Observations on chronic peptic ulcer and its medical treatment

The end and purpose of iedicine is to alleviate pain, prolong life, restore to health, and promote good health in the individual and the community. The science of medicine is being rapidly advanced by those who work in the laboratories of physiology and patho gy, and its art yearly becomes more intricate, as the advance of knowledge adds to the burden of physicians who practise it. Medical research, the instrument of progressive medicine has made great advances in the present century. But whilst realising that the practice of medicine is changing, we must also take into account the change which the human race is under- going. In the evolution of species, especially in human beings, the reactions to environment undergo constant modifications, and certain diseases disappear in whole or in part, and other new diseases just as certainly make their appearance. No other facts in the history of medicine are more soundly established than the results of the laws of evolution of the diseases which inflict mankind. This has been accepted with respect to the plagues of the human race, and the cyclic character of epidemics, but the same study has not been given to the systemic diseases of the body. We rather fail to realise that any particular organ and its environment is constantly and permanently changing, and the disease which today follows a definite course may in the passage of future generations become hardly comparable with the disease which takes its place. A pathologist, reincarnated a hundred years from now would probably find many pathological conditions which he had never seen before, and the microscopic appearances of the various organs under varying pathological reactions would be largely new ground for his once experienced eyes. It is not only new knowledge attained by new methods which changes our conceptions of disease processes; the diseases themselves are changing, and in the course of time it becomes necessary to correlate the facts concerning them in order to establish and to be able to appreciate the extent of this change. There can be little doubt but that the incidence of peptic ulcer of the stomach and duodenum, in the present harassed state of the world and mankind shows a distinct rise in the last quarter of a century and the factors which tend to this and the treatment of the disease as advocated by various authorities I shall endeavour to bring forward clearly in this Thesis.Since graduating, and for the purpose of this Thesis, I have endeavoured to specially interest myself in this disease - chronic peptic ulcer.As Resident Medical Officer, for a year, at St. Andrew's Hospital, Dollis Hill, London, - a general Hospital of fifty -five beds, specially for the professional and middle classes who could not afford high Nursing Home fees, I had ample opportunity to observe a number of these cases, and at the Marylebone Infirmary, London, where I was House Physician, I had similar opportunities. Thereafter, in my own practice and in the Outpatient Department of the Royal Sussex County Hospital, Brighton, I have tried to further my knowledge. In one section, to follow, will be found an analysis of 293 cases of peptic ulcer admitted to the wards of the Royal Sussex County Hospital during the years 1930 and 1931. I have no solution to put forward for this great medical problem of Peptic ulcer, but have endeavoured to express my ideas, especially as regards treatment, from the point of view of the general practitioner.The aetiology of this disease is a subject of mystery and immense interest, for, in the light of our present knowledge, we can really point to no specific factor and can only surmise. But great strides are being made of late years by physicians, though it is rather sad to relate, as Hurst states, that -4- that we owe the enormous progress in our knowledge of gastric and duodenal ulcer during the first twenty years of the present century almost entirely to surgeons; during the last ten years the bio- chemist and radiologist have added their quota. If the general practitioner and physician are prepared to seize the opportunity, the prevention, early recogni- tion and successful treatment of peptic ulcer should in the future be in their hands. Hurst, rather cynically states, when considering operations in general, in this disease, and gastro-enterostomy in particular, that in his experience gastro -enterostomy is the commonest gastric disorder to -day, and undoing open ,,t i oN gastro -enterostomy is the gastricAwe now frequently recommend. Medicine, however, cannot be an exact science because of the ever present and variable factor in our problems, of the human or temperamental element.No amount of chemical, X -ray, or other investi- gations can compensate for the absence of a clinical insight, which is at first innate in varying degree, and later developed by careful observation, clear thinking, and the use of experience

Primate theory of mind is a Turing test

Heyes’s literature review of deception, imitation, and selfrecognition is inadequate, misleading, and erroneous. The anaesthetic artifact hypothesis of self-recognition is unsupported by the data she herself examines. Her proposed experiment is tantalizing, indicating that theory of mind is simply a Turing test

