The ALBI score was associated with short-term post-operative outcomes following hepatic resection and represents a useful pre-operative risk-assessment tool to identify patients at risk for adverse post-operative outcomes.

Healthy aging individuals are more likely to suffer profound memory impairments following an immune challenge than are younger adults. These challenges produce a brain inflammatory response that is exaggerated with age. Sensitized microglia found in the normal aging brain are responsible for this amplified response, which in turn interferes with processes involved in memory formation. Here, we examine factors that may lead aging to sensitize microglia. Aged rats exhibited higher CORT levels in the hippocampus, but not in plasma, throughout the daytime (diurnal inactive phase). These elevated hippocampal CORT levels were associated with increased hippocampal 11β-HSD1 protein expression, the enzyme that catalyzes glucocorticoid formation, and greater hippocampal glucocorticoid receptor (GR) activation. Intracisternal administration of mifepristone, a GR antagonist, effectively reduced immune-activated proinflammatory responses, specifically from hippocampal microglia, and prevented E. coli-induced memory impairments in aged rats. Voluntary exercise as a therapeutic intervention significantly reduced total hippocampal GR expression. These data strongly suggest that increased GR activation in the aged hippocampus plays a critical role in sensitizing microglia.

A marginal maximum a posteriori (MMAP) procedure was implemented to estimate item parameters in the generalized graded unfolding model (GGUM). Estimates from the MMAP method were compared with those derived from marginal maximum likelihood (MML) and Markov chain Monte Carlo (MCMC) procedures in a recovery simulation that varied sample size, questionnaire length, and number of item response categories. MMAP item parameter estimates were generally the most accurate and had the smallest standard errors on average. In contrast, the accuracy and variability of MML estimates suffered substantially when the number of item response categories was small and the true item locations were extreme. MMAP estimates were also more computationally efficient than corresponding MCMC estimates. Consequently, the MMAP procedure is recommended for estimation of GGUM item parameters.

The robotic approach to pancreatectomy was associated with higher rates of pure MIS completion compared to laparoscopy, whereas no difference in MIS completion rates was noted for robotic versus laparoscopic hepatectomy.

No abstract