The Egyptian Cardiothoracic Surgeon (ECTS - E-Journal)
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The Development of a Mental Health Screening Tool and Referral Pathway for Police Custody.
No full textGeography and Global Change Science: Relationships Necessary, Absent, and Possible
No full textInitiated by geoscientists, the growing debate about the Anthropocene, '€˜planetary boundaries'€™ and global '€˜tipping points'€™ is a significant opportunity for geographers to reconfigure two things: one is the internal relationships among their discipline's many and varied perspectives (topical, philosophical, and methodological) on the real; the other the discipline's actual and perceived contributions to important issues in the wider society. Yet, without concerted effort and struggle, the opportunity is likely to be used in a 'safe' and rather predictable way by only a sub-set of human-environment geographers. The socio-environmental challenges of a post-Holocene world invite old narratives about Geography's holistic intellectual contributions to be reprised in the present. These narratives speak well to many geoscientists, social scientists, and decision-makers outside Geography. However, they risk perpetuating an emaciated conception of reality wherein Earth systems and social systems are seen as knowable and manageable if the ‘right’ ensemble of expertise is achieved. I argue that we need to get out from under the shadow of these long-standing narratives. Using suggestive examples, I make the case for forms of inquiry across the human-physical 'divide'€™ that eschew ontological monism and that serve to reveal the many legitimate cognitive, moral, and aesthetic framings of Earth present and future. Geography is unusual in that the potential for these forms of inquiry to become normalised is high compared with other subjects. This potential will only be taken advantage of if certain human-environment geographers unaccustomed to engaging the world of geoscience and environmental policy change their modus operandi
A mixed methods study to explore women and clinicians' response to pain associated with suturing second degree perineal tears and episiotomies [PRAISE].
No full textBACKGROUND: perineal suturing is a common event which affects women across a variety of international settings. Women have expressed pain related to perineal trauma in the postnatal period but little is known about pain during suturing. In addition, there is a lack of evidence to identify how professional decisions are made about pain management during the suturing process. OBJECTIVE: to explore women and clinicians' response to pain during the suturing of second degree tears and episiotomies. DESIGN: mixed method feasibility study which included observation, questionnaires and interviews. SETTING: a Hospital Trust in Northwest England. PARTICIPANTS: 40 women and 21 clinicians participated. MEASUREMENTS AND FINDINGS: mild, moderate and severe pain was measured via the McGill Pain Questionnaire-Short Form (MCPQ-SF). Psychological distress was identified via the Hospital Anxiety and Depression Scale (HADS). Semi-structured face to face interviews identified three themes, Psychological distress and future functioning; Variation in practice and Style of communication. KEY CONCLUSIONS: women who experienced psychological distress during previous or current childbirth scored higher on HADS and MCPQ-SF, and appeared to express more concerns about future functioning and healing. Variation in practice exists and style of communication had the potential to make the difference for women. IMPLICATIONS FOR PRACTICE AND RESEARCH: the process of suturing is complex and is not a standalone event for a woman. It is crucial that health professionals consider previous and subsequent experience of perineal suturing. Future research aims to develop a decision tree to support pain management during suturing
Dimension: Fractal Forms and Periodical Texture
No full textThis essay argues that the patterns of sameness and difference inherent in periodical form can be understood by analogy with the infinitely complex but self-similar forms of fractal geometry. More specifically, the notion of fractal (or fractional) dimension supplies not only a new conceptual vocabulary to describe the increased dimensionality of periodicals but also a quantitative measure of the complexity of form. Using digital tools and visualisations, dimension, together with the complementary notion of texture, can be set to work as the theoretical basis for new comparative analyses. At the same time, this approach raises important questions about the transferability of theoretical concepts from the sciences to the humanities
Justification and good practice in using handheld portable dental X-ray equipment: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR).
No full textHandheld portable X-ray devices are increasingly used for intraoral radiography. This development introduces new challenges to staff and patient safety, for which new or revised risk assessments must be made and acted upon prior to use. Major issues might be: difficulties in using rectangular collimation with beam aiming devices, more complex matching of exposure settings to the x-ray receptor used (e.g. longer exposure times), movements due to the units' weight, protection of the operator and 3rd persons and the use in uncontrolled environments. These problems may result in violation of the ''As Low As Reasonably Achievable'' i.e. ALARA-principle by an increase in (re)exposures compared to the other available intraoral X-ray devices. Hence, the use of handheld portable X-ray devices should be considered only after careful and documented evaluation (which might be done based on medical physics support), when there is evidence that handheld operation has benefits over traditional modalities, and when no new risks to the operators and/or third parties are caused. It is expected, that the use of handheld portable x-ray devices will be very exceptional and for justified situations only. Special attention should be drawn to beam aiming devices, rectangular collimation, the section of the x-ray receptor, focus-skin distance, backscatter shielding and that the unit delivers reproducible dose over the full set of environmental conditions (e.g. battery status and -temperature)
An optimization-based approach to extract faceted crystal shapes from stereoscopic images
No full textHigh-density genotyping of immune loci in Koreans and Europeans identifies eight new rheumatoid arthritis risk loci.