First-passage theory of exciton population loss in single-walled carbon nanotubes reveals micron-scale intrinsic diffusion lengths

One-dimensional crystals have long range translational invariance which manifests as long exciton diffusion lengths, but such intrinsic properties are often obscured by environmental perturbations. We use a first-passage approach to model single-walled carbon nanotube (SWCNT) exciton dynamics (including exciton-exciton annihilation and end effects) and compare it to results from both continuous-wave and multi-pulse ultrafast excitation experiments to extract intrinsic SWCNT properties. Excitons in suspended SWCNTs experience macroscopic diffusion lengths, on the order of the SWCNT length, (1.3-4.7 um) in sharp contrast to encapsulated samples. For these pristine samples, our model reveals intrinsic lifetimes (350-750 ps), diffusion constants (130-350 cm^2/s), and absorption cross-sections (2.1-3.6 X 10^-17 cm^2/atom) among the highest previously reported.and diffusion lengths for SWCNTs.Comment: 6 pages, 3 figure

Evaluation of Police and Fire Reform:Year 1 Summary Report

Police Scotland and the Scottish Fire and Rescue Service (SFRS) became operational in 2013 following the passing of the Police and Fire Reform (Scotland) Act in 2012. In terms of policing, the Act brought together the eight regional Police forces, the Scottish Police Services Authority and the Scottish Crime and Drug Enforcement Agency into two new national bodies: Police Scotland and the Scottish Police Authority. In relation to Fire and Rescue services, the Act established the Scottish Fire and Rescue Service , replacing the eight former Fire and Rescue services and the Scottish Fire Services College. Both sets of reforms are set within a context of decreasing budgets and involve making significant financial savings in relatively short timescales. Both Police Scotland and SFRS are also experiencing important shifts in demand for their services. The aims of this evaluation are to: (i) assess if the three aims of reform (reduced duplication, more equal access to specialist expertise and greater engagement with communities) have been met; (ii) learn the lessons from the implementation of this reform to inform the process of future public service reform; (iii) evaluate the wider impact of reform on the Justice and the wider public sector. The evaluation began in February 2015 and will conclude in February 2019. This first report focuses on findings emerging from the initial two stages of this work: (i) a review of publically available evidence up to the end of November 2015 and (ii) national key informant interviews. The latter were undertaken with a sample of senior representatives across policing and fire in Scotland and a range of national bodies outwith the two services, including other criminal justice sector agencies, local authorities and third sector organisations. This will be complemented with local geographical case study work in years two and four of the evaluation by engaging with local stakeholders including police officers, firefighters, elected members and community representatives. The purpose of the interviews was to focus on perceptions of the processes and experiences of reform in order to help understand 'how' and 'why' the aims of reform have (or have not) been met. The interviews have also highlighted possible lessons for future public service reform processes and the wider impacts of police and fire reform on the justice system and public sector more broadly. No claims can be made for the representativeness of the views articulated by the interviewees but they do give an important if partial perspective on reform. A sample of these interviewees will be revisited at a later stage in the evaluation to capture perceptions of change over time. This Executive Summary section gives an overview of the key themes which have emerged from this first year of work. These are elaborated upon in the main body of the report which captures in greater detail important differences and distinctions in the experiences of reform for the two services

Spatial Patch Occupancy Patterns of the Lower Keys Marsh Rabbit

Reliable estimates of presence or absence of a species can provide substantial information on management questions related to distribution and habitat use but should incorporate the probability of detection to reduce bias. We surveyed for the endangered Lower Keys marsh rabbit (Sylvilagus palustris hefneri) in habitat patches on 5 Florida Key islands, USA, to estimate occupancy and detection probabilities. We derived detection probabilities using spatial replication of plots and evaluated hypotheses that patch location (coastal or interior) and patch size influence occupancy and detection. Results demonstrate that detection probability, given rabbits were present, was \u3c0.5 and suggest that naı¨ve estimates (i.e., estimates without consideration of imperfect detection) of patch occupancy are negatively biased. We found that patch size and location influenced probability of occupancy but not detection. Our findings will be used by Refuge managers to evaluate population trends of Lower Keys marsh rabbits from historical data and to guide management decisions for species recovery. The sampling and analytical methods we used may be useful for researchers and managers of other endangered lagomorphs and cryptic or fossorial animals occupying diverse habitats

Correlation of C2 fractures and vertebral artery injury.

