‘Medic!’ An insight into Scottish field surgeons, physicians, and medical provision during the Thirty Years’ War, 1618-1648

This article investigates the provision of medical care for Scottish soldiers engaged in the Thirty Years' War. It is based on archival research in Scotland, England, Denmark, Sweden and the Netherlands. It shows that factors such as attrition and rates of pay prevented the adequate provision of trained medical men, despite the wishes of the commanders who led them.proofPeer reviewe

Drummer Major James Spens: letters from a common soldier abroad, 1617-1632

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The forgotten '45 : Donald Dubh's rebellion in an archipelagic context

The final rebellion of Donald Dubh, heir to the forfeited MacDonald lordship of the Isles, is usually examined within the context of Highland rebellions that occurred in the half century after forfeiture. However, the factors that motivated the Islesmen to rise in rebellion in 1545 are multi-faceted and can only be fully understood by placing the rising in a wider context, which considers national and archipelagic events. The discussion that follows explores the reasons why the Islesmen, almost unanimously, entered into agreement with Henry VIII to attack Scotland from the west and why this endeavour failed. At the same time, the article highlights Henry’s recognition of the strategic importance of the west which led him into alliance with Donald Dubh and his supporters

A novel isolator-based system promotes viability of human embryos during laboratory processing

In vitro fertilisation (IVF) and related technologies are arguably the most challenging of all cell culture applications. The starting material is a single cell from which one aims to produce an embryo capable of establishing a pregnancy eventually leading to a live birth. Laboratory processing during IVF treatment requires open manipulations of gametes and embryos, which typically involves exposure to ambient conditions. To reduce the risk of cellular stress, we have developed a totally enclosed system of interlinked isolator-based workstations designed to maintain oocytes and embryos in a physiological environment throughout the IVF process. Comparison of clinical and laboratory data before and after the introduction of the new system revealed that significantly more embryos developed to the blastocyst stage in the enclosed isolator-based system compared with conventional open-fronted laminar flow hoods. Moreover, blastocysts produced in the isolator-based system contained significantly more cells and their development was accelerated. Consistent with this, the introduction of the enclosed system was accompanied by a significant increase in the clinical pregnancy rate and in the proportion of embryos implanting following transfer to the uterus. The data indicate that protection from ambient conditions promotes improved development of human embryos. Importantly, we found that it was entirely feasible to conduct all IVF-related procedures in the isolator-based workstations

Defective peroxisomal proliferators activated receptor gamma activity due to dominant-negative mutation synergizes with hypertension to accelerate cardiac fibrosis in mice

Aims Humans with inactivating mutations in peroxisomal proliferators activated receptor gamma (PPARγ) typically develop a complex metabolic syndrome characterized by insulin resistance, diabetes, lipodystrophy, hypertension, and dyslipidaemia which is likely to increase their cardiovascular risk. Despite evidence that the activation of PPARγ may prevent cardiac fibrosis and hypertrophy, recent evidence has suggested that pharmacological activation of PPARγ causes increased cardiovascular mortality. In this study, we investigated the effects of defective PPARγ function on the development of cardiac fibrosis and hypertrophy in a murine model carrying a human dominant‐negative mutation in PPARγ. Methods and results Mice with a dominant‐negative point mutation in PPARγ (P465L) and their wild‐type (WT) littermates were treated with either subcutaneous angiotensin II (AngII) infusion or saline for 2 weeks. Heterozygous P465L and WT mice developed a similar increase in systolic blood pressure, but the mutant mice developed significantly more severe cardiac fibrosis to AngII that correlated with increased expression of profibrotic genes. Both groups similarly increased the heart weight to body weight ratio compared with saline‐treated controls. There were no differences in fibrosis between saline‐treated WT and P465L mice. Conclusion These results show synergistic pathogenic effects between the presence of defective PPARγ and AngII‐induced hypertension and suggest that patients with PPARγ mutation and hypertension may need more aggressive therapeutic measures to reduce the risk of accelerated cardiac fibrosis

Human Embryonic Stem Cell Technology: Large Scale Cell Amplification and Differentiation

Embryonic stem cells (ESC) hold the promise of overcoming many diseases as potential sources of, for example, dopaminergic neural cells for Parkinson’s Disease to pancreatic islets to relieve diabetic patients of their daily insulin injections. While an embryo has the innate capacity to develop fully functional differentiated tissues; biologists are finding that it is much more complex to derive singular, pure populations of primary cells from the highly versatile ESC from this embryonic parent. Thus, a substantial investment in developing the technologies to expand and differentiate these cells is required in the next decade to move this promise into reality. In this review we document the current standard assays for characterising human ESC (hESC), the status of ‘defined’ feeder-free culture conditions for undifferentiated hESC growth, examine the quality controls that will be required to be established for monitoring their growth, review current methods for expansion and differentiation, and speculate on the possible routes of scaling up the differentiation of hESC to therapeutic quantities

