Should eye protection be worn during dermatological surgery: prospective observational study

Background There is a potential risk of infection with blood-borne viruses if a doctor receives a blood splash to a mucous membrane. The quantification of facial contamination with blood has never been documented in the context of dermatological surgery. Objectives (i) To identify the number of facial blood splashes that occur during skin surgery and to identify the procedures that present higher risks for the operator and assistant. (ii) To assess the provision of eye protection and attitudes to its use in dermatological surgery in the U.K. Methods (i) Prospective, observational study in the skin surgery suite of a U.K. teaching hospital assessing 100 consecutive dermatological surgery procedures, plus 100 consecutive operations in which an assistant was present. Primary outcome: number of face-mask visors with at least one blood splash. Secondary outcomes: to identify if any of the following variables influenced the occurrence of a blood splash: grade of operator, site and type of procedure, and the use of electrocautery. (ii) A postal survey of all U.K.-based members of the British Society of Dermatological Surgery (BSDS) was conducted assessing facilities available and the attitudes of U.K.-based clinicians to the use of face masks during surgery. Results (i) In 33% of all surgical procedures there was at least one facial splash to the operator (range 1–75) and in 15% of procedures the assistant received at least one splash (range 1–11). Use of monopolar electrocautery was significantly less likely to result in splashes to the mask compared with bipolar electrocautery [odds ratio (OR) 0Æ04; 95% confidence interval (CI) 0Æ01–0Æ19]. Compared with the head/neck, operations on the body were significantly more likely to result in splashes to the mask (OR 6Æ52) (95% CI 1Æ7–25Æ07). The type of procedure and the status of the operator did not have a bearing on the likelihood of receiving a splash to the mask. (ii) From the survey, 33 of 159 (20Æ8%) of BSDS members had no face masks available and 54 of 159 (34Æ0%) did not wear any facial protection while operating. The majority (53Æ5%) thought they received a splash in £ 1% of procedures. Conclusions There is a substantial risk of a splash of blood coming into contact with the face during dermatological surgery for both the operator and assistant, regardless of the procedure. The risk of receiving a blood splash to the face may be substantially underestimated by U.K.-based dermatologists. The use of protective eyewear is advisable at all times, but particularly when using bipolar electrocautery, or when operating on high-risk individuals

MIG gas shielding : Economic savings without detriment to quality

Over the years a number of claims have been made related to potential savings of the shielding gas used in the MIG process. A number of work streams have been set up to consider such areas from a technical and economic standpoint. The use of small helium additions has particular benefits and despite an increase in unit cost, the overriding benefits are achieved in reduced manhour cost. A similar situation has been established when using a high frequency process to switch shielding gases during welding. The outcome from this was very similar to that already described. Overlaid on these has been the increasing use of a technique that visualises actual gas flow during welding by the use of laser backlighting. Some preliminary work in this area is described particularly related to the effect of drafts on the gas distribution. A recent development on the market place is a piece of equipment, which regulates the gas flow automatically and synchronously with the welding current. Gas savings in the region of 50-60% have been obtained. Data has been produced to illustrate these benefits. The potential benefit of developing a computational fluid dynamic model of the gas flow is also described, and early development stages of the model shown. However, there will always exist the very basic management need to minimise leaks from the gas delivery systems

A new approach to (quasi) periodic boundary conditions in micromagnetics: the macrogeometry

We present a new method to simulate repetitive ferromagnetic structures. This macro geometry approach combines treatment of short-range interactions (i.e. the exchange field) as for periodic boundary conditions with a specification of the arrangement of copies of the primary simulation cell in order to correctly include effects of the demagnetizing field. This method (i) solves a consistency problem that prevents the naive application of 3d periodic boundary conditions in micromagnetism and (ii) is well suited for the efficient simulation of repetitive systems of any size

NNLO fermionic corrections to the charm quark mass dependent matrix elements in B -> X_s gamma

