Developing a sustainability KM strategy for HA planned works

Effective management of sustainability-related knowledge is central to the development of sustainable construction practices. Despite progress In other contexts, existing knowledge management efforts have been of limited value to contexts such as housing association planned works (cyclical replacement of housing components) due to an inability to reflect the specificities of these projects. This paper presents the development of a structured strategy to improve the capture, storage, retrieval and exchange of sustainability-related knowledge within housing association planned works. Knowledge mapping exercises based on semi-structured interviews were carried out within four different sized Scottish housing associations. Sustainability-related knowledge maps were developed for each activity focusing on managerial, economic, social, environmental aspects and overall flow of knowledge providing the basis for recommendations to improve the management of sustainability-related knowledge during planned works. The strategy promotes a structured approach providing housing associations with the opportunity to tailor the strategy to reflect their context and requirements. Practitioners from the case studies confirmed its usefulness especially for housing associations committed to sustainability but struggling to engage with high-level policy and strategies. One case study association has implemented the high-level principles to support its wider sustainability policy and is piloting a strategy for its planned works. </jats:p

An investigation into the nutritional status of patients receiving an Enhanced Recovery After Surgery (ERAS) protocol versus standard care following Oesophagectomy

Enhanced Recovery After Surgery (ERAS) protocols have been effectively expanded to various surgical specialities including oesophagectomy. Despite nutrition being a key component, actual nutrition outcomes and specific guidelines are lacking. This cohort comparison study aims to compare nutritional status and adherence during implementation of a standardised post-operative nutritional support protocol, as part of ERAS, compared to those who received usual care.Two groups of patients undergoing resection of oesophageal cancer were studied. Group 1 (n = 17) underwent oesophagectomy between Oct 2014 and Nov 2016 during implementation of an ERAS protocol. Patients in group 2 (n = 16) underwent oesophagectomy between Jan 2011 and Dec 2012 prior to the implementation of ERAS. Demographic, nutritional status, dietary intake and adherence data were collected. Ordinal data was analysed using independent t tests, and categorical data using chi-square tests.There was no significant difference in nutrition status, dietary intake or length of stay following implementation of an ERAS protocol. Malnutrition remained prevalent in both groups at day 42 post surgery (n = 10, 83% usual care; and n = 9, 60% ERAS). A significant difference was demonstrated in adherence with earlier initiation of oral free fluids (p

Using 3D Printing Technology to Teach Cartilage Framework Carving for Ear Reconstruction

Objective: The aim of this study was to determine the validity of using a carvable 3D printed rib model in combination with a 3D printed auricular framework to facilitate the teaching, training and planning of auricular reconstruction

3D Bioprinting and the Future of Surgery

Introduction: The disciplines of 3D bioprinting and surgery have witnessed incremental transformations over the last century. 3D bioprinting is a convergence of biology and engineering technologies, mirroring the clinical need to produce viable biological tissue through advancements in printing, regenerative medicine and materials science. To outline the current and future challenges of 3D bioprinting technology in surgery. Methods: A comprehensive literature search was undertaken using the MEDLINE, EMBASE and Google Scholar databases between 2000 and 2019. A narrative synthesis of the resulting literature was produced to discuss 3D bioprinting, current and future challenges, the role in personalized medicine and transplantation surgery and the global 3D bioprinting market. Results: The next 20 years will see the advent of bioprinted implants for surgical use, however the path to clinical incorporation will be fraught with an array of ethical, regulatory and technical challenges of which each must be surmounted. Previous clinical cases where regulatory processes have been bypassed have led to poor outcomes and controversy. Speculated roles of 3D bioprinting in surgery include the production of de novo organs for transplantation and use of autologous cellular material for personalized medicine. The promise of these technologies has sparked an industrial revolution, leading to an exponential growth of the 3D bioprinting market worth billions of dollars. Conclusion: Effective translation requires the input of scientists, engineers, clinicians, and regulatory bodies: there is a need for a collaborative effort to translate this impactful technology into a real-world healthcare setting and potentially transform the future of surgery

The amphibolite at Chibuluma Mine Zambia

Chibuluma Mine is situated on the southern flank of the Nkana-Chambishi basin in the central section of the Zambian Copperbelt. The amphibolite at Chibuluma Mine occurs exclusively in the Upper Roan Group sediments overlying the economically important Lower Roan Group. The amphibolite occurs in lenticular, sill-like bodies ranging in thickness from less than 10 feet to over 1,000 feet. It is concluded that these sill-like bodies are intrusive sills of basic magma. The largest sill is a multiple intrusion with two phases, both of which exhibit chilled margins. The younger phase was intruded into the older along a plane approximately 50 feet above its basal contact. Grainsize, specific gravity, and micrometric data indicate that each phase of the intrusion has undergone gravitational differentiation during crystallisation. Variations in the relative amounts of amphibole and feldspar distinguish between a lower melanocratic amphibolite, an upper mesotype amphibolite, and a zone of coarse-grained pegmatitic amphibolite schlieren. The amphibolite consists mainly of hornblende, labradorite, albite, and scapolite, with accessory biotite, chlorite, epidote, clinozoisite, sphene, apatite, quartz, micropegmatite, and calcite. Clouding of the basic plagioclase and zoning in amphibole, plagioclase, and scapolite are features of petrological significance. The opaque minerals in the amphibolites and the adjacent sediments are magnetite, ilmenite, pyrite, chalcopyrite, pyrrhotite, cubanite, valleriite, and pentlandite. Intergrowths of these suggest that their temperatures of formation were probably in excess of 450°C. The chemical data show a close resemblance between the amphibolite and a tholeiitic magma-type although minor spilitic characteristics are also evident. The chemical data also confirm the mineralogical evidence of fractionation and gravitational differentiation. The trend in differentiation followed in the development of the pegmatitic and mesotype amphibolite is very similar to the trends followed by other basic intrusions. The main metamorphic affect accompanying the intrusion of the amphibolite is the soda metasomatism evident in both sediments and intrusions. Some evidence exists to suggest that the amphibolites were emplaced before or during the early stages of the Lufilian orogeny when sediments were essentially horizontal

