Open necrosectomy in acute pancreatitis : obsolete or still useful?

Abstract Background Multiple organ failure and early surgery are associated with high morbimortality after open necrosectomy. Data are mostly derived from historical cohorts with early necrosectomy bereft of step-up treatment algorithm implementation. Thus, mostly circumstantial evidence suggests a better clinical course following mini-invasive surgical and endoscopic necrosectomy. We studied the results of open necrosectomy in a contemporary cohort of patients with complicated pancreatic necrosis treated at a tertiary center. Methods A retrospective cohort study from a university teaching hospital. Results of 109 consecutive patients treated with open necrosectomy during a 12-year period are reported. Results The overall 90-day mortality rate was 22.9%. The 90-day mortality rate was 10.6% if necrosectomy could be delayed until 4 weeks from symptom onset and the necrosis had become walled off on preoperative imaging. The risk factors for 90-day mortality were age over 60 years (OR 19.4), pre-existing co-morbidities (OR 16.9), necrosectomy within 4 weeks (OR 6.5), multiple organ failure (OR 12.2), white blood cell count over 23 × 109 (OR 21.4), and deterioration or prolonged organ failure as an indication for necrosectomy (OR 10.4). None or one of these risk factors was present in 52 patients (47.7% of all patients), and these patients had no mortality. Conclusion Late open necrosectomy for walled-off necrosis has a low mortality risk. Open necrosectomy can be done without mortality in the absence of multiple risk factors for surgery

Men, masculinities and young people: north–south dialogues

Dialoguing across national borders and specifically global North-South centres and margins has increasingly been viewed as a way to enhance critical and feminist studies and engagement with men and masculinities. This article draws on narratives levels, both in interpersonal and intergroup relations, as well as in public representation of collaborative work. generated by a group of researchers in South Africa and Finland who have been engaged in a transnational research project that included a strong focus on young men, masculinities and gender and sexual justice. The piece provides an account of the nuanced and complex experiences and dynamics involved in transnational research collaboration, particularly within the framework on historical and continued inequalities between the global North and South. While obvious benefits are raised, this experience also foregrounds a range of challenges and constraints involved in transnational research collaboration within this field and possibly many others. Key learnings gleaned from this analysis of reported experiences and thoughts include the importance of careful, considered and critical reflexivity at all moments and at al

Atomic force microscope adhesion measurements and atomistic molecular dynamics simulations at different humidities

Due to their operation principle atomic force microscopes (AFMs) are sensitive to all factors affecting the detected force between the probe and the sample. Relative humidity is an important and often neglected-both in experiments and simulations-factor in the interaction force between AFM probe and sample in air. This paper describes the humidity control system designed and built for the interferometrically traceable metrology AFM (IT-MAFM) at VTT MIKES. The humidity control is based on circulating the air of the AFM enclosure via dryer and humidifier paths with adjustable flow and mixing ratio of dry and humid air. The design humidity range of the system is 20-60 % rh. Force-distance adhesion studies at humidity levels between 25 % rh and 53 % rh are presented and compared to an atomistic molecular dynamics (MD) simulation. The uncertainty level of the thermal noise method implementation used for force constant calibration of the AFM cantilevers is 10 %, being the dominant component of the interaction force measurement uncertainty. Comparing the simulation and the experiment, the primary uncertainties are related to the nominally 7 nm radius and shape of measurement probe apex, possible wear and contamination, and the atomistic simulation technique details. The interaction forces are of the same order of magnitude in simulation and measurement (5 nN). An elongation of a few nanometres of the water meniscus between probe tip and sample, before its rupture, is seen in simulation upon retraction of the tip in higher humidity. This behaviour is also supported by the presented experimental measurement data but the data is insufficient to conclusively verify the quantitative meniscus elongation.Peer reviewe

