Examining the distribution of ketamine and metabolites in decomposed skeletal tissues: development of a high throughput approach and application to an environmental and decomposition study

The use of skeletal tissues in forensic toxicology research has increased dramatically in the last 5 years. These studies have yielded valuable information pertinent to using skeletal tissues as a biological matrix in drug analysis. The majority of these studies have been completed on a small scale so a larger scale is needed for further research. Here, a high throughput microwave assisted extraction (MAE) and microplate solid phase extraction (MPSPE) protocol is developed and implemented to examine how body position and microclimate affect ketamine and metabolite distribution in decomposed skeletal tissue. Analytes were successful recovered in 30 min following MAE compared to 180 min for passive solvent extraction (PSE). Body proved to be significantly different in the observed drug levels at both microclimates. The sunlit microclimate had significantly higher drug levels, with less maggot activity, compared to the shaded microclimate.Master of Science (MSc) in Chemical Science

Pressure Poisson Method for the Incompressible Navier-Stokes Equations Using Galerkin Finite Elements

In this thesis we examine the Navier-Stokes equations (NSE) with the continuity equation replaced by a pressure Poisson equation (PPE). Appropriate boundary conditions are developed for the PPE, which allow for a fully decoupled numerical scheme to recover the pressure. The variational form of the NSE with PPE is derived and used in the Galerkin Finite Element discretization. The Galerkin finite element method is then used to solve the NSE with PPE. Moderate accuracy is shown

Torah in the Diaspora: A Comparative Study of Philo and 4 Maccabees

This thesis examines how Judaism was Hellenized by comparing how difference, boundaries, and syncretism function in both Philo and 4 Maccabees. Recent historical and anthropological methods demand rejection of old approaches to these works which differentiated between the Judaism and the Hellenism in them and were often dominated by attempts to show where these authors’ intellectual fidelities lay. By re-evaluating ideas of boundaries and identity, this thesis argues that these authors could be committed to the ends of both Judaism and Hellenism. This necessitates recognition that identity and boundaries are ultimately products of individual self-consciousness; these authors attempt to understand the world around them using multifarious resources. While the Torah is vitally important to the Jewish identity of both these authors, it becomes a symbol which transcends perceived boundaries between Judaism and Hellenism and becomes applicable to both paradigms

Pregnancy outcomes following different types of bariatric surgery: A national cohort study

OBJECTIVE: To assess the impact of type of bariatric surgery on pregnancy outcomes. STUDY DESIGN: This is a national prospective observational study using the UK Obstetric Surveillance System (UKOSS). Data collection was undertaken in 200 consultant-led NHS maternity units between November 2011 and October 2012 (gastric banding), and April 2014 and March 2016 (gastric bypass and sleeve gastrectomy). Participants were pregnant women following gastric banding (n = 127), gastric bypass (n = 134) and sleeve gastrectomy (n = 29). Maternal and perinatal outcomes were compared using generalised linear and linear mixed models. Maternal outcomes included gestational weight gain, pre-eclampsia, gestational diabetes, anaemia, surgical complications. Perinatal outcomes included birthweight, small/large for gestational age (SGA/LGA), preterm birth, stillbirth. RESULTS: Maternal: Women pregnant after gastric banding and sleeve gastrectomy had a lower risk of anaemia compared with gastric bypass (banding (16 %) vs bypass (39 %): p = 0.002, sleeve (21 %) vs bypass: p = 0.04). Gestational diabetes risk was lower after gastric banding compared with gastric bypass (7 % vs 16 %, p = 0.03) despite women with banding having significantly greater weight at booking as well as gestational weight gain. Women pregnant after gastric banding and sleeve gastrectomy had a lower risk of surgical complications than after gastric bypass (banding (0.9 %) vs bypass (11.4 %): p = 0.03, sleeve (0.0 %) vs bypass: p = 0.06). Perinatal: Infants born to mothers after gastric banding had a higher birthweight than those born to mothers after gastric bypass (mean difference = 260 g (125-395), p < 0.001). Infants were more likely to be LGA if their mothers had gastric banding compared with gastric bypass or sleeve gastrectomy (banding (21 %) vs bypass (5 %): p = 0.006; banding vs sleeve (3 %): p = 0.03). Risk of preterm birth was higher in women with gastric banding compared with gastric bypass (13 % vs 8 %, p = 0.04). CONCLUSIONS: Women planning bariatric surgery should be counselled regarding the differing impacts of different types of procedure on any future pregnancy. Pre-existing gastric bypass is associated with higher rates of potentially serious surgical complications during pregnancy

Impacted fetal head at caesarean section:a national survey of practice and training

This is a national survey of UK obstetric trainees and consultant labour ward leads designed to investigate the current practice and training for an impacted foetal head (IFH) at Caesarean Section (CS). An anonymous, on-line survey was disseminated to trainees via Postgraduate Schools and RCOG trainee representatives, and to labour ward leads via their national network. Three hundred and forty-five obstetric trainees and consultants responded. The results show that IFH is variably defined and encountered by most UK obstetricians (98% had encountered IFH and 76% had experienced it before full cervical dilatation). There is significant variation in management strategies, although most respondents would use a vaginal push up to assist delivery prior to reverse breech extraction. Responses revealed a paucity of training and lack of confidence in disimpaction techniques: over one in ten respondents had not received any training for IFH and less than half had received instruction in reverse breech extraction.Impact statement What is already known on the subject? IFH is an increasingly recognised, technically challenging complication of intrapartum CS. A recent report suggested that birth injuries associated with IFH are now as common as with shoulder dystocia. However, there is no consensus nor guidelines regarding the best practice for management or training. What do the results of this study add? This study demonstrates that IFH is poorly defined and commonly encountered by UK obstetricians. It highlights that IFH is not restricted to CS at full dilatation and reveals the ubiquity of the vaginal push method in UK practice. We found evidence that UK obstetricians are using techniques which have not been investigated and are not recommended for managing an IFH. Moreover, this survey is an eye-opener as to the paucity of training, highlighting that UK obstetric trainees are not adequately prepared to manage this emergency. What are the implications of these findings for clinical practice and/or further research? There is a pressing need to standardise the definition, guidance and training for IFH at CS. Further research should clarify the appropriate techniques for IFH and establish consensus for the best practice. An evidence-based simulation training package, which allows clinicians to learn and practice recognised disimpaction techniques is urgently required

UK deep‐sea conservation: Progress, lessons learned, and actions for the future

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