Competencies and skills to enable effective care of severely obese patients undergoing bariatric surgery across a multi-disciplinary healthcare perspective: a systematic review.

Increasing numbers of illicit and unlicensed medicines are in general circulation and regularly seized by the police and other regulatory authorities. Forensic identification of seized tablets tends to focus on visual appearance and chromatographic identification of the contained drug. This process is relatively time consuming and places a strain on forensic laboratories. It was therefore of interest to investigate the possible application of differential scanning calorimetry (DSC) as a fast and efficient tool to facilitate the identification of contained drug/s and associated tablet excipients. Sixteen different cases (Cases A to P) of diazepam tablets obtained from Police Scotland were characterised based on visual appearance (colour and manufacturers' logos), physical attributes (size, weight and hardness), drug type, drug quantity (HPLC) and thermal properties (DSC). Raw DSC data was further processed using principal component analysis (PCA) as an objective assessment of the thermograms obtained with a view to statistical grouping of different cases. Cases J/K, M/O and L/P could be paired on visual appearance and Cases B/C/E/G and J/K/L/P on tablet hardness (17-23 and 80-89 N respectively). HPLC indicated that 75% of the cases examined contained diazepam but less than half of these contained the recognised amount (10 mg); Cases B/E/L/P contained phenazepam and J/K contained etizolam. The thermal signatures of individual tablets provided by DSC produced qualitative information about both drugs and excipients, indicating lactose in Cases D/F/H/I/J/K/M/N/O and Emcompress' in B/E/L/P. In particular, DSC coupled with PCA provided confident groupings of A/C/G, B/E/L/P and H/I/J/K, and specific pairings of B/E, L/P and F/N

The Lantern Vol. 43, No. 1, Fall 1976

• Frustration • Think Again • My Sweet • Secret Society of One • November Ghosts • A Lonely Girl\u27s Prayer • Visions of You • The Innocence Baby • Society • Silence • Don\u27t Turn Around • Waves • Loneliness • Time Writer • Brood • It\u27s Not Funny • Four Haiku, Entwined • We\u27ll Have to Stop Meeting Like This • Castles In the Sand • The Seahttps://digitalcommons.ursinus.edu/lantern/1109/thumbnail.jp

The Lantern Vol. 43, No. 2, May 1977

• Ode to Loneliness • Windy Grief! • Death • The Icicle Vase • To Ellen • The Arrival of Night • The Reserve Clause • The Unspoken War • Bull\u27s Eye • Closing Scene • Brown Bottle Candles • Goodbye • There\u27s Individuality In The Surf • Impermanence • Dark Nightshttps://digitalcommons.ursinus.edu/lantern/1110/thumbnail.jp

Clinical outcomes and adverse events of bariatric surgery in adults with severe obesity in Scotland: the SCOTS observational cohort study

Background: Bariatric surgery is a common procedure worldwide for the treatment of severe obesity and associated comorbid conditions but there is a lack of evidence as to medium-term safety and effectiveness outcomes in a United Kingdom setting. Objective: To establish the clinical outcomes and adverse events of different bariatric surgical procedures, their impact on quality of life and the effect on comorbidities. Design: Prospective observational cohort study. Setting: National Health Service secondary care and private practice in Scotland, United Kingdom. Participants: Adults (age >16 years) undergoing their first bariatric surgery procedure. Main outcome measures: Change in weight, hospital length of stay, readmission and reoperation rate, mortality, diabetes outcomes (HbA1c, medications), quality of life, anxiety, depression. Data sources: Patient-reported outcome measures, hospital records, national electronic health records (Scottish Morbidity Record 01, Scottish Care Information Diabetes, National Records Scotland, Prescription Information System). Results: Between December 2013 and February 2017, 548 eligible patients were approached and 445 participants were enrolled in the study. Of those, 335 had bariatric surgery and 1 withdrew from the study. Mean age was 46.0 (9.2) years, 74.7% were female and the median body mass index was 46.4 (42.4; 52.0) kg/m2. Weight was available for 128 participants at 3 years: mean change was −19.0% (±14.1) from the operation and −24.2% (±12.8) from the start of the preoperative weight-management programme. One hundred and thirty-nine (41.4%) participants were readmitted to hospital in the same or subsequent 35 months post surgery, 18 (5.4% of the operated cohort) had a reoperation or procedure considered to be related to bariatric surgery gastrointestinal complications or revisions. Fewer than five participants (<2%) died during follow-up. HbA1c was available for 93/182 and diabetes medications for 139/182 participants who had type 2 diabetes prior to surgery; HbA1c mean change was −5.72 (±16.71) (p = 0.001) mmol/mol and 65.5% required no diabetes medications (p < 0.001) at 3 years post surgery. Physical quality of life, available for 101/335 participants, improved in the 3 years post surgery, mean change in Rand 12-item Short Form Survey physical component score 8.32 (±8.95) (p < 0.001); however, there was no change in the prevalence of anxiety or depression. Limitations: Due to low numbers of bariatric surgery procedures in Scotland, recruitment was stopped before achieving the intended 2000 participants and follow-up was reduced from 10 years to 3 years. Conclusions: Bariatric surgery is a safe and effective treatment for obesity. Patients in Scotland, UK, appear to be older and have higher body mass than international comparators, which may be due to the small number of procedures performed. Future work: Intervention studies are required to identify the optimal pre- and post surgery pathway to maximise safety and cost-effectiveness. Study registration: This study is registered as ISRCTN47072588. Funding details: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 10/42/02) and is published in full in Health Technology Assessment; Vol. 28, No. 7. See the NIHR Funding and Awards website for further award information