No full textOBJECTIVE: A highly polygenic aetiology and high degree of allele-sharing between ancestries have been well elucidated in genetic studies of rheumatoid arthritis. Recently, the high-density genotyping array Immunochip for immune disease loci identified 14 new rheumatoid arthritis risk loci among individuals of European ancestry. Here, we aimed to identify new rheumatoid arthritis risk loci using Korean-specific Immunochip data. METHODS: We analysed Korean rheumatoid arthritis case-control samples using the Immunochip and genome-wide association studies (GWAS) array to search for new risk alleles of rheumatoid arthritis with anticitrullinated peptide antibodies. To increase power, we performed a meta-analysis of Korean data with previously published European Immunochip and GWAS data for a total sample size of 9299 Korean and 45 790 European case-control samples. RESULTS: We identified eight new rheumatoid arthritis susceptibility loci (TNFSF4, LBH, EOMES, ETS1-FLI1, COG6, RAD51B, UBASH3A and SYNGR1) that passed a genome-wide significance threshold (
No Such Thing as Accident: Rethinking the Relation between Causal and Moral Responsibility
No full textAccording to the conventional view, causal and moral responsibility have a strict hierarchical relationship. Determining causal responsibility comes first; then we sort through the factors to which we have assigned causal responsibility and determine which, if any, should be assigned moral responsibility too. Moral inquiry accordingly stands not only apart but also above causal inquiry. But I am going to argue that this way of looking at causal and moral responsibility is a mistake. Rather than being separate and independent inquires with different purposes and concerns, I am going to argue that finding causal responsibility actually entails finding moral responsibility even when there is no evidence of what we would call traditional fault. Indeed, I am going to argue we cannot find someone causally responsible without finding them morally responsible too
A classical force field for tetrahedral oxyanions developed using hydration properties: The examples of pertechnetate (TcO4-) and sulfate (SO42-)
No full textRadioactive pertechnetate, (TcO4-)-Tc-99, is one of the most problematic ionic species in the context of the clean up and storage of nuclear waste. Molecular simulations can be used to understand the behavior of TcO4- in dilute aqueous solutions, providing reliable potentials are available. This work outlines the development of a new potential model for TcO4- and competing SO42-, optimized using their hydration properties, such as the Gibbs hydration free energy (calculated using Bennett's acceptance ratio method). The findings show that the TcO4- oxyanion has a very low hydration free energy (-202 kJ mol(-1)) compared to other anions (Cl-, I-, SO42-) leading to fast water exchange dynamics and explaining its observed high mobility in the aqueous environment. Its hydrated structure, investigated using ion-water radial distribution functions, shows that it is unique amongst the other anions in that it does not possess well-defined hydration shells. Since contaminants and ubiquitous species in the aqueous environment are often present as tetrahedral oxyanions, it is proposed that the approach could easily be extended to a whole host of other species. (C) 2015 AIP Publishing LLC
The use of a novel bone allograft wash process to generate a biocompatible, mechanically stable and osteoinductive scaffold for use in bone tissue engineering.
No full textFresh-frozen biological allograft remains the most effective substitute for the 'gold standard' autograft, sharing many of its osteogenic properties but, conversely, lacking viable osteogenic cells. Tissue engineering offers the opportunity to improve the osseointegration of this material through the addition of mesenchymal stem cells (MSCs). However, the presence of dead, immunogenic and potentially harmful bone marrow could hinder cell adhesion and differentiation, graft augmentation and incorporation, and wash procedures are therefore being utilized to remove the marrow, thereby improving the material's safety. To this end, we assessed the efficiency of a novel wash technique to produce a biocompatible, biological scaffold void of cellular material that was mechanically stable and had osteoinductive potential. The outcomes of our investigations demonstrated the efficient removal of marrow components (~99.6%), resulting in a biocompatible material with conserved biomechanical stability. Additionally, the scaffold was able to induce osteogenic differentiation of MSCs, with increases in osteogenic gene expression observed following extended culture. This study demonstrates the efficiency of the novel wash process and the potential of the resultant biological material to serve as a scaffold in bone allograft tissue engineerin