Lumbar puncture for the generalist

The safe and successful performance of a lumbar puncture demands a working and yet specific knowledge as well as competency in performance. This review aims to aid understanding of the knowledge framework, the pitfalls and complications of lumbar puncture. It includes special reference to three dimensional relationships, functional anatomy, imaging anatomy, normal variation and living anatomy. A lumbar puncture is a commonly performed procedure for diagnostic and therapeutic purposes. Epidural and spinal anaesthesia, for example, are common in obstetric practice and involve the same technique as a lumbar puncture except for the endpoint of the needle being in the epidural space and subarachnoid space respectively. The procedure is by no means innocuous and some anatomical pitfalls include inability to find the correct entry site for placement of the lumbar puncture needle and lack of awareness of structures in relation to the advancing needle. Headache is the most common complication and it is important to avoid traumatic and dry taps, herniation syndromes and injury to the terminal end of the spinal cord. With a thorough knowledge of the contraindications, the regional anatomy and rationale of the technique and adequate prior skills practice, a lumbar puncture can be performed safely and successfully

Professional bodies and continuing professional education

This chapter focuses on the role of professional bodies in relation to continuing professional development (CPD) in two different professional spheres - further education and legal services. Similarities and differences between these two areas, and in particular the approaches to continuing professional development, are highlighted. The chapter concludes by identifying commonalities and differences in the trajectories, circumstances and regimes of the professions. We consider whether there are key features of CPD that should be common to all professions or whether models of CPD are contingent and dependent on circumstances. We propose a model that covers emerging factors in the conception of CPD. We argue that these findings have applicability to professions and their professional bodies more widely, as well as employers of professionals

Inoculum selection influences the biochemical methane potential of agro-industrial substrates

Obtaining a reliable estimation of the methane potential of organic waste streams in anaerobic digestion, for which a biochemical methane potential (BMP) test is often used, is of high importance. Standardization of this BMP test is required to ensure inter-laboratory repeatability and accuracy of the BMP results. Therefore, guidelines were set out; yet, these do not provide sufficient information concerning origin of and the microbial community in the test inoculum. Here, the specific contribution of the methanogenic community on the BMP test results was evaluated. The biomethane potential of four different substrates (molasses, bio-refinery waste, liquid manure and high-rate activated sludge) was determined by means of four different inocula from full-scale anaerobic digestion plants. A significant effect of the selected inoculum on the BMP result was observed for two out of four substrates. This inoculum effect could be attributed to the abundance of methanogens and a potential inhibiting effect in the inoculum itself, demonstrating the importance of inoculum selection for BMP testing. We recommend the application of granular sludge as an inoculum, because of its higher methanogenic abundance and activity, and protection from bulk solutions, compared with other inocula

Entrepreneurial Inclination Among Business Students: a Malaysian Study

Entrepreneurship has been the fundamental topics of discussion among the politicians, economists, and academics. Business creation is especially critical in developing countries to stimulate economic growth. The present study attempts to examine entrepreneurial inclination among students who are a potential source of entrepreneurs. The fi ndings of the present research study indicate that majority of our business students are not entrepreneurial-inclined. They do not seem to possess strong entrepreneurial characteristics and entrepreneurial skills, and they are not keen in starting a new business. The roles of higher institutes of education and the government in promoting entrepreneurship are discussed

Breakdown of Hydrodynamic Transport Theory in the Ordered Phase of Helimagnets

It is shown that strong fluctuations preclude a hydrodynamic description of transport phenomena in helimagnets, such as MnSi, at T>0. This breakdown of hydrodynamics is analogous to the one in chiral liquid crystals. Mode-mode coupling effects lead to infinite renormalizations of various transport coefficients, and the actual macroscopic description is nonlocal. At T=0 these effects are weakened due to the fluctuation-dissipation theorem, and the renormalizations remain finite. Observable consequences of these results, as manifested in the neutron scattering cross-section, are discussedComment: 4pp., 1 eps figur

