Interpreting infrastructure: Defining user value for digital financial intermediaries.

The 3DaRoC project is exploring digital connectivity and peer-to-peer relationships in financial services. In the light of the near collapse of the UK and world financial sector, understanding and innovating new and more sustainable approaches to financial services is now a critical topic. At the same time, the increasing penetration and take-up of robust high-speed networks, dependable peerto- peer architectures and mobile multimedia technologies offer novel platforms for offering financial services over the Internet. These new forms of digital connectivity give rise to opportunities in doing financial transactions in different ways and with radically different business models that offer the possibility of transforming the marketplace. One area in the digital economy that has had such an effect is in the ways that users access and use digital banking and payment services. The impact of the new economic models presented by these digital financial services is yet to be fully determined, but they have huge potential as disruptive innovations, with a potentially transformative effect on the way that services are offered to users. Little is understood about how technical infrastructures impact on the ways that people make sense of the financial services that they use, or on how these might be designed more effectively. 3DaRoC is exploring this space working with our partners and end users to prototype and evaluate new online, mobile, ubiquitous and tangible technologies, exploring how these services might be extended.Executive Summary: Drawing from Studies of Use - the value, use and interpretation of infrastructure in digital intermediaries to their users. The UK economy has a huge dependence on financial services, and this is increasingly based on digital platforms. Innovating new economic models around consumer financial services through the use of digital technologies is seen as increasingly important in developed economies. There are a number of drivers for this, ranging from national economic factors to the prosaic nature of enabling cheap, speedy and timely interactions for users. The potential for these new digital solutions is that they will allay an over-reliance on the traditional banking sector, which has proved itself to be unstable and risky, and we have seen a number of national policy moves to encourage growth in this sector. Partly as a result of the 2008 banking crisis, there has been an explosion in peer-to-peer financial services for non-professional consumers. These organisations act as intermediaries between users looking to trade goods or credit. However, building self-sustaining or profitable financial services within this novel space is itself fraught with commercial, regulatory, technical and social problems. This document reports on the value, use and interpretation of infrastructure in digital intermediaries to their users, describing analysis of contextual field studies carried out in two retail digital financial intermediary organisations: Zopa Limited and the Bristol Pound. It forms the second milestone document in the 3DaRoC project, developing patterns of use that have arisen on the back of the technical infrastructures in the two organisations that form cases for examination. Its purpose is to examine how the two different technical infrastructures that underpin the transactions that they support–composed of the back-office hardware and software, data structures, the networking and communications technologies used, supported consumer devices, and the user interfaces and interaction design–have provided opportunities for users to realise their financial and other needs. While we orient towards the issues of service use (and its problems), we also examine the activities and expectations of their various users. Our research has involved teams from Lancaster University examining Zopa and Brunel University focusing on the Bristol Pound over approximately a one-year period from October 2013 to October 2014. Extensive interviews, document analysis, observation of user interactions, and other methods have been employed to develop the process analyses of the firms presented here. This report comprises of three key sections: descriptions of the user demographics for Zopa and the Bristol Pound, a discussion about the user experience and its role in community, and an examination of the role of usage data in the development of these a products. We conclude with final analytical section drawing preliminary conclusions from the research presented.The 3DaRoC project is funded by the RCUK Digital Economy ‘Research in the Wild’ theme (grant no. EP/K012304/1)

Bloodless open heart surgery: simple and safe

OBJECTIVES: The use of blood or blood products is routine in cardiac surgery, but is associated with various complications. Aware of this, we have always tried to avoid the use of blood products whenever possible. In this study we sought to evaluate the results of this policy. METHODS: The records of 1505 adult patients who underwent coronary (732) or valve (773) surgery under cardiopulmonary bypass (CPB) in 2002 and 2003 were reviewed retrospectively. Of these, 1058 were male (70.3%) and the mean age was 62.1+/-11.4 years. Mean weight was 68.5+/-10.2 kg and body surface area was 1.7+/-0.2 m2, corresponding to a blood volume of 4119.9+/-593.6 ml. Preoperative hematocrit (Hct) was 40.6+/-4.2% and the prothrombin index was 87.0+/-17.4%. A bloodless prime of the bypass circuit was used for all patients with Hct > or =36%. The prime volume was reduced to the minimum possible. Plasma was used when coagulation was deficient. All blood remaining in the CPB circuit was reinfused at the end of the procedure, either in the operating room or in the ICU. Shed mediastinal blood was retransfused in the first 6 hours in the ICU. RESULTS: Operative mortality was 0.7% for coronary and 0.5% for valve patients. Blood or blood products were not used in 77.3% of the patients (88.7% of coronary and 66.5% of valve patients). Blood and/or plasma was initially added to the prime in 18.2% of cases and during CPB in 11%. Hct was 28.9+/-4.0% after initiation and 28.8+/-3.9% after discontinuation of CPB. The number of units (300 cc) of blood used was 0.25.57 per patient (1.09+/-0.73 per patient transfused). The number of units (300 cc) of plasma used was 0.24+/-0.72. Reoperation for bleeding was required in 2.4% of the patients. CONCLUSIONS: This blood-sparing policy is simple, effective and safe, resulting in low mortality and morbidity rates. More than three quarters of the patients did not require blood or blood products. Additional measures are possible to further decrease the use of blood products