STUDY DESIGN: Retrospective review of prospectively collected data. SUMMARY OF BACKGROUND DATA: Vertebral artery injuries (VAI) occur commonly after cervical spine trauma. No study has yet examined the association between VAI and specific variants of C2 fractures. OBJECTIVE: To evaluate the incidence of VAI (as defined by magnetic resonance imaging/angiography [MRI/A]) in subtypes of C2 fractures. To define the association between the incidence, morphology, and severity of C2 fractures, based on fracture angulation and comminution, and the occurrence of VAI. METHODS: Patients admitted to the hospital with C2 fractures between October 2006 and December 2008 to a tertiary care referral center were identified through a prospectively maintained database. Computed tomography (CT) and MRI/A studies were individually reviewed to evaluate the specific C2 fracture type and the occurrence of VAI. Fracture displacement and angulation were measured. Incidence of VAI was compared between different types and subtypes of C2 fractures. The effects of displacement and angulation of the fracture, morphology of foramen transversarium fracture, patient age, and patient gender on VAI were also analyzed. RESULTS: One hundred one patients were identified with C2 fractures that met inclusion criteria, and 18 (17.8%) had VAI by MRI/A. There was no correlation between fracture types and VAI. However, in subtype analysis, there was a correlation of VAI with traumatic spondylolisthesis of axis (TSA) and greater degree of angulation (P = 0.0023), communition fracture (P = 0.0341), and presence of bone fragment(s) within the foramen transversarium (P = 0.0075). Multivariate logistic regression indicated that age, gender and the presence of fragments within foramen transversarium were associated with greater risk of VAI. CONCLUSION: Vertebral artery injuries are more likely to occur in C2 fractures with comminuted fractures involving the foramen transversarium, with fractures manifesting bony fragment(s) within the foramen transversarium, or with fractures having greater angulation. These risk factors should be considered when a patient presents with isolated axis fracture

Mercury's Surface Magnetic Field Determined from Proton-Reflection Magnetometry

Solar wind protons observed by the MESSENGER spacecraft in orbit about Mercury exhibit signatures of precipitation loss to Mercury's surface. We apply proton-reflection magnetometry to sense Mercury's surface magnetic field intensity in the planet's northern and southern hemispheres. The results are consistent with a dipole field offset to the north and show that the technique may be used to resolve regional-scale fields at the surface. The proton loss cones indicate persistent ion precipitation to the surface in the northern magnetospheric cusp region and in the southern hemisphere at low nightside latitudes. The latter observation implies that most of the surface in Mercury's southern hemisphere is continuously bombarded by plasma, in contrast with the premise that the global magnetic field largely protects the planetary surface from the solar wind

Geochemical Logging in the Cajon Pass Drill Hole and Its Application to a New, Oxide, Igneous Rock Classification Scheme

A new elemental oxide classification scheme for crystalline rocks is developed and applied to geochemical well logs from the Cajon Pass drill hole. This classification scheme takes advantage of measurements of elements taken by a geochemical logging tool string. It uses K_2O versus SiO_2/Al_2O_3 to distinguish between granites, granodiorites, tonalites, syenites, monzonites, diorites, and gabbros. Oxide measurements from cores are used to calibrate the elemental abundances determined from the well logs. From these logs, a detailed lithologic column of the core is generated. The lithologic column derived from the well log classification scheme is compared with a lithologic column constructed from core samples and well cuttings. In the upper 1295 m of the well, agreement between the two columns is good. Discrepancies occur from 1295 to 2073 m and are believed to be caused by the occurrence of rock types not distinguished by the classification scheme and/or the occurrence of secondary minerals. Despite these discrepancies, the well log-based classification scheme helps to distinguish changes in rock type and shows potential as an aid to the construction of lithologic columns in boreholes of crystalline rocks