McMillan and Moss Research

Despite advancements in treatment and HIV viral suppression, people with HIV experience a risk of myocardial infarction that is 1.73 times higher than in people without HIV.[1][1] Believed to be in part a result of chronic low-grade inflammation, atherosclerotic cardiovascular disease (ASCVD)

To analyze the association of a surgeon's experience with postoperative outcomes of pancreatoduodenectomies (PDs) when stratified by Fistula Risk Score (FRS). Centralization is now well-established for pancreatic surgery. Nevertheless, the benefits of individual surgeon's experience in high-volume settings remain undefined. Pancreatoduodenectomies performed by 82 surgeons across 18 international specialty institutions (median: 140 PD/year) were analyzed. Surgeon cumulative PD volume was linked with postoperative outcomes through multivariable models, adjusted for patient/operative characteristics and the FRS. Then, surgeon experience was also stratified by the 10, previously defined, most clinically impactful scenarios for clinically relevant pancreatic fistula (CR-POPF) development. Of 8189 PDs, 18.7% suffered severe complications (Accordion≥3), 4.8% were reoperated upon and 2.2% expired. Although the most experienced surgeons (top-quartile; >525 career PDs) more often operated on riskier cases, their experience was significantly associated with declines in CR-POPF ( P <0.001), severe complications ( P =0.008), reoperations ( P <0.001), and length of stay (LOS) ( P <0.001)-accentuated even more in the most impactful FRS scenarios (2830 patients). Risk-adjusted models indicate male sex, increasing age, ASA class, and FRS, but not surgeon experience, as being associated with severe complications, failure-to-rescue, and mortality. Instead, upper-echelon experience demonstrates significant reductions in CR-POPF (OR 0.66), reoperations (OR 0.64), and LOS (OR 0.65) in moderate-to-high fistula risk circumstances (FRS≥3, 68% of cases). At specialty institutions, major morbidity, mortality, and failure-to-rescue are primarily associated with baseline patient characteristics, while cumulative surgical experience impacts pancreatic fistula occurrence and its attendant effects for most higher-risk pancreatoduodenectomies. These data also suggest an extended proficiency curve exists for this operation.

There has been a great deal said in the literature about what would be librarians can do to find a job; less has been said about what would be employers can do if they are having problems recruiting. This article gives some ideas about things that libraries, especially those in rural areas, can do to help them find the employees they need. There are many possibilities discussed, including helping spouses of new hires get jobs in the community, hiring from out of region or country, hiring older workers or new grads, reconsidering what competencies are core for the position and what tasks should be in the job description. The world has changed for job seekers, who must now show that they are more than competent to be competitive, and perhaps it needs to change for employers too. If you don’t think the job you are posting is a great opportunity, then potential applicants likely won’t either.

Book Review| June 01 2009 Review: Moderns Abroad: Architecture, Cities, and Italian Imperialism, by Mia Fuller Moderns Abroad: Architecture, Cities, and Italian Imperialism, by Mia Fuller. New York: Routledge, 2007, 273 pp., 90 b/w illus. $125, ISBN 0415194636. Anne Parmly Toxey Anne Parmly Toxey Toxey / McMillan Design Associates Search for other works by this author on: This Site PubMed Google Scholar Journal of the Society of Architectural Historians (2009) 68 (2): 263–265. https://doi.org/10.1525/jsah.2009.68.2.263 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Anne Parmly Toxey; Review: Moderns Abroad: Architecture, Cities, and Italian Imperialism, by Mia Fuller. Journal of the Society of Architectural Historians 1 June 2009; 68 (2): 263–265. doi: https://doi.org/10.1525/jsah.2009.68.2.263 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentJournal of the Society of Architectural Historians Search This content is only available via PDF. © 2009 by the Society of Architectural Historians.2009 Article PDF first page preview Close Modal You do not currently have access to this content.

Under the Equal Opportunities Act, anybody making a selection or promotion decision may have that decision challenged in the relevant Industrial Tribunal, if someone decides to allege that the promotion or selection showed discrimination on the grounds of sex. It is an open secret that similar legislation on race is likely to follow. If we follow the American pattern, we may even have legislation about discrimination on the grounds of age.

A rapid and very simple technique using induction heating is reported for obtaining the spectral, or total, emissivity of a ceramic material up to its melting point. The measurement system employs a PbS detector, in conjunction with a sensitive galvanometer. Spectral emissivity data are shown for several alumina bodies and for three rare‐earth oxides, erbium, samarium, and gadolinium, up to 1700°C.