Naresuan University Journal
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Non-invasive imaging of localised scleroderma for assessment of skin blood flow and structure.
No full textExtensive morphoea causes major morbidity, disability and disfigurement; pathophysiology is poorly understood. The aim of this study was to investigate, with non-invasive imaging, the relationship between localised abnormalities of skin structure and perfusion, which characterise morphoea. Thirty-two patients with morphoea underwent imaging at affected and unaffected sites. Skin thickness was imaged with optical coherence tomography (OCT) and high-frequency ultrasound (HFUS). Perfusion was imaged with dual-wavelength laser Doppler imaging (LDI) and thermography. Epidermal thickness showed a small increase from affected to unaffected site (OCT, active and inactive plaques [p = 0.005 and p = 0.004], HFUS active plaques only [p = 0.03]). Deeper perfusion was higher within affected than unaffected sites (LDI p
A comprehensive review on learning curve associated problems in endoscopic vein harvesting and the requirement for a standardised training programme
No full textEndoscopic vein harvesting is becoming one of the most favourable vein harvesting techniques in multiple bypasscoronary surgery, due to its short term post-operative benefits with high patient satisfaction. However, long-termgraft patency has been both supported and questioned in the literature. Graft failure can be affected by harvestingmethods and operator’s experience. Endoscopic vein harvesting is associated with a learning curve period, duringwhich the incidence of vein trauma is high due to unfamiliarity with the surgical technique. There is a paucity ofstructured learning tools for novice practitioners, meaning that training differs significantly between hospital centres.Inconsistent training methods can lead to poor surgical technique, which can have a significant impact on vein qualityand stress level of the practitioner. In turn, this can lead to increased postoperative complications and longer surgicalduration. The main aim of this literature review is to understand the impact of the learning curve on the vein conduitand whether there is a requirement for a standardised training programme for the novice practitioners.Keywords: Coronary artery bypass, Saphenous vein, Endoscopic vein harvesting, Learning curv
Bioreduction of iodate in sediment microcosms
No full textIodine-129 is a high-yield fission product formed in nuclear reactors and is a risk-driving radionuclide in both contaminated land and radioactive waste disposal due to its high mobility and long half-life. Here, the bioreduction behaviour of iodate was investigated by tracking iodine speciation and concentration in solution during the development of progressive anoxia in sediment microcosm experiments incubated at neutral pH. Experiments with acetate added as an electron donor showed the expected cascade of terminal electron-accepting processes. Analysis of solution chemistry showed reduction of iodate to iodide during the early stages of metal (Mn(IV) and Fe(III)) reduction, but with no significant retention of iodine species on solids. There was, however, a net release of natural iodine associated with the sediments to solution when robust iron reduction / sulfate reduction had developed. In addition, over 210 days, the controls with no electron donor and the sterile controls showed no Mn(IV) or Fe(III) reduction but displayed modest sorption of iodate to the sediments in the absence of bioreduction. Overall these results show that under oxic conditions iodate may be partially sorbed to sediments over extended periods but that development of mildly reducing conditions leads to the reductive release of iodine to solution as iodide
Sustainable manufacturing of consumer appliances: reducing life cycle environmental impacts and costs of domestic ovens.
No full textAn experimental study of the effect of ply orientation on ballistic impact performance of multi-ply fabric panels
No full textThis paper presents a comprehensive experimental study of the effect of ply orientation on the ballistic performance of the multi-ply fabric panels. The fabric panels used in the experiments were constructed by laying plies of plain-wovenfabrics in a selection of orientations. Particular attention was paid to the stacking sequence of fabrics with different laying angles. Ballistic impact tests were carried out on such angled fabric panels. The results showed significant improvement in energy-absorbing capacity of the angled multi-ply panel over the conventional aligned panel where all fabric plies are laid in the same orientation. The impact energy absorption by these angled fabric panels showed a 14% increase over the aligned counterpart, depending on the number of the plies. Optimizing the stacking sequence of the angled plies caused a 15% increase in impact energy absorption. For the panels with a large number of plies, such as the eight-ply panels, the effective panel construction can be determined according to the performance of the sub-level ply group
Protocol for the CONVERT trial-Concurrent ONce-daily VErsus twice-daily RadioTherapy: an international 2-arm randomised controlled trial of concurrent chemoradiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small cell lung cancer (LS-SCLC) and good performance status.