Abolishing The Police

“This is the first time we are seeing… a conversation about defunding, and some people having a conversation about abolishing the police and prison state. This must be what it felt like when people were talking about abolishing slavery.” – Patrisse Cullors, Black Lives Matter. Abolishing the Police (An Illustrated Introduction) is both a contribution to this conversation and an invitation to join it. It provides rigorous and accessible analyses of why we might want to abolish the police, what abolishing them would involve, and how it might be achieved, introducing readers to the rich existing traditions of anti-police theory and practice. Its authors draw on their diverse on-the-ground experiences of political organising, protest, and resistance to policing in the UK, France, Germany, and the United States, as well as their original research in academic fields ranging from law to security studies, political theory to sociology to public health

Report to Congress on Server and Data Center Energy Efficiency: Public Law 109-431: Appendices

This report is the appendices to a companion report, prepared in response to the request from Congress stated in Public Law 109-431 (H.R. 5646),"An Act to Study and Promote the Use of Energy Efficient Computer Servers in the United States." This report assesses current trends in energy use and energy costs of data centers and servers in the U.S. (especially Federal government facilities) and outlines existing and emerging opportunities for improved energy efficiency. It also makes recommendations for pursuing these energy-efficiency opportunities broadly across the country through the use of information and incentive-based programs

N=2 Quantum String Scattering

We calculate the genus-one three- and four-point amplitudes in the 2+2 dimensional closed N=(2,2) worldsheet supersymmetric string within the RNS formulation. Vertex operators are redefined with the incorporation of spinor helicity techniques, and the quantum scattering is shown to be manifestly gauge and Lorentz invariant after normalizing the string states. The continuous spin structure summation over the monodromies of the worldsheet fermions is carried out explicitly, and the field-theory limit is extracted. The amplitude in this limit is shown to be the maximally helicity violating amplitude in pure gravity evaluated in a two-dimensional setting, which vanishes, unlike the four-dimensional result. The vanishing of the genus-one N=2 closed string amplitude is related to the absence of one-loop divergences in dimensionally regulated IIB supergravity. Comparisons and contrasts between self-dual field theory and the N=2 string theory are made at the quantum level; they have different S-matrices. Finally, we point to further relations with self-dual field theory and two-dimensional models.Comment: 42 pages, 4 eps figures. v2: minor corrections, 2 refs. added, version to appear in Nucl. Phys.

Report to Congress on Server and Data Center Energy Efficiency: Public Law 109-431: Appendices

This report is the appendices to a companion report, prepared in response to the request from Congress stated in Public Law 109-431 (H.R. 5646),"An Act to Study and Promote the Use of Energy Efficient Computer Servers in the United States." This report assesses current trends in energy use and energy costs of data centers and servers in the U.S. (especially Federal government facilities) and outlines existing and emerging opportunities for improved energy efficiency. It also makes recommendations for pursuing these energy-efficiency opportunities broadly across the country through the use of information and incentive-based programs