As a team of workforce analysts and academics with an interest in workforce planning, we are aware that the data available to support primary care workforce planning are disorganised and overwhelming. This makes it difficult for General Practice to extract meaningful and relevant information. We deliver workforce planning workshops across England. Participants at our workshops regularly express their frustration with the quantity of information they are required to produce and the quality of information they receive from other parts of the system. We are dismayed at what we sense to be growing cynicism with data generation and information analysis and are interested in stimulating a conversation about what data matter and how primary care teams can extract data that are useful.Bottom up ownership of information and local benchmarking is needed to underpin workforce planning in primary care.As with other parts of England, primary care in London faces considerable challenges in terms of recruiting and retaining staff. It is highly dependent upon locum, interim and agency staff. In London the challenge is less about recruitment of staff and more about retaining experienced, qualified staff. As well In 2015 Health Education England London teams (HEE) commissioned the University of West London to deliver training for CCG and practice staff. One element of this support was the development of CCG regional profiles so that the eight CCGs of North West London (NWL) and the 12 in North Central and East London (NCEL) could benchmark workforce performance against one another and against average performance in England. We used one of the largest English healthcare databases available, the NHS benchmarking database, for this exercise. The database (available from the corresponding author) combines 1400 workforce planning and development data sets from around 20 sources into one easily accessible location. Organisations, localities and regions can use the database to benchmark their performance against best practice organisations . This database has been used extensively in secondary care settings for over a decade. It clearly predicted one failing Trust’s demise in 2008 (though results were ignored) and has consistently demonstrated the link between an investment in staffing  and mortality rates.Is Primary Care service-quality related to staffing? How does my practice compare with ‘best practice sites? The answers to these lie in Figure We used this to help London CCGs and GP practices to consider the questions: Is patient satisfaction the best differentiating variable?Is London so different that a national average becomes unhelpful?Figure Demonstrate many system relationships; for example the relationship between failing primary care services and ED admissions: - important evidence for a primary care community arguing for additional resources or different ways of working.Scrutinise and defend variation: The Carter report  states tTake ownership of decision-making at a local level. Primary care staff attending our workshops report that much of the data they are sent is used not for service and systems improvement but rather for micro management of performance. We concur with the views of Nigel Edwards of the Nuffield Trust that plans ‘to impose benchmarks from the top down risks turning into another round of the kneejerk centralisation that has served the NHS badly in recent years’. Open resBetter use of openly available strategic datasets will enable primary care to:t.houston@nhs.netThe Workforce Transformation team at HEE are developing a free, user-friendly interface for the NHS Benchmarking database to enable healthcare providers across the capital to benchmark what matters most to them. The trial version of this interface is available from Tom Houston, Healthy London Partnership at This will be the first of a series of brief papers and in future editions we will identify where London staff really do provide ‘best practice’ care … and where there is room for improvement.All three authors deliver commercial workforce planning education and training courses commissioned by HEE for primary care organisations working across West, North, Central and East London. Keith Hurst develops and maintains the NHS Benchmarking Database and this tool is used to support a range of training and education programmes delivered by the University of West LondonNo potential conflict of interest was reported by the authors.


