Reconceptualizing Incomplete Attempt

Purpose:To evaluate the rate of complications in resident-performed phacoemulsification and influencing factors.Methods:In this retrospective cohort study, the outcomes of cataract surgeries performed by 18 ophthalmology residents were analyzed. The outcome of first 80 phacoemulsification cataract surgeries (1440 cataract surgeries) performed by each resident were analyzed. Outcome measures included the rate of intraoperative capsular rupture requiring anterior vitrectomy, nucleus drop, and incomplete attempts at uncomplicated procedures. Changes in the rate of complications over the surgical training course were also assessed.Results:The most common surgical complications were capsular rupture (7.5%), followed by incomplete attempt(s) (5.9%), and nucleus drop (1.1%). Comparing the first 40 and second 40 surgeries, the rate of complications decreased as a function of surgeon experience in all resident cohorts. Greater theoretical skills and younger surgeon age were associated with a lower rate of intraoperative capsular rupture (hazard ratios = 1.421 and 1.481, respectively; P = 0.047 and P = 0.041, respectively). The use of antianxiety drugs and number of surgeries in the first 6 months demonstrated no predictive value for a lower rate of intraoperative complications (hazard ratios = 0.929 and 1.002; P = 0.711 and P = 0.745, respectively).Conclusion:The use of antianxiety medication and more surgeries in the first 6 months did not decrease the rate of intraoperative complications of phacoemulsification, while improvement of theoretical skills may have increased the safety of resident-performed cataract surgery.

El trabajo ofrece una reconstrucción de aquello que la dogmática del derecho penal denomina una “tentativa inacabada”, cuya estructura es analizada a partir de premisas obtenidas de la filosofía de la acción. El argumento se centra en demostrar por qué y cómo la así llamada “resolución-al-hecho”, en cuanto presupuesto de tal forma de tentativa, ha de ser caracterizada como una intención previa, a través de cuya formación el agente adquiere el compromiso práctico de ejecutar u omitir una acción de cierta índole. El objetivo así perseguido consiste en identificar las condiciones de las cuales depende que una tentativa inacabada pueda ser constitutiva de un quebrantamiento de la misma norma quebrantada por el autor del respectivo delito consumado.

During the 1991–1992 excavation of the ruins of the medieval cathedral in Hamar, Norway, the broken skull of an elderly man was found, showing evidence of an incomplete trepanation. The ‘surgeon’ had obviously tried to penetrate the skull surface around bregma in an irregular circle of 23 × 21 mm. Upon investigation, the skull revealed a reactive‐pathological area of the internal surface of the occipital bone, which probably represents a respite after a meningeal disorder (a tumour or an infectious process), causing us to suggest that the trepanation was meant to cure the patient's increasing headache. However, as a second skull with similar marks was found in the same churchyard, another explanation seems possible. Because the brain tumour in the first case may have altered the patient's mental state, we may surmise that these incomplete operations were an attempt to remove from these patients' heads the ‘Stone of Madness’, which was then commonly considered to be the reason for psychiatric diagnoses as well as persistent headache, and often depicted in European art, most notably in the 16th and 17th centuries. The second skull, revealing an even more incomplete attempt, did not show any skeletal pathology at all. Copyright © 2007 John Wiley & Sons, Ltd.

Systemics and cybernetics can be viewed as a metalanguage of concepts and models for transdisciplinarian use, still now evolving and far from being stabilized. This is the result of a slow process of accretion through inclusion and interconnection of many notions, which came and are still coming from very different disciplines. The process started more than a century ago, but has gathered momentum since 1948 through the pioneering work of Wiener, von Neumann, von Bertalanffy, von Förster and Ashby, among many others. This paper tries to retrace the history of the accretion process and to show that our systemic and cybernetic language is an evolving conceptual network. This is of course only a first and quite incomplete attempt, merely destined to give the ‘feel’ of the process. Systemic concepts and models are underlined in order to enhance the perception of the process, as well as its systemic significance. Copyright © 1999 John Wiley & Sons, Ltd.

