Seismic, structural and stratigraphic evolution of the cretaceous sequences of the orphan basin, offshore Newfoundland and Labrador

The continental margin of Newfoundland is made up of a series of interconnected, deep, Mesozoic sedimentary basins. Between the Cumberland Belt Transform Zone and the Charlie Gibbs Transform Zone the Avalon terrane is dissected into a 450 km wide track of extensional ridges and grabens collectively known as the Orphan Basin. From both a tectonic and a petroleum potential point of view the basin can be divided into an older (Late Triassic - Early Jurassic) sub-basin known as the East Orphan Basin and a younger (Cretaceous) sub-basin known as the West Orphan Basin. The Orphan Basin is an underexplored area and few studies have been completed on the structural, tectonic and stratigraphic framework of the area. -- Seismic stratigraphic analysis of the basin identified six major sequence boundaries ranging in age from pre-Mesozoic (Seismic Basement) to present (Water Bottom) and four Cretaceous sequences were identified, mapped and described. Four fault families were defined within the study area on the basis of their regionality, timing and duration of movement and depths of detachment: the Basin Bounding Fault Family, the Basement Involved Fault Family, the Sedimentary Fault Family and the Transfer Fault Family. -- Based on the mapping of the Cretaceous sequences and the orientations of major faults seen in the study area, the Orphan Basin can be divided into three distinct tectonostratigraphic regions. From west to east they are Areas A, B, and C. Areas B and C were affected by the Late Triassic - Early Jurassic Tethys Rift and the Late Jurassic - Early Cretaceous Atlantic Rift. Area B was reactivated for a third time with the Aptian - Albian Labrador rift that caused uplift and inversion of large structures in this area. Area A was predominantly affected by the Aptian - Albian Labrador rift and has Early and Late Cretaceous basin fill. The orientation of the major basement involved and basin bounding faults in the basin show a counterclockwise rotation from east to west as the rift propagated landward. The oldest faults (located in Area C) have a NE-SW orientation in line with the Tethys rift while those faults in the younger Area A have an approximate N- S to NNW-SSE orientation in line with the Labrador rift. -- A proven petroleum system has not been identified in the Orphan basin; however, due to the timing of rifting, two different petroleum systems are proposed for the East Orphan and the West Orphan basins. Considering all the elements and processes required for a working hydrocarbon system, the most likely plays within the East Orphan Basin are: an oil prone source rock equivalent to the Egret Member of the Rankin Formation; reservoirs of Early Cretaceous stacked sandstones, a seal of Late Cretaceous and Tertiary shales; large structural traps in the form of drape over horst blocks, extensional anticlines and rotated fault blocks of Late Jurassic - Early Cretaceous age. The petroleum system for the East Orphan Basin is likely analogous to that of the Jeanne d'Arc Basin. In the West Orphan Basin the most likely plays are: Late Cretaceous and early Tertiary organic rich shales equivalent to the Bjarni and Markland Formations in the Labrador basins; reservoirs made up of Late Cretaceous and early Tertiary sands; seals of thick Nautilus or Banquereau equivalent shales; structural, stratigraphic and combination traps, most likely basin margin fans pinched out updip or draped over some form of structure. The petroleum system for the West Orphan Basin is likely analogous to that of the Labrador basins

Telling tales: the development and impact of digital stories and digital storytelling in healthcare

