The Pacific Northwest Governors’ Comprehensive Energy Review: How Comprehensive?

43 pages (includes illustrations). Contains footnotes and 1 page of references

Dupuytren's Disease: Anatomy and Surgical Treatment

The principal aim of this written account is to describe the evolution of a surgical approach to the treatment of Dupuytren's Disease based on current knowledge of pathogenesis and precise description of the anatomy. The historical record of the life and works of Baron Guillaume Dupuytren, together with those of his contemporaries, pupils and critics have been reviewed to clarify the understanding of the condition at that time and to uncover wisdom which has been forgotten. The disease process is considered by analysis of studies of incidence, aetiological factors, pathology and related fibromatous lesions. Series of dissections of the palm and digits in fresh and preserved cadaveric hands have been performed to establish a new perspective on the micro-anatomy of the normal ligamentous components of the hand. The lesions of Dupuytren's Disease - palmar nodules, pits and cords, distortion of palmar creases and knuckle changes - have been examined by observations of clinical signs and operative dissections. New clinical signs -the "blanching" sign in the palm, and knuckle changes -have been described. A new classification of operative interventions is described according to the approach to a) the skin, b) the fascia and c) the joints. The operative experience and long term results, using an evolution of techniques, have been reviewed in a series of 100 patients. Dupuytren's Disease is viewed as a process akin to wound healing which involves not only the palmar fascia, as described by Dupuytren, but many of the connective tissues of the hand including the dermis of the skin. The distribution of the pathological tissue is not random, but dictated by lines of tension or stress concentrations transmitted through certain anatomical pathways. Movement of the hand may be the stimulus to the propagation of the contracture once it has commenced. Treatment has been found to be generally not curative, but affording only temporary release. A less extensive and more precise operative approach has been developed. The values of minimal surgery and maximal rehabilitation are stressed

Magnetohydrodynamic turbulence: The development of lattice Boltzmann methods for dissipative systems

Computer simulations of complex phenomena have become an invaluable tool for scientists in all disciplines. These simulations serve as a tool both for theorists attempting to test the validity of new theories and for experimentalists wishing to obtain a framework for the design of new experiments. Lattice Boltzmann Methods (LBM) provide a kinetic simulation technique for solving systems governed by non-linear conservation equations. Direct LBMs use the linearized single time relaxation form of the Boltzmann equation to temporally evolve particle distribution functions on a discrete spatial lattice. We will begin with a development of LBMs from basic kinetic theory and will then show how one can construct LBMs to model incompressible resistive magnetohydrodynamic (MHD) conservation laws. We will then present our work in extending existing models to the octagonal lattice, showing that the increased isotropy of the octagonal lattice produces better numerical stability and higher Reynolds numbers in MHD simulations. Finally, we will develop LBMs that use non-uniform grids and apply them to one dimensional MHD systems

The effect of spatial competition between object-level representations of target and mask on object substitution masking

One of the processes determining object substitution masking (OSM) is thought to be the spatial competition between independent object file representations of the target and mask (e.g., Kahan & Lichtman, 2006). In a series of experiments, we further examined how OSM is influenced by this spatial competition by manipulating the overlap between the surfaces created by the modal completion of the target (an outline square with a gap in one of its sides) and the mask (a four-dot mask). The results of these experiments demonstrate that increasing the spatial overlap between the surfaces of the target and mask increases OSM. Importantly, this effect is not caused by the mask interfering with the processing of the target features it overlaps. Overall, the data indicate, consistent with Kahan and Lichtman, that OSM can arise through competition between independent target and mask representation

Identification of novel keloid biomarkers through Profiling of Tissue Biopsies versus Cell Cultures in Keloid Margin specimens Compared to adjacent Normal Skin

Objective: Keloid disease (KD) is a benign fibroproliferative skin tumor that results from abnormal wound healing and has no single definitive treatment. This study aims to identify KD biomarkers, which are cellular mediators that can serve as indicators of normal, pathological, and therapeutic processes. Methods: Bioinformatics analytic approaches, including comprehensive literature searches and DAVID Bioinformatics Resources 2008, were performed on the established KD linkage and previously reported microarray data to identify potential candidate genes for the study. Keloid margins and unaffected skin were obtained from KD patients (n = 4). RNA was extracted from the biopsies and second-passage culture equivalents. Reverse-transcriptase quantitative polymerase chain reactions were used to determine the gene expression levels. Student t tests were used to analyze the statistical significance in differential gene expressions. Results: Nineteen candidate genes were initially selected by bioinformatics analysis. Of the 19 genes, 10 were significantly (P < .05) upregulated in keloid margin biopsy specimens. The top-5 fold changes range from 10-fold to 175-fold, including aggrecan; asporin; inhibin, beta A; tumor necrosis factor-α inducible protein 6; and chromosome 5 open reading frame 13. There was no significant differential gene expression between the fibroblasts established using keloid margin or internal control sites. Conclusions: The transcriptomic data generated from cultures did not consistently correlate to the biopsy equivalents. This study has demonstrated 10 genes that are significantly upregulated in biopsy samples of keloid margin, 5 of which have a fold change higher than 10-fold. Importantly these genes may serve as a potential biomarker for KD

