Selection Of Candidates Research Articles

Role of biomarkers in the diagnosis and management of HCC.

For many cancers, biomarkers have served as an important tool across the cancer care continuum from risk stratification and early detection to diagnosis and treatment. Alpha fetoprotein (AFP) remains one of the few validated biomarkers for patients with hepatocellular carcinoma (HCC). Although AFP has shown potential for each of these steps, its performance when used alone has often been suboptimal. There continues to be discordant recommendations about AFP's value when combined with ultrasound for surveillance as well as its role in diagnostic algorithms. Conversely, high AFP levels are associated with aggressive tumor biology and survival, so it remains a key factor for selection of liver transplant candidates. There have been immense efforts to identify and validate additional biomarkers for each of these steps in the HCC care continuum. Indeed, biomarker panels have shown promising data for HCC risk stratification and surveillance among patients with cirrhosis, as well as prognostication and detection of minimal residual disease in patients undergoing HCC treatment. Several large prospective studies to evaluate the role of these emerging biomarkers in clinical practice are currently ongoing.

Metallicities for more than 10 million stars derived from Gaia BP/RP spectra

The third $Gaia$ Data Release, which includes BP/RP spectra for 219 million sources, has opened a new window into the exploration of the chemical history and evolution of the Milky Way. The wealth of information encapsulated in these data is far greater than their low resolving power ($R would suggest at first glance, as shown in many studies. We zeroed in on the use of these data for the purpose of the detection of "new" metal-poor stars, which are hard to find yet essential for understanding several aspects of the origin of the Galaxy, star formation, and the creation of the elements, among other topics. We strive to refine a metal-poor candidate selection method that was developed with simulated $Gaia$ BP/RP spectra with the ultimate objective of providing the community with both a recipe to select stars for medium and high resolution observations, and a catalog of stellar metallicities. We used a dataset comprised of GALAH DR3 and SAGA database stars in order to verify and adjust our selection method to real-world data. For that purpose, we used dereddening as a means to tackle the issue of extinction, and then we applied our fine-tuned method to select metal-poor candidates, which we thereafter observed and analyzed. We were able to infer metallicities for GALAH DR3 and SAGA stars with color excesses up to $E(B-V)<1.5$ and an uncertainty of $ Fe/H inf 0.36$, which is good enough for the purpose of identifying new metal-poor stars. Further, we selected 26 metal-poor candidates via our method for observations. As spectral analysis showed, 100<!PCT!> of them had $ Fe/H <-2.0$, 57<!PCT!> had $ Fe/H <-2.5$, and 8<!PCT!> had $ Fe/H <-3.0$. We inferred metallicities for these stars with an uncertainty of $ Fe/H inf as was proven when comparing $ Fe/H inf $ to the spectroscopic $ Fe/H $. Finally, we assembled a catalog of metallicities for 10 861 062 stars.

Problems of protection of labor rights during hiring with the use of artificial intelligence algorithms

Abstract In recent years, artificial intelligence has found wide application in labor law, including in hiring processes. Artificial intelligence algorithms are used to automate recruiting, skills assessment and decision making. Although this can provide certain advantages and efficiency in the selection of candidates, the use of artificial intelligence algorithms in hiring also creates new legal problems and challenges, in particular in the context of the protection of labor rights in hiring: discrimination, transparency of artificial intelligence algorithms, protection of personal data. The problems caused by the use of artificial intelligence in labor law create challenges for lawyers in the context of creating ethical criteria and legal frameworks that regulate the use of artificial intelligence in the hiring process. The purpose of this article is to outline the main legal issues related to the violation and protection of labor rights in the case of the use of artificial intelligence algorithms in hiring. To achieve the goal of the research, methods of analysis, generalization, formal-logical, comparison, forecasting, dialectical and others were used. The current state of Ukrainian legislation and the experience of foreign countries are considered. The signs by which the artificial intelligence system can be classified as high-risk are highlighted. The problems of personal data protection during recruitment using artificial intelligence algorithms are analyzed. The definition of discrimination contained in international legal acts has been studied. Insufficient legal regulation of discrimination with the use of artificial intelligence algorithms has been established, which in turn creates problems in law enforcement. The criteria necessary to prevent manifestations of discrimination during recruitment with the use of artificial intelligence algorithms are highlighted. On the basis of the conducted research, a conclusion was made about the insufficient legal regulation of the use of artificial intelligence algorithms in domestic legislation, criteria that should become key for the protection of labor rights during employment with the use of artificial intelligence algorithms.

