'How compliant do we want to be with the colonoscopy surveillance guidelines?'

Objective: To assess the referral practice for surveillance colonoscopy amongst clinicians and to measure whether practice was inline with the current Association of Coloproctology of Great Britain and Ireland (ACPGBI) and the British Society of Gastroenterology (BSG) guidelines. Method: A questionnaire was sent to members of the ACPGBI. Results: A total of 195 (49%) clinicians responded, providing information on their referral habits with comments on where they deviated from the guidelines. Conclusions: The BSG and ACPGBI guidelines are well established amongst clinicians and generally accepted as best practice however the majority of clinicians deviate from the guidelines for particular clinical scenarios. In fact only 18% of respondents followed all recommendations for surveillance colonoscopy for patients with polyps, previous cancers and a family history

Mineral Warfare: The Dark Side of Technology and International Mediation

Conflict surrounding the extraction and trade of natural resources is not an uncommon phenomenon. Especially in the case of the Democratic Republic of Congo (DRC), which has historically suffered from the negative impacts of the resource curse since their mineral wealth was first discovered by their Colonial administrators. The importance of Congo’s minerals has fluctuated over the years but has peaked during recent times, as their use in technological advancements are becoming more vital. The global demand for these mineral ores have sky rocketed and consequentially, the largely informal trade has benefitted certain rebel groups, playing a pivotal role in the ongoing violence of Africa’s War. Despite the heightened media attention on the region, the development and enforcement of new international regulations and the creation of industry-led initiatives employed to break the tie between minerals and armed conflict in the DRC, violence is still prevalent. This thesis attempts to understand why this is, arguing that the dominant Western narrative on conflict minerals and its links to the ongoing violence is limited, as it neglects the historical context of the onset of the fighting, as well as the voice of local miners and grassroots organisations in formalisation efforts. I argue that this simplistic account and understanding of the conflict, has impeded current efforts as it overlooks and fails to solve the fundamental and underlying causes of Congo’s conflict

Number of children and risk of hormone receptor-positive versus hormone receptor-negative breast cancer

Introduction: With around 2.3 million cases, breast cancer became the most frequently diagnosed cancer in 2020 surpassing lung cancer cases and mortality. Based on histology and molecular characteristics, hormone receptor-positive (HR+) cancer has tumors with both estrogen and progesterone receptors. On the contrary, hormone receptor-negative (HR-) cancer has tumors not expressing estrogen or progesterone receptors. Getting pregnant before age of 30 years reduced the probability of disease by 50% compared to women who were childless. Material and Methods: Data from the Norwegian Women and Cancer (NOWAC) cohort study from 1991 to 2018 was used. Based on the DAG diagram, our final survival model included the age of participants at the start of the study, their age at menarche, height, and the use of oral contraceptives. The Cox proportional hazards method was used to determine the effect of the number of children diagnosed with HR+ or HR- breast cancer. All demographic and lifestyle variables were compared with the number of children, breast cancer, and non-cases using the Chi-square test and one-way ANOVA test in the two descriptive tables. Results: The multivariable analysis showed that multiparous women had a 26% lower risk of breast cancer (HR= 0.74, 95% CI: 0.65-0.85) while women with one or two children also had a 12 % reduced risk of breast cancer compared to the reference group (HR= 0.88, 95% CI: 0.78-1.01). The multivariable analysis of HR+ breast cancer showed women with multiple children had 34% lower risk (HR=0.66, 95% CI: 0.57-0.76) and women with one or two children had 16% decreased risk of HR+ breast cancer (HR=0.84, 95% CI: 0.72 - 0.96) compared to nulliparous women. Moreover, the multivariable analysis comparing with the reference group showed a greater risk of HR- breast cancer by 24% among women having multiple children (HR=1.24, 95% CI: 0.70 - 2.17) while women with fewer children had a 25 % greater risk of HR- breast cancer (HR=1.25, 95% CI: 0.72 -2.19). Conclusion: In conclusion, having children was associated with a lower risk of breast cancer overall and hormone receptor-positive breast cancer diagnosis in Norwegian women. On the contrary, we have not observed the same association between the number of children and the risk of hormone receptor-negative breast cancer

