The Egyptian Cardiothoracic Surgeon (ECTS - E-Journal)
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The timing of general population and patient suicide in England, 1997-2012
No full textBackground There have been conflicting findings on temporal variation in suicide risk and few have examined the phenomenon in clinical populations. The study investigated seasonal and other temporal patterns using national data. Methods Data on 73,591 general population and 19,318 patient suicide deaths in England between 1997 and 2012 were collected through the National Confidential Inquiry into Suicide examining suicide rates in relation to month of the year, day of the week, and individual days of national or religious significance. Results Suicide incidence fell over successive months of the year and there was evidence of an overall spring peak. Monday was associated with the highest suicide rates and in the patient population this effect appeared to be more pronounced in those aged over 50 or those who lived alone. Suicide risk was significantly lower during Christmas, particularly for women. There was a peak in suicide on New Year's Day in the general population. Other ‘special days’ were not associated with a change in suicide incidence. Limitations We were limited to identifying associations between the variables investigated and were unable to explore causal mechanisms. We did not carry out comprehensive multi-variable adjustment in our regression models. Conclusions There is substantial seasonal and temporal variation in suicide deaths, and there appears to be some evidence in the clinical as well as the general population in England. Clinical services should be aware of the risk of suicide just after the weekend, especially in people who live alone, and the potential need for closer supervision during this period
Assessing size of pituitary adenomas: a comparison of qualitative and quantitative methods on MR
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In vitro-in vivo extrapolation scaling factors for intestinal P-glycoprotein and breast cancer resistance protein: Part II. The impact of cross-laboratory variations of intestinal transporter relative expression factors on predicted drug disposition
No full textRelative Expression Factors (REFs) are used to scale in vitro transporter kinetic data via In Vitro–In Vivo Extrapolation linked to Physiologically-Based Pharmacokinetic (IVIVE-PBPK) models to clinical observations. Primarily two techniques to quantify transporter protein expression are available, immunoblotting and LC-MS/MS. Literature collated Relative Expression Factors (REF) ranged from 0.4 to 5.1 and 1.1 to 90 for intestinal Pglycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP), respectively. The impact of using human jejunum-Caco-2 REFs, for P-gp (REFiP-gp) and BCRP (REFiBCRP), generated from the same samples, employing different proteomic methodologies from independent laboratories, on PBPK outcomes was assessed. A 5-fold decrease in REFiP-gp for a single oral dose of digoxin resulted in a 1.19- and 1.31-fold higher plasma AUC and Cmax, respectively. All generated REFiP-gp values led to simulated digoxin Cmax values within observed ranges; however, combining kinetic data generated from a different laboratory, with the 5-fold lower REFiP-gp, could not recover a digoxin-rifampicin DDI; emphasising the necessity to obtain transporter-specific kinetic estimates and REFs from the same in vitro system. For a theoretical BCRP compound, with absorption taking place primarily in the jejunum, a decrease in the REFiBCRP from 2.22 (University of Manchester) to 1.11 (Bertin Pharma) promoted proximal intestinal absorption, while delaying tmax 1.44-fold. Laboratory-specific differences in REF may lead to different IVIVE-PBPK outcomes. To understand the mechanisms underlying projected PK liabilities, it is important to assess the potential impact of bias on the generation of REFs on an inter-individual basis within a target population
The task-related dynamic division of labour between anterior temporal and lateral occipital cortices in representing object size.
