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When unexploded ordnance (UXO) is embedded in the body, the effect of explosive weapons used in conflict is amplified. Though relatively rare, such events present potentially devastating consequences for the patient and medical providers as routine diagnostic and therapeutic procedures hold potential to initiate detonation of the embedded UXO (eUXO). The objective is to identify and synthesize available literature relating to the management of eUXO in low resource settings.
Methods
A scoping review was conducted using PRISMA-ScR methodology to evaluate literature in all languages from all date ranges until January 31, 2024, discussing the management of casualties with eUXO, including types of ordnance, injury patterns, diagnostics, resource utilization, surgical interventions, and outcomes.
Results
Search strings identified 3,425 records. After title and abstract screening 3,397 were excluded yielding 18 for full text screening of which 5 were excluded. Therefore 13 reports were included in analysis. Data variable reporting was heterogeneous but themes and subthemes regarding safety, planning and communication emerged.
Conclusions
A scoping review was conducted to identify gaps in existing literature on the management of eUXO in low resource settings. Coordinated engagement from personnel representing a variety of clinical and non-clinical specialties is required to safely manage eUXO.
The articles collected here bear witness to the continued and wide interest in England and its neighbours in the "long" thirteenth century. The volume includes papers on the high politics of the thirteenth century, international relations, the administrative and governmental structures of medieval England and aspects of the wider societal and political context of the period. A particular theme of the papers is Anglo-French political history, and especially the ways in which that relationship was reflected in the diplomatic and dynastic arrangements associated with the Treaty of Paris, the 750th anniversary of which fell during 2009, a fact celebrated in this collection of essays and the Paris conference at which the original papers were first delivered.
Contributors: Caroline Burt, Julie E. Kanter, Julia Barrow, Benjamin L. Wild, William Marx, Caroline Dunn, Adrian Jobson, Adrian R. Bell, Chris Brooks, Tony K. Moore, David A. Trotter, William Chester Jordan, Daniel Power, Florent Lenègre
By 18 months children demonstrate a range of social–cognitive skills that can be considered important precursors to more advanced forms of social understanding such as theory of mind. Although individual differences in social cognition have been linked to neurocognitive maturation, sociocultural models of development suggest that environmental influences operate in the development of children's social–cognitive outcomes. In the current study of 501 children and their mothers, we tested and found support for a model in which distal environmental risk, assessed when children were newborns, was indirectly associated with children's social–cognitive competency at 18 months through mothers' responsivity at 18 months. Part of this effect also operated through children's concomitant language skills, suggesting both a language-mediated and a language-independent mechanism of social–cognitive development. These findings are discussed with respect to the Vygotskian themes of internalization and semiotic mediation.
This chapter provides an overview of Earth system models, the various model ‘flavours’, their state of development including model evaluation, benchmarking and optimization against observational data and their application to climate change issues.
Introduction
The Earth system can be conceptualized as a suite of interacting physical, chemical, biological and anthropogenic processes that regulate the planet’s low of matter and energy. Earth system models (ESMs; Box 5.1 ) are built to mirror these processes. In fact, ESMs are the only tool available to the scientific community to investigate the system properties of the Earth, as we do not have an alternative planet to manipulate that could serve as a scientist’s laboratory.
The term ‘Earth system model’ is commonly used to describe coupled land–ocean–atmosphere models that include interactive biogeochemical components. Such models have developed progressively from the physical climate models first created in the 1960s and 1970s. Conventional climate models apply physical laws to simulate the general circulation of atmosphere and ocean. As our understanding of the natural and anthropogenic controls on climate has grown, and given the steady advances in computing power, global climate models have been extended to include more comprehensive representations of biological and geochemical processes, involving the addition of the various interacting components of the Earth system with their own feedback mechanisms. Figure 5.1 shows the conceptual differences between a conventional global coupled atmosphere–ocean general circulation model (AOGCM) and an ESM. In terms of the coupling between components, ESMs are more complex, and they have correspondingly higher computational demands.
Paul Trueman and colleagues (3) have reported on an important issue. Several HTAs on the same topic have been published recently. They have examined four recent HTA reports on drug-eluting stents (DES), demonstrating varying methods and conclusions. All four HTAs included local registry data and economic evaluations in addition to analyses of published research. The authors concluded that the published evidence considered by most of the agencies had “only limited influence on the resulting recommendations.”
