Modern treatment of appendicitis

Appendicitis is a disease which has only very recently - within the last twenty years - been studied at all. The pathology of the disease shows us that it occurs in attacks of three kinds - acute, medium, and very mild. In the acute variety the disease is well under - stood and the treatment is acknowledged by everyone to be immediate operative interference. In the mild variety, the symptoms are so slight that the disease cannot be definitely recognised. Nevertheless pathological changes occur in the appendix which produce serious results later on. In the medium variety, the symptoms are definite but the treatment varies. Appendicectomy during the height of a first attar is a perfectly safe operation, as well as a simple one. Appendicectomy during the quiescent period after an attack is no safer, and is far more liable to be a difficult operation. Convalescence is prolonged. The expectant treatment of a medium attack is unsafe and unreliable. Further attacks are almost certain to occur, and operation is called for in the long run - but the operation after several attacks is attended by difficulties and dangers which are not present in an operation during the first attack. The questions set down in the Preface may therefore be answered thus: - Definite recognisable appendicitis should be transferred entirely to the domain of surgery. Appendicectomy should not however be left to the specialist. When done at the right time it is a simple operation which can and should be performed by every medical ractitioner. Appendicitis should always be treated surgically except under circumstances where extraneous considerations make the operation a greater risk than the disase. The present mortality of the disease could be firiensely reduced were all cases operated on as soon as he condition was diagnosed. Under these circumstances he mortality should not exceed 2 -3 per cent. The resent mortality of the disease being from 7 to 10 er cent in all cases. The one rule of treatment should be that directly appendicitis is diagnosed, an operation should be performed at the earliest possible moment

Study on the proposal evaluation system for the EU R&I framework programme. Final Report

RAND Europe wurde von der Generaldirektion Forschung und Innovation (bekannt unter dem Kürzel DG RTD) beauftragt, eine umfassende Überprüfung der in Horizont 2020 (H2020) verwendeten Verfahren zur Bewertung von Vorschlägen durchzuführen und ein internationales Benchmarking dieser Verfahren im Vergleich zur anerkannten Praxis und der breiteren Wissensbasis in diesem Bereich vorzunehmen. Der vorliegende Bericht enthält die Ergebnisse dieser Studie und soll als Grundlage für die Gestaltung von Vorschlagsbewertungsverfahren für Horizont Europa dienen. Die Arbeit kann auch für andere Organisationen, die Forschung und Innovation (F&I) finanzieren, sowie für die gesamte europäische Forschungs- und Innovationsgemeinschaft von Interesse sein. Der vorliegende Bericht enthält die wichtigsten Ergebnisse der Analyse. Ihm ist ein Anhang beigefügt, der nähere Einzelheiten zu den Methoden und den verwendeten und zu Referenzzwecken erstellten Daten sowie zu den durchgeführten spezifischen Analysen enthält. In diese Studie sind die von Clarivate durchgeführte bibliometrische Analyse und die fachliche Beratung durch Prof. Jonathan Grant, Prof. Liv Langfeldt, Prof. Ana Marušić und Prof. Ulf Sandström eingeflossen

Temperature in housing: stratification and contextual factors

Overheating in new and retrofit low carbon dioxide homes is a growing issue in the UK due to climate change and other factors, with 99% of existing housing predicted to be at medium to high risk if summer temperatures become 1·4°C warmer. A year-long field study in two residential developments in the north of England monitored housing at three different scales: two-storey houses and three- and ten-storey blocks of flats. This revealed significant temperature stratification in the staircase zone, which allows a stack effect, as well as temperature differences between dwellings depending on their location in the building, both for summer and winter conditions even in the low-rise housing. Further investigation revealed that albedo and east–west orientation also contributed to non-linear overheating. Analyses of inhabitants’ thermal comfort and security practices as well as occupancy patterns also challenge the regulatory modelling used to predict building performance. It is suggested that these additional physical as well as user factors in residential developments need further investigation and should now be considered in relation to thermal comfort modelling

The thick-bedded tail of turbidite thickness distribution as a proxy for flow confinement: examples from Tertiary basins of central and northern Apennines (Italy)