Performing women: The gendered dimensions of the UK new research economy

This paper explores the development and maintenance of familiar gendered employment patterns and practices in UK universities, which are exemplars of new modes of knowledge production, commodification and marketisation. After discussing in detail the evidence of gender discrimination in UK higher education and the changes in the academic labour process consequent to the incorporation, at least at the policy level, of universities into the ‘knowledge economy’, institution-specific data is used to highlight the gendered aspects of the research economy from the three intermeshing perspectives of research culture, research capital and the research production process. This nexus is constructed in such a way as to systematically militate against women’s full and equal involvement in research. Lack of transparency, increased competition and lower levels of collegiate activity coupled with networking based on homosociability are contributing to a research production process where women are marginalized

Second-harmonic generation from coupled plasmon modes in a single dimer of gold nanospheres

We show that a dimer made of two gold nanospheres exhibits a remarkable efficiency for second-harmonic generation under femtosecond optical excitation. The detectable nonlinear emission for the given particle size and excitation wavelength arises when the two nanoparticles are as close as possible to contact, as in situ controlled and measured using the tip of an atomic force microscope. The excitation wavelength dependence of the second-harmonic signal supports a coupled plasmon resonance origin with radiation from the dimer gap. This nanometer-size light source might be used for high-resolution near-field optical microscopy.Comment: 6 pages, 5 figure

Challenges of Religious Literacy in Education : Islam and the Governance of Religious Diversity in Multi-faith Schools

This chapter seeks take part in an emerging research where religion is approached as a whole school endeavor. Previous research and policy recommendations typically focused on teaching about religion in school, but the accommodation of religious diversity in the wider school culture merits more attention. Based on observations in our multiple case studies, we discuss the multi-level governance of religious diversity in Finnish multi-faith schools with a particular focus on the challenges of religious literacy for educators. The three examples we present focus on the inclusion of Muslims in Finnish schools and in particular on the challenges for educator (1) in interpreting the distinction between religion and culture, (2) in recognizing and handling intra-religious diversity, and (3) in being aware of Protestant conceptions of religion and culture. A theme cutting across these examples is how they reflect the tendencies either to see different situations merely through the lens of religion (religionisation), or not to recognize the importance of religion at all (religion-blindness). We argue that religious literacy should be recognized and developed as a vital part of the intercultural competencies of educators.Peer reviewe

Interrogating violence against women and state violence policy: Gendered intersectionalities and the quality of policy in The Netherlands, Sweden and the Uk

This article builds on feminist scholarship on intersectionality to address violence against women, and state policy thereon. It takes up the challenge of analysing the complex, situated and spatial relationship between theorizing on violence against women and state policy on such violence. Drawing on extensive comparative European data, it explores the relations of gender and intersectionality, conceptualized as gendered intersectionalities, by examining how multiple inequalities are made visible and invisible in state policy and debates in the Netherlands, Sweden and the UK. Attention is paid to different forms of gendered intersectionalities in policy, for example, tendencies to degender violence against women. A key aim of the article is to investigate how comparative analysis can be a starting point for assessing if, how and to what extent the inclusion of multiple inequalities could increase the quality of policy, for both reducing and stopping violence, and assisting those subject to violence

The Perils of Gender Beliefs for Men Leaders as Change Agents for Gender Equality

This article examines the potentially damaging role that gender beliefs can play in hindering women's equal representation in leadership positions. Based on a secondary analysis of a large‐scale EU‐wide survey (Eurobarometer 76.1), the article shows that essentialist gender beliefs lower support for equality interventions such as quotas or targets, particularly among men as leaders. The results show that discriminatory gender beliefs partially mediate this relationship and produce a more negative effect among men leaders. The paper contributes to understanding the role essentialist gender beliefs often lay the groundwork for gender discriminatory beliefs. Those in turn hinder support for effective gender equality measures. Gender essentialist beliefs can be held by everyone but are more prevalent among men leaders. We conclude that greater gender balance in leadership cannot be achieved without tackling underlying gender beliefs, particularly among men leaders since they are called upon to enact change. We thereby argue that simply asking for men to become change agents for gender equality is not an effective strategy if underlying gender beliefs are left unchallenged