Studies on hepatic blood flow and the rate of Bromsulphalein clearance in dogs with portacaval transposition

Hepatic plasma and blood flows were determined in dogs with modified portacaval transposition. Mean hepatic blood flow was 43 ml. per kilogram per minute, approximately that expected in a normal dog. Similarly, the rate of Bromsulphalein clearance was in the range expected for normal dogs. © 1962

Recent La Plata basin drought conditions observed by satellite gravimetry

The Gravity Recovery and Climate Experiment (GRACE) provides quantitative measures of terrestrial water storage (TWS) change. GRACE data show a significant decrease in TWS in the lower (southern) La Plata river basin of South America over the period 2002-2009, consistent with recognized drought conditions in the region. GRACE data reveal a detailed picture of temporal and spatial evolution of this severe drought event, which suggests that the drought began in lower La Plata in around austral spring 2008 and then spread to the entire La Plata basin and peaked in austral fall 2009. During the peak, GRACE data show an average TWS deficit of ~12 cm (equivalent water layer thickness) below the 7 year mean, in a broad region in lower La Plata. GRACE measurements are consistent with accumulated precipitation data from satellite remote sensing and with vegetation index changes derived from Terra satellite observations. The Global Land Data Assimilation System model captures the drought event but underestimates its intensity. Limited available groundwater-level data in southern La Plata show significant groundwater depletion, which is likely associated with the drought in this region. GRAC-observed TWS change and precipitation anomalies in the studied region appear to closely correlate with the ENSO climate index, with dry and wet seasons corresponding to La Ni\~na and El Ni\~no events, respectively

An analysis of media reporting on the closure of freestanding midwifery units in England

PROBLEM: Despite clinical guidelines and policy promoting choice of place of birth, 14 Freestanding Midwifery Units were closed between 2008 and 2015, closures justified by low use and financial constraints. BACKGROUND: The Birthplace in England Programme found that freestanding midwifery units provided the most cost-effective birthplace for women at low risk of complications. Women planning birth in a freestanding unit were less likely to experience interventions than those planning obstetric unit birth, with no difference in outcomes for babies. METHODS: This paper uses an interpretative technique developed for policy analysis to explore the representation of these closures in 191 news articles, to explore the public climate in which they occurred. FINDINGS AND DISCUSSION: The articles focussed on underuse by women and financial constraints on services. Despite the inclusion of service user voices, the power of framing was held by service managers and commissioners. The analysis exposed how neoliberalist and austerity policies has privileged representation of individual consumer choice and market-driven provision as drivers of changes in health services. This normative framing makes the reasons given for closure as hard to refute and cultural norms persist that birth is safest in an obstetric setting, despite evidence to the contrary. CONCLUSION: The rise of neoliberalism and austerity in contemporary Britain has influenced the reform of maternity services, in particular the closure of midwifery units. Justifications given for closure silence other narratives, predominantly from service users, that attempt to present women's choice in terms of rights and a social model of care

A multiple catheter technique for studies or hepatic metabolism and blood flow in dogs with portacaval transposition

A technique is described for in vivo hepatic metabolic studies, employing a multiple catheterization technique in dogs with chronic portacaval transposition. The animals are studied in the unanesthetized state immediately after the insertion of catheters through peripheral cut-downs. The gradient of metabolites entering and leaving the liver can be measured concomitantly with hepatic plasma flow. Additional simultaneous gradients can be obtained across the splanchnic capillary bed, or the hindquarters. Drugs can be introduced into the circulation by a systemic route or by primary injection into the hepatic circulation. The advantages of this approach compared to other methods of evaluating moment to moment hepatic function are discussed. © 1962

Factors influencing utilisation of ‘free-standing’ and ‘alongside’ midwifery units for low-risk births in England: a mixed-methods study

Background Midwifery-led units (MUs) are recommended for ‘low-risk’ births by the National Institute for Health and Care Excellence but according to the National Audit Office were not available in one-quarter of trusts in England in 2013 and, when available, were used by only a minority of the low-risk women for whom they should be suitable. This study explores why. Objectives To map the provision of MUs in England and explore barriers to and facilitators of their development and use; and to ascertain stakeholder views of interventions to address these barriers and facilitators. Design Mixed methods – first, MU access and utilisation across England was mapped; second, local media coverage of the closure of free-standing midwifery units (FMUs) were analysed; third, case studies were undertaken in six sites to explore the barriers and facilitators that have an impact on the development of MUs; and, fourth, by convening a stakeholder workshop, interventions to address the barriers and facilitators were discussed. Setting English NHS maternity services. Participants All trusts with maternity services. Interventions Establishing MUs. Main outcome measures Numbers and types of MUs and utilisation of MUs. Results Births in MUs across England have nearly tripled since 2011, to 15% of all births. However, this increase has occurred almost exclusively in alongside units, numbers of which have doubled. Births in FMUs have stayed the same and these units are more susceptible to closure. One-quarter of trusts in England have no MUs; in those that do, nearly all MUs are underutilised. The study findings indicate that most trust managers, senior midwifery managers and obstetricians do not regard their MU provision as being as important as their obstetric-led unit provision and therefore it does not get embedded as an equal and parallel component in the trust’s overall maternity package of care. The analysis illuminates how provision and utilisation are influenced by a complex range of factors, including the medicalisation of childbirth, financial constraints and institutional norms protecting the status quo. Limitations When undertaking the case studies, we were unable to achieve representativeness across social class in the women’s focus groups and struggled to recruit finance directors for individual interviews. This may affect the transferability of our findings. Conclusions Although there has been an increase in the numbers and utilisation of MUs since 2011, significant obstacles remain to MUs reaching their full potential, especially FMUs. This includes the capacity and willingness of providers to address women’s information needs. If these remain unaddressed at commissioner and provider level, childbearing women’s access to MUs will continue to be restricted. Future work Work is needed on optimum approaches to improve decision-makers’ understanding and use of clinical and economic evidence in service design. Increasing women’s access to information about MUs requires further studies of professionals’ understanding and communication of evidence. The role of FMUs in the context of rural populations needs further evaluation to take into account user and community impact. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information

