Clinical review: Can we predict which patients are at risk of complications following surgery?

There are a vast number of operations carried out every year, with a small proportion of patients being at highest risk of mortality and morbidity. There has been considerable work to try and identify these high-risk patients. In this paper, we look in detail at the commonly used perioperative risk prediction models. Finally, we will be looking at the evolution and evidence for functional assessment and the National Surgical Quality Improvement Program (in the USA), both topical and exciting areas of perioperative prediction

Creativity on command

In the ongoing debate between nature and nurture, between biological determinism and behaviourism, behaviourists maintain that an individual has little control over inspiration and creativity and is a mere helpless recipient, waiting to be shaped and filled by positive or negative socialization. Contemporary social psychologists, on the other hand, build on genetic influences and tell us that a person’s social environment can activate potential. Since family socialization is critical to development of the child’s core identity, we seem to be condemning a person who fails to receive adequate love and nurturing. The truth lies somewhere in between. However, if we define “creativity” as the ability of a writer-reporter to uniquely configure a person or situation so that elements of the seemingly insignificant stand for the whole, then perhaps creativity can be cultivated by careful, thoughtful instruction and willing self-discipline

Bipolar jets produced by a spectroscopic binary

We present evidence that the spectroscopically identified bipolar jets of the pre-main sequence binary KH 15D are a common product of the whole binary system, rather than being launched from either star individually. They may be launched from the innermost part of the circumbinary disk (CBD) or may result from the merging of two outflows driven by the individual stars. This evidence is based on high-resolution H-alpha and [OI] 6300A line profiles obtained during eclipse phases of this nearly edge-on system. The occultation of star A (the only currently visible star) by the disk strongly suppresses the stellar H-alpha and continuum emission and allows one to study the faint redshifted and blueshifted emission components of the bipolar jets. The strongest evidence for jet production by the whole binary system comes from the observed radial velocity symmetry of the two jet components relative to the systemic velocity of the binary, in combination with current accretion models from the CBD onto a binary system.Comment: ApJ Letters, in press [6 pages

Transport and ageing: Extending quality of life for older people via public and private transport

Accessible public transport and the independence that comes with car driving are generally thought to be linked to quality of life in old age. However, there has been almost no research on this topic in the UK. This study by researchers from the University of Paisley and the University of East London used a multi-method approach to explore the relationship between quality of life and access to public and private transport. The study also examined the extent to which the transport needs of older people are taken into account by transport professionals

Serving children: the impact of poverty on children's experiences of services

This study arose from the identification of a gap in knowledge and corresponding need for the development of a better contemporary understanding of children's experiences of poverty. Focusing on children aged 10 - 14 years, the study aimed to provide a perspective on the lives of children and young people affected by poverty in Scotland through comparing the experiences of children living in poverty with those more economically advantaged

Drivers of Microbial Risk for Direct Potable Reuse and de Facto Reuse Treatment Schemes: The Impacts of Source Water Quality and Blending.

Although reclaimed water for potable applications has many potential benefits, it poses concerns for chemical and microbial risks to consumers. We present a quantitative microbial risk assessment (QMRA) Monte Carlo framework to compare a de facto water reuse scenario (treated wastewater-impacted surface water) with four hypothetical Direct Potable Reuse (DPR) scenarios for Norovirus, Cryptosporidium, and Salmonella. Consumer microbial risks of surface source water quality (impacted by 0-100% treated wastewater effluent) were assessed. Additionally, we assessed risks for different blending ratios (0-100% surface water blended into advanced-treated DPR water) when source surface water consisted of 50% wastewater effluent. De facto reuse risks exceeded the yearly 10-4 infections risk benchmark while all modeled DPR risks were significantly lower. Contamination with 1% or more wastewater effluent in the source water, and blending 1% or more wastewater-impacted surface water into the advanced-treated DPR water drove the risk closer to the 10-4 benchmark. We demonstrate that de facto reuse by itself, or as an input into DPR, drives microbial risks more so than the advanced-treated DPR water. When applied using location-specific inputs, this framework can contribute to project design and public awareness campaigns to build legitimacy for DPR

Complex Variability of the Hα\alpha Emission Line Profile of the T Tauri Binary System KH 15D: The Influence of Orbital Phase, Occultation by the Circumbinary Disk, and Accretion Phenomenae