ADEPT - Abnormal Doppler Enteral Prescription Trial

<p>Abstract</p> <p>Background</p> <p>Pregnancies complicated by abnormal umbilical artery Doppler blood flow patterns often result in the baby being born both preterm and growth-restricted. These babies are at high risk of milk intolerance and necrotising enterocolitis, as well as post-natal growth failure, and there is no clinical consensus about how best to feed them. Policies of both early milk feeding and late milk feeding are widely used. This randomised controlled trial aims to determine whether a policy of early initiation of milk feeds is beneficial compared with late initiation. Optimising neonatal feeding for this group of babies may have long-term health implications and if either of these policies is shown to be beneficial it can be immediately adopted into clinical practice.</p> <p>Methods and Design</p> <p>Babies with gestational age below 35 weeks, and with birth weight below 10th centile for gestational age, will be randomly allocated to an "early" or "late" enteral feeding regimen, commencing milk feeds on day 2 and day 6 after birth, respectively. Feeds will be gradually increased over 9-13 days (depending on gestational age) using a schedule derived from those used in hospitals in the Eastern and South Western Regions of England, based on surveys of feeding practice. Primary outcome measures are time to establish full enteral feeding and necrotising enterocolitis; secondary outcomes include sepsis and growth. The target sample size is 400 babies. This sample size is large enough to detect a clinically meaningful difference of 3 days in time to establish full enteral feeds between the two feeding policies, with 90% power and a 5% 2-sided significance level. Initial recruitment period was 24 months, subsequently extended to 38 months.</p> <p>Discussion</p> <p>There is limited evidence from randomised controlled trials on which to base decisions regarding feeding policy in high risk preterm infants. This multicentre trial will help to guide clinical practice and may also provide pointers for future research.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN: 87351483</p

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Time Limit and Sanction Effects of the Texas TANF Waiver

Key provisions of the Texas TANF waiver, Achieving Change for Texans (ACT), allowed the state to implement variable time limits, sanctions, and geographically-targeted work assistance programs. An innovative aspect of ACT was the provision that the state\u27s variable time limits did not begin until a case was notified of an available slot in the job assistance program. Thus, state time limits were directly linked with the provision of job services while sanction penalties were applicable to the entire caseload. In this paper, we examine the time limit and sanction effects on the duration of cash assistance for all families that entered the caseload from January 1997 to September 1999. The findings suggest that nonrnetropolitan families are more likely to be sanctioned and have longer spell durations than metropolitan families. In both areas, the imposition of sanctions and state time limits increased the likelihood of exiting the caseload

‘Bereft of all human help?’ : Scottish widows during the Thirty Years’ War (1618-1648)

The role of Scottish officers and soldiers during the Thirty Years’ War has received considerable scholarly attention in the last two decades. Historians such as Alexia Grosjean and David Worthington have established that thousands of Scots served the Scandinavian and Imperial armies during the first half of the seventeenth centuries often embarking on remarkable military careers. Their research mainly focused on the experience of officers and moved the narrative from one of simple mercenary engagement to a more nuanced understanding which has covered such issues as motive, recruitment and command and control of various armies in the conflict. It is a startling point that the vast majority of these men, whether generals or private soldiers, lost their lives during service. What has so far been neglected is an analysis of the role and fate of those who depended on these men: their widows and dependent children who travelled with the armies. This article seeks to fill this gap by analysing a compendium of over fifty letters obtained from Swedish and Dutch archives which were written by women who lost their husbands as a result of the conflict. In particular, the article will zoom in on individual cases like that of Margaretha Forrat, the wife of Colonel James Spens of Wormiston. After her husband’s death in 1632 Margaretha implored the Swedish chancellor Axel Oxenstierna and other high-ranking officials for financial help for herself and her children. This was eventually granted proving that Margaretha managed to successfully lobby and to exert influence over the Swedish authorities. Other widows such as Elizabeth Clerck (whose husband James Drummond died in 1645) were less successful. Indeed, as the records of widow’s petititions to the Dutch authorities show, gaining pensions or support after the death of a soldier was something of a lottery for the women left behind and other avenues of support had to be sought. The widow of Sergeant Bruce was not even accorded her own name in the judgement of the Dutch authorities denying her pension. Analysing the networks and activity of women like Margareta Forrat, Elizabeth Clerck will help us understand the degree to which they were embedded into the Swedish and Dutch military and social elite and to determine which factors allowed them to become agents of their own fate or made them victims of adverse circumstances. Consideration will also be given to the wives of soldiers from the lower ranks, such as ‘Widow Bruce’ which highlight the differing attitudes and care given to their support. As such the article will contribute to our knowledge of the impact of war on women, their agency and the perception of women and family relations by the Swedish and Dutch authorities and the intimate networks to whom they also turned to for support.PostprintPeer reviewe