We derived novel, testable predictions from a mathematical model of the budding yeast cell cycle. A key qualitative prediction of bistability was confirmed in a strain simultaneously lacking cdc14 and G1 cyclins. The model correctly predicted quantitative dependence of cell size on gene dosage of the G1 cyclin CLN3, but it incorrectly predicted strong genetic interactions between G1 cyclins and the anaphase-promoting complex specificity factor Cdh1. To provide constraints on model generation, we determined accurate concentrations for the abundance of all nine cyclins as well as the inhibitor Sic1 and the catalytic subunit Cdc28. For many of these we determined abundance throughout the cell cycle by centrifugal elutriation, in the presence or absence of Cdh1. In addition, perturbations to the Clb-kinase oscillator were introduced, and the effects on cyclin and Sic1 levels were compared between model and experiment. Reasonable agreement was obtained in many of these experiments, but significant experimental discrepancies from the model predictions were also observed. Thus, the model is a strong but incomplete attempt at a realistic representation of cell cycle control. Constraints of the sort developed here will be important in development of a truly predictive model.

The radicular variety of dens invaginatus

Dropouts of a weight reduction program are not evaluated for the lasting effects of weight reduction. This study was an attempt to learn about the benefits of weight reduction received and sustained by the dropouts of the program. Ninety-seven males and females dropping out of a dietary weight management program after 16-18 weeks of treatment, and after 9-9.4kg weight loss and wishing to rejoin the program for a second time after at least 9 months' absence from it, were considered for the study. Their body weight, serum cholesterol, serum triglyceride, and blood sugar levels at the beginning of the second attempt, were compared with the respective values at the beginning of the first attempt. All patients had regained the weight lost during their first attempt when they reported for a second attempt. However, serum cholesterol and triglyceride values were 15% and 26% less for females, and 17% and 24% less for males, compared to their respective values on the first attempt, in the subgroup of patients with normal blood sugar levels. In the subgroup with above normal blood sugar levels, however, serum cholesterol and triglyceride values showed an increase by 12% and 17% respectively, for females, and by 2% and 7% respectively, for males, compared to their baseline values on their first attempt. The mechanism responsible for this observation was not uncovered. However, the observation that even an incomplete attempt at weight reduction appears to contribute in maintaining lower levels of serum cholesterol and triglyceride of at least those with normal blood sugar levels, is useful in nutritional counseling for emphasizing the health benefits of the weight reduction.

Through an ethnographic case study within one struggling Afrocentric public charter school in the Mid-Atlantic from 2009 to 2011, I show how broader neoliberal reforms and an incomplete attempt at Afrocentric education combined to redefine Blackness as poverty, danger, and failure through the co-optation of school-based practices. Using a Critical Race theoretical framework, I argue that culturally focused programs, which explicitly aim to serve students of color, are at risk of failing their students because of the interests of the reform movements they are accountable to. These findings suggest that culturally responsive educational programs, despite their holistic and empowering frameworks, may be particularly vulnerable to marginalizing the students they aim to serve in ways that are distinctly and overtly connected to broader racist conceptions of Blackness.

Integrated Catchment Management (ICM) can be viewed as an institutional instrument designed to ameliorate losses of economic efficiency that have arisen due to incomplete specification of the privileges and restrictions attached to property rights. If applied appropriately ICM can facilitate the emergence of a market in which parties disadvantaged by incomplete specification attempt to bribe those advantaged, with the aim of obtaining the latter's agreement to more complete specification. The instrument provides potential for transactions costs of bargaining to be reduced substantially by reducing the number of parties eligible to participate in, and installing the state as broker and arbiter of, the bargaining process. Participation by sub-catchment committees and their constituents in the bargaining process can also, by fostering peer pressure, reduce the transactions costs of monitoring and obtaining compliance with any bargains successfully negotiated. However, the extent to which transactions costs are reduced in practice, and bargains are entered into and complied with as a result, depends on how successfully ICM principles are applied in practice.

