A blended neurostimulation protocol to delineate cortico-muscular and spino-muscular dynamics following neuroplastic adaptation.

In this paper we propose a novel neurostimulation protocol that provides an intervention-based assessment to distinguish the contributions of different motor control networks in the cortico-spinal system. Specifically, we use a combination of non-invasive brain stimulation and neuromuscular stimulation to probe neuromuscular system behavior with targeted impulse-response system identification. In this protocol, we use an in-house developed human-machine interface (HMI) for an isotonic wrist movement task, where the user controls a cursor on-screen. During the task, we generate unique motor evoked potentials based on triggered cortical or spinal level perturbations. Externally applied brain-level perturbations are triggered through TMS to cause wrist flexion/extension during the volitional task. The resultant contraction output and related reflex responses are measured by the HMI. These movements also include neuromodulation in the excitability of the brain-muscle pathway via transcranial direct current stimulation. Colloquially, spinal-level perturbations are triggered through skin-surface neuromuscular stimulation of the wrist muscles. The resultant brain-muscle and spinal-muscle pathways perturbed by the TMS and NMES, respectively, demonstrate temporal and spatial differences as manifested through the human-machine interface. This then provides a template to measure the specific neural outcomes of the movement tasks, and in decoding differences in the contribution of cortical- (long-latency) and spinal-level (short-latency) motor control. This protocol is part of the development of a diagnostic tool that can be used to better understand how interaction between cortical and spinal motor centers changes with learning, or injury such as that experienced following stroke.

Drivers of vegetative dormancy across herbaceous perennial plant species.

Vegetative dormancy, that is the temporary absence of aboveground growth for ≥ 1 year, is paradoxical, because plants cannot photosynthesise or flower during dormant periods. We test ecological and evolutionary hypotheses for its widespread persistence. We show that dormancy has evolved numerous times. Most species displaying dormancy exhibit life-history costs of sprouting, and of dormancy. Short-lived and mycoheterotrophic species have higher proportions of dormant plants than long-lived species and species with other nutritional modes. Foliage loss is associated with higher future dormancy levels, suggesting that carbon limitation promotes dormancy. Maximum dormancy duration is shorter under higher precipitation and at higher latitudes, the latter suggesting an important role for competition or herbivory. Study length affects estimates of some demographic parameters. Our results identify life historical and environmental drivers of dormancy. We also highlight the evolutionary importance of the little understood costs of sprouting and growth, latitudinal stress gradients and mixed nutritional modes.

College nursing faculty job satisfaction and retention: A national perspective.

The need for registered nurses in the United States continues to grow. To meet this need for increased numbers of nurses, recruitment and retention of qualified nurse educators has become a priority. In addition, the factors associated with nursing faculties' intent to stay have emerged as important considerations for administrators. The concepts of job satisfaction and intent to stay become vital to recruiting and retaining nursing faculty. In the past decade few empirical studies have been conducted on a national scale to address job satisfaction and intent to stay in academia. The purpose of this retrospective study is to analyze variables of relationships with nurse faculty job satisfaction and intent to stay from data collected throughout the United States. The Collaborative on Academic Careers in Higher Education (COACHE) survey was employed for the purposes of this study. Over 1350 nurse educators were included in the survey. The findings support a variety of modifiable variables that are viewed as important by nursing faculty. The strongest relationship was found to be institutional leadership. The implications can inform academic administrators seeking to retain nursing faculty.

Academic nursing administrators' workplace satisfaction and intent to stay.

BACKGROUND: In nursing education, the academic administrator is critical given the multitude of challenges associated with program delivery (e.g., shortages of faculty, strict and changing regulations for program accreditation, and the sheer demand for more nurses). Unfortunately, with the focus on recruiting and retaining new novice faculty to teach students, academic nursing administrators have been overlooked in recent studies. PURPOSE: As such, this study aims to explore the workplace satisfaction and intent to stay of academic nursing administrators by considering their relation to a variety of demographic and work related variables. METHODS: A secondary data source was used from the Collaborative on Academic Careers in Higher Education (COACHE). One-way Analysis of Variance (ANOVA) with post hoc Fisher's Least Significant Difference tests and t-tests were used in the analysis. DISCUSSION/CONCLUSION: Results indicate that several modifiable work factors positively relate to both job satisfaction and intent to stay.

Abdominal Wall Reconstruction: A Comparison of Totally Extraperitoneal and Transabdominal Preperitoneal Approaches.

