Anatomical variations of the superficial and deep palmar arches

The use of radial arteries as an arterial bypass conduit is an invasive procedure which is becoming popular among various medical centres. The greatest risk associated with harvesting the radial artery is ischaemia of the soft tissues of the hand. In this study we dissected 200 hands derived from 100 formalin-fixed cadavers in order to identify arterial patterns that will allow safe removal of the radial artery for use in bypass procedures. A complete superficial palmar arch (SPA) was found in 90% of the cases and divided into 5 types, while the remaining 10% possessed an incomplete palmar arch. Types of SPA are designated by the letter S. In type S-I (40%), the SPA is formed by anastomosis of the superficial volar branch of the radial artery to the ulnar artery. Type S-II (35%) is formed entirely of the ulnar artery. Type S-III (15%) is formed by anastomosis of the ulnar and median arteries. Type S-IV (6%) is formed by anastomosis of the ulnar, radial, and median arteries and Type S-V (4%) is formed by a branch of the deep palmar arch (DPA) communicating with the SPA.DPA was identified in all specimens and classified into three types, all designated by the letter D. Type D-I (60%) is formed by anastomosis of the deep volar branch of the radial artery and the inferior deep branch of the ulnar branch. Type D-II (30%) is formed by anastomosis of the deep volar branch of the radial artery and the superior deep branch of the ulnar artery. Type D-III (10%) is formed by anastomosis of the deep volar branch of the radial artery with both deep branches of the ulnar artery. This data could provide an important source of information for vascular surgeons harvesting radial arteries

Cultural Competency in Capital Mitigation

Cultural factors so pervasively influence the interactions of the client with other people - including all of those with whom he comes into contact at significant times in his life (e.g. in educational, medical, and correctional institutions), those surrounding him in the community in which he develops, and, critically, the members of the defense team - that it is imperative for the defense team to have the talents necessary to conduct a mitigation investigation that is culturally competent. The investigation must recognize and surmount an array of barriers, overt and subtle, to obtaining information from people of variegated backgrounds. As the courts have long recognized, in the context of mitigation, culturally competent investigation is more than an admirable and desirable skill. It is a standard of performance. Building on the framework provided by the ABA\u27s Guidelines for the Appointment and Performance of Defense Counsel in Death Penalty Cases reprinted in 31 Hofstra L. Rev. 913 (2003) and the Supplementary Guidelines that are the subject of this issue, this article details what capital defense counsel needs to do in order to (a) meet that standard and (b) of equal importance, utilize the fruits of the investigation to construct a persuasive narrative of the client\u27s life course that emerges authentically from his culture. Counsel must comprehend the world from the client\u27s viewpoint and be able to present his life story from the inside out

Evidence of Health Effects Associated with Marijuana Use: A Comprehensive Public Health Review

Starting in 2014, Colorado Department of Public Health was designated to monitor the emerging science and medical information relevant to the health effects associated with marijuana use. After years of conducting an ongoing systematic review of scientific literature, we have established 139 evidence statements within 11 health topics. Our mission is to translate the science into meaningful public health statements and recommendations to inform and educate the general public, healthcare providers, and everyone in-between on the health effects associated with marijuana use. This chapter summarizes evidence from all of our health topics; ranging from respiratory effects of marijuana to cognitive and academic effects of marijuana use on adolescents and young adults

Memorandum: To Selected Members of The Florida IWY Delegation

Invitation to Seminar on Procedures and Strategy November 6, 1977

Monte Carlo Studies of Water Monolayer Clusters on Substrates: Hexagonal AgI

A Monte Carlo procedure is used to study the stability and structure of small water clusters adsorbed on model basal and prism faces of hexagonal AgI. Effective pair potentials for the H2O-AgI interaction [B. N. Hale and J. Kiefer, J. Chem. Phys. 73, 923 (1980)] and the revised central force potentials for the H2O-H2O interaction [F. H. Stillinger and A. Rahman, J. Chem. Phys. 68, 666 (1978)] are used to determine average internal cluster binding energy and average cluster-substrate binding energy for water clusters containing 6, 24, and 44 water molecules at temperatures 240, 265, and 298 K. The results (using an effective substrate point charge of 0.4e) give between 5 and 6 kcal/mol per molecule for each of the above average binding energies. The iodine exposed basal AgI face organizes the H2O into five- and six-membered rings centered around the exposed I atoms. The prism face appears less effective in promoting ring structure and gives, in general, lower average internal cluster binding energies. The basal AgI face positions the water molecules (in H2O-substrate high binding sites) about 2.8 A apart while the water-water interactions orient the H2O dipole moments into configurations favorable for hydrogen bonding. The resulting six-membered ring structure is similar to that in ice Ih (crinkled) basal face layers, and appears to be qualitatively the same for all the temperatures studied

Rural Teachers in Project Launch

The success of Project Launch, a teacher induction program sponsored by a regional teacher center and a consortium of universities, is compared for rural and non-rural participants. Indicators of success include teacher accomplishment of action plan goals, teacher self and mentor assessment of teaching strengths related to action plan goals, profiles of teaching strengths, and retention in teaching. Measures of teaching strength are related to INTASC standards. Rural participants differed significantly from non-rural participants in their lower self-perceived accomplishment of action plan goals. Rural participants were significantly more likely to move from their 1st positions after 1 year, but their attrition was not significantly different in later years. Ways to structure induction programs more effectively for rural participants are proposed

Ramadhan fasting for people living with chronic illness: A narrative literature review

Muslims constitute approximately 20% of the world’s population. In South Africa, Muslims constitute just under 2% of the total population. Fasting is one of the mandatory activities of adherents of the Islamic faith, where all healthy adult Muslims abstain from food, drink, and sexual activities between dawn and dusk during the month of Ramadhan. Medical doctors are frequently required to provide advice to their Muslim patients about the safety or other health impacts of this type of fasting. This narrative review provides an overview of research conducted on Muslim populations during the fasting period, with special reference to non-communicable diseases (NCDs) that are prevalent in the Muslim community. In the absence of evidence-based clinical guidelines, this article summarises the latest published research on this topic, providing a resource for clinicians and researchers. This paper provides an evidence summary to clinicians when engaging with their patients who may be engaging in Ramadhan fasting, while also identifying gaps in the body of evidence that could inform future research

Ethnographic Advocacy Against the Death Penalty

This article develops the concept of “ethnographic advocacy” to make sense of the humanizing, open‐ended knowledge practices involved in the defense of criminal defendants charged with capital murder. Drawing from anthropological fieldwork with well‐respected figures in the American capital defense bar, as well as my own professional experience as an investigator specializing in death penalty sentencing mitigation, I argue that effective advocacy for life occurs through qualitative knowledge practices that share notable methodological affinities with contemporary anthropological ethnography. The article concludes with a preliminary exploration of what the concept of ethnographic advocacy might reveal about academic anthropology\u27s own advocative engagements

The Effect of Dust and Hotspots on the Thermal Stability of Laser Sails

Laser sails propelled by gigawatt-scale ground-based laser arrays have the potential to reach relativistic speeds, traversing the solar system in hours and reaching nearby stars in years. Here, we describe the danger interplanetary dust poses to the survival of a laser sail during its acceleration phase. We show through multi-physics simulations how localized heating from a single optically absorbing dust particle on the sail can initiate a thermal-runaway process that rapidly spreads and destroys the entire sail. We explore potential mitigation strategies, including increasing the in-plane thermal conductivity of the sail to reduce the peak temperature at hotspots and isolating the absorptive regions of the sail which can burn away individually.Comment: 7 pages, 4 figure