Investigations into b-o defect formation-dissociation in cz-silicon and their effect on solar cell performance

About 30% of the total market share of industrial manufacture of silicon solar cells is taken by single crystalline Czochralski (CZ) grown wafers. The efficiency of solar cells fabricated on boron-doped Czochralski silicon degrades due to the formation of metastable defects when excess electrons are created by illumination or minority carrier injection during forward bias. The recombination path can be removed by annealing the cell at about 200° C but recombination returns on exposure to light. Several mono-crystalline and multi-crystalline solar cells have been characterized by methods such as laser beam induced current (LBIC), Four-Probe electrical resistivity etc. to better understand the light induced degradation (LID) effect in silicon solar cells. All the measurements are performed as a function of light soaking time. Annealed states are produced by exposing the cells/wafer to temperature above 200° C for 30 minutes and light soaked state was produced by exposure to 1000 W/m2 light using AM1.5 solar simulator for 72 hours. Dark I-V data are analyzed by a software developed at NREL. This study shows that LID, typically, has two components- a bulk component that arises from boron-oxygen defects and a surface component that appears to be due to the SiNx:H-Si interface. With the analysis of dark saturation current (J02), it is seen that the surface LID increases with an increase in the q/2kT component. Results show that cell performance due to bulk effect is fully recovered upon annealing where as surface LID does not recover fully. This statement is also verified by the study of mc- silicon solar cells. Multi-crystalline silicon solar cell has very low oxygen content and, therefore, recombination sites will not be able to form. This shows that there is no bulk degradation in mc- Si solar cells but they exhibit surface degradation. The results suggest that a typical Cz-silicon solar cell with an initial efficiency of — 18% could suffer a reduction in efficiency to — 17.5% after the formation of a metastable defect, out of which — 0.4% comes from a bulk effect and —0.1 % is linked to a surface effect

Estimation of daily Class A pan evaporation from meteorological data

Evaporation is an important process in many hydrological, physiological and atmospheric processes. It is controlled by the availability of water and the meteorological conditions over the evaporating surface. The Class A pan evaporimeter is a popular instrument for the measurement of evaporation from a free water surface. Evaporimeter data are used primarily to estimate evapotranspiration from crop surfaces, and water requirements for irrigation. They are an important input parameter for the soil moisture computer program used at Iowa State University to estimate soil moisture and to forecast yields for corn;The Class A pan evaporimeter has drawbacks. Data are lost due to overflow during heavy rainfall and it is expensive to operate due to the requirement of a skilled operator for regular management. Also, the number of sites is very limited giving inadequate areal coverage. Because of these shortcomings, a network of automated weather stations was set up at three locations and meteorological data were collected to see if this parameter could be estimated more effectively. Using combination equations and some other empirical equations, daily Class A pan evaporation was estimated from meteorological data. Daily Class A pan evaporation was also estimated from a simplified empirical equation which used only commonly observed meteorological parameters. The simplified method assumed that minimum temperature represents the dew point temperature;Methods were evaluated by comparing the estimated values with measured pan evaporation. The combination equation gave the best performance giving most unbiased and precise results compared to other methods tested. The use of minimum temperature instead of dew point temperature on the tested empirical equations gave almost similar results

Examining live-in foreign domestic helpers as a coping resource for family caregivers of people with dementia in Singapore