Since its inception in 2003, the Patient Voices Programme has been gathering and disseminating digital stories of healthcare created by patients, carers and clinicians involved in delivering and receiving that care. It is one of the longest-running digital storytelling projects in the world and, as far as can be determined, the only digital storytelling project to focus specifically on healthcare. During this time, more than 1000 digital stories have been created. Once released by storytellers, these stories are made freely available by a publicly accessible website for use in healthcare education and service improvement programmes. The aim of Patient Voices was, through sharing the stories of what really matters to the people who design, deliver and receive healthcare, to bring about a transformation, resulting in safer, higher quality care characterised by greater humanity and compassion. I am one of the founders of the Patient Voices Programme. I have played a key role in every aspect of the Programme’s development, from working with the first storytellers and writing the original rationale, to conducting research on the impact of the stories, presenting at numerous conferences, writing papers for publication, facilitating workshops and consulting on use of the stories. Not only has the Patient Voices Programme had an impact on the world of healthcare, particularly in the UK, but it has also had an impact on the wider world of digital storytelling, where the Patient Voices Programme is regarded as the world leader in digital storytelling in healthcare; indeed, I have given a keynote address at four of the last five international digital storytelling conferences. Through an examination of eight published papers and the Patient Voices website, this thesis will demonstrate the contribution that I have made, through the Patient Voices Programme, to healthcare and healthcare education as well as to the wider, emerging field of digital storytelling

Evaluating mobile solutions of integrated Community Case Management (iCCM): Making the final connection

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Investigating the role of CRL5, an ubiquitin ligase, in ovarian follicle development.

During oogenesis, follicle cells surround maturing oocytes, which produce factors necessary for proper oocyte growth and development. Correct encapsulation of the oocyte by follicle cells is therefore essential for reproduction. While many signaling pathways have been linked to encapsulation, mechanisms of early follicle development, particularly in mammals, are not fully understood. Recent evidence demonstrates that Cullin-RING E3 ubiquitin ligases (CRLs) are necessary for oogenesis in both mammals and Drosophila. CRLs include a Cullin family scaffolding protein and a RING-domain protein that facilitates recruitment of ubiquitin ligases. CRLs are known to control many cellular processes; however, it is unclear how CRLs control early follicle development. In Drosophila, loss of Cul5, results in follicle death and improper encapsulation. We therefore tested whether the Cul5-containing CRL (CRL5) is required for early follicle development by analyzing loss-of-function mutants of the ligase complex. Loss of Cul5 or the RING protein Roc2 resulted in fused follicles, ruptured follicular epithelium, and improper encapsulation. The encapsulation phenotypes are not due to an over proliferation of germ cell; in fact, Cul5 mutants display a disturbance of the cell cycle which causes a decrease in germline stem cell proliferation. Genetic mosaics of Cul5 or Roc2 show that CRL5 is primarily required in developing follicle cells for cyst encapsulation. CRL5 mutant follicle cells display mislocalization of the polarity protein Bazooka and decreased Stat expression. Data also suggest that Cul5 may mediate signaling between the follicle cells and the underlying cyst. Results suggest that CRL5 controls early follicle development by regulating early follicle cell polarity and specification. Our studies highlight the role of CRLs in early follicle development, and may lead towards a better understanding of the cellular and mechanical processes that control follicle formation

Patient-Centered Outcomes From Multiparametric MRI and MRI-Guided Biopsy for Prostate Cancer: A Systematic Review.

OBJECTIVE: To identify and characterize patient-centered outcomes (PCOs) relating to multiparametric MRI (mpMRI) and MRI-guided biopsy as diagnostic tests for possible prostate cancer. METHODS: Medline via OVID, EMBASE, PsycInfo, and the Cochrane Central register of Controlled Trials (CENTRAL) were searched for relevant articles. Hand searching of reference lists and snowballing techniques were performed. Studies of mpMRI and MRI-guided biopsy that measured any PCO were included. There were no restrictions placed on year of publication, language, or country for study inclusion. All database search hits were screened independently by two reviewers, and data were extracted using a standardized form. RESULTS: Overall, 2,762 database search hits were screened based on title and abstract. Of these, 222 full-text articles were assessed, and 10 studies met the inclusion criteria. There were 2,192 participants featured in the included studies, all of which were conducted in high-income countries. Nineteen different PCOs were measured, with a median of four PCOs per study (range 1-11). Urethral bleeding, pain, and urinary tract infection were the most common outcomes measured. In the four studies that compared mpMRI or MRI-guided biopsy to transrectal ultrasound biopsy, most adverse outcomes occurred less frequently in MRI-related tests. These four studies were assessed as having a low risk of bias. DISCUSSION: PCOs measured in studies of mpMRI or MRI-guided biopsy thus far have mostly been physical outcomes, with some evidence that MRI tests are associated with less frequent adverse outcomes compared with transrectal ultrasound biopsy. There was very little evidence for the effect of mpMRI and MRI-guided biopsy on emotional, cognitive, social, or behavioral outcomes