Introduction: Ulcerative colitis (UC) is a debilitating disorder of colon. The incidence of UC peaks in the age group of 15 to 25, and only 1% are infantile. Despite initial medical treatment, in refractory cases, colectomy is needed. There are few studies regarding surgical results of treatment of UC in infancy. Material & Methods: In our descriptive retrospective study we reviewed medical files of infants with ulcerative colitis that consulted with us for surgery between 2009 and 2014. Age at onset, family history of inflammatory bowel disease, symptoms of onset, colonoscopic findings, duration of Medical treatment, Indication of surgery, Type of operation, surgical complications and their Management and mortality was recorded. Results: We found five patients with the diagnosis of UC in their first year of life; 4 boys and 1girl. The mean age of onset of the disease was 35 days (range 3-60). The mean age of patients at the time of surgical consult was 7 months. The disease began in 3 patients with watery diarrhea. Family history was positive in only one of our cases. He had sever FTT with no response to medical treatment which was an indication for surgery and he underwent total proctocoletomy, ileoanal anastomosis and loop ileostomy which failed and 3 days after the first operation we performed an end ileostomy. Two cases had colon perforation following their colonoscopy and one of them (a 4 month girl) expired before laparotomy and the other (a 12 month boy) underwent colostomy creation while he was in septic shock. The fourth patient was a 2 day old neonate with abdominal distention and intestinal obstruction. Rectal biopsy showed agangliosis so he underwent a transanal pull through procedure with a diagnosis of hirschsprung’s disease. After surgery he experienced recurrent watery diarrhea and further diagnostic investigations brought about the diagnosis of UC. Our last patient was a 3 day old neonate that underwent ileostomy in the initial surgery with suspicion of total colonic agangliosis and underwent subtotal colectomy when he was 2 months old. At 1.5 years he developed toxic mega-colon in the remnant of colon when he was old and thus was referred to us and underwent colostomy. After 3 month the final surgery was carried out. Conclusions: If a child presents with recurrent bloody or watery diarrhea even in infancy, UC should be considered as a differential diagnosis. The pattern of the disease in infancy appears more rigorous. Evidence-based management of UC presenting in infancy is incomplete but early surgical attempt can reduce catastrophic results.

This book looks at the possible benefits of linguistic diversity for society and the economy. Its publication can be seen as an incomplete yet well-meaning attempt to popularise part of the economi...

Much of what is described as advertising pretesting is better viewed as an incomplete and imaginative attempt to measure steps along a surmised hierarchical process that is only indirectly related to the purposes for which the advertising is created. This paper reviews design weaknesses in current advertising pretesting and highlights prevalent misconceptions. Elements that, when present, contribute to enhanced brand feelings are identified. It finds a link between how people feel towards the brand and the way they react to its advertising but strength of brand has no affect on gaining attention.

That to this day the vast majority of those on the French Left remain wedded to a conception of the French Revolution as an anticipation of later movements towards greater social and economic equality is beyond dispute. Likewise, it is clear (and well-known) that this reverence for the Great Revolution and its offspring, Jacobinism, is not of recent origin. It was in place certainly by the early years of the Third Republic and so much so that, as Patrick Hutton has remarked, it had become part of the 'mental universe' of broad sections of leftwing opinion.' Yet this predominantly democratic and republican model of social transformation was never able to obtain universal assent on the Left. First Saint-Simon and Fourier and then Proudhon voiced their reservations about the Revolution and to these were added the arguments of such groups as the proletarian positivists who, following Comte, saw 1789 predominantly as an 'aborted' and incomplete attempt to secure a superior level of civilization and organization.2 But the greatest challenge to the ascendancy of the French Revolution and the Jacobin tradition came in the form of the

High prevalence of T-cell receptor V delta 2-(D)-D delta 3 or D delta 1/2-D delta 3 rearrangements in B-precursor acute lymphoblastic leukemias

High Prevalence of T-Cell Receptor Vδ2-(D)-Dδ3 or Dδ1/2-Dδ3 Rearrangements in B-Precursor Acute Lymphoblastic Leukemias