861 research outputs found
Integration of computer technology into the medical curriculum: The King's experience
King's College London has developed a new curriculum which prepares students to deliver a highâquality clinical service. A variety of activeâlearning techniques are utilized to produce a deep approach to learning with an emphasis on vocational needs in the domains of knowledge, attitudes and skills. Integration of academic and clinical studies, as recommended by the General Medical Council (GMC), poses a number of difficulties, particularly in terms of communication between disparate geographical sites. The new curriculum aims to take advantage of computer technology to supplement and enhance traditional methods of learning and to ensure that students are competent in a defined range of skills. To aid integration, all students joining the new course are offered notebook computers and enhanced access to desktop computers, both with facilities to link to the main network This allows students to use multimedia material incorporated into the new curriculum and to access online services from remote locations. This paper reviews the integration of such computer technology into the new medical curriculum at King's
Forensic science evidence in question
How should forensic scientists and other expert witnesses present their evidence in court? What kinds and quality of data can experts properly draw on in formulating their conclusions? In an important recent decision in R. v T1 the Court of Appeal revisited these perennial questions, with the complicating twist that the evidence in question incorporated quantified probabilities, not all of which were based on statistical data. Recalling the sceptical tenor of previous judgments addressing the role of probability in the evaluation of scientific evidence,2 the Court of Appeal in R. v T condemned the expertâs methodology and served notice that it should not be repeated in future, a ruling which rapidly reverberated around the forensic science community causing consternation, and even dismay, amongst many seasoned practitioners.3 At such moments of perceived crisis it is essential to retain a sense of perspective. There is, in fact, much to welcome in the Court of Appealâs judgment in R. v T, starting with the courtâs commendable determination to subject the quality of expert evidence adduced in criminal litigation to searching scrutiny. English courts have not consistently risen to this challenge, sometimes accepting rather too easily the validity of questionable scientific techniques.4 However, the Court of Appealâs reasoning in R. v T is not always easy to follow, and there are certain passages in the judgment which, taken out of context, might even appear to confirm forensic scientistsâ worst fears. This article offers a constructive reading of R. v T, emphasising its positive features whilst rejecting interpretations which threaten, despite the Court of Appealâs best intentions, to diminish the integrity of scientific evidence adduced in English criminal trials and distort its probative value
Designing and managing multiple pipelines
There is now a growing recognition that supply chains should be designed from
âthe customer backwardsâ rather than from âthe company outwardsâ. If such a view
is accepted then the implication is that since the organisation will likely be
serving multiple markets or segments there will be the need to design and manage
multiple âpipelinesâ to serve those different customers. To assist decision
makers in their choice of appropriate supply chain design a framework is
proposed based upon multiple criteria. A case study is presented which
highlights the benefits of selecting, engineering and operating multiple
pipelines tailored to the needs of th
Attack/Affect: System of a Down and Genocide Activism
This article problematizes the affective capacities of popular music to perform tactical and sometimes violent disruptions in conventional thought, especially when these capacities are oriented toward political activism. I offer a critical analysis of âAttackâ and âHoly Mountainsâ (Hypnotize 2005), two songs by Los Angeles heavy metal band System of a Down. I also examine the melding of the disruptive aesthetics of heavy metal with socially conscious lyrics, and contestations over historical memory, specifically the recognition of the Armenian genocide. I ask what potential this music has to signal new and different ways of (re)thinking history and inquire into the questions that arise from such a strategy
Renal function, uraemia and early arteriovenous fistula failure
Background
Guidance varies regarding the optimal timing of arteriovenous fistula (AVF) creation. The aim of this study was to evaluate the association between uraemia, haemodialysis and early AVF failure.
Methods
Immunoblotting and cell proliferation assays were performed on vascular smooth muscle cells (VSM) cells isolated from long saphenous vein samples to evaluate the cellsâ ability to proliferate when stimulated with uraemic (post-dialysis) and hyperuraemic (pre-dialysis) serum. Clinical data was collected prospectively for 569 consecutive radiocephalic (RCF) and brachiocephalic (BCF) fistulae. The primary outcome was AVF failure at 6 weeks. Dialysis status (haemodialysis (HD); pre-dialysis (Pre-D)), eGFR and serum urea were evaluated to determine if they affected early AVF failure.