Choosing legislative candidates via primaries: The pivotal role of executive incumbency

How much influence does incumbency have on the way parties nominate candidates? I address this question in the context of Argentina, examining how political parties decide on candidate nomination methods for National Deputies. I argue that holding the governorship creates an imbalanced distribution of resources within a party, leading party factions to lean toward consensus in candidate selection and reducing the likelihood of choosing a primary election. Conversely, when a party lacks the governorship, its provincial party leader may have a weaker influence in deterring primary elections. I also theorize the various situations and resources governors can employ to discourage primary elections, including potential coattail effects, the option of seeking reelection, control over the primaries’ selectorate, and control of the electoral calendar. To test my expectations, I employ a regression discontinuity design, focusing on governors and those who finished as runners-up in lower chamber elections from 1985 to 2023. My findings reveal that governor incumbency decreases the probability of holding a primary election. I conduct further analyses by examining subgroups, considering the governor’s circumstances and the resources I previously theorized as factors influencing primary deterrence. I find that incumbency only deters primaries when the governor and National Deputies elections are concurrent, when the governor is not term-limited, and when they have control over the electorate and the electoral calendar.

The type-I, III nodal ring, type-I, III quadratic nodal point, and Dirac valley phonons in 2D kagome lattices M2C3 (M = As, Bi, Cd, Hg, P, Sb, Zn)

Topological phases in kagome systems have garnered considerable interest since the introduction of the colloidal kagome lattice. Our study employs first-principle calculations and symmetry analysis to predict the existence of ideal type-I, III nodal rings (NRs), type-I, III quadratic nodal points (QNPs), and Dirac valley phonons (DVPs) in a collection of two-dimensional (2D) kagome lattices M2C3 (M = As, Bi, Cd, Hg, P, Sb, Zn). Specifically, the Dirac valley points (DVPs) can be observed at two inequivalent valleys with Berry phases of +π and −π , connected by edge arcs along the zigzag and armchair directions. Additionally, the QNP is pinned at the Γ point, and two edge states emerge from its projections. Notably, these kagome lattices also exhibit ideal type-I and III nodal rings protected by time inversion and spatial inversion symmetries. Our work examines the various categories of nodal points and nodal ring phonons within the 2D kagome systems and presents a selection of ideal candidates for investigating topological phonons in bosonic systems.

Addressing Barriers to Women's Representation in Party Candidate Selections

AbstractAn analysis of Conservative and Labour Party candidate selections reveals persistent gender disparities, with the Conservative Party nominating a significantly higher proportion of men. While various factors, such as local connections and harassment, abuse and intimidation (HAI) are cited as explanations, they fail to address systemic issues within the Conservative Party's recruitment processes and organisational culture. This article argues that the focus should shift from individual women to party structures and practices that perpetuate gender inequality. Drawing on previous research and empirical evidence, it calls for institutional reforms including the implementation of quotas and greater transparency in candidate selection. Finally, it calls for a gender‐sensitive audit of party culture to address underlying barriers to women's participation in politics.

Impaired lung function and lung cancer risk in 461 183 healthy individuals: a cohort study

BackgroundIt has been known that smoking and various lung diseases including lung cancer can cause lung function impairment. However, the impact of different types of lung function impairments, such as...

Efficacy and Safety of Surgical Resection in Elderly Patients with Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.