The rate of thermal dissociation of direnzyl

1) The most recent work on the pyrolysis of dibenzyl suggested that a thermal equilibrium:- PhCH₂CH₂Ph == 2 PhCH₂- was set up as a preliminary to decomposition. The aim of this research was to test this idea by heating mixtures of PhCH₂CH₂Ph (M.W. 182) and PhCD₂CD₂Ph (M.W. 186) and following mass spectrometrically the growth of PhCH₂CH₂Ph (M.W. 184) formed by radical recombination. 2) A four stage synthesis of deuterated dibenzyl was developed and used to prepare dibenzyl of 95% isotopic purity with the composition:- PhCD₂CD₂Ph, 81%; PhCD₂CDHPh, 18 %; PhCDHCDHPh, 1%. PhCH₂CD₂Ph was synthesized by the same sequence of reactions. 3) In order to provide the necessary experimental equipment, the following items have been developed and constructed and descriptions of them are given in this Thesis:- a) a 2 litre reaction vessel with an electronically controlled furnace was arranged with a gas circulating system feeding the inlet of a mass spectrometer; b) an existing mass spectrometer was extensively modified in order to give resolution of 1 in 200:- i) the spectrometer tube was stiffened and accurately re-aligned; ii) the ion collector unit was made detachable and its construction improved; iii) a new ion source was designed and built to the required high accuracy; iv) a new scanning unit was built for variation of the magnetic field. 4) The rate of formation of PhCH₂CD₂Ph was followed in mixtures of PhCH₂CD₂Ph and PhCD₂CD₂Ph at pressures of 0.08 to 0.66 mm. in the reaction vessel, and at pressure up to 142 mm. in sealed tubes, using temperatures between 400° and 500°C. Data were also obtained on the rate of decomposition of PhCH₂CH₂Ph alone in similar systems. 5) The rate of radical exchange was found to be first order, independent of surface and of pressure of added A, N₂, D₂, and O₂. The decomposition reaction was shown to be 1.5 order at low pressures, and tended to first order at high pressures. At lower pressures it was much slower than the radical exchange. 6) A rate equation for radical exchange in terms of the rate of dissociation of dibenzyl, making due allowance for the simultaneous decomposition of dibenzyl has been developed and applied in the lower pressure region where exchange was of major importance. It gives:- kf sec⁻¹ = 10 ¹⁴.⁰³ exp -6000/RT 7) The energy of activation in 6) has been identified with D(PhCH₂-CD₂Ph) in dibenzyl. This value has been discussed in relation to current data on the heat of formation of the benzyl radical and bond dissociation energies in benzyl compounds, notably D(PhCH₂-H) in toluene. 8) The energy of activation for the decomposition was found to be 47 kcal and the nature and proportions of the reaction products were established and compared with previous work. The proportions of side-chain deuterated toluenes formed were consistent with a deuterium isotope effect of 2 or less, and with toluene being made by the abstraction of hydrogen from the central carbon atoms of dibenzyl by benzyl radicals. Benzyl radicals were also shown to react with deuterium to form toluene

Biodurability of Poly Implant Prothèse (PIP) breast implants: A prospective analysis of 1028 prostheses in 514 patients

Poly Implant Prothèse (PIP) was a company that manufactured substandard breast implants using cheaper non-medical grade silicon. Around 40,000 women in the UK are thought to have PIP implants inserted(1). The advice for Women in Wales is: seek clinical advice prior to requesting routine removal. If there is clinical need, the National Health Service (NHS) in Wales funds removal and replacement of PIP breast implants inserted privately. This is in contrast to NHS in England where only PIP implants placed on the NHS are replaced. The Department of Health estimates the rate of implant rupture or significant silicone bleed for PIP implants could rising to 15-30% after 10 years; whilst other brands demonstrate rupture rates of 10-14% after 10 years. Therefore, making this an important issue to address in terms of outcomes, implant longevity and health economics. We present the largest heterogenous (private and public health services) experience case series of PIP breast implants to date

Nucleoside Analogues as Antibacterial Agents

The rapid increase in antibiotic-resistant bacteria has emphasized the urgent need to identify new treatments for bacterial infections. One attractive approach, reducing the need for expensive and time-consuming clinical trials, is to repurpose existing clinically approved compounds for use as antibacterial agents. Nucleoside analogues are commonly used for treating viral and fungal infections, as well as for treating cancers, but have received relatively little attention as treatments for bacterial infections. However, a significant number of clinically approved derivatives of both pyrimidines and purines including halogenated, thiolated, and azolated compounds have been shown to have antibacterial activity. In the small number of studies carried out to date, such compounds have shown promise in treating bacterial infections. Here, we review the mechanisms of action and antibacterial activities of nucleoside analogues that can potentially be repurposed for treating infections as well as considering possible limitations in their usage