This study reviews the thickness statistics of non-channelized turbidites from four tertiary basins of Central-Northern Apennines (Italy), where bed geometry and sedimentary character have been previously assessed. Though very different in terms of size and, arguably, character of feeder system, these basins share a common stratigraphic evolution consisting in transition from an early ponded to a late unconfined setting of deposition. Based on comparison of thickness subsets from diverse locations and stratigraphic heights within the studied turbidite fills, this paper seeks to answer the following questions: i) how data collection procedures and field operational constraints (e.g. measure location, outcrop quality, use of thicknesses data from single vs. multiple correlative sections, stratigraphic thickness of the study interval) can affect statistics of sample data? ii) how depositional controls of confined vs. unconfined turbidite basins can result in different thickness-frequency distributions?; and iii) is there in thickness statistics a ‘flow confinement’ signature which can be used to distinguish between confined and unconfined turbidites? Results suggest that: i) best practices of data collection are crucial to a meaningful interpretation of sample data statistics, especially in presence of stratigraphic and spatial trends of turbidite bed thickness; ii) a systematic bias against cm-thick Tcd Bouma sequence turbidites exists in sample data, which can result in the low-end tail of empirical thickness-frequency distributions to depart significantly from the actual distribution of turbidite thickness; and iii) thickness statistics of beds starting with a basal Ta/Tb Bouma division bear a coherent relationship to the transition from ponded to unconfined depositional settings, consisting in reduction of variance and mean and, consequently, parameters, or even type, of best fit model distribution. This research highlights the role of flow stripping, sediment by-pass and bed geometry in altering the initial thickness distribution of ponded turbidites and suggests how fully ponded mini-basins represent the ideal setting for further research linking turbidite thickness statistics and frequency distribution of parent flow volumes

Costs and benefits of thermal acclimation for codling moth, Cydia pomonella (Lepidoptera: Tortricidae): implications for pest control and the sterile insect release programme

Sterile insect release (SIR) is used to suppress insect pest populations in agro-ecosystems, but its success hinges on the performance of the released insects and prevailing environmental conditions. For example, low temperatures dramatically reduce SIR efficacy in cooler conditions. Here, we report on the costs and benefits of thermal acclimation for laboratory and field responses of codling moth, Cydia pomonella. Using a component of field fitness, we demonstrate that low temperature acclimated laboratory-reared moths are recaptured significantly more (∼2–4×) under cooler conditions in the wild relative to warm-acclimated or control moths. However, improvements in low temperature performance in cold-acclimated moths came at a cost to performance under warmer conditions. At high ambient temperatures, warm-acclimation improved field performance relative to control or cold-acclimated moths. Laboratory assessments of thermal activity and their limits matched the field results, indicating that these laboratory assays may be transferable to field performance. This study demonstrates clear costs and benefits of thermal acclimation on laboratory and field performance and the potential utility of thermal pretreatments for offsetting negative efficacy in SIR programmes under adverse thermal conditions. Consequently, the present work shows that evolutionary principles of phenotypic plasticity can be used to improve field performance and thus possibly enhance pest control programmes seeking increased efficacy

Critical Media Industry Studies: A Research Approach

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73139/1/j.1753-9137.2009.01037.x.pd

Murid Herpesvirus-4 Exploits Dendritic Cells to Infect B Cells

Dendritic cells (DCs) play a central role in initiating immune responses. Some persistent viruses infect DCs and can disrupt their functions in vitro. However, these viruses remain strongly immunogenic in vivo. Thus what role DC infection plays in the pathogenesis of persistent infections is unclear. Here we show that a persistent, B cell-tropic gamma-herpesvirus, Murid Herpesvirus-4 (MuHV-4), infects DCs early after host entry, before it establishes a substantial infection of B cells. DC-specific virus marking by cre-lox recombination revealed that a significant fraction of the virus latent in B cells had passed through a DC, and a virus attenuated for replication in DCs was impaired in B cell colonization. In vitro MuHV-4 dramatically altered the DC cytoskeleton, suggesting that it manipulates DC migration and shape in order to spread. MuHV-4 therefore uses DCs to colonize B cells

The planning system and fast food outlets in London: lessons for health promotion practice

This article considers how health promotion can use planning as a tool to enhance healthy eating choices. It draws on research in relation to the availability and concentration of fast food outlets in a London borough. Current public health policy is confining planning to local settings within a narrow framework drawing on discourses from social psychology and libertarian economics. Policy is focusing on behaviour change, voluntary agreements and devolution of the public health function to local authorities. Such a framework presents barriers to effective equity-based health promotion. A social determinant-based health pro-motion strategy would be consistent with a national regulatory infrastructure supporting planning

Metaethics, teleosemantics and the function of moral judgements

This paper applies the theory of teleosemantics to the issue of moral content. Two versions of teleosemantics are distinguished: input-based and output-based. It is argued that applying either to the case of moral judgements generates the conclusion that such judgements have both descriptive (belief-like) and directive (desire-like) content, intimately entwined. This conclusion directly validates neither descriptivism nor expressivism, but the application of teleosemantics to moral content does leave the descriptivist with explanatory challenges which the expressivist does not face. Since teleosemantics ties content to function, the paper also offers an account of the evolutionary function of moral judgements