Factors influencing the utilisation of free-standing and alongside midwifery units in England: a qualitative research study

OBJECTIVE: To identify factors influencing the provision, utilisation and sustainability of midwifery units (MUs) in England. DESIGN: Case studies, using individual interviews and focus groups, in six National Health Service (NHS) Trust maternity services in England. SETTING AND PARTICIPANTS: NHS maternity services in different geographical areas of England Maternity care staff and service users from six NHS Trusts: two Trusts where more than 20% of all women gave birth in MUs, two Trusts where less than 10% of all women gave birth in MUs and two Trusts without MUs. Obstetric, midwifery and neonatal clinical leaders, managers, service user representatives and commissioners were individually interviewed (n=57). Twenty-six focus groups were undertaken with midwives (n=60) and service users (n=52). MAIN OUTCOME MEASURES: Factors influencing MU use. FINDINGS: The study findings identify several barriers to the uptake of MUs. Within a context of a history of obstetric-led provision and lack of decision-maker awareness of the clinical and economic evidence, most Trust managers and clinicians do not regard their MU provision as being as important as their obstetric unit (OU) provision. Therefore, it does not get embedded as an equal and parallel component in the Trust's overall maternity package of care. The analysis illuminates how implementation of complex interventions in health services is influenced by a range of factors including the medicalisation of childbirth, perceived financial constraints, adequate leadership and institutional norms protecting the status quo. CONCLUSIONS: There are significant obstacles to MUs reaching their full potential, especially free-standing midwifery units. These include the lack of commitment by providers to embed MUs as an essential service provision alongside their OUs, an absence of leadership to drive through these changes and the capacity and willingness of providers to address women's information needs. If these remain unaddressed, childbearing women's access to MUs will continue to be restricted

Numerical simulation of centrifugal pumps

The power computers increase and the specific calculation software development have made possible, nowadays, the numerical simulation of flow and energy transfer inside the turbomachinery. To teach Fluid Mechanics is not easy not only for the professors but also for the students because the theoretical part must be complemented with a technical part where students can see the phenomena. However, specially in hydraulic turbomachinery, we canít see the phenomena except if we have a specific material, for example a PIV. Even if we would have this material, the access to specific parts of turbomachinery is not possible due to its constructive layout. The use of numerical simulation tools allows us to obtain data in inaccessible positions for the experimentation, as well as the study of unusual or dangerous performances. With the numerical simulation, the pressure fluctuation at any point of the pump can be easily obtained. Other important results are the radial forces on the impeller, which have a significant variation with the working points. One of the advantages of this kind of modelling is the ease to carry out changes in the geometry, parametric studies and analysis of anomalous operation conditions

Received signal characteristics of outdoor body-to-body communications channels at 2.45 GHz

In this paper we conduct a number of experiments to assess the impact of typical human body movements on the signal characteristics of outdoor body-to-body communications channels using flexible patch antennas. A modified log-distance path loss model which accounts for body shadowing and signal fading due to small movements is used to model the measured data. For line of sight channels, in which both ends of the body-to-body link are stationary, the path loss exponent is close to that for free space, although the received signal is noticeably affected by involuntary or physiological-related movements of both persons. When one person moves to obstruct the direct signal path between nodes, attenuation by the person's body can be as great as 40 dB, with even greater variation observed due to fading. The effects of movements such as rotation, tilt, walking in line of sight and non-line of sight on body-to-body communications channels are also investigated in this study. © 2011 IEEE

Interrogating fragments using a protein thermal shift assay

Protein thermal shift is a relatively rapid and inexpensive technique for the identification of low molecular weight compound interactions with protein targets. An increase in the melting temperature of the target protein in the presence of a test ligand is indicative of a promising ligand-protein interaction. Due to its simplicity, protein thermal shift is an attractive method for screening libraries and validating hits in drug discovery programs. The methodology has been used successfully in high throughput screens of small molecule libraries, and its application has been extended to report on protein-drug-like-fragment interactions. Here, we review how protein thermal shift has been employed recently in fragment-based drug discovery (FBDD) efforts, and highlight its application to protein-protein interaction targets. Multiple validation of fragment hits by independent means is paramount to ensure efficient and economical progress in a FBDD campaign. We discuss the applicability of thermal shift assays in this light, and discuss more generally what one does when orthogonal approaches disagree