: With increased life expectancy, the management of elderly hepatocellular carcinoma (HCC) patients became a crucial issue, yet it is still challenging due to comorbidities and high surgical risks. While surgical resection is considered as primary treatment for eligible HCC patients, systematic evidence on its outcomes in elderly patients remains scarce. In this review, we aimed to analyze the efficacy and safety outcomes of surgical resection in elderly HCC patients. : The studies included in this meta-analysis were selected from Ovid-MEDLINE, Ovid-Embase, CENTRAL, KoreaMed, KMbase, and KISS databases following a predefined protocol. Efficacy outcomes included overall survival and disease-free survival, while the safety outcomes included postoperative mortality and complications. : Patients in the elderly group (≥65 years) who underwent surgery exhibited non-inferior overall survival (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.92 to 1.74) and disease-free survival (HR, 1.03; 95% CI, 0.99 to 1.08) compared to the non-elderly group. Overall postoperative mortality exhibited no statistical difference (odds ratio [OR], 1.07; 95% CI, 0.87 to 1.31), but 30-day, 90-day, and in-hospital mortality were higher in the elderly group. The incidence of overall complications was higher in the elderly group (OR, 1.44; 95% CI, 1.22 to 1.69). Sensitivity analysis for the super elderly group (≥80 years) showed significantly higher in-hospital mortality compared to the non-super elderly group (OR, 2.51; 95% CI, 1.16 to 5.45). : The efficacy outcome of surgical resection in the elderly HCC patients was not worse than that in the non-elderly HCC patients, while in-hospital mortality and complications rates were higher. Therefore, surgical resection should be purposefully considered in the elderly population, with careful candidate selection.

The Impact of Online Competition on Local Newspapers: Evidence from the Introduction of Craigslist

Abstract How does competition from online platforms affect the organization, performance, and editorial choices of newspapers? What are the implications of these changes for the information voters are exposed to and for their political choices? We study these questions using the staggered introduction of Craigslist — the world’s largest online platform for classified advertising — across US counties between 1995 and 2009. This setting allows us to separate the effect of competition for classified advertising from other changes brought about by the Internet, and to compare newspapers that relied more or less heavily on classified ads ex ante. We find that, following the entry of Craigslist, local newspapers reliant on classified ads experienced a significant decline in the number of management and newsroom staff, including in the number of editors covering politics. These organizational changes led to a reduction in news coverage of politics and resulted in a decline in newspaper readership, particularly among readers with high political interest. Finally, we document that reduced exposure to local political news was associated with an increase in partisan voting and increased entry and success of ideologically extreme candidates in congressional elections. Taken together, our findings shed light on the determinants of the decline of print media and on its broader implications for democratic politics.

Not Tough Enough? Gender Stereotypes and Vote Choice in Switzerland

ABSTRACT While many studies examine the effect of gender stereotypes on electoral chances of women candidates in the U.S. little research investigates this relationship outside two-party systems and experimental designs. This article examines the relationship between gender stereotypes and vote choice for women candidates in the Swiss federal election of 2019. Our regression analyses show that voters holding male issue stereotypes are less likely to elect women candidates, while voters holding female issue stereotypes are more likely to elect women candidates. Interaction effects suggest differing effects depending on a respondent’s age, political knowledge, and the candidate’s party position.

Delivery of miRNAs Using Porous Silicon Nanoparticles Incorporated into 3D Hydrogels Enhances MSC Osteogenesis by Modulation of Fatty Acid Signaling and Silicon Degradation.

Strategies incorporating mesenchymal stromal cells (MSC), hydrogels and osteoinductive signals offer promise for bone repair. Osteoinductive signals such as growth factors face challenges in clinical translation due to their high cost, low stability and immunogenicity leading to interest in microRNAs as a simple, inexpensive and powerful alternative. The selection of appropriate miRNA candidates and their efficient delivery must be optimised to make this a reality. This study evaluated pro-osteogenic miRNAs and used porous silicon nanoparticles modified with polyamidoamine dendrimers (PAMAM-pSiNP) to deliver these to MSC encapsulated within gelatin-PEG hydrogels. miR-29b-3p, miR-101-3p and miR-125b-5p are strongly pro-osteogenic and are shown to target FASN and ELOVL4 in the fatty acid biosynthesis pathway to modulate MSC osteogenesis. Hydrogel delivery of miRNA:PAMAM-pSiNP complexes enhanced transfection compared to 2D. The osteogenic potential of hBMSC in hydrogels with miR125b:PAMAM-pSiNP complexes is evaluated. Importantly, a dual-effect on osteogenesis occurred, with miRNAs increasing expression of alkaline phosphatase (ALP) and Runt-related transcription factor 2 (RUNX2) whilst the pSiNPs enhanced mineralisation, likely via degradation into silicic acid. Overall, this work presents insights into the role of miRNAs and fatty acid signalling in osteogenesis, providing future targets to improve bone formation and a promising system to enhance bone tissue engineering.