The focus of this research was to present a data article for analyzing the cost of displacing a drilling fluid during the drilling operation. The cost of conventional Spud, KCl and Pseudo Oil base (POBM) muds used in drilling oil and gas wells are compared with that of a Reversible Invert Emulsion Mud. The cost analysis is limited to three sections for optimum and effective Comparison. To optimize drilling operations, it is important that we specify the yardstick by which drilling performance is measured. The most relevant yardstick is the cost per foot drilled. The data have shown that the prices for drilling mud systems are a function of the mud system formulation cost for that particular mud weight and maintenance per day. These costs for different mud systems and depend on the base fluid. The Reversible invert emulsion drilling fluid, eliminates the cost acquired in displacing Pseudo Oil Based mud (POBM) from the well, possible formation damage (permeability impairment) resulting from the use of viscous pill in displacing the POBM from the wellbore, and also eliminates the risk of taking a kick during mud change-over. With this reversible mud system, the costs of special fluids that are rarely applied for the well-completion purpose (cleaning of thick mud filter cake) may be reduced to the barest minimum. Specifications TableValue of the data•These data describe the volume and material estimate needed for each hole section and the type of mud necessary to achieve smooth drilling operation in each hole section.•The data showed the cost, the quantity of materials and sequence at which these materials are applied to achieve optimum displacement.•These data can be used to study the economic analysis of new mud systems proposed by researchers and also help to compare if these mud systems are economically viable.•These data can also be used to analyze and predict prices and/or build cost for drilling mud systems for a certain mud weight and daily maintenance expense.•The data reveals that cost varies according to the different mud types and are dependent on the base fluid phase.1The type of drilling fluid systems and the volume of drilling fluid needed for each hole section is summarized in The volume of drilling fluids needed for three sections was estimated and presented in The cost for drilling a typical well may be constant when drilled without any instability case. Instability during a drilling operation in wells can quickly escalate cost dramatically The build cost for a drilling fluid system is the price for the individual components and mixing requirements. The total build cost includes purchasing the initial drilling systems materials and the expenses involved with conditioning the drilling mud system in the well as it is drilled.2The water-based mud in the wellbore from the previous hole section is displaced and replaced with POBM drilling fluid. The first step is to lower the viscosity and gel strength of the water-based mud. The suggested method is to dilute the fluid with water to obtain a low rheology After drilling and prior to running completion hardware, the fluid in the borehole is often displaced to a water-based completion fluid, usually a solution of various salts. During this displacement, chemical washes and viscous spacers are placed in the solution to make surfaces water- wet, while helping to remove oil mud and residual oil-wet material from the borehole The viscosity and gel strengths of the POBM are low prior to displacement. The suggested method was to dilute the fluid with premix, base fluid or a thinner to obtain the low rheology if this is necessary. The optimal thinning of the POBM fluid will dictate how easy the mud will be displaced out of the hole.ID = Hole Internal Diameter, inchD = Hole Depth, ftThe volume of drilling fluid needed for each section was obtained using the equation below:Eqs. sxs = Sackslb/bbl = Pound per barrelbbl = BarrelEq.


Tumor metastasis is challenged by its resistance to microenvironmental stress infringed during escape from the primary tumor and the colonization of a foreign secondary tissue. Because of its great metastatic potential and its strong resistance to anticancer drugs, pancreatic cancer is regarded as a paradigm of the adaptation of cancer cells to microenvironmental stress. Thus, to understand how pancreatic cancer cells adapt to the different endogenous and therapy-related stresses is crucial for understanding their etiology and for the development of new efficient anticancer strategies. This review summarizes the multiple functions accomplished by one major factor of pancreatic cancer cell stress response, the stress protein p8.


The aim of this review is to highlight emerging trends about Chinese people and gambling addiction over the last 15 years, and to provide a discourse on the potential link between gambling and Chinese culture and history. The authors reported on the phenomenon of gambling among Chinese people using relevant research studies and reports and traditional Chinese literature. Chinese people have elevated levels of gambling addiction compared to their Western counterparts. These elevated rates are coupled with the rapid expansion of gambling venues within the Pan-Pacific region. While there is an accumulated body of research on Chinese and gambling, a systematic cultural analysis of Chinese gambling is still under development. We undertook a brief comparison between two ancient civilizations, China and Rome, in order to gain better understanding about gambling among Chinese people. To effectively deal with gambling addictions among Chinese people, it is imperative to develop culturally responsive interventions.


Although the role of intense psychological distress in psychopathology has been recognized for centuries, the metaphorical use of the word ‘trauma’ to indicate intense psychological distress only became popular in the midst of the industrial revolution  may point to innovative strategies for the treatment of trauma-related psychopathology and medical conditions (Lanius & Olff,


