Major abdominal surgery in Jehovah’s Witnesses

Introduction Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients. Methods The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer. Results All patients were supported in their decision making by the clinical team and the Hospital Liaison Committee for Jehovah’s Witnesses. The patients recognised the ethical and moral difficulties experienced by clinicians in this setting. However, they described taking strength from their belief in Jehovah. A multitude of techniques are available to minimise the risk associated with major surgery in Jehovah’s Witness patients, many of which have been adopted to minimise unnecessary use of blood products in general. Nevertheless, the risks of catastrophic haemorrhage and consequent mortality remain an unresolved issue for the treating team. Conclusions Respect for a patient’s autonomy in this setting is the overriding ethical principle, with detailed discussion forming an important part of the preparation of a Jehovah’s Witness for major abdominal surgery. Clinicians must be diligent in the documentation of the patient’s wishes to ensure all members of the team can abide by these

Theoretical frameworks for the study of structuring processes in group decision support systems

Most theoretical perspectives used to explain the use and effects of communication and decision support technologies assume someform of technological a&rminism. lnwnsisten&s in the research jindings have prompted theorists to reject the assumptions of technological determinism in favor of an emergent perspective. To date, only adaptive structuration theo y CAST) offers the promise of satisfying two requirements for exphnation based on an emergent perspective: recursivify and unique effects. The current article reviews the application of AST to the study of a relatively recent technology in the workplace--group decision support systems (GDSS). Next it discusses AST's chal- lenge to capture, dynamically and precisely, GDSS processes and outcomes. In response to these concerns, self-organizing systems theory (SOST) is reviewed and applied to problematic areas in GDSS research with the aim of advancing AST

Serotype-specific differences in inhibition of reovirus infectivity by human-milk glycans are determined by viral attachment protein σ1

AbstractHuman milk contains many bioactive components, including secretory IgA, oligosaccharides, and milk-associated proteins. We assessed the antiviral effects of several components of milk against mammalian reoviruses. We found that glucocerebroside (GCB) inhibited the infectivity of reovirus strain type 1 Lang (T1L), whereas gangliosides GD3 and GM3 and 3′-sialyllactose (3SL) inhibited the infectivity of reovirus strain type 3 Dearing (T3D). Agglutination of erythrocytes mediated by T1L and T3D was inhibited by GD3, GM3, and bovine lactoferrin. Additionally, α-sialic acid, 3SL, 6′-sialyllactose, sialic acid, human lactoferrin, osteopontin, and α-lactalbumin inhibited hemagglutination mediated by T3D. Using single-gene reassortant viruses, we found that serotype-specific differences segregate with the gene encoding the viral attachment protein. Furthermore, GD3, GM3, and 3SL inhibit T3D infectivity by blocking binding to host cells, whereas GCB inhibits T1L infectivity post-attachment. These results enhance an understanding of reovirus cell attachment and define a mechanism for the antimicrobial activity of human milk

‘Look into the Book of Life’: Muslim musicians, Sufism, and postmodern spirituality in Britain

Spirituality has been theorised as a characteristic of late-modern society, a consequence of individualisation and of a relativized marketplace of religion. Drawing on findings from ethnographic fieldwork conducted with Muslim musicians in the UK, the author claims that spirituality can indeed be considered a postmodern discourse of belief – with trans-religious applicability – but that at the same time it can be articulated from within a clear understanding of group/religious membership. The concepts of ‘spiritual capital’ and ‘expressive communalism’ are used to explain the ways through which a postmodern discourse of spirituality is utilised by Muslim musicians from within contemporary networks of Sufism in the West. The author suggests that the cosmopolitan and inclusive nature of these types of Sufism in Britain – particularly amongst third and fourth generation Muslims – represents a frontier of religious change in the UK and a challenge to traditional forms of religious authority, discourse and membership

From sparse to dense and from assortative to disassortative in online social networks

Inspired by the analysis of several empirical online social networks, we propose a simple reaction-diffusion-like coevolving model, in which individuals are activated to create links based on their states, influenced by local dynamics and their own intention. It is shown that the model can reproduce the remarkable properties observed in empirical online social networks; in particular, the assortative coefficients are neutral or negative, and the power law exponents are smaller than 2. Moreover, we demonstrate that, under appropriate conditions, the model network naturally makes transition(s) from assortative to disassortative, and from sparse to dense in their characteristics. The model is useful in understanding the formation and evolution of online social networks.Comment: 10 pages, 7 figures and 2 table

Nitrides as ammonia synthesis catalysts and as potential nitrogen transfer reagents

In this article, an overview of the application of selected metal nitrides as ammonia synthesis catalysts is presented. The potential development of some systems into nitrogen transfer reagents is also described

Predicting language diversity with complex network

Evolution and propagation of the world's languages is a complex phenomenon, driven, to a large extent, by social interactions. Multilingual society can be seen as a system of interacting agents, where the interaction leads to a modification of the language spoken by the individuals. Two people can reach the state of full linguistic compatibility due to the positive interactions, like transfer of loanwords. But, on the other hand, if they speak entirely different languages, they will separate from each other. These simple observations make the network science the most suitable framework to describe and analyze dynamics of language change. Although many mechanisms have been explained, we lack a qualitative description of the scaling behavior for different sizes of a population. Here we address the issue of the language diversity in societies of different sizes, and we show that local interactions are crucial to capture characteristics of the empirical data. We propose a model of social interactions, extending the idea from, that explains the growth of the language diversity with the size of a population of country or society. We argue that high clustering and network disintegration are the most important characteristics of models properly describing empirical data. Furthermore, we cancel the contradiction between previous models and the Solomon Islands case. Our results demonstrate the importance of the topology of the network, and the rewiring mechanism in the process of language change

A perspective on multinational enterprise’s national identity dilemma

This conceptual paper identifies gaps and contributes to the literature on ‘identity’ dilemmas faced by multinational enterprises operating in a globalised world. Various characteristics and business strategies of multinational enterprises are delineated and analysed through the lens of social identity theory and international business concepts such as market and institutional logic. Our analysis, based on multiple cases, and derived from a variety of industries and countries, associates the identity dilemma to informed business strategy. Our findings suggest that while multinational enterprises face identity dilemmas that they sometimes use to their advantage, it also poses several challenges. Through our conceptualisation, we derive five distinct propositions to shape future research directions

Ki67 expression levels are a better marker of reduced melanoma growth following MEK inhibitor treatment than phospho-ERK levels

The loss of tumour phospho-extracellular responsive kinase (pERK) positivity is the major treatment biomarker for mitogen-activated protein kinase/extracellular responsive kinase (MEK) inhibitors. Here, we demonstrate that there is a poor correlation between pERK inhibition and the anti-proliferative effects of MEK inhibitors in melanoma cells. We suggest that Ki67 is a better biomarker for future clinical studies