Fox Valley Technical College (Fox Valley Tech or FVTC) is a public technical college in Grand Chute, Wisconsin. It is a member of the Wisconsin Technical College System and serves people in the Appleton, Wisconsin/Fox Cities area. It serves about 50,000 people each year and offers more than 200 associate degree, technical diploma, and certificate programs as well as instruction related to 20 apprenticeship trades. It has credit transfer agreements with more than 30 four-year colleges and universities.The main campus is in Grand Chute with a second campus in Oshkosh. FVTC has smaller regional centers in Chilton, Clintonville, Waupaca, and Wautoma. It also operates a Public Safety Training Center in Greenville.
Background and study aims Concomitant hiatal hernia (HH) repair with transoral incisionless fundoplication (TIF) is a therapeutic option for patients with HH > 2 cm and gastroesophageal reflux disease (GERD). Data comparing this approach with laparoscopic Nissen fundoplication (LNF) are lacking. We performed an exploratory analysis to compare these two approaches' adverse events (AEs) and clinical outcomes. Patients and methods This was a multicenter retrospective cohort study of HH repair followed by LNF versus HH repair followed by TIF in patients with GERD and moderate HH (2-5 cm). AEs were assessed using the Clavien-Dindo classification. Symptoms (heartburn/regurgitation, bloating, and dysphagia) were compared at 6 and 12 months. Results A total of 125 patients with HH repair with TIF and 70 with HH repair with LNF were compared. There was no difference in rates of discontinuing or decreasing proton pump inhibitor use, dysphagia, esophagitis, disrupted wrap, and HH recurrence between the two groups ( P > 0.05). The length of hospital stay (1 day vs. 2 days), 30-day readmission rate (0 vs. 4.3 %), early AE rate (0 vs. 18.6 %), and early serious AE rate (0 vs. 4.3 %) favored TIF (all P < 0.05). The rate of new or worse than baseline bloating was lower in the TIF group at 6 months (13.8 % vs. 30.0 %, P = 0.009). Conclusions Concomitant HH repair with TIF is feasible and associated with lower early and serious AEs compared to LNF. Further comparative efficacy studies are warranted.
Fox Valley Family Medicine Residency, Appleton, WI The corresponding author is Kathryn Jacobe; [email protected]. The authors declare no conflict of interest.
Nanomechanical communication (NMC) is a new mode of information transmission, where information can be exchanged through mechanical movements between two entities coming together and forming a junction. In NMC, unique and repeatable movements can be encoded into information bits. In our earlier work, we looked at some fundamental concepts of NMC and developed a framework based on state transitions. In this paper, we study allostery from the NMC perspective and point out some of the connections between the two.
Allostery is a fundamental mechanism by which many biological conformational processes are controlled. In this paper, we view the activities of allosteric macromolecules as the dynamics of a spatial network, where the nodes represent intramolecular sites or residues, and the links are the physical connections or bonds. We discuss how mutual information, an information-theoretic quantity, could be used to characterize the spatial relationships among the different intramolecular sites caused by allosteric activities. We envision that such an approach could reduce the apparent complexity of the network by identifying the critical nodes and their interrelationships in allostery. Such a mapping from spatial network to information network may allow information bit representation of allosteric interactions, which coupled with machine learning tools may be used to study complex biological processes and develop new therapeutics.
More than two million U.S. families receive home visiting services each year, yet little is known about the content and process of home visit interventions. Home visit observations are a recommended tool to address this gap in knowledge, but guidance regarding how much observation time is needed to provide a trustworthy picture of home visits is not available. This study estimated the length of observation needed to provide a reliable description of the content and process of home visits delivered through an Early Head Start (EHS) home-based program. Observations of 555 home visits involving 88 families and 17 home visitors were coded with the Home Visit Observation Form-Revised (HVOF-R). The HVOF-R describes the proportions of time spent among several subcategories within each of three major categories: Primary Interaction Partners, Content of Interactions, and Nature of the Home Visitor’s Interactions. The psychometric theory of test reliability guided use of bootstrap resampling and the Spearman-Brown prediction formula to estimate the duration of observation necessary to achieve conventional psychometric standards of reliability (r = .90 and r = .80). Results showed that 40–60 min of a home visit observation yields a reliable estimate of the proportion of time spent on most key features of home visits, especially those behaviors observed most frequently, including interactions among the home visitor, parent, and/or child. Fairly brief observations yield reliable description of home visit activities, and use of observation is recommended to guide program implementation efforts and enhance program quality.
