203 research outputs found

    Doing our work better, together: a relationship-based approach to defining the quality improvement agenda in trauma care

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    Article presents a study conducted at Gold Coast University Hospital that aimed to define and improve relational aspects of trauma care and facilitate co-creation of targeted interventions designed to improve team relationships and performance

    Plutonic foundation of a slow-spreading ridge segment : oceanic core complex at Kane Megamullion, 23°30′N, 45°20′W

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    Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 9 (2008): Q05014, doi:10.1029/2007GC001645.We mapped the Kane megamullion, an oceanic core complex on the west flank of the Mid-Atlantic Ridge exposing the plutonic foundation of a ∼50 km long, second-order ridge segment. The complex was exhumed by long-lived slip on a normal-sense detachment fault at the base of the rift valley wall from ∼3.3 to 2.1 Ma (Williams, 2007). Mantle peridotites, gabbros, and diabase dikes are exposed in the detachment footwall and in outward facing high-angle normal fault scarps and slide-scar headwalls that cut through the detachment. These rocks directly constrain crustal architecture and the pattern of melt flow from the mantle to and within the lower crust. In addition, the volcanic carapace that originally overlay the complex is preserved intact on the conjugate African plate, so the complete internal and external architecture of the paleoridge segment can be studied. Seafloor spreading during formation of the core complex was highly asymmetric, and crustal accretion occurred largely in the footwall of the detachment fault exposing the core complex. Because additions to the footwall, both magmatic and amagmatic, are nonconservative, oceanic detachment faults are plutonic growth faults. A local volcano and fissure eruptions partially cover the northwestern quarter of the complex. This volcanism is associated with outward facing normal faults and possible, intersecting transform-parallel faults that formed during exhumation of the megamullion, suggesting the volcanics erupted off-axis. We find a zone of late-stage vertical melt transport through the mantle to the crust in the southern part of the segment marked by a ∼10 km wide zone of dunites that likely fed a large gabbro and troctolite intrusion intercalated with dikes. This zone correlates with the midpoint of a lineated axial volcanic high of the same age on the conjugate African plate. In the central region of the segment, however, primitive gabbro is rare, massive depleted peridotite tectonites abundant, and dunites nearly absent, which indicate that little melt crossed the crust-mantle boundary there. Greenschist facies diabase and pillow basalt hanging wall debris are scattered over the detachment surface. The diabase indicates lateral melt transport in dikes that fed the volcanic carapace away from the magmatic centers. At the northern edge of the complex (southern wall of the Kane transform) is a second magmatic center marked by olivine gabbro and minor troctolite intruded into mantle peridotite tectonite. This center varied substantially in size with time, consistent with waxing and waning volcanism near the transform as is also inferred from volcanic abyssal-hill relief on the conjugate African plate. Our results indicate that melt flow from the mantle focuses to local magmatic centers and creates plutonic complexes within the ridge segment whose position varies in space and time rather than fixed at a single central point. Distal to and between these complexes there may not be continuous gabbroic crust, but only a thin carapace of pillow lavas overlying dike complexes laterally fed from the magmatic centers. This is consistent with plate-driven flow that engenders local, stochastically distributed transient instabilities at depth in the partially molten mantle that fed the magmatic centers. Fixed boundaries, such as large-offset fracture zones, or relatively short segment lengths, however, may help to focus episodes of repeated melt extraction in the same location. While no previous model for ocean crust is like that inferred here, our observations do not invalidate them but rather extend the known diversity of ridge architecture.NSF Grants OCE-0118445, OCE-0624408 and OCE-0621660 supported this research. B. Tucholke was also supported by the Henry Bryant Bigelow Chair in Oceanography at Woods Hole Oceanographic Institution

    Prima facie reasons to question enclosed intellectual property regimes and favor open-source regimes for germplasm

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    In principle, intellectual property protections (IPPs) promote and protect important but costly investment in research and development. However, the empirical reality of IPPs has often gone without critical evaluation, and the potential of alternative approaches to lend equal or greater support for useful innovation is rarely considered. In this paper, we review the mounting evidence that the global intellectual property regime (IPR) for germplasm has been neither necessary nor sufficient to generate socially beneficial improvements in crop plants and maintain agrobiodiversity. Instead, based on our analysis, the dominant global IPR appears to have contributed to consolidation in the seed industry while failing to genuinely engage with the potential of alternatives to support social goods such as food security, adaptability, and resilience. The dominant IPR also constrains collaborative and cumulative plant breeding processes that are built upon the work of countless farmers past and present. Given the likely limits of current IPR, we propose that social goods in agriculture may be better supported by alternative approaches, warranting a rapid move away from the dominant single-dimensional focus on encouraging innovation through ensuring monopoly profits to IPP holders

    Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

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    Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

    Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

    Get PDF
    Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome
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