Teaching webside manner: development and initial evaluation of a video consultation skills training module for undergraduate medical students

Background Video consultations are increasingly used to communicate with patients, particularly during the current COVID-19 pandemic. However, training in video consultation skills receives scant attention in the literature. We sought to introduce this important topic to our undergraduate medical school curriculum. Objective To increase final year medical students’ video consultation skills and knowledge. Methods We used Plan, Do, Study, Act (PDSA) quality improvement methodology with a pre-post study design to develop a teaching session for 5th year medical students, informed by a literature review and online clinician survey. The 2 hour session comprised an introduction and three practical stations: patient selection and ethics, technology and example videos, and simulation. Subjective pre- and post-session confidence was reported by students across seven domains using 5-point scales (1: not at all confident; 5: extremely confident). Students and facilitators completed post-session feedback forms. Results The 40 students and 3 facilitators who attended, over two separate teaching sessions, provided unanimously positive feedback. All students considered the session relevant. Subjective confidence ratings (n = 34) significantly increased from pre- to post-session (mean increase 1.78, p < 0.001). Conclusions The inaugural teaching session was well-received and subjective assessment measures showed improvement in taught skills. This pilot has informed a UK-wide multi-centre study with subjective and objective data collection

Non-eruptive geological hazards of dormant volcanoes: Sao Miguel, Azores Perigos geologicos nao erurptivos en vulcoes adormecidos: Sao Miguel, Acores

São Miguel Island presents a diversity of geological hazards that are related to non-eruptive processes. Frequent seismic swarms and destructive earthquakes, of volcanic and tectonically related origin, have been recorded on the Island since it was settled in the 15th century. Large areas of volcanic edifices of Sete Cidades, Fogo and Furnas are unstable. Steep slopes, unconsolidated and poorly consolidated materials, such as volcaniclastic deposits occasionally weathered by hydrothermal activity, play an important role in landslide activity. Slope instability is mainly triggered by intense rainfall, but also by seismic activity, sea and fluvial erosion and/or anthropogenic activity. Volcano degassing represents a major risk during anomalous gas release and a continuous menace for the public health

Volcanic hazard vulnerability on Sao Miguel Island, Azores

"In recent years much progress has been made in researching a wide variety of extreme events on S. Miguel. In addition there are a number of volcano-related risks which impact upon the people of S. Miguel. Some of these may occur both before and during volcanic emergencies (e.g. earthquakes), whilst others render S. Miguel dangerous even when its volcanoes are not erupting (e.g. flooding, landslides, tsunamis and health impacts, especially the effects of CO2 seepage into dwellings). In this chapter we first define what vulnerability means to the people of São Miguel, and relate this to the cultural and economic characteristics of the island. The following aspects of vulnerability are discussed: a. physical (i.e. housing, settlement and the characteristics of evacuation routes and plans); b. demographic and economic; c. social and cultural and perceptual (i.e. do people have an accurate cognition of risk). Particular areas of concern relate to housing; the identification of isolated dwellings which would be difficult to evacuate; the vulnerability/resilience of evacuation routes following recent infrastructure improvements; characteristics of the island's transient population; management of livestock under emergency conditions; local leadership roles and educational outreach.

Reversible tongue atrophy in Lambert-Eaton myasthenic syndrome

Peer reviewedPublisher PD

Cash Economy and Store-Bought Food Biases in Food Security Assessments of Inuit Nunangat

Researchers, community organisations, and Inuit leaders increasingly question the suitability of methods to assess the prevalence of food insecurity in Inuit Nunangat (the Inuit homeland in Canada). Of particular contention is the United States Department of Agriculture’s (USDA) Household Food Security Survey Module (HFSSM), applied in modified form as part of Health Canada’s nationwide Canadian Community Health (CCHS) and Aboriginal Peoples Surveys. The 18-question HFSSM is the primary survey tool used by the Government of Canada to assess food security prevalence, yet the Module asks only about the affordability of store-bought foods (also termed ‘market foods’ elsewhere in literature) when collecting data to designate food security status. This is despite communities in Inuit Nunangat having complex ‘dual’ or ‘mixed’ food systems and foodways: relying on foods harvested from ancestral lands (country foods) in combination with store-bought foods to sustain mixed cash-subsistence economies and diets. Sourcing country foods requires money for the purchase of equipment and machinery. However, they also have numerous access and availability criteria dictated by non-financial factors. In this paper, we explore the problem of the monetary bias (the focus on an individual or household’s ability to purchase foods) in the HFSSM and discuss the knock-on effects of using monetary metrics as the sole means of measuring and monitoring food security in dual food environments. We contend that relying on monetary access as a measure presents an incomplete picture of the reality of food insecurity in Inuit Nunangat. Presently, there is little consideration of the nuance of social norms and cultural values that govern dual food systems or the importance of less tangible non-financial factors that might affect food access (e.g. knowledge of where and how to harvest and maintain machinery, suitable environmental conditions for travel, conducive harvest regulations, social relationships, and ecological stability). Ultimately, this contributes to restricted policy-level understandings of what it means to ensure stable, culturally adequate, and just food systems, and limits self-determination in northern food environments