Abstract PO2-08-09: Prevalence of germline genetic variants in breast cancer susceptibility genes among patients with metaplastic breast cancer

Abstract Background: Pathogenic or likely pathogenic variants (PV) in breast cancer (BC) susceptibility genes are present in approximately 5-10% of individuals with breast cancer and approximately 13-15% of those with triple-negative breast cancer (TNBC). Identifying patients with PV in BRCA1 and BRCA2 can inform selection of appropriate candidates for poly(ADP-ribose) polymerase inhibitors (PARPi), which have improved progression-free and overall survival in the metastatic and adjuvant settings, respectively. Metaplastic breast cancer (MpBC) is a rare, aggressive subtype of breast cancer that is often triple-negative and refractory to chemotherapy. To date, limited data describe germline genetic findings in patients with MpBC. Methods: We conducted a retrospective chart review including patients with pathology results at the Hospital of the University of Pennsylvania from 2021 through May 2023 demonstrating MpBC. Germline genetic test results and tumor histopathologic characteristics including estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status were evaluated. Descriptive statistics as well as two-tailed t tests were used for data analysis. Results: Of 89 patients identified with MpBC, 51 had germline genetic testing results available for review. Nine patients (17.6%) had MpBC with PV in BC predisposition genes (PV-MpBC) and 42 (82.4%) had PV-negative MpBC (PVneg-MpBC). Seven patients (13.7%) had a PV in BRCA1, 1 (2.0%) in BRCA2, and 1 (2.0%) in CHEK2. Median age at diagnosis was 45 years for patients with PV-MpBC and 56.5 years for those with PVneg-MpBC (p=0.005). Among patients with PV-MpBC, 6 (66.7%) had ER and PR negative disease by ASCO-CAP guidelines and 3 (33.3%) had ER and/or PR positive disease. Among patients with PVneg-MpBC, 31 (73.8%) had ER and PR negative disease and 11 (26.2%) had ER and/or PR positive disease. All 9 patients with PV-MpBC had HER2-negative disease, one (11.1%) of whom had HER2-low disease. Among patients with PVneg-MpBC, 40 (95.2%) had HER2-negative disease, two (4.8%) of whom had HER2-low disease, and 2 (4.8%) had HER2-positive BC. Conclusions: The frequency of PV in breast cancer susceptibility genes among patients with MpBC is comparable to, and possibly higher than, the reported rates of such PV in patients with TNBC, for whom genetic testing is recommended. If confirmed in a larger dataset, germline testing should be considered for all patients with MpBC regardless of ER, PR, and HER2 status, as findings may help identify candidates for PARPi therapy and genetically-directed clinical trials. Citation Format: Kaitlin Demarest, Anupma Nayak, Payal Shah. Prevalence of germline genetic variants in breast cancer susceptibility genes among patients with metaplastic breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-08-09.

Conversion therapy for advanced hepatocellular carcinoma in the era of precision medicine: Current status, challenges and opportunities.

Hepatocellular carcinoma (HCC), the most prevalent malignancy of the digestive tract, is characterized by a high mortality rate and poor prognosis, primarily due to its initial diagnosis at an advanced stage that precludes any surgical intervention. Recent advancements in systemic therapies have significantly improved oncological outcomes for intermediate and advanced-stage HCC, and the combination of locoregional and systemic therapies further facilitates tumor downstaging and increases the likelihood of surgical resectability for initially unresectable cases following conversion therapies. This shift toward high conversion rates with novel, multimodal treatment approaches has become a principal pathway for prolonged survival in patients with advanced HCC. However, the field of conversion therapy for HCC is marked by controversies, including the selection of potential surgical candidates, formulation of conversion therapy regimens, determination of optimal surgical timing, and application of adjuvant therapy post-surgery. Addressing these challenges and refining clinical protocols and research in HCC conversion therapy is essential for setting the groundwork for future advancements in treatment strategies and clinical research. This narrative review comprehensively summarizes the current strategies and clinical experiences in conversion therapy for advanced-stage HCC, emphasizing the unresolved issues and the path forward in the context of precision medicine. This work not only provides a comprehensive overview of the evolving landscape of treatment modalities for conversion therapy but also paves the way for future studies and innovations in this field.