We have obtained 48 high resolution echelle spectra of the pre-main sequence eclipsing binary system KH~15D (V582 Mon, P = 48.37 d, $e$ $\sim$ 0.6, M$_{A}$ = 0.6 M$_{\odot}$, M$_{B}$ = 0.7 M$_{\odot}$). The eclipses are caused by a circumbinary disk seen nearly edge on, which at the epoch of these observations completely obscured the orbit of star B and a large portion of the orbit of star A. The spectra were obtained over five contiguous observing seasons from 2001/2002 to 2005/2006 while star A was fully visible, fully occulted, and during several ingress and egress events. The H$\alpha$ line profile shows dramatic changes in these time series data over timescales ranging from days to years. A fraction of the variations are due to "edge effects" and depend only on the height of star A above or below the razor sharp edge of the occulting disk. Other observed variations depend on the orbital phase: the H$\alpha$ emission line profile changes from an inverse P Cygni type profile during ingress to an enhanced double-peaked profile, with both a blue and red emission component, during egress. Each of these interpreted variations are complicated by the fact that there is also a chaotic, irregular component present in these profiles. We find that the complex data set can be largely understood in the context of accretion onto the stars from a circumbinary disk with gas flows as predicted by the models of eccentric T Tauri binaries put forward by Artymowicz & Lubow, G\"{u}nther & Kley, and de Val-Borro et al. In particular, our data provide strong support for the pulsed accretion phenomenon, in which enhanced accretion occurs during and after perihelion passage.Comment: accepted to Ap

The Kinematics of Forearm Passing in Low Skilled and High Skilled Volleyball Players

Passing may well be the least glamorous of all volleyball techniques. It is usually appreciated only by players and coaches who realize its importance. Since the advent of the forearm pass in the 1950's, many volleyball coaches at all levels of play, find themselves spending an inordinate amount of practice time in perfecting this skill. Some of the variables that make it difficult to successfully pass the ball are the varying ball speeds, angles, and unpredictable flight paths associated with float serves and block deflections. Every offensive play begins with a pass. The flow of the match is very much influenced by the serve reception which mainly is done with a forearm pass. Bad receptions prevent quick combination attacks which many teams rely on in today's game. Today's quick paced game has created an even greater need for exact, consistent passing. The goal in today's game is to isolate hitters against only one blocker. Pinpoint passing accuracy is required so that the setter has a choice of several quick play-sets and is not forced to always go outside where a double block is waiting. In higher levels of play forearm passing is often executed with low passing angles and a quick delivery to the setter in order to speed up the offensive pace and decrease the defense's time to set up effectively against the attack. Few studies (Koenh, 1978; Rauh, 1972; Plunket, 1969) have investigated the kinematics of the forearm pass and no published research has been identified that has studied passing in both high and low skilled passers. The purposes of this study were to produce a kinematic profile of low skilled and high skilled volleyball players on the forearm pass. The resulting profile will be a significant step in the development of sound coaching techniques

The Many Hats of Sonic Hedgehog Signaling in Nervous System Development and Disease.

Sonic hedgehog (Shh) signaling occurs concurrently with the many processes that constitute nervous system development. Although Shh is mostly known for its proliferative and morphogenic action through its effects on neural stem cells and progenitors, it also contributes to neuronal differentiation, axonal pathfinding and synapse formation and function. To participate in these diverse events, Shh signaling manifests differently depending on the maturational state of the responsive cell, on the other signaling pathways regulating neural cell function and the environmental cues that surround target cells. Shh signaling is particularly dynamic in the nervous system, ranging from canonical transcription-dependent, to non-canonical and localized to axonal growth cones. Here, we review the variety of Shh functions in the developing nervous system and their consequences for neurodevelopmental diseases and neural regeneration, with particular emphasis on the signaling mechanisms underlying Shh action

The 2nd order renormalization group flow for non-linear sigma models in 2 dimensions

We show that for two dimensional manifolds M with negative Euler characteristic there exists subsets of the space of smooth Riemannian metrics which are invariant and either parabolic or backwards-parabolic for the 2nd order RG flow. We also show that solutions exists globally on these sets. Finally, we establish the existence of an eternal solution that has both a UV and IR limit, and passes through regions where the flow is parabolic and backwards-parabolic