In Singapore, the responsibility of caring for persons with dementia falls on family members who cope with long - term caregiver burden depending on available support resources. Hiring foreign domestic workers to alleviate caregiver burden becomes a prevalent coping strategy that caregivers adopt. This strategy allows caregivers to provide home care as part of fulfilling family obligations while managing caregiver burden. This study aimed to investigate primary caregivers’ relationship with hired support and its impact on coping with caregiver burden. Twenty in-depth interviews were conducted with primary caregivers who hired live-in domestic helpers to take care of their family members with dementia. The findings revealed that caregivers perceived the normative obligations to provide home care to family members with dementia. They sought support from domestic helpers to cope with physical and mental burnout, disruption of normal routines, and avoidance of financial strain. A mutual-support relationship was built between caregivers and domestic helpers through trust and interdependence. The presence of domestic helpers as a coping resource reveals the positive outcomes of problem, emotional, and diversion focused coping. This study illustrates that coping strategies are employed in different ways depending on the needs of caregivers, access to infrastructure, cultural expectations, and available resources

2015 Nepal Earthquake lessons for COVID-19: how to put women at the forefront of the crisis and recovery

5 years on from the devasting earthquake in Nepal, Kripa Basnyat (LSE) and Dipti Tamang (Darjeeling Government College in West Bengal, India) explain the fundamental role Nepalese women played in the country's response to the natural disaster, and what lessons we can learn when confronting the country's response to current COVID-19 global epidemic

Head and Neck Manifestations of Eosinophilic Granulomatosis with Polyangiitis: A Systematic Review.

OBJECTIVE: To conduct the first and only systematic review of the existing literature on head and neck manifestations of eosinophilic granulomatosis with polyangiitis to guide clinical decision making for the otolaryngologist. DATA SOURCES: PubMed, Cochrane Library, Scopus, and LILACS. REVIEW METHODS: A systematic review of the aforementioned sources was conducted per the PRISMA guidelines. RESULTS: From an initial 574 studies, 28 trials and reports were included, accounting for a total of 1175 patients with eosinophilic granulomatosis with polyangiitis. Among clinical and cohort studies, 48.0% to 96.0% of all included patients presented with head and neck manifestations. In a distinct group of patients detailed in case reports describing patients presenting with head and neck manifestations, patients on average fulfilled 4.6 diagnostic criteria per the American College of Rheumatology. Furthermore, 95.8% of reported cases were responsive to steroids, and 60% required additional therapy. CONCLUSION: Otolaryngologists are in a unique position for the early diagnosis and prevention of late complications of eosinophilic granulomatosis with polyangiitis. The American College of Rheumatology criteria should be relied on in the diagnostic workup. Close surveillance of these patients in a multidisciplinary fashion and with baseline complete blood counts, chest radiographs, and autoimmune laboratory tests is often necessary. Such patients with head and neck manifestations of the disease are nearly always responsive to steroids and often require additional immunosuppressive therapy or surgical intervention in cases of cranial neuropathies, temporal bone involvement, and refractory symptoms

Optimum strategies for mapping management zones using temporal remote sensing information

Non-Peer ReviewedTechnological advances in variable rate application and global positioning systems (GPS) make site-specific management technically feasible. No longer do fertilizer and pesticides need to be applied uniformly across a field, they may be varied to match the soil productivity across the field. However, successful site-specific management depends on identifying management zones and the determining optimum input application rate for those zones Unfortunately, identifying management zones that are reasonably consistent from year to year has been the greatest problem to successful site-specific management. In this study we found that crop vigor measured with normalized difference vegetation index (NDVI) based on satellite (LANDSAT) remote sensing for two different years was successful for identifying management zones. Based on the NDVI, we divided a field near Shaunavon in southwestern Saskatchewan into two zones: zone 1 with low crop and vigor zone 2 with high crop vigor. The zones corresponded to differences in soils, particularly, soil moisture, but it would be too costly and impractical to try to delineate these zones from detailed soil sampling. Wheat yield and protein were more responsive to N in zone 1 than in zone 2. The optimal N fertilizer rate was 95 kg/ha for zone 1 and 75 kg/ha for zone 2. Satellite remote sensing is a cost-effective method to delineate management zones for site-specific management