Outcomes and Complications after Left Ventricular Assist Device Implantation

Heart transplantation is the treatment of choice for selected patients with end-stage heart failure. Persistent donor organ shortage causes a growing demand for mechanical circulatory support not only as a bridge to transplantation but mainly as a destination therapy (DT). The aim of the study was to analyze the indications, comorbidities, and complications during the follow-up of all patients undergoing left ventricular assist device (LVAD) implantation with at least 12 months of follow-up time in one of the most experienced clinics in Poland between 2015 and 2023. There were 125 individuals with LVAD implantation, from which 90 had full 12 months of follow-up (85 males - 94%, 5 females - 6%), with a median age of 58 (50.25-63.75) years. The median body mass index was 27.12 (25.27-29.68). The etiology of heart failure was ischemic (n = 44, 49%), dilated cardiomyopathy (n = 44, 49%), and others. Preoperative echocardiography revealed a mean LV ejection fraction of 13.8% and a median LV dimension of 7.55 (6.92-8.2) cm. In 61 patients (68%), imaging confirmed pulmonary hypertension. Thirty-four patients (38%) had diabetes and 16 (18%) were active smokers. Median follow-up was 30 (17.25-42) months, with the longest period being about 82 months. 40 (44%) patients had kidney failure before LVAD implantation, and in 43 cases (48%), we observed relevant, transient deterioration of kidney function. Almost all patients (n = 82, 91%) suffered from anemia (Hb <13 g/dL in males and <12 g/dL in females) in different periods after LVAD implantation due to perioperative bleeding, gastrointestinal bleeding or unknown causes. The lowest Hb level was observed in the first week after LVAD implantation in 53 cases (58%). Median red cell concentrate transfusion demand before the discharge after surgery was 6 (2-8, 5) units. Appropriate selection of candidates and timing of LVAD implantation are critical for improved outcomes of DT. Anemia and kidney failure are the most frequent follow-up complications. Improved results and increased applicability and durability of LVADs have established this treatment option as an excellent alternative for patients with end-stage heart failure.

Driveline Infection in Patients With Left Ventricular Assist Devices Implanted as Destination Therapy

Donor organ shortages cause increasing demand for mechanical circulatory support in patients with end-stage heart failure not only as a bridge to heart transplantation but mainly as a destination therapy. Improved results and increased applicability and durability of left ventricular assist devices (LVADs) have established this treatment option as an alternative to heart transplantation in selected patients. One of the most common complications after LVAD implantation is driveline infections (DLIs). This study aimed to expand the understanding of DLI epidemiology and potential changes in implantation techniques regarding optimizing DLI prevention and treatment among all patients undergoing LVAD (Medtronic's Heartware HVAD and HeartMate 3 Abbott LVAD system) implantation with at least 12 months of follow-up time between 2015 and 2022. There were 120 individuals with LVAD implantation, of whom 90 had 12 months of follow-up (85 men [94%], 5 women [6%]) with a median age of 58 years (50.25-63.75). The median body mass index was 27.12 kg/m2 (25.27-29.68). Of the 90 patients, 43 had ischemic heart failure (48%), 43 had dilated cardiomyopathy (48%), and the remaining 3 had other etiologies (3%), such as postinflammatory, and the remaining 1 had congenital heart defect (1%). Preoperative echocardiography revealed a mean left ventricle ejection fraction of 13.8% and a median left ventricle dimension of 7.55 cm (6.92-8.2). Imaging confirmed pulmonary hypertension in 61 patients (68%). Thirty-four of the 90 patients had diabetes (38%), and 16 were active smokers (18%). Median follow-up was 30 months (17.25-42), with the longest period being 82 months. More than half of the patients (n = 52; 57%) experienced a DLI. The median time to the first episode of DLI was 13 months (6-25). The most common pathogen revealed in wound swab culture was methicillin-sensitive Staphylococcus aureus (n = 23; 44%), Pseudomonas aeruginosa (n = 9; 17%), Proteus mirabilis (n = 4; 7%), and others. We observed that deeper driveline implantation below the left rectus muscle and just above the posterior rectus sheath resulted in fewer DLIs and longer free-from-DLI follow-up time. There was no statistically significant difference in DLI frequency between patients with or without diabetes mellitus. Appropriate selection of candidates and timing of LVAD implantation are critical for improved outcomes of destination therapy. DLI is the most common complication after LVAD implantation. Optimal surgical techniques and early implementation of targeted antibiotics are crucial. Significant challenges remain in optimizing DLI prevention and treatment.