Over recent decades, the numerous coronary revascularisation procedures performed either by percutaneous coronary intervention (PCI), or coronary bypass surgery has led to an increasing number of patients who are no longer eligible for additional revascularisation procedures. This number of patients is expected to rise even further in view of an increase in life expectancy in patients with coronary artery disease.In a recent issue of the Netherlands Heart Journal, the investigators from the University Medical Center Utrecht report interesting findings on the use of a coronary sinus device in patients with refractory angina in whom there were no options for conventional revascularisation procedures . This deThe principle of improving myocardial perfusion by elevating coronary venous pressure was introduced as early as 1954 when the coronary sinus was partially ligated in patients with angina pectoris . The pubThe implantation of the balloon expandable stent into the coronary sinus creates a focal stenosis and, as a result, an increase in coronary venous pressure. It is remarkable that none of the aforementioned clinical studies verified this supposed increase in venous pressure by using either fluid-filled catheters or pressure guidewires. There are several postulated mechanisms that may explain the improvement in angina status, although they have not been proven in the clinical setting. First, the increase in venous pressure may lead to the enhancement of collateral blood flow to ischaemic regions , 5. AddiCoronary back pressure can also be increased intermittently and this modification of the technique has recently been tested in the setting of reperfusion in primary PCI . It has The authors are to be commended for conducting this trial and for their tenacity in using this device in patients with refractory angina. Previous clinical trials and the promising results of the present study encourage further exploration of this novel mode of therapy for the increasing number of patients who are not eligible for current revascularisation therapies. The relative simplicity of the implantation techniques and their documented efficacy and safety warrants further evaluation in larger sized trials to verify these interesting findings. We must await the long-term clinical outcome of the patients enrolled in the trials, including their safety, to show if implantation of this coronary sinus device adds to the armamentarium of the coronary interventionalist for the treatment of patients with refractory angina who are no longer candidates for current coronary revascularisation procedures.


An elective course for PhD students in cardiovascular and respiratory sciences was modeled and developed by a team of faculty at the Aga Khan University, Karachi. This course dealt with the multidisciplinary integrated concepts of heart, circulation and respiration components of human physiology. The understanding of basic science concepts enables students to better understand problems to derive solutions. Only those who understand how the healthy human body functions can recognize changes in diseased body to interpret the investigation rightly for an effective treatment. This forms the basis of dialectical imagination and experimentation.This was a unique course of its kind where the concept of ‘lecture debate’ was introduced. Students and faculty indulged in mutual learning and difficult concepts were dealt with thought provoking visual cues e.g. elucidating data in the form of graphs and tables instead of textual slides.The student’s feedback was encouraging. They remained highly motivated and committed throughout this course as being active team learners. They took active part in session discussions, execution of experimental work and tutorials. Their status of pre-knowledge enabled them to understand problems in light of application of currently grasped multidisciplinary integrated concepts. This offered a unique opportunity of turning teaching into learning mode.Students at the end of the course were found to have developed the curiosity for learning and were able to think in response to challenges. This was evidenced by critical analysis of concepts through experimentation.The following concepts of cardiovascular and respiratory system forms the content of this course while integrating morphology, biochemistry and physiology. This integration forms the basis of physiological sciences.*Cardiac Mechanics*Cardiac Cycle*Cardiac Rhythm*Cardiac Electricity*Hemodynamics*Micro-circulation*CVS Control System*Pulmonary Mechanics*Gas Exchange*Gas Transport*Respiratory Control SystemCardiovascular and respiratory concepts were continuously developed in interactive learning sessions. This was supplemented with experimental lectures and tutorials. The course was of 12 weeks duration with two lectures, one tutorial and one laboratory work per week. This was supplemented with take home assignments of reading articles associated with the topics. The analysis of current scientific literature on the topics covered was critically debated in the context of premises and conclusion. This new model enabled the students to transform their imagination into experimentation to test the correlation between the two variables in order to arrive at an evidence based conclusion. Such a strategy of experimentation based learning could be possible through a horizontal enabling environment. Thus, this enabled to unfold the creative energy of students.The assessment was based on the following distribution of marks. It included 30% Continuous assessment (CAT), 20% student presentation and 50% formal written examination. CAT was based on the students’ performance in the lecture debate and laboratory sessions. Student presentations during tutorial sessions were peer-reviewed by faculty involved in the module. Comprehensive written examination contained Best Choice and Extended Matching Questions and short integrated essay questions which included analysis and interpretations of data.This course was a unique model of how active thinking driven by curiosity for knowledge enhanced the learning experience of students. How thinking oscillates between a group and an individual and how critique enhances learning. One is winged with the ability of going back and forth with imagination and experimentation to be enlightened and nurture the learning curve of consciousness.