Results
Human VSM cells demonstrated increased capacity to proliferate when stimulated with hyperuraemic serum. There was no significant difference in early failure rate of either RCF or BCF depending on dialysis status (pre-D RCF 31.4% (nâ=â188); pre-D BCF 22.4% (nâ=â165); HD RCF 29.3% (nâ=â99); HD BCF 25.9% (nâ=â116); pâ=â0.34). There was no difference in mean eGFR between those patients with early AVF failure and those without (11.2+/-0.2 ml/min/1.73 m2 vs. 11.6+/-0.4 ml/min/1.73 m2; pâ=â0.47). Uraemia was associated with early AVF failure (serum urea: 35.0+/-0.7 mg/dl vs. 26.6+/-0.3 mg/dl (pâ<â0.001)).
Conclusions
We present the first in vivo evidence of an association between adverse early AVF outcomes and uraemia. This is supported mechanistically by in vitro work demonstrating a pro-mitogenic effect of hyperuraemic serum. We hypothesise that uraemia-driven upregulation of VSM cell proliferation at the site of surgical insult in contributes to higher early AVF failure rates.</p
Is neurosurgery referral warranted for small brain aneurysms?
The risk of rupture of a small cerebral aneurysm (<10 mm) is very low in asymptomatic patients who have never had a subarachnoid hemorrhage. Because the risk of morbidity and mortality from surgical intervention significantly exceeds that of nonsurgical monitoring for this group, primary care physicians do not need to refer patients with this condition to a neurosurgeon for clipping (strength of recommendation [SOR]: B, based on cohort and case-control studies). For patients managed conservatively, annual office follow-up and imaging evaluation should be considered, and is necessary if a specific symptom should arise (SOR: C, based on expert opinion)
Assessing the probative value of DNA evidence: guidance for judges, lawyers, forensic scientists and expert witnesses
Practical guidance for judges, lawyers, forensic scientists and expert witnesses on the logical analysis of DNA profiles, and their probative value in criminal proceedings. Explains technical aspects of DNA profiling and how this information should be presented and interpreted in criminal trials
Measurement of Resonant Frequency and Quality Factor of Microwave Resonators: Comparison of Methods
Precise microwave measurements of sample conductivity, dielectric, and
magnetic properties are routinely performed with cavity perturbation
measurements. These methods require the accurate determination of quality
factor and resonant frequency of microwave resonators. Seven different methods
to determine the resonant frequency and quality factor from complex
transmission coefficient data are discussed and compared to find which is most
accurate and precise when tested using identical data. We find that the
nonlinear least-squares fit to the phase vs. frequency is the most accurate and
precise when the signal-to-noise ratio is greater than 65. For noisier data,
the nonlinear least squares fit to a Lorentzian curve is more accurate and
precise. The results are general and can be applied to the analysis of many
kinds of resonant phenomena.Comment: 29 pages, 11 figure
The ambivalences of piracy : BitTorrent media piracy and anti-capitalism
This thesis argues that a more nuanced study of online media piracy is necessary
in order to augment the dominant focus on piracy's relationship to copyright. Copyright
as a frame for understanding piracy's relationship to capitalism has left potentially more
crucial areas of study neglected. An approach to understanding the relationship of media
piracy to anticapitalist projects must engage with forms of media piracy in their
specificity and not as a homogeneous field. The thesis argues that it is possible and
necessary to push beyond the constraints of copyright activism and intellectual property
and in so doing opens up new areas of inquiry into online media piracy's potential to
challenge logics of property and commodification.
Original research is presented in the form of a highly detailed description and
analysis of private BitTorrent filesharing sites. These sites are secretive and yet to
receive scholarly attention in such a detailed and systematic way. This research finds
both public and private variants of BitTorrent media piracy to be highly ambivalent with
regards to their transformative potentials in relation to capital and thus tempers more
extreme views of piracy as wholly revolutionary and emancipatory, and those that see
pirate as a 'simple' form of theft.
Public and private BitTorrent filesharing are theorised through the lens of
Autonomist Marxism, a perspective that has a novel view of technology both as a tool
of domination and a force for potential emancipation. Piracy is analysed for its capacity
to refuse the valorisation of the enjoyment of music or film via the surveillance and
tracking of audiences, which has become typical for contemporary legal online
distribution venues. The thesis further analyses BitTorrent piracy's relationship to the
'common', the shared capacities for creating knowledge, ideas, affects.
The thesis concludes that further scholarly research must move beyond concerns
for creators' remuneration and its focus on reforming existing copyright policy and
instead engage with the emergent institutional structures of organised media piracy.
Though publicly accessible BitTorrent piracy has contributed to a broadening of
awareness about issues of access to information, such an awareness often leaves in place
logics of private property and capitalist accumulation. Finally, the thesis argues that the
richness and complexity of private sites' organisational valences carry with them greater
potential for radically destabilising capitalist social relations with regard to the
distribution of cultural production
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