Marquette General Hospital

Firearm-related injuries are the leading cause of death among youth in the United States, and rates of firearm-related suicide in rural youth are more than double those in urban youth. Although safe firearm storage has been shown to reduce firearm injuries, little is known about how to culturally tailor such interventions for rural families in the United States. Informed by community-based participatory methods, focus groups and key informant interviews were conducted to design a safe storage prevention strategy for rural families. Participants included a broad array of community stakeholders (n = 40; 60% male, 40% female; age 15-72, M = 36.9, SD = 18.9) who were asked to identify acceptable messengers, message content, and delivery mechanisms that were perceived as respectful to the strengths of rural culture. Independent coders analyzed qualitative data using an open coding technique. Emerging themes included (1) community norms, values, and beliefs about firearms; (2) reasons for ownership; (3) firearm safety; (4) storage practices; (5) barriers to safe storage; and (6) suggested intervention components. Firearms were described as a "way of life" and family tradition in rural areas. Owning firearms for hunting and protection influenced family storage decisions. Intervention strategies that use respected firearm experts as messengers, refer to locally derived data, and that reflect community pride in firearm safety and responsible ownership may improve the acceptability of prevention messages in rural areas.

Environmental factors in saxicolous lichen communities are scale dependent, yet the influence of scale is not often specifically addressed in ecological studies. This study examined three scales [micro (cm), meso (meters–10s of meters), macro (km)] in granite rock communities and compared species assemblages and disturbance regimes in Lake Superior shoreline and inland habitats. Percent cover of lichens and environmental variables were measured in 1280 20 × 20-cm plots across 16 sites (8 lakeshore and 8 inland). A perMANOVA analysis showed that the composition of lakeshore and inland lichen communities was significantly different (F=17.2, df=1,4, P <0.001). Adjacent lakeshore sites were more similar (F=8.550; df = 1, 26; p=0.007) to each other than they were to sites further away, while inland sites were not (F=0.545; df=1, 26; p=0.467). Variation in disturbance is likely more important in determining inter-site variation in inland areas. Mesoscale environmental variables such as solar radiation, height above Lake Superior, and an aspect/slope index were better predictors of species assemblages than microscale variables. However, individual species differed greatly in their associations with specific habitat variables. A host of microhabitats were discovered, with some lichens specializing on rock overhangs, quartz veins, cracks, subtle variations in rock texture, and mafic intrusions within granite.

Taking Aim at Attack Advertising: Understanding the Impact of Negative Campaigning in U.S. Senate Races. By Kim L. Fridkin and Patrick J. Kenney. New York: Oxford University Press, 2019. 266p. 27.95 paper. - Volume 17 Issue 4

Three generations of Co(iii)-salen complexes containing electron-deficient aromatic moieties (acceptors) have been synthesized. When electron-rich aromatic compounds (donors) were introduced, these complexes were designed to form catalyst assemblies through aromatic donor-acceptor interaction. For all three generations of complexes, the addition of a proper donor led to higher catalytic efficiency in the hydrolytic kinetic resolution (HKR) of epichlorohydrin. The reaction rates are in the following order: Generation 3 > Generation 2 > Generation 1. The aromatic donor-acceptor interaction was verified by NMR spectroscopy and UV-vis absorption spectroscopy studies. These results demonstrated that aromatic donor-acceptor interaction can be a valuable driving force in the assembly of supramolecular catalysts.

Johnson, Stuart K. DO; Bidle, David MD; O'Connor, Christopher MD, MPH; Van Antwerp, Jason MD Author Information

This study builds on prior theory and research within the Attention Based View (ABV) and competitive dynamics fields by examining changes in the patterns of strategic actions in the context of the recent financial crisis. Past research has examined firm adaptation to significant environmental change, but only in the context of deregulation or strikes rather than a prolonged economic crisis. We posit that during the crisis, managers’ focus of attention will shift thus the issues and resulting answers will result in fundamental changes to prior patterns of strategic actions. Specifically, we find that firms pursue less complex strategies reflected in more limited repertoires of actions, while simultaneously engaging in an increased volume of actions.

Background:In this video-abstract, we present a one burr-hole craniotomy for the upper retrosigmoid approach developed in Helsinki Neurosurgery to access the lateral cerebellar hemisphere, the cerebellopontine angle, and lateral skull base (e.g. including the posterior petrous bone). This approach may be utilized to manage tumors of the lateral posterior fossa and to perform microvascular cranial nerve decompression of the V or VII cranial nerves. The upper portion of the vertebral-posterior cerebral artery complex, and the anterior inferior cerebellar artery may also be accessed with this technique. Even though the specific location and size of the lesion may vary, this approach accesses all mentioned structures with a very minimal variation.Case Description:The patient with an unsuspected right cerebellopontine angle metastasis from a lung cancer is placed in the park bench position. Spinal drainage is inserted to release 50–100 ml of cerebrospinal fluid. The head and upper torso are elevated so that the head is about 20 cm above the heart level. A single-layer skin incision is made about one inch behind the mastoid process; the exact cranial to caudal location of the incision varies depending on how high or low one has to be from the foramen magnum and locus of pathology. The junction of the sigmoid and the transverse sinus is usually located just caudal to the zygomatic line, between the zygoma and the external occipital protuberance, and posterior to the mastoid line that is running caudally through the tip of the mastoid process. Dissection with curved retractors creates a clean space for the craniotomy. First, a burr-hole is made at the posterior border of the bone flap. Two curved cuts are made towards the mastoid process, allowing the sigmoid sinus to be partially exposed. The bone is cracked after thinning the anterior border of the craniotomy. A few drill holes are then made for tacking-up sutures. Finally, a sinus-based dura opening is performed under the microscope.Conclusion:Here, we described a one burr-hole craniotomy that provides an excellent approach to retrosigmoid lesions.Videolink:http://surgicalneurologyint.com/videogallery/retrosigmoid-approach