The possible occurrence of metabolic acidosis in patients with intestinal ileus is not well recognized. We describe a patient with acute alcohol-induced pancreatitis and a large transverse colon ileus in which plasma bicarbonate dropped rapidly in the absence of an increase in the plasma anion gap. The urinary anion gap and ammonium excretion were consistent with an appropriate renal response to metabolic acidosis and against the possibility of respiratory alkalosis. The cause of the falling plasma bicarbonate was ascribed to intestinal bicarbonate sequestration owing to the enhancement of chloride-bicarbonate exchange in a dilated paralyzed colon.


Effective site supervision plays an important role in construction project delivery. This situates site supervisors in taking the responsibilities of coordinating and controlling all physical aspects of the day-to-day task in construction projects. A cross-sectional design approach was adopted by administering a well-structured questionnaire to selected built environment professionals. Descriptive statistics was performed on the data obtained and are presented on figures and tables. The data was also subjected to inferential statistics using Kruskal Wallis test to analyze the perceptions of respondents on effects of site supervision of construction works on completion time and quality respectively. The significance of the analyzed data is on identifying the effects of site supervision on project completion time and quality delivery. The analyzed data will also guide project stakeholders in selecting competent personnel in executing construction projects. Specifications TableValue of the data•The data reveal cogent roles of site supervisors in construction projects towards elimination of reworks, minimization of waste and ensuring conformity to standards.•The impacts of site supervision on project accomplishment of time and quality will be a contribution provided by the data.•The identification of the effects of site supervision will provide basics for local construction sector to equip themselves for future selection of site supervisors.•The data will also guide academia in fulfilling their teaching requirements hence producing competent hands that can handle construction works.1A total of 78 online well-structured data instrument was administered to various built environment professionals comprising of Architects, Builders, Quantity Surveyors and Civil Engineers. The demographic features of the selected built environment professionals are presented in 2The collected data was based on the survey of selected construction practitioner's perception on the effects of site supervision on project completion time and quality delivery. Several literatures have reported similar accounts of the subject matter and can be found in


An exact probabilities method is proposed for computing the confidence limits of medical binomial parameters obtained based on the 2×2 contingency table. The developed algorithm was described and assessed for the difference between two binomial proportions . The behavior of the proposed method was analyzed and compared to four previously defined methods: Wald and Wilson, with and without continuity corrections. The exact probabilities method proved to be monotonic in computing the confidence limits. The experimental errors of the exact probabilities method applied to the difference between two proportions has never exceeded the imposed significance level of 5%.


Cost and availability of a database often impede research while the lack of compatibility inhibits collaboration by making merging of databases difficult or impossible. The Global Pregnancy Collaboration (CoLab) has promoted harmonization of studies and standardized data collection to facilitate pregnancy and placental research. Its online database, COLLECT, allows collection of minimal and optimal clinical datasets to accompany basic and applied science studies and provides a placental sample inventory system. COLLECT is available free of charge in LMIC and for $100 per month in HIC. Data is the property of the investigator but with permission can be combined into larger studies across centers and countries. •High quality clinical data can usefully assist basic placental research studies.•Designing a database is expensive and existing databases are usually incompatible.•CoLab has designed and made available a tried and tested database at low or no cost.•Data is the property of the investigator but can be easily combined with permission. Increasing amounts of evidence indicates that these syndromes, and preeclampsia in particular, are heterogeneous disorders with more than one subtype including those with involvement of the placenta. The burden of these disorders falls disproportionately on low and middle income countries (LMIC) where we know less of their pathophysiology and characteristics which indeed may be different from high income countries (HIC). Recent large scale studies of up to 5000 subjects have failed to accurately predict the occurrence of preeclampsia The Global Pregnancy Collaboration (CoLab) was established with support from the Bill & Melinda Gates Foundation as an international consortium of investigators and centers to enable sharing of data and biological samples worldwide with the objective of facilitating collaborative research studies of adverse pregnancy outcomes and ultimately improve the health of women and their infants. As part of this objective the members of CoLab have published position papers which outline standards they feel are necessary for data collection, including minimal and optimal datasets 2CoLab has designed and built a database, initially to facilitate preeclampsia studies worldwide. The database has been adapted by MedSciNet from that they designed for the international SCOPE study, ensuring it is tried, tested and robust. The database will be available free for use for investigators in LMIC with limited resources and available in HIC at a nominal charge ($100 per month). This is much less than that incurred for designing and operating one's own database. The database contains the minimal and optimal datasets as specified by Myatt et al., 2014 3COLLECT is an opportunity for members of the clinical and basic science placental research communities to use a high level comprehensive clinical database where none existed before. This will enable harmonization of data collection to facilitate later merging with other studies if desired and help elucidate the role of the placenta in the great obstetric syndromes dickensonke2@mwri.magee.edu or Tel 412 641 1427.COLLECT is available now via The Data Manager of the Global Pregnancy Collaboration, email Bill & Melinda Gates Foundation (OPP1119324).The Global Pregnancy Collaboration is funded by the