No full textObject size is represented by functionally distinct sectors along the ventral visual pathway. The early visual cortex encodes objects' sensory-retinal size. Subsequently, the occipitotemporal cortex computes objects' canonical size based on statistical regularities of visual features. Although the neurocomputation of size has been studied in a “bottom-up” sensory-driven framework, little is known about how perceptual size information is transformed into conceptual knowledge and how this computation is modulated by “top-down” goal-driven signals. Using continuous theta burst stimulation, we demonstrated that behavioral goal shapes the neurocognitive network underpinning object size. We manipulated the congruency of perceptual versus conceptual object size, which provides a robust behavioral probe reflecting implicit size knowledge. Neurostimulation was targeted at the lateral occipital cortex (LOC), a key region for object perception, or the anterior temporal lobe (ATL), a “hub” of supramodal conceptual processing. We observed striking contextual modulation of the neurocognitive architecture: when human participants judged perceptual size, the congruency effect was significantly attenuated by LOC stimulation but stayed resilient to ATL stimulation. By contrast, when they judged conceptual size, both LOC and ATL stimulation eradicated the otherwise robust effect. Our findings demonstrate disparate functional profiles of the LOC and ATL, providing the first evidence of a malleable network adaptively altering its division of labor with top-down states. The LOC, regardless of task demand, automatically represents “bottom-up” statistical regularities of visual conformation (reflecting typical object size), whereas the ATL contributes to this computation when the context requires semantically based linkage of visual attributes to object recognition
On the thermally developing force convection through a porous material under the local thermal non-equilibrium condition: an analytical study
No full textThe aim of the present analytical study is to investigate a thermally developing forced convective heat transfer inside a channel filled with a porous medium whose walls are imposed to a constant heat flux (i.e. the iso-flux thermal boundary condition). The Darcy’s law of motion and the two-energy equation (i.e. local thermal non-equilibrium, LTNE) model are considered. A perturbation analysis is conducted to avoid using any model for the iso-flux thermal boundary condition. Thermally developing forced convection inside a porous-filled channel has previously not been analyzed without implementing a heuristic model for the iso-flux thermal boundary condition. The temperature difference between the fluid and solid phases (called the LTNE intensity) is analytically obtained. Results concerning the LTNE intensity is compared with the available models of the iso-flux thermal boundary condition. In addition, the Nusselt number of a thermally developing convection through a porous material is obtained for the LTNE condition. Also, an expression representing the developing length, i.e. the dimensionless axial location at which the flow becomes fully developed, for a porous-filled channel is proposed for the first time
Trajectories of Vision in Older People: The role of age and social position
No full textVisual impairment becomes more prevalent with age. Rather than a uniform decline in vision with age, the strength and direction of change varies between people. This study applies an analytical method that posits multiple trajectories in eyesight, allowing for a more specific description of developmental course of this health outcome and its relationship with social position. The analysis uses the responses of 2956 respondents, aged 60 years and over, followed over 8 years (five observations) as part of the English longitudinal study of ageing. At each observation respondents self-reported their general vision. Optimal matching (sequence analysis), hierarchical clustering, and multinomial logistic regression were used to describe the sequential data, produce a typology of vision trajectories, and examine the socio-demographic characteristics associated with different trajectories. Eight distinctive clusters of trajectories were identified. The probability of reporting different types of vision trajectory varies with a change in age; however, the magnitude of the age effect is associated with social position. Visual impairment in older people is an increasingly relevant area for policy focus, with the rapid growth and diversity of the older population. Identifying factors underpinning the patterning of changes in visual function is essential for developing evidence-based policy, which both meets the needs of those most at risk and increases cost-effectiveness of public health interventions
Rebellion, Government and the Scottish Response to Argyll's Rising of 1685
No full textThe short and militarily inglorious rebellion launched in May 1685 by Archibald Campbell, 9th earl of Argyll against the regime of James VII and II is often overlooked, partly on account of its rapid disintegration and partly because outside events – not least the much more famous Monmouth rebellion in south-eastern England – tend to draw attention away from it. Yet in ignoring the rising, historians risk missing its value as a tool for understanding the social and political dynamics of late-seventeenth-century Scotland. This article presents a reassessment of Argyll’s rebellion from that perspective, demonstrating how the insurgency and the government counter-attack threw the ongoing processes of Highland/Lowland convergence into sharp relief, while also revealing the nature, and limitations, of Stuart pretensions towards monarchical ‘absolutism’
Gappiness and the Case for Liberalism About Phenomenal Properties
No full textConservatives claim that all phenomenal properties are sensory. Liberals countenance non-sensory phenomenal properties such as what it’s like to perceive some high-level property, and what it’s like to think that p. A hallmark of phenomenal properties is that they present an explanatory gap, so to resolve the dispute we should consider whether experience has non-sensory properties that appear ‘gappy’. The classic tests for ‘gappiness’ are the invertibility test and the zombi�ability test. I suggest that these tests yield conflicting results: non-sensory properties lend themselves to zombie scenarios but not to inversion scenarios. Which test should we trust? Against Carruthers & Veillet, I argue that invertibility is not a viable condition of phenomenality. In contrast, being zombi�able is credibly necessary and suf�cient for phenomenality. I conclude that there are non-sensory properties of experience that are ‘gappy’ in the right way, and that liberalism is therefore the most plausible position