Ultrasound by emergency physicians to detect abdominal aortic aneurysms: a UK case series

Early identification of abdominal aortic aneurysms in some patients can be difficult and the diagnosis is missed in up to 30% of patients. Ultrasound cannot be used to identify a leak, but the presence of an aneurysm in an unstable patient is conclusive. With minimal training emergency physicians can easily identify the aorta and thus in the early phase of resuscitation an aneurysm can be confidently excluded. The purpose of the examination is not to delineate the extent of the aneurysm, but to identify those patients that will need emergency surgery. A series of patients presented to the department in an unstable condition with equivocal abdominal signs. An ultrasound scan in the resuscitation room by members of the emergency department revealed an aneurysm, which was enough to convince the vascular surgeons to take the patient straight to theatre with good results. In patients who are stable, computed tomography will continue to be used to evaluate the extent of the aneurysm and identify a leak

Harry Walker, 1918-1959: an Illustration of the Mid-Twentieth Century History of Anaesthesia. Middlesbrough, Edinburgh, Burma

I am writing a hybrid memoir-biography drawing on my father’s life. He, Harry Walker, was one of the earlier Fellows of the Faculty of Anaesthetists and when I contacted the College, I learned that he was unusual for his time in that he decided to become an anaesthetist while he was a medical student. I thought a summary of his career might be of interest to the History of Anaesthesia Society. I am a physician and my account lacks detail about anaesthetic techniques but I hope it illustrates the extraordinary events that young anaesthetists lived through in the mid-twentieth century

Surgery on the battlefield: Mobile surgical units in the Second World War and the memoirs they produced

In the Second World War, there was a flowering of the battlefield surgery pioneered in the Spanish Civil War. There were small, mobile surgical units in all the theatres of the War, working close behind the fighting and deployed flexibly according to the nature of the conflict. With equipment transported by truck, jeep or mule, they operated in tents, bunkers and requisitioned buildings and carried out abdominal, thoracic, head and neck, and limb surgery. Their role was to save life and to ensure that wounded soldiers were stable for casualty evacuation back down the line to a base hospital. There is a handful of memoirs by British doctors who worked in these units and they make enthralling reading. Casualty evacuation by air replaced the use of mobile surgical units in later wars, throwing into doubt their future relevance in the management of battle wounds. But recent re-evaluations by military planners suggest that their mobility still gives them a place, so the wartime memoirs may have more value than simply as war stories

Colwyn Bay

n/

Current occupational health policy issues for universities in the United Kingdom

Universities are large organisations with diverse occupational hazards and some unusual features as employers. They need expert professional advice for generalist managers on occupational health matters and they need specialist services such as immunisations for medical students and respiratory health surveillance for staff and students whose research involves the use of animals. We have reviewed these varied occupational health needs in detail in a separate paper (Venables and Allender 2006). Universities need an occupational health response which is proportionate to their needs.<br /

Distributional fixed point equations for island nucleation in one dimension: a retrospective approach for capture zone scaling

The distributions of inter-island gaps and captures zones for islands nucleated on a one-dimensional substrate during submonolayer deposition are considered using a novel retrospective view. This provides an alternative perspective on why scaling occurs in this continuously evolving system. Distributional fixed point equations for the gaps are derived both with and without a mean field approximation for nearest neighbour gap size correlation. Solutions to the equations show that correct consideration of fragmentation bias justifies the mean field approach which can be extended to provide closed-from equations for the capture zones. Our results compare favourably to Monte Carlo data for both point and extended islands using a range of critical island size $i=0,1,2,3$. We also find satisfactory agreement with theoretical models based on more traditional fragmentation theory approaches.Comment: 9 pages, 7 figures and 1 tabl

Μελέτη και σχεδίαση Ε/Γ ‐ Ο/Γ πλοίου κλειστού τύπου

128 σ.Νικόλαος Ηρ. Παναγιωτακόπουλο

Capture-zone scaling in island nucleation: phenomenological theory of an example of universal fluctuation behavior

In studies of island nucleation and growth, the distribution of capture zones, essentially proximity cells, can give more insight than island-size distributions. In contrast to the complicated expressions, ad hoc or derived from rate equations, usually used, we find the capture-zone distribution can be described by a simple expression generalizing the Wigner surmise from random matrix theory that accounts for the distribution of spacings in a host of fluctuation phenomena. Furthermore, its single adjustable parameter can be simply related to the critical nucleus of growth models and the substrate dimensionality. We compare with extensive published kinetic Monte Carlo data and limited experimental data. A phenomenological theory sheds light on the result.Comment: 5 pages, 4 figures, originally submitted to Phys. Rev. Lett. on Dec. 15, 2006; revised version v2 tightens and focuses the presentation, emphasizes the importance of universal features of fluctuations, corrects an error for d=1, replaces 2 of the figure

Diamond Solitaire

We investigate the game of peg solitaire on different board shapes, and find those of diamond or rhombus shape have interesting properties. When one peg captures many pegs consecutively, this is called a sweep. Rhombus boards of side 6 have the property that no matter which peg is missing at the start, the game can be solved to one peg using a maximal sweep of length 16. We show how to construct a solution on a rhombus board of side 6i, where the final move is a maximal sweep of length r, where r=(9i-1)(3i-1) is a "rhombic matchstick number".Comment: 11 pages, 12 figure

Crossover in the scaling of island size and capture zone distributions

Simulations of irreversible growth of extended (fractal and square) islands with critical island sizes i=1 and 2 are performed in broad ranges of coverage \theta and diffusion-to-deposition ratios R in order to investigate scaling of island size and capture zone area distributions (ISD, CZD). Large \theta and small R lead to a crossover from the CZD predicted by the theory of Pimpinelli and Einstein (PE), with Gaussian right tail, to CZD with simple exponential decays. The corresponding ISD also cross over from Gaussian or faster decays to simple exponential ones. For fractal islands, these features are explained by changes in the island growth kinetics, from a competition for capture of diffusing adatoms (PE scaling) to aggregation of adatoms with effectively irrelevant diffusion, which is characteristic of random sequential adsorption (RSA) without surface diffusion. This interpretation is confirmed by studying the crossover with similar CZ areas (of order 100 sites) in a model with freezing of diffusing adatoms that corresponds to i=0. For square islands, deviations from PE predictions appear for coverages near \theta=0.2 and are mainly related to island coalescence. Our results show that the range of applicability of the PE theory is narrow, thus observing the predicted Gaussian tail of CZD may be difficult in real systems.Comment: 9 pages, 7 figure