Left ventricular false aneurysm characterized by cardiovascular magnetic resonance and late enhancement technique

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. Differentiation between true and false aneurysms, although difficult, is crucial, because of the different treatment options they entail. We present a rare case of a giant pseudoaneurysm of the left ventricle related with a previous myocardial infarction. The present case highlights the pivotal role of magnetic resonance imaging for differential diagnosis between these entities

Can the mitochondrial malondialdehyde content be an useful tool to distinguish ecological quality of Petromyzon marinus habitat?

The sea lamprey is an anadromous species that migrates twice during its life cycle between freshwater and seawater. Microphagous larvae generally spend 4–5 years burrowed in the substrate of rivers and streams before undergoing metamorphosis that ends with the beginning of the juvenile trophic migration. Once metamorphosis is complete, sea lamprey juvenile downstream migrants are fully tolerant to 35 PSU seawater. Pollution resulting from industrial effluents may disturb the seawater acclimatization causing oxidative damages, and ultimately may lead to a decrease of sea lamprey population. The aim of this study was to compare salt acclimation of sea lamprey juveniles captured in river basins with different levels of aquatic pollution, using mitochondrial glutathione and malondialdehyde of gills and liver as markers of physiological stress and cell damages. The results showed that juveniles from Lima basin exhibited the highest levels of mitochondrial malondialdehyde in gills, even though significant changes in the stress markers of mitochondrial gills of all animals subject to salt acclimation were not detected. In addition, an increase in the oxidative damages of hepatic mitochondria of macrophthalmia from Vouga basin suggests the occurrence of metabolic failures with the potential to disturb the capacity to adaptation to the marine environment

Hepatic mitochondrial content in malondialdehyde may be a marker of sea lamprey contact with atrazine

The atrazine attracts special attention as pollutant because of itspersistence in the aquatic environment. Although this herbicide has been studied in teleost, its toxicity in the sea lamprey, Petromyzon marinus is still poorly understood. Oxidative stress may occur if chemical pollutants contribute to block the capacity of mitochondria to generate ATP with continuous production of reactive oxygen species (ROS), disturbing the success of P. marinus seawater acclimation. So, the aim of this study was to evaluate how atrazine influences the malondialdehyde (MDA), glutathione (GSH) and glutathione disulfide (GSSG) contents of gills and liver mitochondria of juveniles from Lima river basin, Portugal during salt acclimation. Sampling occurred at the beginning of the P. marinus downstream migration. The sampled juveniles were transported alive to the laboratory and maintained in 200 l tanks with LSS 8 life support system. Two groups of 40 specimens were hold in tanks with 50 or 100 lg/l atrazine, during 30 days. The salinity was gradually increased from 0 to 35 psu,following a three step procedure during a 30 days period. The control group was maintained in freshwater without atrazine. Mitochondria obtained by centrifugation at 15000 g, 30 min, 4°C, of tissues homogenates prepared in 50 mM Tris-HCl pH 7.5 buffer were used in determination of ROS, MDA, GSH and GSSG by fluorescence. The statistical analysis were performed by ANOVA I and Duncan (p < 0.05), using SPSS 22 for Windows.The results showed that in P. marinus juveniles, no significant changes in the markers of oxidative stress and cell damages were detected in the mitochondrial gills. Nevertheless, in the animals exposed to 50 lg/l atrazine the content in glutathione and GSSG increased. A similar pattern of stress markers was detected in hepatic mitochondria. However, in the presence of atrazine, the MDA level of the mitochondria of liver increased threefold in the animals during salt acclimation. The high level of mitochondrial damages, detected in the hepatic mitochondria of macrophthalmia treated with atrazine, suggests that herbicide exposure caused metabolic failures which can disturb the adaptation of these specimens to the oceanic feeding phase. The hepatic mitochondrial MDA levels of P. marinus, may eventually detect sea lamprey contact with chlorine herbicides

