Annular Pancreatitis and Gastric Cancer

Annular pancreas can present in adult life, usually when inflammation of the pancreatic ring causes duodenal stenosis. Although peptic ulcer is often associated with annular pancreas, an association with gastric carcinoma has not been previously described. Here we report a patient with annular pancreas, chronic alcoholic pancreatitis and gastric carcinoma, who was successfully treated by radical proximal pancreatoduodenectomy

How do new midwives’ early workforce experiences influence their career plans? An integrative review of the literature

Aim To explore how the early workforce experiences of new midwives influence their career plans. Background Each year, thousands of new midwives graduate from entry-to-practice midwifery courses, gain professional registration, and enter the workforce. Despite this, the world continues to face a shortage of midwives. The first five years of clinical practice, commonly referred to as the early career period, can be highly stressful for new midwives, contributing to early attrition from the profession. Supporting the transition from midwifery student to registered midwife is vital if we are to grow the workforce. Whilst the early career experiences of new midwives have been more broadly explored; little is currently understood about how these can influence their career plans. Methods Following Whittemore and Knafl’s (2005) five-stage process, an integrative review was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the criteria for inclusion. Thematic analysis was undertaken to organise and present the findings. Findings Thematic analysis, guided by the review question led to the identification of three overarching themes: ‘the need for support’, ‘sustaining health and wellbeing’, and ‘being able to provide safe and effective midwifery care’. Conclusion Very little research to date has specifically explored how the early career experiences of new midwives influence their career plans, particularly within the Australian context. Further research is required to better understand how the early workforce experiences of new midwives can either strengthen their commitment to the profession or contribute to the decision to leave midwifery prematurely. This knowledge would provide a basis for the development of appropriate strategies to minimise early attrition from the midwifery profession and promote career longevity

Linking Dynamical and Population Genetic Models of Persistent Viral Infection

This article develops a theoretical framework to link dynamical and population genetic models of persistent viral infection. This linkage is useful because, while the dynamical and population genetic theories have developed independently, the biological processes they describe are completely interrelated. Parameters of the dynamical models are important determinants of evolutionary processes such as natural selection and genetic drift. We develop analytical methods, based on coupled differential equations and Markov chain theory, to predict the accumulation of genetic diversity within the viral population as a function of dynamical parameters. These methods are first applied to the standard model of viral dynamics and then generalized to consider the infection of multiple host cell types by the viral population. Each cell type is characterized by specific parameter values. Inclusion of multiple cell types increases the likelihood of persistent infection and can increase the amount of genetic diversity within the viral population. However, the overall rate of gene sequence evolution may actually be reduced

The dangers of sublethal carvacrol exposure: increases in virulence of Bacillus cereus during endophthalmitis

Bacillus cereus can cause endophthalmitis through secretion of virulence factors, including hemolysin BL (Hbl) and nonhemolytic entertoxin (Nhe). Carvacrol is an extract from oregano oil, with potential for curtailing B. cereus endophthalmitis, due to antimicrobial and anti-inflammatory qualities. However, sublethal levels of carvacrol increases B. cereus virulence. The goal of this study was to investigate the increase in B. cereus virulence potential in response stress induced by a subinhibitory concentration (SIC) of carvacrol. Enterotoxin production and tissue damage were examined during ocular infections in vitro and in vivo. We hypothesized that the SIC of carvacrol would significantly increase toxin production in B. cereus without progressing systemically. RT-PCR determined SIC carvacrol-treated B. cereus had significantly higher hblC and nheA mRNA expression levels than controls in vitro. ELISA and RPLA analysis revealed a 46.8% and 50% increase in NheA and HblC toxin levels, respectively, in SIC-treated cultures. Caenorhabditis elegans-fed SIC carvacrol-treated B. cereus had a significantly higher mean mortality rate than nematodes fed untreated B. cereus. Significantly higher TNF-α levels were observed in SIC carvacrol-treated B. cereus mice compared to other treatment groups except for mice infected with B. cereus alone. Significantly higher IL-6 levels were also found in SIC-B. cereus mice. Histological analysis using Rose-Bengal and DAPI determined that the eyes of mice infected with SIC carvacrol-treated B. cereus had significantly more damage than eyes treated with B. cereus alone. The SIC of carvacrol increased B. cereus virulence in vitro and in vivo, with a mild systemic infection noted

Immorality and Irrationality

Does immorality necessarily involve irrationality? The question is often taken to be among the deepest in moral philosophy. But apparently deep questions sometimes admit of deflationary answers. In this case we can make way for a deflationary answer by appealing to dualism about rationality, according to which there are two fundamentally distinct notions of rationality: structural rationality and substantive rationality. I have defended dualism elsewhere. Here, I’ll argue that it allows us to embrace a sensible – I will not say boring – moderate view about the relationship between immorality and irrationality: roughly, that immorality involves substantive irrationality, but not structural irrationality. I defend this moderate view, and argue that many of the arguments for less moderate views turn either on missing the distinction between substantive and structural rationality, or on misconstruing it

Reasons, Coherence, and Group Rationality

Philosophy and Phenomenological Research, EarlyView

Designing cost-sharing methods for Bayesian games

We study the design of cost-sharing protocols for two fundamental resource allocation problems, the Set Cover and the Steiner Tree Problem, under environments of incomplete information (Bayesian model). Our objective is to design protocols where the worst-case Bayesian Nash equilibria, have low cost, i.e. the Bayesian Price of Anarchy (PoA) is minimized. Although budget balance is a very natural requirement, it puts considerable restrictions on the design space, resulting in high PoA. We propose an alternative, relaxed requirement called budget balance in the equilibrium (BBiE).We show an interesting connection between algorithms for Oblivious Stochastic optimization problems and cost-sharing design with low PoA. We exploit this connection for both problems and we enforce approximate solutions of the stochastic problem, as Bayesian Nash equilibria, with the same guarantees on the PoA. More interestingly, we show how to obtain the same bounds on the PoA, by using anonymous posted prices which are desirable because they are easy to implement and, as we show, induce dominant strategies for the players

Computing brains:Learning algorithms and neurocomputation in the smart city

This article examines IBM’s ‘Smarter Education’ programme, part of its wider ‘Smarter Cities’ agenda, focusing specifically on its learning analytics applications (based on machine learning algorithms) and cognitive computing developments for education (which take inspiration from neuroscience for the design of brain-like neural networks algorithms and neurocomputational devices). The article conceptualizes the relationship between learning algorithms, neuroscience and the new learning spaces of the city by combining the notion of programmable ‘code/space’ with ideas about the ‘social life of the brain’ to suggest that new kinds of ‘brain/code/spaces’ are being developed where the environment itself is imagined to possess brain-like functions of learning and ‘human qualities’ of cognition performed by algorithmic processes. IBM’s ambitions for education constitute a sociotechnical imaginary of a ‘cognitive classroom’ where the practices associated with data analytics and cognitive computing in the smart city are being translated into the neuropedagogic brain/code/spaces of the school, with significant consequences for how learners are to be addressed and acted upon. The IBM imaginary of Smarter Education is one significant instantiation of emerging smart cities that are to be governed by neurocomputational processes modelled on neuroscientific insights into the brain’s plasticity for learning, and part of a ‘neurofuture’ in-the-making where nonconscious algorithmic ‘computing brains’ embedded in urban space are intended to interact with human cognition and brain functioning