Head injury at a tertiary referral centre in the Eastern Region of Nepal

Background: The purpose of this epidemiologic study was to determine the pattern and characteristics of head injuries and to establish an epidemiologic data bank for designing preventive strategies for head injuries in the eastern region of Nepal.Patients and Methods: This retrospective review was done at B.P.Koirala institute of Health Sciences, Dharan, Nepal. All the patients with head injury admitted to the Department of Surgery between the periods January 2005 to December 2005 were included in the study.Results: The study population consisted of 334 patients who sustained head injuries. Their ages ranged from 1 to 88 with a mean age of 28.53 years. The majority (66.3%), were young adults in the 2nd to 5th decades The male to female sex ratio was 2.6:1. Road traffic crushes were the most common cause (43.4%) followed by fall from heights (30.8%). X-ray of skull showed lesions in 114 cases (49.8%) such as depressed fracture (11.4%) and linear fracture (24.0%). Common lesions on CT scan included cerebral contusion (21.6%), extradural haematoma (20.9%), linear fracture (23.8%), subarachnoid haemorrhage (18.5%) and pnemocephalus (11.2%). Forty patients (12.0%) sustained moderate head injury. There were 15 deaths. One patient had associated intra-abdominal injury (splenic rupture) and two patient sustained pulmonary trauma and succumbed to haemothorax and aspiration.Conclusion: A clearer understanding of the patterns of head injuries will assist health care providers to plan and manage the treatment of traumatic facial injuries. Such epidemiological information can also be used to guide the future funding of public health programs geared toward prevention

External sources of clean technology: evidence from the clean development mechanism

New technology is fundamental to sustainable development. However, inventors from industrialized countries often refuse technology transfer because they worry about reverse-engineering. When can clean technology transfer succeed? We develop a formal model of the political economy of North–South technology transfer. According to the model, technology transfer is possible if (1) the technology in focus has limited global commercial potential or (2) the host developing country does not have the capacity to absorb new technologies for commercial use. If both conditions fail, inventors from industrialized countries worry about the adverse competitiveness effects of reverse-engineering, so technology transfer fails. Data analysis of technology transfer in 4,894 projects implemented under the Kyoto Protocol’s Clean Development Mechanism during the 2004–2010 period provides evidence in support of the model

Counterfactual reasoning and knowledge of possibilities

Williamson has argued against scepticism concerning our metaphysically modal knowledge, by arguing that standard patterns of suppositional reasoning to counterfactual conclusions provide reliable sources of correct ascriptions of possibility and necessity. The paper argues that, while Williamson’s claims relating to necessity may well be right, he has not provided adequate reasons for thinking that the familiar modes of counterfactual reasoning to which he points generalise to provide a decent route to ascriptions of possibility. The paper also explores another path to ascriptions of possibility that may be extracted from Williamson’s ideas, before briefly considering the general status of counterfactual reasoning in relation to our knowledge of possibilities

The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

<p>Abstract</p> <p>Background</p> <p>Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell.</p> <p>Methods</p> <p>We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell.</p> <p>Results</p> <p>Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement).</p> <p>Conclusions</p> <p>Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT.</p

Psychometric properties of three measures of “Facebook engagement and/or addiction” among a sample of English speaking Pakistani university students

For researchers interested in measuring the construct of “Facebook engagement and/or addiction,” there are a number of existing measures including the Bergen Facebook Addiction Scale, the Facebook Intensity Scale, and the Addictive Tendencies Scale. Currently, there is limited data on the psychometric properties of these three scales, especially among South Asian samples. The present aim was to address this shortfall. A sample of 308 English-speaking Pakistani university students completed the scales, in their original English versions, on two occasions separated by four weeks. Results demonstrated that for each of the scales, across both administrations, satisfactory psychometric properties were found, including internal reliability, temporal stability, and construct validity. Moreover, for these three scales, using confirmatory factor analysis, a one-factor structure was generally found to be a good description of the data for both male and female samples. These data provide further evidence for the reliability and validity of three scales concerned with “Facebook engagement and/or addiction.

Simpson's Paradox, Lord's Paradox, and Suppression Effects are the same phenomenon – the reversal paradox

This article discusses three statistical paradoxes that pervade epidemiological research: Simpson's paradox, Lord's paradox, and suppression. These paradoxes have important implications for the interpretation of evidence from observational studies. This article uses hypothetical scenarios to illustrate how the three paradoxes are different manifestations of one phenomenon – the reversal paradox – depending on whether the outcome and explanatory variables are categorical, continuous or a combination of both; this renders the issues and remedies for any one to be similar for all three. Although the three statistical paradoxes occur in different types of variables, they share the same characteristic: the association between two variables can be reversed, diminished, or enhanced when another variable is statistically controlled for. Understanding the concepts and theory behind these paradoxes provides insights into some controversial or contradictory research findings. These paradoxes show that prior knowledge and underlying causal theory play an important role in the statistical modelling of epidemiological data, where incorrect use of statistical models might produce consistent, replicable, yet erroneous results

Comparing orbiter and rover image-based mapping of an ancient sedimentary environment, Aeolis Palus, Gale crater, Mars

This study provides the first systematic comparison of orbital facies maps with detailed ground-based geology observations from the Mars Science Laboratory (MSL) Curiosity rover to examine the validity of geologic interpretations derived from orbital image data. Orbital facies maps were constructed for the Darwin, Cooperstown, and Kimberley waypoints visited by the Curiosity rover using High Resolution Imaging Science Experiment (HiRISE) images. These maps, which represent the most detailed orbital analysis of these areas to date, were compared with rover image-based geologic maps and stratigraphic columns derived from Curiosity's Mast Camera (Mastcam) and Mars Hand Lens Imager (MAHLI). Results show that bedrock outcrops can generally be distinguished from unconsolidated surficial deposits in high-resolution orbital images and that orbital facies mapping can be used to recognize geologic contacts between well-exposed bedrock units. However, process-based interpretations derived from orbital image mapping are difficult to infer without known regional context or observable paleogeomorphic indicators, and layer-cake models of stratigraphy derived from orbital maps oversimplify depositional relationships as revealed from a rover perspective. This study also shows that fine-scale orbital image-based mapping of current and future Mars landing sites is essential for optimizing the efficiency and science return of rover surface operations