Left ventricular false aneurysm characterized by cardiovascular magnetic resonance and late enhancement technique

Left ventricular pseudoaneurysm is a rare complication of myocardial infarction. Differentiation between true and false aneurysms, although difficult, is crucial, because of the different treatment options they entail. We present a rare case of a giant pseudoaneurysm of the left ventricle related with a previous myocardial infarction. The present case highlights the pivotal role of magnetic resonance imaging for differential diagnosis between these entities

Mathematical modelling of shallow flows: closure models drawn from grain-scale mechanics of sediment transport and flow hydrodynamics

Canadian Journal of Civil Engineering 36(10) 1605–16Mathematical modelling of river processes is, nowadays, a key element in river engineering and planning. River modelling tools should rest on conceptual models drawn from mechanics of sediment transport, river mechanics, and river hydrodynamics. The objectives of the present work are (i) to describe conceptual models of sediment transport, deduced from grain-scale mechanics of sediment transport and turbulent flow hydrodynamics, and (ii) to present solutions to specific river morphology problems. The conceptual models described are applicable to the morphologic evolution of rivers subjected to the transport of poorly sorted sediment mixtures at low shear stresses and to geomorphic flows featuring intense sediment transport at high shear stresses. In common, these applications share the fact that sediment transport and flow resistance depend, essentially, on grain-scale phenomena. The idealized flow structures are presented and discussed. Numerical solutions for equilibrium and nonequilibrium sediment transport are presented and compared with laboratory and field data

Renal Pathology in Portuguese HIV-Infected Patients

HIV-infected patients may be affected by a variety of renal disorders. Portugal has a high incidence of HIV2 infection and a low prevalence of HIV-infected patients under dialysis treatment. The aim of this study was to characterise the type of renal disease in Portuguese HIV-infected patients and to determine if HIV2 infection is associated to renal pathology. Only 60 of the 5158 HIV-infected patients followed in our hospital underwent renal biopsy. Clinical and laboratory data and the type of renal disease were reviewed. Male gender was predominant (76.7%), as was Caucasian race (78.3%). Mean age was 37.9±10.6 years. The majority had criteria for AIDS, 66% were on combined antiretroviral therapy and 18.3% were on dialysis. The predominant lesions were immunecomplex glomerulonephritis (n=19), tubulointerstitial nephropathy (n=12), focal segmental glomerulosclerosis(n=11), followed by HIVAN (n=8). Other patterns(amyloidosis, vasculitis, minimal change lesion) were observed. Only three patients were HIV2 infected, and presented diabetic nephropathy, acute tubular necrosis and tubulointerstitial nephritis. No correlations between clinical findings and renal pathology were found. In conclusion, renal disease in HIV patients has a broad spectrum, and renal biopsy remains the gold standard for establishing the diagnosis and guide treatment. Renal disease is not frequent in HIV2-infected patients, and, when present, is probably not directly associated with HIV infection

Patient-doctor continuity and diagnosis of cancer: electronic medical records study in general practice

This is the final version of the article. Available from Royal College of General Practitioners via the DOI in this record.BACKGROUND: Continuity of care may affect the diagnostic process in cancer but there is little research. AIM: To estimate associations between patient-doctor continuity and time to diagnosis and referral of three common cancers. DESIGN AND SETTING: Retrospective cohort study in general practices in England. METHOD: This study used data from the General Practice Research Database for patients aged ≥40 years with a diagnosis of breast, colorectal, or lung cancer. Relevant cancer symptoms or signs were identified up to 12 months before diagnosis. Patient-doctor continuity (fraction-of-care index adjusted for number of consultations) was calculated up to 24 months before diagnosis. Time ratios (TRs) were estimated using accelerated failure time regression models. RESULTS: Patient-doctor continuity in the 24 months before diagnosis was associated with a slightly later diagnosis of colorectal (time ratio [TR] 1.01, 95% confidence interval [CI] =1.01 to 1.02) but not breast (TR = 1.00, 0.99 to 1.01) or lung cancer (TR = 1.00, 0.99 to 1.00). Secondary analyses suggested that for colorectal and lung cancer, continuity of doctor before the index consultation was associated with a later diagnosis but continuity after the index consultation was associated with an earlier diagnosis, with no such effects for breast cancer. For all three cancers, most of the delay to diagnosis occurred after referral. CONCLUSION: Any effect for patient-doctor continuity appears to be small. Future studies should compare investigations, referrals, and diagnoses in patients with and without cancer who present with possible cancer symptoms or signs; and focus on 'difficult to diagnose' types of cancer.This work was funded by Cancer Research UK (C41384/A13266)