The data article provides the factors that influence the cost; time performance of the Industrialized Building System (IBS), its prospects and challenges. A survey technique was used for this research. Structured Questionnaires were administered to occupants of prefabricated buildings and interviews were conducted with the professionals in the building industry. Statistical Package for Social Sciences (SPSS version20) was used to analyse the data obtained from the questionnaires. The variables were ranked based on Relative Importance Index (RII) calculation. The Data indicated that IBS would be more economical if used for mass production. Specifications TableValue of the data•This data provides a benchmark for further studies on the performance of the precast concrete system in the construction industry.•This data shows the significance of using Industrial Building Systems (IBS), its impact and valuable benefits of incorporating it in the industry.•This data shows cost- time effectiveness and perception of the implementation of the building system for policy making.•This data can be used to compare findings from other countries where this type of construction method is prevalent.1The data article provides the factors that influence the cost; time performance of the Industrialized Building System (IBS), its prospects and challenges.22.1Data was obtained from building professionals involved in the construction of precast concrete structures and 60 questionnaires were distributed to occupants of already constructed precast buildings in Lagos state. Data was also collected from secondary sources which include information from published journals, articles and thesis 2.2Data collected from the questionnaires administered to respondents were analysed and presented as follows.


Viruses are highly abundant in aquatic environments  to illustrate how sequencing technologies and associated bioinformatics tools can be utilized to trace aquatic viruses, and (ii) to discuss the new opportunities they offer for understanding the emergence of viral diseases and controlling their spread.Mutoloki et al.). In the second paper, Abbadi et al. looked at the evolution of two viruses that cause high mortalities in rainbow trout farms, the infectious haematopoietic necrosis virus (IHNV) and the viral haemorrhagic septicaemia virus (VHSV). They analyzed the glycoprotein (G) gene sequences of many isolates collected over a period of nearly 30 years and concluded that the two viruses have distinct evolutionary rates. Integration of these molecular data with high-quality epidemiological information led to propose different patterns of virus spread among trout farms.The two first articles of this topic show how sequencing a single gene of a virus may help understand the ways it propagates between aquaculture settings. Sequence comparison of VP2 gene from infectious pancreatic necrosis virus isolates showed the existence of two clades that differed by a distinct signature motif in the hypervariable region, each motif being associated with a different level of infection . Likewise, metagenomics has greatly accelerated the pace of virus discovery in the recent years, and also appears valuable to design proactive diagnostic tools able to identify novel viruses before they cause disease outbreaks .The following two articles discuss the ability of metagenomics to uncover the environmental factors that influence virus spread in aquatic environments and to identify novel pathogenic viruses. Most of our knowledge on the epidemiology of viral diseases in aquaculture so far is derived from studies carried out on infected aquatic organisms. Metagenomics offers the possibility to study the epidemiology of viral diseases outside their host species by the direct analysis of environmental samples, which in turn enables to follow the environmental factors that influence the composition of viral communities . WGS not only enables to resolve micro-evolutionary distances, but it also has the power to discover new and rare variations, including polymorphisms that arise during an outbreak or that evolve in vivo during an infection. It thus offers the possibility to track the emergence and spread of a given variant, while it may also provide predictive information concerning key phenotypic traits  represents the “ultimate” typing methodology in terms of discriminatory power emergence: the potential role of fish endogenous retroviruses. While several exogenous retroviruses have been clearly identified as etiological agents of some fish diseases data. Besides, both metagenomics and WGS are facing technological challenges when applied to aquatic viruses, which the third and fourth generations of sequencing will probably only partly overcome (Nkili-Meyong et al., The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The current Ebola outbreak in West Africa and the large scale