Supporting information for National, regional, and worldwide estimates of low birthweight rates in 2015, with trends from 2000: a systematic analysis

Data produced by the World Health Organization, UNICEF, LSHTM and Johns Hopkins University to estimate national low birthweight (LBW) and numbers for 195 countries. LBW data was collated through a systematic review of national routine/registration systems, nationally representative surveys, and other data sources, and subsequently modelled using restricted maximum likelihood estimation with country-level random effects. Data includes a list of 1447 rate data points used as an input to the modelled estimates, yearly national-level covariates for each of the 195 countries studied from 2000 to 2015, and information on estimated low birthweight rates from 2000 to 2015 for 148 countries with data. Stata code used to generate these estimates is provided

Qualitative study to explore radiologist and radiologic technologist perceptions of outcomes patients experience during imaging in the USA.

OBJECTIVE: We aimed to explore the patient-centred outcomes (PCOs) radiologists and radiologic technologists perceive to be important to patients undergoing imaging procedures. DESIGN: We conducted a qualitative study of individual semi-structured interviews. PARTICIPANTS: We recruited multiple types of radiologists including general, musculoskeletal neuroradiology, body and breast imagers as well as X-ray, ultrasound, CT or MRI radiologic technologists from Washington and Idaho. OUTCOME: Thematic analysis was conducted to identify themes and subthemes related to PCOs of imaging procedures. RESULTS: Ten radiologists and six radiology technologists participated. Four main domains of PCOs were identified: emotions, physical factors, knowledge and patient burden. In addition to these outcomes, we also identified patient and provider factors that can potentially moderate these outcomes. CONCLUSIONS: Radiologists and technologists perceived outcomes related to the effect of imaging procedures on patients' emotions, physical well-being, knowledge and burden from financial and opportunity costs to be important to patients undergoing imaging procedures. There are opportunities for the radiology community to measure and use these PCOs in comparisons of imaging procedures and potentially identify areas where these outcomes can be leveraged to drive a more patient-centred approach to radiology

Assessing the feasibility of mobile phones for follow-up of acutely unwell children presenting to village clinics in rural northern Malawi.

BACKGROUND: Patient follow-up is a routine component of clinical practice and valuable for evaluating the effectiveness of interventions, but because of the broad dispersion of health facilities and lack of standardised medical reporting in Malawi, collecting patient outcome data can be challenging. Increasing accessibility and affordability of mobile technology in resource-poor settings may facilitate patient follow-up in the community. The objective of this study was to evaluate the potential utility of mobile phones for collecting follow-up clinical data from parents or caregivers of acutely unwell under-5 children, for intervention evaluation purposes. METHODS: Parents' or caregivers' mobile phone numbers were obtained by health surveillance assistants (HSAs) during study enrollment. Guardians who provided a telephone number were contacted by the study team to establish re-consultations or hospitalisations of their child(ren) within 14 days of recruitment. Health records at village clinics and higher-level health facilities were hand-searched to identify or confirm presentations and abstract clinical data. RESULTS: 87 out of 149 (58.4%) guardians provided a mobile telephone number, of whom the study team could contact 44 (29.5%). Seven guardians stated they took their child for further treatment: three of these returned to village clinics and four presented to secondary care facilities; attendance could only be confirmed from health records for one child. CONCLUSIONS: With continued expansion of cellular network coverage and mobile ownership in Malawi, mobile phones may facilitate collection of patient outcomes for intervention evaluation purposes. Future consideration should also be given to integrating mobile technologies into HSA clinical practice