Between a rock and a hard place of geopolitically sensitive threats - critical incidents and decision inertia

While the SAFE-T model of decision making emphasizes naturalistic decision making, its potential for cross-comparative analysis of incidents with global implications remains underutilized, which the current paper aims to address. To this end, it draws upon open-source reports from unclassified American, British and Russian intelligence reports to explore the management of three types of 10 high-profile geopolitically sensitive threats from across the globe (verifying potential terrorist identity, hostage rescue and national/international security). Defining features of such incidents include decision makers’ ability to prospectively model competing scenarios in which they must select between options and where every outcome looks aversive and high risk (‘damned if you do or damned if you don’t decisions’). A frequent consequence of such calculations is ‘decision inertia’ (a failure to execute an important, irrevocable decision resulting in non-optimal consequences), or ‘implementation failure’ (a failure to make a choice). Combining the benefit of the theoretical framework and hindsight knowledge of the analyzed incidents, the paper facilitates theoretical understanding of decision inertia and failures to act. Encouraging the consideration of multiple scenario endings contingent on a wide spectrum of factors and unique cultural-historical context, it also helps identify past decision errors in order to inform assessment and management of similar geopolitical threats in the future

Effects of peripheral nerve injury on parvalbumin expression in adult rat dorsal root ganglion neurons

Background: Parvalbumin (PV) is a calcium binding protein that identifies a subpopulation of proprioceptive dorsal root ganglion (DRG) neurons. Calcitonin gene-related peptide (CGRP) is also expressed in a high proportion of muscle afferents but its relationship to PV is unclear. Little is known of the phenotypic responses of muscle afferents to nerve injury. Sciatic nerve axotomy or L5 spinal nerve ligation and section (SNL) lesions were used to explore these issues in adult rats using immunocytochemistry. Results: In naive animals, the mean PV expression was 25 % of L4 or L5 dorsal root ganglion (DRG) neurons, and this was unchanged 2 weeks after sciatic nerve axotomy. Colocalization studies with the injury marker activating transcription factor 3 (ATF3) showed that approximately 24 % of PV neurons expressed ATF3 after sciatic nerve axotomy suggesting that PV may show a phenotypic switch from injured to uninjured neurons. This possibility was further assessed using the spinal nerve ligation (SNL) injury model where injured and uninjured neurons are located in different DRGs. Two weeks after L5 SNL there was no change in total PV staining and essentially all L5 PV neurons expressed ATF3. Additionally, there was no increase in PV-ir in the adjacent uninjured L4 DRG cells. Co-labelling of DRG neurons revealed that less than 2 % of PV neurons normally expressed CGRP and no colocalization was seen after injury. Conclusion: These experiments clearly show that axotomy does not produce down regulation of PV protein in the DRG. Moreover, this lack of change is not due to a phenotypic switch in PV immunoreactive (ir) neurons, or de novo expression of PV-ir in uninjured neurons after nerve injury. These results further illustrate differences that occur when muscle afferents are injured as compared to cutaneous afferents

Neuronal circuitry for pain processing in the dorsal horn

Neurons in the spinal dorsal horn process sensory information, which is then transmitted to several brain regions, including those responsible for pain perception. The dorsal horn provides numerous potential targets for the development of novel analgesics and is thought to undergo changes that contribute to the exaggerated pain felt after nerve injury and inflammation. Despite its obvious importance, we still know little about the neuronal circuits that process sensory information, mainly because of the heterogeneity of the various neuronal components that make up these circuits. Recent studies have begun to shed light on the neuronal organization and circuitry of this complex region

COVID-19 in congenital heart disease (COaCHeD) study

Background: COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.// Objective: Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.// Methods: Multicentre UK study undertaken 1 March 2020–30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.// Results: There were 405 reported cases (127 paediatric/278 adult). In children (age <16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p<0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p<0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).// Conclusions: Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD

COVID-19 in congenital heart disease (COaCHeD) study

BACKGROUND: COVID-19 has caused significant worldwide morbidity and mortality. Congenital heart disease (CHD) is likely to increase vulnerability and understanding the predictors of adverse outcomes is key to optimising care.OBJECTIVE: Ascertain the impact of COVID-19 on people with CHD and define risk factors for adverse outcomes.METHODS: Multicentre UK study undertaken 1 March 2020-30 June 2021 during the COVID-19 pandemic. Data were collected on CHD diagnoses, clinical presentation and outcomes. Multivariable logistic regression with multiple imputation was performed to explore predictors of death and hospitalisation.RESULTS: There were 405 reported cases (127 paediatric/278 adult). In children (age &lt;16 years), there were 5 (3.9%) deaths. Adjusted ORs (AORs) for hospitalisation in children were significantly lower with each ascending year of age (OR 0.85, 95% CI 0.75 to 0.96 (p&lt;0.01)). In adults, there were 24 (8.6%) deaths (19 with comorbidities) and 74 (26.6%) hospital admissions. AORs for death in adults were significantly increased with each year of age (OR 1.05, 95% CI 1.01 to 1.10 (p&lt;0.01)) and with pulmonary arterial hypertension (PAH; OR 5.99, 95% CI 1.34 to 26.91 (p=0.02)). AORs for hospitalisation in adults were significantly higher with each additional year of age (OR 1.03, 95% CI 1.00 to 1.05 (p=0.04)), additional comorbidities (OR 3.23, 95% CI 1.31 to 7.97 (p=0.01)) and genetic disease (OR 2.87, 95% CI 1.04 to 7.94 (p=0.04)).CONCLUSIONS: Children were at low risk of death and hospitalisation secondary to COVID-19 even with severe CHD, but hospital admission rates were higher in younger children, independent of comorbidity. In adults, higher likelihood of death was associated with increasing age and PAH, and of hospitalisation with age, comorbidities and genetic disease. An individualised approach, based on age and comorbidities, should be taken to COVID-19 management in patients with CHD.</p

The body in question : some perceptions, problems and perspectives of the body in relation to character, c. 1750-1850

This work is a critical and historical exploration of some of the issues raised once it is posited that the appearance of the human body is a reliable and accurate indicator of psychological life beneath the skin. Its object is not to provide a continuous narrative [say, about the rise of scientific psychology] but to assemble and juxtapose a wide array of disparate materials and thereby resolve a number of issues. What made the appearance of the body an important subject of inquiry, what forms that inquiry took, and what made possible the development of a variety of discourses and practices centered on the body as a sign-system- such questions are at the centre of this study. The thesis is divided into 3 parts. The first takes as its focus the work of a number of leading intellectual figures of the mid- and late-eighteenth century, and explores their treatment of the body. The second deals with the rise of scientific culture in Britain and with the shift in discursive structures from the realms of 'artistic' and 'literary' culture to that of the scientific. The third seeks through scientific culture to deal with a set of popular characterologies- physiognomy, phrenology, and organology- tracing the relations of each to a number of different discourses. In what is a long and complex series of arguments and expositions, the thesis is equipped with numerous general and particular summaries and introductions to facilitate reading

Bringing Process to Post Production

Recent developments in the field of business process management have made it possible to effectively deal with large collections of process models that exhibit many similarities but also context-dependent differences. In this paper these developments are exploited in the domain of screen business. In particular, different processes in audio editing are described in an integrated artifact, called reference process model, capturing their context-dependent variation points. This model can then be configured by domain experts, who are asked to select the process variants that best suit the needs of a specific audio editing project, via the use of a questionnaire. It is argued that configurable reference process models provide a structured basis for communicating the state-of-the-art in this rapidly evolving field