The Evolution of Enhanced Recovery After Surgery: Assessing the Clinical Benefits of Developments Within Enhanced Recovery After Surgery Protocols in Adult Cervical Deformity Surgery.

Retrospective cohort. To investigate the impact of evolving Enhanced Recovery After Surgery (ERAS) protocols on outcomes after cervical deformity (CD) surgery. ERAS can help accelerate patient recovery and assist hospitals in maximizing the incentives of bundled payment models while maintaining high-quality patient care. However, there remains a paucity of literature assessing how developments have impacted outcomes after adult CD surgery. Patients with operative CD 18 years or older with pre-baseline and 2 years (2Y) postoperative data, who underwent ERAS protocols, were stratified by increasing implantation of ERAS components: (1) early (multimodal pain program), (2) intermediate (early protocol + paraspinal blocks, early ambulation), and (3) late (early/intermediate protocols + comprehensive prehabilitation). Differences in demographics, clinical outcomes, radiographic alignment targets, perioperative factors, and complication rates were assessed through Bonferroni-adjusted means comparison analysis. A total of 131 patients were included (59.4 ± 11.7 y, 45% females, 28.8 ± 6.0 kg/m 2 ). Of these patients, 38.9% were considered "early," 36.6% were "intermediate," and 24.4% were "late." Perioperatively, rates of intraoperative complications were lower in the late group ( P = 0.036). Postoperatively, discharge disposition differed significantly between cohorts, with late patients more likely to be discharged to home versus early or intermediate cohorts [χ 2 (2) = 37.973, P < 0.001]. In terms of postoperative disability recovery, intermediate and late patients demonstrated incrementally improved 6 W modified Japanese Orthopedic Association scores ( P = 0.004), and late patients maintained significantly higher mean Euro-QOL 5-Dimension Questionnaire and modified Japanese Orthopedic Association scores by 1 year ( P < 0.001, P = 0.026). By 2Y, cohorts demonstrated incrementally increasing SWAL-QOL scores (all domains P < 0.028) domain scores versus early or intermediate cohorts. By 2Y, incrementally decreasing reoperation was observed in early versus intermediate versus late cohorts ( P = 0.034). The present study demonstrates that patients enrolled in an evolving ERAS program demonstrate incremental improvement in preoperative optimization and candidate selection, greater likelihood of discharge to home, decreased postoperative disability and dysphasia burden, and decreased likelihood of intraoperative complications and reoperation rates.

Дискуссии об избирательных правах должностных лиц крестьянского самоуправления в земстве в конце XIX века

This article examines the discussions by the zemstvo assemblies of the circular request of the Ministry of Internal Affairs about the possibility of banning volost elders and volost clerks from being elected as zemstvo deputies. Based on the materials of minute books and resolutions of the zemstvo assemblies, as well as reports of the zemstvo administrations, the main points of view on this issue are singled out. Five standpoints of the zemstvo assemblies and zemstvo administrations are considered here: to preserve the right of volost elders and volost clerks to be elected, to preserve the right of volost elders to be candidates, to ban volost elders from being candidates, to ban volost clerks from being candidates, and to ban volost elders and volost clerks from being candidates. The article provides key arguments of zemstvo representatives for preserving (voters’ trust and good knowledge of the needs of the peasant population) or abolishing (dependence on the land captains who are zemstvo deputies and difficulty of combining the work as a deputy with the official duties in the peasant administration) the right to be elected for the abovementioned officials in peasant self-government. Further, the paper presents zemstvo initiatives to introduce additional changes to the articles of the Statute on Zemstvo Institutions in order to protect the rights of peasant zemstvo deputies when executing their duties as such (restricting the discretionary power of land captains and banning land captains from being elected as zemstvo deputies). The discussion of these initiatives and their criticism are presented. Furthermore, a memorandum by the head of the Economy Department of the Ministry of Internal Affairs is introduced into academic discourse, demonstrating the distribution of the standpoints of the zemstvos on the right of volost elders and volost clerks to be candidates in zemstvo elections and the suggestions of the department’s leadership on how to solve this issue.