Maternal nutritional status before and during pregnancy is important for the growth and development of the fetus. The effects of pre-pregnancy nutrition (estimated by maternal size) are well documented. There is little information in today's Western society on the effect of maternal nutrition during pregnancy on the fetus. The aim of the study was to describe dietary patterns of a cohort of mothers during pregnancy (using principal components analysis with a varimax rotation) and assess the effect of these dietary patterns on the risk of delivering a small-for-gestational-age (SGA) baby. The study was a case–control study investigating factors related to SGA. The population was 1714 subjects in Auckland, New Zealand, born between October 1995 and November 1997, about half of whom were born SGA ( ≤ 10th percentile for sex and gestation). Maternal dietary information was collected using FFQ after delivery for the first and last months of pregnancy. Three dietary patterns (traditional, junk and fusion) were defined. Factors associated with these dietary patterns when examined in multivariable analyses included marital status, maternal weight, maternal age and ethnicity. In multivariable analysis, mothers who had higher ‘traditional’ diet scores in early pregnancy were less likely to deliver a SGA infant (OR = 0·86; 95 % CI 0·75, 0·99). Maternal diet, particularly in early pregnancy, is important for the development of the fetus. Socio-demographic factors tend to be significantly related to dietary patterns, suggesting that extra resources may be necessary for disadvantaged mothers to ensure good nutrition in pregnancy.
Quantum stochastic integrals have been constructed in various contexts [2, 3, 4, 5, 9] by adapting the construction of the classical L2-Itô-integral with respect to Brownian motion. Thus, the integral is first defined for simple integrands as a finite sum, then one establishes certain isometry relations or suitable bounds to allow the extension, by continuity, to more general integrands. The integrator is typically operator-valued, the integrand is vector-valued or operator-valued and the quantum stochastic integral is then given as a vector in a Hilbert space, or as an operator on the Hilbert space determined by its action on suitable vectors.
Studies on the effects of caffeine on health, while numerous, have produced inconsistent results. One of the most uncertain and controversial effects is on pregnancy outcome. Studies have produced conflicting results due to a number of methodological variations. The major challenge is the accurate assessment of caffeine intake. The aim of the present study was to explore different methods of assessing caffeine exposure in pregnant women. Twenty-four healthy pregnant women from the UK city of Leeds completed both a detailed questionnaire, the caffeine assessment tool (CAT) designed specifically to assess caffeine intake and a prospective 3 d food and drink diary. The women also provided nine saliva samples over two consecutive days for estimation of caffeine and a metabolite (paraxanthine). Caffeine intakes from the CAT and diary showed adequate agreement (intra-class correlation coefficient of 0·5). For saliva caffeine and paraxanthine measures, the between-sample variation (within the same woman) was greater than between-woman and between-day variation. However, there was still adequate agreement between these measures and the CAT. The CAT is a valuable tool that is now being used in a large prospective study investigating caffeine's role in pregnancy outcome.
The improvement of quality and quantitative traits in industrial crops is among the most important goals in plant breeding. Many traits of interest are controlled by multiple genes and improvements have so far only been obtained through conventional breeding. The use of biotechnological tools to modify quantitative traits is highly challenging. CropDesign has developed TraitMill™, an automated plant evaluation platform allowing high-throughput testing of the effect of plant-based transgenes on agronomically valuable traits in crop plants. The focus of the platform is currently on rice, a good model for other important cereals such as maize and wheat. TraitMill™ offers a high-throughput prediction of gene function. Genes of validated function that confer trait improvement can then be transferred to other cereal crop species such as maize, but also to dicots, trees and ornamentals. TraitMill™ involves the following key components: (i) selection of candidate trait improvement genes among genes involved in signal transduction, cell cycle control, transcription, nutrient metabolism, etc.; (ii) a suite of validated constitutive or tissue-specific promoters from rice allowing for the selection of the most appropriate promoter–gene combination in view of the desired trait improvement; (iii) an industrialized plant transformation system generating tens of thousands of transgenic plants annually; and (iv) a robotized trait evaluation set-up for plant evaluation, proprietary image analysis software for measuring plant performance parameters and statistical analysis of results.
The forests of the Kilum-Ijim area, around Mount Oku in West Cameroon, are the largest remaining patch of montane forest in West Africa, and the highest in altitude. This important habitat harbours endemic species of both animals and plants but is surrounded by a high density of human settlements: c. 300,000 people live within a day's walk of the forest, which covers only 200 sq km. BirdLife International and the Ministry of the Environment and Forestry, Government of Cameroon, are currently operating the Kilum-Ijim Forest Project, with the overall goal of conserving representative areas of the Cameroon montane forest biome in the long-term. The purpose of the project is toensure that the biodiversity, extent and ecological processes of the Kilum-Ijim Forest are maintained and that the forest is used sustainably by the local communities. The existence of a small Sphagnum community and associated wetland plant species was discovered in 1997 on the summit of Mount Oku, at 2900 m. This site is of extremely high conservation importance because several plant species endemic to the Kilum-Ijim area have been recorded there. In addition, it is the highest Sphagnum bog and the source of the highest stream in West Africa.
Quantum stochastic integrals are constructed using the non-commutative Lp-space theory of Haagerup. The existence and uniqueness of the solution to quantum stochastic differential equations driven by quasi-Wiener noises, or noises satisfying generalized standing hypotheses, is established as is the Markov behaviour of the solution. Various examples of the theory are discussed, and quantum Ornstein-Uhlenbeck processes are obtained as explicit solutions.
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