Dynamic correlations in stochastic rotation dynamics

The dynamic structure factor, vorticity and entropy density dynamic correlation functions are measured for Stochastic Rotation Dynamics (SRD), a particle based algorithm for fluctuating fluids. This allows us to obtain unbiased values for the longitudinal transport coefficients such as thermal diffusivity and bulk viscosity. The results are in good agreement with earlier numerical and theoretical results, and it is shown for the first time that the bulk viscosity is indeed zero for this algorithm. In addition, corrections to the self-diffusion coefficient and shear viscosity arising from the breakdown of the molecular chaos approximation at small mean free paths are analyzed. In addition to deriving the form of the leading correlation corrections to these transport coefficients, the probabilities that two and three particles remain collision partners for consecutive time steps are derived analytically in the limit of small mean free path. The results of this paper verify that we have an excellent understanding of the SRD algorithm at the kinetic level and that analytic expressions for the transport coefficients derived elsewhere do indeed provide a very accurate description of the SRD fluid.Comment: 33 pages including 16 figure

Design of an object-oriented framework for modelling the partitioning of captured solar radiation and evapotranspiration in intercropping systems

x-library is a C++ object-oriented framework for modelling the partitioning of captured solar radiation and evapotranspiration in intercropping systems. The design and analysis of the x-library are done to ensure that the soil-plant-atmosphere system is categorised into classes, such as weather, microclimate, intercrop, crop, canopy, leaf, roots, soil, heat, and radiation. Meanwhile, x-library implements two kinds of solar radiation models; namely, one-dimensional (1-D), and two-dimensional (2-D) model, where irradiance varies in one dimension (vertical) and in two dimensions (vertical and horizontal), respectively. Radiation partitioning is based on weighting criteria so that a crop having the larger leaf area index and extinction coefficient would have greater share of captured radiation. Evapotranspiration partitioning is calculated using the Shuttleworth- Wallace equation. Model comparisons with a field experiment showed an overall good agreement between the simulated and measured solar radiation and transpiration values. A graphical user interface front-end for the x-library known as the x-model was also developed, primarily for non-modellers and non-programmers

Methodological issues in testing the marginal productivity theory

Previous tests of the marginal productivity theory have been criticized on several grounds reviewed by the authors. One important deficiency has been the small number of factor inputs entered in the production functions. In 1978 Gottschalk suggested a method to estimate production functions with many inputs by assuming that the production process can be split into subprocesses. This reduces the probability of multicollinearity. The authors show that the method depends on an additional assumption. Tinbergen has developed a method for avoiding this assumption. Its application to American cross-section (state) data did not alter the estimated coefficients greatly

DEM modelling of a jointed rock beam with emphasis on interface properties

This paper compares analyses performed via the distinct element method (DEM), employing rigid blocks and compliant joints, with results using finite-difference software (FLAC) obtained previously by other researchers. The paper then examines the capability of the rigid-block DEM at modelling joints realistically, with emphasis on the moment transfer between blocks. The line of thrust from this analysis was found to fit well with the well-established uniform catenary curve and the parabola, which has been used extensively in the rock engineering literature. This is an important verification exercise that is still lacking in the literature, especially for the rigid-block DEM. Finally, a comparison is made between the DEM and experimental work carried out previously by other researchers. The previously reported laboratory data were reinterpreted to derive more accurate contact laws in both normal and shear directions. A strain hardening or continuously yielding model was adopted in the latter. The calibration approach is demonstrated. The numerical findings suggest that improved predictions of beam deflections can be obtained and the predicted horizontal thrusts are comparable to the results obtained by FLAC

Reply to the Comment by B. Andresen

All the comments made by Andresen's comments are replied and are shown not to be pertinent. The original discussions [ABE S., Europhys. Lett. 90 (2010) 50004] about the absence of nonextensive statistical mechanics with q-entropies for classical continuous systems are reinforced.Comment: 5 pages. This is Reply to B. Andresen's Comment on the paper entitled "Essential discreteness in generalized thermostatistics with non-logarithmic entropy", Europhys. Lett. 90 (2010) 5000