Fractures in Patients With Diabetes Mellitus: Findings From a 20-year Registry at a Single Level 1 Trauma Center

Introduction: Diabetes mellitus (DM) is a risk factor of infection. Although DM has been associated with worse functional outcomes after acetabular fracture, literature regarding the effect of DM on surgical site infection and other early complications is lacking. Methods: A 20-year registry from a level 1 trauma center was queried to identify 134 patients with DM and 345 nondiabetic patients with acetabular fractures. Results: The diabetic patient population was older (57.2 versus 43.2; P &lt; 0.001) and had higher average body mass index (33.6 versus 29.5; P &lt; 0.001). Eighty-three patients with DM and 270 nondiabetics were treated surgically (62% versus 78%; P &lt; 0.001). Diabetic patients who were younger (54.6 versus 61.4; P = 0.01) with fewer comorbidities (1.7 versus 2.2; P = 0.04) were more frequently managed surgically. On univariate analysis, patients with DM more commonly developed any early infection (28.4% versus 21%; P = 0.049) but were no more likely to develop surgical site infection, or other postoperative complications. Older patient age, length of stay, baseline pulmonary disease, and concurrent abdominal injury were independent predictors of postoperative infection other than surgical site infection. Diabetics that developed infection had more comorbidities (2.4 versus 1.5; P &lt; 0.001) and higher Injury Severity Score (24.1 versus 15.8; P = 0.003), and were more frequently insulin-dependent (72.7% versus 41%; P = 0.01). Discussion: Independent of management strategy, diabetic patients were more likely to develop an infection after acetabular fracture. Insulin dependence was associated with postoperative infection on univariate analysis. Optimal selection of surgical candidates among patients with DM may limit postoperative infections.

The Level of Administrative Creativity among the Principals of Post-Basic Education Schools in Al Dakhiliyah Governorate, Sultanate of Oman

The study aimed to identify the administrative creativity’s level among the principals of post-basic education schools in the Governorate of Al Dakhiliyah in the Sultanate of Oman. A descriptive survey research methodology was used. Also, the questionnaire was used as a tool. It consisted of (59) items. It was applied to (274) teachers. Results showed that the administrative creativity’s level among the principals was high. The study also revealed no statistically significant differences in the study sample’s subjects estimates of the administrative creativity’s level due to qualification. There were statistically significant differences attributed to gender in all fields of administrative creativity favoring females. Among the most important recommendations of the study: the need to take into account when nominating for the position of a school principal, the selection of candidates who possess creative leadership skills and creative personality traits.

Candidate selection for lung transplantation - considerations beyond the medical evidence.

The scarcity of organs available for lung transplantation makes it necessary to develop consistent practices for candidate selection and organ allocation. Such policies are mainly built on prognostic estimations, which are again built on medical evidence. In addition, however, other factors also guide these practices. These factors are not always explicit. The purpose of this review is to discuss some of these factors. While one candidate may be considered to be in need of a transplant, the extent to which this need is weighed up against other patients at need varies, depending on how societal responsibility is conceived at the transplant center. Individual survival benefit may be in conflict with the concept of a just distribution of life years ('fair innings'). Furthermore, the need to expand medical knowledge, and the perceived patient autonomy and right to choose may affect the selection and allocation practices. Finally, financial considerations and nationality may have great influence. Although well trained in medical judgment, the clinicians' candidate selection for lung transplantation is often influenced by factors beyond the medical evidence. These factors should be discussed just as transparently and accountably as the medical judgments.