These four primary outcomes will be followed-up at 1- 3-, 6-, 9- and 12-months after injury for all patients. The Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) method will be used to assess implementation processes. Data from the primary outcome analysis and implementation process assessment will be used to inform an end-of-study policy summit with the American College of Surgeons Committee on Trauma. The policy summit will facilitate acute care practice changes related to patient-centered care transitions over the course of a single 5-year funding cycle. Trial registration (Clinicaltrials.govNCT03569878). To determine the effects of alpha lipoic acid (ALA) and vitamin E (Vit E) on mitochondrial dysfunction caused by statins. A total of 38 Wistar Albino rats were used in this study.  https://www.selleckchem.com/products/congo-red.html  The control group received dimethyl sulfoxide. The atorvastatin (A) group received atorvastatin (10 mg/kg). The A + ALA group received atorvastatin (10 mg/kg) and ALA (100 mg/kg). The A + Vit E group was administered atorvastatin (10 mg/kg) and Vit E (100 mg/kg). The A + ALA + Vit E group was administered atorvastatin (10 mg/kg), ALA (100 mg/kg) and Vit E (100 mg/kg). All applications were administered simultaneously by gavage for 20 days. ATP level and complex I activity were measured from liver, muscle, heart, kidney and brain. Atorvastatin significantly decreased the ATP levels in heart and kidney, while a slight decrease was seen in liver, muscle and brain. Atorvastatin caused an insignificant decrease in the complex I activity in all tissues examined. ALA administration significantly improved the ATP levels in the liver, heart and kidney, while Vit E improved the ATP levels in all tissues except the muscle compared to Atorvastatin group. Single administration of both ALA and vit E ameliorated complex I activity in the muscle, heart, kidney and brain. The combination of ALA and Vit E significantly improved the ATP levels in the liver, heart, kidney and brain and also provided significant improvements the complex I activity in all tissues. The undesirable effects of Atorvastatin on mitochondrial functions in this study ameliorated by using ALA and/or Vit E alone and in combination. V.STUDY OBJECTIVE Compare rates of urinary retention in patients undergoing endoscopic hysterectomy with those undergoing non-hysterectomy endoscopic gynecologic surgery DESIGN Retrospective case control study matched by operative time SETTING Academic medical center PATIENTS All patients undergoing endoscopic gynecologic surgeries between January 2013 and December 2018 INTERVENTIONS Outpatient endoscopic gynecologic surgery MEASUREMENTS AND MAIN RESULTS A total of 200 endoscopic hysterectomy cases were matched to endoscopic non-hysterectomy gynecologic surgery controls in a 11 ratio. Differences in baseline and operative characteristics between the two groups included age (years, 48.6 vs. 45.7, p = 0.04), perioperative opioid administration (morphine mg equivalents, 11.6 vs. 7.6, p = 0.01) and estimated blood loss (mL, 64.1 vs. 31.8, p=0.001). Rate of urinary retention in the hysterectomy group was double that of the non-hysterectomy group (26.5% vs. 13%, p = 0.01). In the hysterectomy group age, perioperative opioids, operative time, and estimated blood loss did not differ between those that failed or passed the void trial. In the non-hysterectomy group, only operative time was significantly longer in those that failed the void trial (mins, 108 vs. 94.3, p=0.04). After adjusting for perioperative opioid use and operative time, the relative risk of urinary retention in the hysterectomy group was 2.3 (p=0.002, 95% CI 1.38 - 3.98). CONCLUSION Hysterectomy appears to be an independent and major factor contributing to postoperative urinary retention. When compared to non-hysterectomy gynecologic surgical controls with similar operative times, the rate of urinary retention in hysterectomy patients was doubled. PURPOSE To report the outcome of stereotactic ablative radiotherapy (SABR) to the primary tumor for patients with metastatic pancreatic cancer. MATERIALS AND METHODS We examined the records of patients with metastatic pancreatic cancer treated with SABR to the primary tumor between 2002 and 2018. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03. Pain intensity pre- and post-SABR was scored according to the Stanford Pain Scale as reported by the patient. Time-to-events were calculated from the date of end of SABR delivery. RESULTS In total, 27 patients were identified that met the inclusion criteria. Seventeen (63%) patients received single fraction SABR with a median dose of 25 Gy (range 12.5-25), while 10 (37%) patients were treated in 5 fractions with a median dose of 33 Gy (range 25-40). Prior to the start of SABR, 17 (63%) patients reported having abdominal pain, with a median intensity of 5 in the 0 to 10 pain scale (range 1-9), 11 (41%) of them necessitating continuous opioid use. The median follow-up was of 6 months (range 0-18). Median overall survival was of 7 months (95% CI, 3-10), with a cumulative incidence of local failures at 1 year of 25% (95% CI, 10-44). After SABR, there was a significant reduction in the mean intensity of pain (P = 0.01), and a 46% relative reduction in continuous opioid use. Only two patients (7%) presented a grade 3 toxicity that could be attributed to treatment. CONCLUSION In this small series, SABR demonstrated to be a safe and effective option for the local palliation of metastatic pancreatic cancer, with measurable improvements in abdominal pain and opioid necessity. Magnetic Resonance Imaging (MRI) is critical in diagnosing post-operative complications following implant surgery and imaging anatomy adjacent to implants. Increasing field strengths and use of gradient-echo sequences have highlighted difficulties from susceptibility artefacts in scan data. Artefacts manifest around metal implants, including those made from titanium alloys, making detection of complications (e.g. bleeding, infection) difficult and hindering imaging of surrounding structures such as the brain or inner ear. Existing research focusses on post-processing and unorthodox scan sequences to better capture data around these devices. This study proposes a complementary up-stream design approach using lightweight structures produced via additive manufacturing (AM). Strategic implant mass reduction presents a potential tool in managing artefacts. Uniform specimens of Ti-6Al-4V structures, including lattices, were produced using the AM process, selective laser melting, with various unit cell designs and relative densities (3.