We compute the virtual O(alpha_s^2) fermionic contributions to the charm quark mass dependent matrix elements of the B -> X_s gamma decay. In the case of a massless quark loop insertion into the gluon propagator, our result obtained as an expansion in z=m_c^2/m_b^2 and an exact expression in terms of multi-fold MB integrals, confirms the findings of Bieri, Greub and Steinhauser [19]. We observe, however, large deviations in the case of a b-quark loop insertion.The charm quark loop shows smaller, but still noticeable differences.Comment: 11 pages, 3 figures, 1 tabl

The zinc finger transcription factor PLAGL2 enhances stem cell fate and activates expression of ASCL2 in intestinal epithelial cells

O encaminhamento de textos originais para submissão seguem algumas orientações básicas, levando em conta, inicialmente, que devem ser inéditos e que serão submetidos à aprovação de avaliadores especialistas nos temas tratados. Para acessar as informações acerca dos objetivos, da política editorial e das diretrizes e normas de publicação da Revista Trabalho & Educação, clique nos links SOBRE e/ou NORMAS, localizados no topo da página eletrônica da Revista. Agradecemos muitíssimo o interesse em publicar na Revista

Land Use Changes in Europe. Processes of Change, Environmental Transformations and Future Patterns

Patterns of land use in Europe owe much to the boundaries set by the natural environment. The alterations imposed by man are still ultimately constrained by natural limitations of which climate pays a major role. Possible global climatic change, therefore, is likely to have a major effect on land use patterns and this is the first volume to describe the potential changes against the background of historical land use changes in Europe, the likely future land use patterns and the policy implications that are becoming evident in relation to feasible land use management strategies. This book covers a wide spectrum of issues: How will the characteristics of the land resource change? What are the implications of these changes on the environment? What policies need to be introduced to encourage sensitivity to environmental supply limitations? What is the scale of response that is needed to address these issues? The workshop that addressed these topics was sponsored by IIASA in association with the Institute of Geography and Spatial Organization of the Polish Academy of Sciences. The Stockholm Environment Institute collaborated in this and took on the main responsibility of producing this volume from the range of contributions at the workshop

Pre‐service teacher training and special educational needs in England 1970–2008: is government learning the lessons of the past or is it experiencing a groundhog day?

The paper outlines the findings from a literature review of the English government’s response to the issue of training pre‐service teachers in the delivery of effective special educational needs support. The review’s findings detail that although educational practice in mainstream classrooms has changed considerably since the 1970s the training of pre‐service teachers with regards to special educational needs has seemingly changed very little. The paper argues that the government needs to re‐think radically its policy of inclusion to ensure that a coherent plan is formulated which enables higher education institutions’ initial teacher training programmes to train students who are competent and confident in their abilities to work with children with special educational needs and/or disabilities

Conservation of structure and mechanism in primary and secondary transporters exemplified by SiaP, a sialic acid binding virulence factor from Haemophilus influenzae

Extracytoplasmic solute receptors (ESRs) are important components of solute uptake systems in bacteria, having been studied extensively as parts of ATP binding cassette transporters. Herein we report the first crystal structure of an ESR protein from a functionally characterized electrochemical ion gradient-dependent secondary transporter. This protein, SiaP, forms part of a tripartite ATP-independent periplasmic transporter specific for sialic acid in Haemophilus influenzae. Surprisingly, the structure reveals an overall topology similar to ATP binding cassette ESR proteins, which is not apparent from the sequence, demonstrating that primary and secondary transporters can share a common structural component. The structure of SiaP in the presence of the sialic acid analogue 2,3-didehydro-2-deoxyN-acetylneuraminic acid reveals the ligand bound in a deep cavity with its carboxylate group forming a salt bridge with a highly conserved Arg residue. Sialic acid binding, which obeys simple bimolecular association kinetics as determined by stopped-flow fluorescence spectroscopy, is accompanied by domain closure about a hinge region and the kinking of an alpha-helix hinge component. The structure provides insight into the evolution, mechanism, and substrate specificity of ESR-dependent secondary transporters that are widespread in prokaryotes