Ureteropelvic junction obstruction caused by metastatic cholangiocarcinoma

We describe the rare case of a 61-year-old female with right ureteropelvic junction (UPJ) obstruction caused by metastatic cholangiocarcinoma. Her past medical history was notable for cholangiocarcinoma treated with neoadjuvant chemoradiation and two orthotopic liver transplants six years earlier. Urology was consulted when she presented with flank pain and urinary tract infection. Diagnostic workup demonstrated right UPJ obstruction. She was managed acutely with percutaneous nephrostomy. She subsequently underwent robotic pyeloplasty and intrinsic obstruction of the UPJ was discovered. Histological examination revealed adenocarcinoma, consistent with systemic recurrence of the patient\u27s known cholangiocarcinoma

INSIDE SOLARIS: THE PRESENCE OF GAME TECHNOLOGY IN ARCHITECTURAL DESIGN

Tarkovsky’s 1971 film Solaris is an exquisitely evocative meditation on the relationship between technology, memory and loss – not only through it’s presentation of the characters, narrative and themes of Stanislav Lem’s novel, but also through the specific qualities of film as a medium of perception (Tarkovsky). Tarkovsky’s oeuvre itself, particularly Nostalgia and Stalker, are tours-de-force in this respect. Yet there is always a melancholic distance between the viewer and the medium, perhaps impossible to traverse in any medium, but especially recognized in Tarkovsky’s work. This in fact is a key issue, as Doležel has outlined in his study of literature and possible worlds, in the understanding of the force of fictional constructs within the representative arts, including literature (Doležel). The need to explain how it is possible and necessary to construct possible worlds that have both representative similarities with the real world and with hylomorphic qualities (i.e. a purposive and necessary form) in and of themselves is an opportunity that the making of digital environments cannot avoid. This paper questions whether the same material for ‘world-making’ might be possible in persistent digital environments as there is in film. In the quest for an increasingly vivid experience of the presence of architecture, digital means of representation have achieved significant successes. Interestingly, there remains the opportunity to consider modes of digital realization as being sufficiently material within their mode of delivery – digital media. If we stay within the digital there are a number of modes by which its architectural product can be experienced. The question of this paper concerns the manner in which a recent mode of digital representation and exploration has developed: the game engine

‘It just opens up their world’: autism, empathy, and the therapeutic effects of equine interactions

Experiences of autism-spectrum disorder are now increasingly studied by social scientists. Human–animal relations have also become a major focus of social inquiry in recent years. Examining horse-assisted therapy for autistic spectrum disorders, this is the first paper that brings these fields together. Drawing on participant observation and interviews at a UK horse therapy Centre, this article examines how staff and the parents of riders account for the successes and limitations of equine therapy. To the respondents, horses ‘open up’ autistic children and make possible interactions that seemed impossible before. Horses were regarded as facilitating the emergence of apparently social behaviours, which included eye contact, pointing, and speech. Three key explanations emerged for therapeutic success: the sensorial, embodied experience of riding the horse; the specific movements and rhythms of the horse; and, the ‘personality’ of the horse. Equine therapy can be regarded as enabling a form of multispecies intersubjectivity, with the resonance between rider and horse seeming to make possible a new attunement between humans. Practices of equine therapy, and perceptions of its efficacy, serve in turn to attune social scientists to a version of empathy constituted through lively and sensorial interactions, as opposed to one that is restricted to particular kinds of humans

The changing brain: Neuroscience and the enduring import of everyday experience

Discourses of ‘neuroplasticity’ have become increasingly apparent in the neurosciences and wider society. These connect with broader narratives about the ‘changing brain’ throughout the life-course. Here, we explore their presence in the talk of a range of publics. Their presence is indicative of how novel neuroscience is accepted, or not, by our participants. In particular, we suggest that any acceptance of the science relates to their personal and/or professional experiences of change (to their own or others’ subjectivities) rather than to some intrinsic and widely-held significance of scientific concepts per se. Accordingly, we also submit that it is in part through the congruence of some neuroscientific claims to everyday experiences and perspectives that the former are rendered legible and salient. In this respect, ‘lay’ knowledge has considerable import for the wider cultural authorisation of that of ‘experts’

Architecture and horror: analogical explorations in architectural design

This thesis examines the relationship between the practice of architectural design and the media through which it is represented. It makes a consistent critical appraisal of the philosophical presumptions under which architectural theory is made, in particular, the relationship between theories of expression and representation. The thesis presents seven distinct projects by the author which developmentally explore the degree to which architecture is able to represent the sublime - in particular through the concept of horror. In this instance horror emerges as a category of excess that supervenes the uses of the term in the genres of film and literary studies. Within the thesis horror describes an (impossible) objective for representation The thesis argues that the environment within which these philosophical questions of 'effect' may most resonantly be explored is, ultimately, digital media. The author draws on contemporary commentary by Jacques Derrida and Georges Bataille, in particular Derrida's discussion of the Parergon and contemporary discussion of l'informe, the informal to support these arguments. It is within the apparently 'real' environments of virtual reality that the presentation of the mise-en-scene of horror may be explored. Immersive digital environments, it is argued, provide an appropriate level of freedom and direction for the exploration of the spatial experience of the abyss. The thesis concludes by presenting observations on the antinomy of aspirations that any materialist theory of architectural practice must attend to when working within digital media

The role of intrinsic disorder and dynamics in the assembly and function of the type II secretion system

International audienceMany Gram-negative commensal and pathogenic bacteria use a type II secretion system (T2SS) to transport proteins out of the cell. These exported proteins or substrates play a major role in toxin delivery, maintaining biofilms, replication in the host and subversion of host immune responses to infection. We review the current structural and functional work on this system and argue that intrinsically disordered regions and protein dynamics are central for assembly, exo-protein recognition, and secretion competence of the T2SS. The central role of intrinsic disorder-order transitions in these processes may be a particular feature of type secretion

Discrimination, labour markets and the Labour Market Prospects of Older Workers: What Can a Legal Case Teach us?

As governments become increasingly concerned about the fiscal implications of the ageing population, labour market policies have sought to encourage mature workers to remain in the labour force. The ‘human capital’ discourses motivating these policies rest on the assumption that older workers armed with motivation and vocational skills will be able to return to fulfilling work. This paper uses the post-redundancy recruitment experiences of former Ansett Airlines flight attendants to develop a critique of these expectations. It suggests that policies to increase older workers’ labour market participation will not succeed while persistent socially constructed age- and gender- typing shape labour demand. The conclusion argues for policies sensitive to the institutional structures that shape employer preferences, the competitive rationality of discriminatory practices, and the irresolvable tension between workers’ human rights and employers’ property rights

What is psychiatry? Co-producing complexity in mental health

What is psychiatry? Such a question is increasingly important to engage with in light of the development of new diagnostic frameworks that have wide-ranging and international clinical and societal implications. I suggest in this reflective essay that ‘psychiatry' is not a singular entity that enjoins consistent forms of critique along familiar axes; rather, it is a heterogeneous assemblage of interacting material and symbolic elements (some of which endure, and some of which are subject to innovation). In underscoring the diversity of psychiatry, I seek to move towards further sociological purchase on what remains a contested and influential set of discourses and practices. This approach foregrounds the relationships between scientific knowledge, biomedical institutions, social action and subjective experience; these articulations co-produce both psychiatry and each other. One corollary of this emphasis on multiplicity and incoherence within psychiatric theory, research and practice, is that critiques which elide this complexity are rendered problematic. Engagements with psychiatry are, I argue, best furthered by recognising its multifaceted nature