BACKGROUND: Abdominal wall reconstruction for complex ventral and incisional hernias is associated with significant complications. Commonly, the peritoneal cavity is opened and adhesiolysis is performed with the potential for enterotomy. A totally extraperitoneal (TE) approach to abdominal wall reconstruction is feasible in many ventral hernia repairs and can reduce visceral injuries without impacting other outcomes. This study compares outcomes after retro-rectus ventral hernia repairs with TE and transabdominal (TA) preperitoneal approaches. STUDY DESIGN: An IRB-approved review of a prospective hernia database was performed for all ventral hernia repairs between 2009 and 2013. Preoperative patient characteristics, including demographics and comorbidities; operative variables, including surgical technique, operative duration, type/size/location of mesh, concomitant procedures, and incidence of inadvertent injury; and patient outcomes in terms of length of stay, wound and nonwound complications, and readmissions or returns to the operating room were obtained. Groups were compared using t-tests, Mann-Whitney U tests, chi-square tests, and Fisher's exact tests as appropriate. Significance was set at p < .05. RESULTS: One hundred and seventy-five complex abdominal wall reconstructions were performed between 2009 and 2013. Of those, 85 patients underwent hernia repair for CDC grade 1 hernias with retro-rectus mesh placement performed (n = 45 TA, n = 40 TE). Groups did not differ in age, BMI, sex, smoking status, hernia defect size, history of COPD, asthma, hypertension, cancer, or renal failure. More TA patients had diabetes (36% vs. 13%; p = 0.02) and previous hernia repair (73% vs. 45%; p = 0.01) than TE patients. Mesh size was larger in the TE group (625 ± 234 cm(2) vs. 424 ± 214 cm(2); p < .001). There was no difference in enterotomy between TA and TE groups (0% vs. 2%; p = 1.0). However, there was a reduced operative time with TE (170 ± 49 minutes vs. 212 ± 49 minutes; p < .001). CONCLUSIONS: Abdominal wall reconstruction can be performed safely in a TE fashion. The extraperitoneal approach results in shorter operative duration, but had similar complications when compared with TA preperitoneal approach.

Laparoscopic parastomal hernia repair: No different than a laparoscopic ventral hernia repair?

BACKGROUND: Parastomal hernia (PH) is a common complication when a stoma is used. The high incidence (35-50%) and patient longevity have created a situation where patients are being referred for consideration of repair with more frequency. Due to the presence of an ostomy and the increased bacterial contamination of the area, the insertion of a prosthetic material is concerning for complications. Laparoscopic repair of parastomal hernias utilizing a modified Sugarbaker technique has been demonstrated to have excellent outcomes. The purpose of this study is to demonstrate that laparoscopic PH repair has outcomes similar to laparoscopic ventral hernia (LVH) repair without the presence of a stoma. METHODS: After obtaining institutional review board approval, patients with parastomal hernia who underwent laparoscopic repair using Sugarbaker technique between 2009 and 2012 were compared to patients with ventral hernias who underwent LVH repair in a retrospective review, with a match of 1:3. Data collected included demographics, comorbidities, operative time, defect size, and mesh size. Outcomes and complications were compared between the two groups. RESULTS: Twenty patients underwent Sugarbaker repair, and these cases were compared to 60 patients with ventral hernia that received LVH repair. There was no statistically significant difference in age, BMI, smoking status, ASA score, defect size, or mesh size between groups. Operative time was significantly longer in the PH group: 172 ± 35 versus the LVH group: 94 ± 32 min (p < 0.1). Length of stay was longer, 3 days (3-5.5) for PH versus 1 day (1-2.8) for LVH, p < 0.1. The two groups did not differ in terms of wound complications or recurrence, with a median follow-up of 37 days (IQ range 27-518). CONCLUSION: The Sugarbaker technique is as safe as LVH repair with no more complications given the presence of a stoma.

Development of a nonchiral HPLC method with circular dichroism detection for chiral analysis of molybdenum-catalyzed enantioselective synthesis products.

The combination of a circular dichroism detector and nonchiral liquid chromatography was used for the chiral analysis of unresolved enantiomers to determine the enantioselectivity of a molybdenum-catalyzed asymmetric allylic alkylation reaction. The CD/UV peak area ratio of the unresolved enantiomers was calculated and compared with that of a reference standard to determine the enantiomeric purity. The limit of quantitation (LOQ) is 20 ng for the chiral ligand and 1 microg for the branched chiral product. The viability of the system depends on the limit of quantitation of the CD response and the linearity range of the CD and UV response.