No full textIntroduction Concurrent ONce-daily VErsus twice-daily RadioTherapy (CONVERT) is the only multicentre, international, randomised, phase III trial open in Europe and Canada looking at optimisation of chemoradiotherapy (RT) in limited stage small cell lung cancer (LS-SCLC). Following on from the Turrisi trial of once-daily versus twice-daily (BD) concurrent chemoradiotherapy, there is a real need for a new phase III trial using modern conformal RT techniques and investigating higher once-daily radiation dose. This trial has the potential to define a new standard chemo-RT regimen for patients with LS-SCLC and good performance status.Methods and analysis 447 patients with histologically or cytologically proven diagnosis of SCLC were recruited from 74 centres in eight countries between 2008 and 2013. Patients were randomised to receive either concurrent twice-daily RT(45 Gy in 30 twice-daily fractions over 3 weeks) or concurrent once-daily RT(66 Gy in 33 once-daily fractions over 6.5 weeks) both starting on day 22 of cycle 1. Patients are followed up until death. The primary end point of the study is overall survival and secondary end points include local progression-free survival, metastasis-free survival, acute and late toxicity based on the Common Terminology Criteria for Adverse Events V.3.0, chemotherapy and RTdose intensity.Ethics and dissemination The trial received ethical approval from NRES Committee North West—Greater Manchester Central (07/H1008/229). There is a trial steering committee, including independent members and an independent data monitoring committee. Results will be published in a peer-reviewed journal and presented at international conferences.<br/
COPD patients have short lung magnetic resonance T1 relaxation time
No full textMagnetic resonance imaging (MRI) may provide attractive biomarkers for assessment of pulmonary disease in clinical trials as it is free from ionizing radiation, minimally invasive and allows regional information. The aim of this study was to characterize lung MRI T1 relaxation time as a biomarker of chronic obstructive pulmonary disease (COPD); and specifi cally its relationship to smoking history, computed tomography (CT), and pulmonary function test (PFT) measurements in comparison to healthy age-matched controls. Lung T1 and inter-quartile range (IQR) of T1 maps from 24 COPD subjects and 12 healthy age-matched non-smokers were retrospectively analyzed from an institutional review board approved study. The subjects underwent PFTs and two separate MR imaging sessions at 1.5 tesla to test T1 repeatability. CT scans were performed on the COPD subjects. T1 repeatability (intraclass correlation coeffi cient) was 0.72 for repeated scans acquired on two visits. The lung T 1 was signifi cantly shorter (p <0.0001) and T 1 IQR was signifi cantly larger (p =0.0002) for the COPD subjects compared to healthy controls. Lung T 1 signifi cantly (p = 0.001) correlated with lung density assessed with CT. Strong signifi cant correlations (p <0.0001) between lung T1 and all PFT measurements were observed. Cigarette exposure did not correlate with lung T 1 in COPD subjects. In conclusion, lung MRI T 1 mapping shows potential as a repeatable, radiation free, non-invasive imaging technique in the evaluation of COPD
Understanding the Professional Project Manager: Cosmopolitans, Locals and Identity Work
No full textAn abiding concern and mission in the work of Peter Morris over many years has been to develop project management as a profession, with particular concern to bridge the rift between abstract theory and practice (cf. Morris 2006; 2011; 2013). That this is necessary reflects project management'€™s status as a new '€˜expert occupation'€™ (Reed, 1996), built primarily upon a specific set of competencies seen as applicable to a range of activities across industries. As the field has grown, project management practice has been increasingly standardised as practitioners have been '˜credentialised' with a standard set of competencies, while being employed in an increasingly diverse variety of workplaces. As a result, many project managers rely upon both local '€˜familiarity' and domain knowledge of company and industry, and at the same time a formal global 'competence' in the practice of project management. In this paper, we seek to explore this duality, examining how project managers rely in part on the authority and expertise of the profession and in part rely instead upon technical expertise and industry/organisational experience to perform their role, and how these two are reconciled. Drawing on thirty nine semi-structured interviews in an industry where project management is established and '€˜mature'€™, we adopt Gouldner'€™s (1958) cosmopolitan and local typologies to understand how project managers orientate themselves in relation to the two main institutions that dominate their employment. It further indicates that this binary distinction is complicated by a number of contradictions which project managers must make sense of in construction of a valid identity. Some project managers draw heavily on the cosmopolitan discourse, others draw on the localist discourse, but the majority seek to articulate positions which integrate both. In constructing the intermediate orientations project managers are implicitly challenging the utility of the concept of portable bodies of knowledge and universal methodologies. This questions the strategy of professionalism for this occupation and indeed opens a wider debate about the efficacy of new corporate professionalism. Further this research implies that both professional bodies and employers need to understand how to navigate these discourses. This reveals dual challenges. For the professions the challenge is to convince locals to become cosmopolitans by adopting the trappings of professionalism but without contesting too far the sovereignty of the corporation as employer. For corporations, the challenge is to capture the broad expertise of the cosmopolitan without compromising their affiliation to their employer. Ironically both institutions are complicit, often working together to meet different ends. Finally this research suggests that project management is rich in identity work and that this may provide an important lens to analyse the ongoing evolution of the wider management professions, specifically in relation to the compromises that professionalism brings to this particular form of expert labour
