological Medicine / Volume 21 / Issue 1 / February 1991
- Published online by Cambridge University Press:
- 09 July 2009, pp. 29-41
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In a case control study which formed one arm of a large, population-based investigation of colorectal cancer incidence, aetiology and survival, ‘The Melbourne Colorectal Cancer Study’, among others, 22 psychosocially orientated questions were asked by personal interview of 637 histologically confirmed new cases of colorectal cancer and 714 age/sex frequency matched community controls, from Melbourne (population 2·81 million). Self-reported childhood or adult life ‘unhappiness’ was statistically significantly more common among the cancer cases, while ‘unhappiness with retirement’ was similarly distributed among cases and controls. Questions which were formulated to test a particular personality profile as a cancer risk, and which included the elements of denial and repression of anger and of other negative emotions, a commitment to prevailing social norms resulting in the external appearance of a ‘nice’ or ‘good’ person, a suppression of reactions which may offend others and the avoidance of conflict, showed a statistically significant discrimination between cases and controls. The risk of colorectal cancer with respect to this model was independent of the previously found risk factors of diet, beer intake, and family history of colorectal cancer, and was also independent of other potential confounding factors of socioeconomic level, marital status, religion and country of birth. Although the results must be interpreted with caution, the data are consistent with the hypothesis that this personality type may play a role in the clinical expression of colorectal cancer and was also independent of other potential confounding factors of socioeconomic level, marital status, religion and country of birth. Although the results must be interpreted with caution, the data are consistent with the hypothesis that this personality type may play a role in the clinical expression of colorectal cancer and merits further study.
1 - Climate Variation, Vulnerability and Sustainable Development in the Semi-arid Tropics
- Edited by Jesse C. Ribot, World Resources Institute, Washington DC, Antonio Rocha Magalhães, Ministry of Planning, Brazil, Stahis Panagides
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- Book:
- Climate Variability, Climate Change and Social Vulnerability in the Semi-arid Tropics
- Published online:
- 02 December 2009
- Print publication:
- 27 June 1996, pp 13-52
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Summary
INTRODUCTION
This chapter aims to capture the central issues that emerged from the papers, presentations and discussions at the International Conference on the Impacts of Climatic Variations and Sustainable Development in Semi-arid Regions (ICID), held in Fortaleza-Ceará, Brazil from 27 January through 1 February 1992 (see Preface). But, given the breadth and depth of the 76 papers and the wide-ranging discussions during the conference, this chapter could cover only a small subset of the issues that arose. We chose to focus on the plight of socially, politically, economically and spatially marginal populations in semi-arid lands, and the urgent need for environmentally sound and equitable development efforts. These themes recurred throughout the papers, presentations and discussions at the conference.
This chapter draws from the materials and information presented at the conference, as well as the broader literature where relevant. While the themes within this chapter are derived largely from the conference, the arguments are shaped – as could not have been otherwise – by the experiences and perspectives of the authors. We did not try to represent the scope nor the depth of the issues covered at the conference, but rather, to characterize the problems and opportunities, and to explore what we felt were the most pressing concerns within the semi-arid regions of the world.
Climate variability, natural resources and development in semi-arid regions
Vulnerability to dislocation, hunger and famine are the most critical problems facing the inhabitants of semi-arid lands. These regions are subject to extreme variations in their relatively scant seasonal and inter-annual precipitation, resulting in recurrent droughts and floods.
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