wild Polio virus outbreak in several countries are the top most issues among international public health and scientific communities' debates and concerns. These two outbreaks were judged to be declared as Public Health Emergency of International Concern (PHEIC) during 2014. This is the first time ever to have such circumstance of two PHEICs at the same time.PHEIC, which has to be declared by WHO Director General after a recommendation of IHR Emergency Committee; is observed to start in countries with fragile health system and conflict areas. Then it rapidly spread to threaten the global public health. The year 2014 has uniquely witnessed declaration of two events as PHEIC according to IHR (2005); Polio and Ebola Virus Disease (EVD). Both outbreaks are caused by viruses such as H1N1 which was previously declared as PHEIC in 2009.Public Health Emergencies of International Concern in 2014 occurred in countries with weak health systems and conflicts and threatening the whole globe. International collaborative work is required to contain the event and to mobilize resources/capacities between countries. Moreover, public health surveillance systems as core capacity for IHR (2005) should be strengthened in all countries with focus on those with limited capacity and ongoing conflicts. The ultimate aim is timely detection of potential PHEIC events in the future along with early preparedness and response plans. This was due to international spread of Wild Polio Virus (WPV) particularly during the known low virus transmission season (January–April/May) 2.0) of EVD is 2  While it is 6 For WPV-basic reproductive number is an epidemiological parameter that indicates the average secondary cases attributed to the index case of a communicable disease The year 2014 has uniquely witnessed declaration of two PHEIC events according to IHR (2005); Polio and EVD are on the top of global public health and international scientific communities' debate and agenda. Both outbreaks are caused by viruses such as H1N1 which was previously declared as PHEIC in 2009 In 2014 WPV was actively transmitted within at least ten countries with a risk of exportation and infection to others. Eastern Mediterranean Region is shouldering the greater portion of this burden particularly due to “Pakistan to Afghanistan” and “Syria to Iraq” exportations. While, “Cameroon to Equatorial Guinea” and “Equatorial Guinea to Brazil” are the other documented exportations in the rest of world during 2014 EVD in 2014 started and propagated in western Africa. Guinea was the index country which exported the infection to Sierra Leone and Liberia initially, and later to Nigeria, Senegal and Mali in addition to Spain and United States of America.WHO had made case specific recommendations based on IHR (2005) to cope with current states of Polio and EVD. These recommendations are generally temporary and are subject to the day to day progress and developments. For Polio, recommendations in infected and exporting countries included official governmental declaration that Polio transmission is a national public health emergency. In addition to vaccination for travelers and documentation with international vaccination certificate as per IHR PHEIC in developing countries that are represented in this discussion by Afghanistan, Pakistan and Sudan carries and tells several stories and lessons that need to be well taken. These countries like other several developing countries have been subject to long standing civil wars and turmoil. Two of these countries are directly involved in the current declared PHEIC related to Polio in the epidemiological block that includes both Afghanistan and Pakistan with a common viral circulation pattern and exporting the virus to each other. While Sudan is an African country that been affected by major disease outbreaks during the recent years such as Rift Valley fever outbreak in 2007 and Yellow fever outbreak in 2012. Within these countries we notice that classical index areas for spreading these outbreaks are the most vulnerable and security compromised areas. In Afghanistan, the Southern region including Kandahar and Helmand is persistently being the reservoir for WPV. The same is true for the tribal areas in northern part of Pakistan that remain as major contributor in terms of Polio related outbreaks. In Sudan, the index cases of Rift Valley fever outbreak started in the previous conflict border between Sudan and the republic of South Sudan. In 2012, the yellow fever outbreak started and spread from security compromised areas in newly formed central Darfur state in the western part of the country.Eastern Mediterranean Region Office for WHO that including theses three countries had recently conducted an assessment for country preparedness to EVD potential case importations. It revealed that countries have very low capacity to respond and control potential outbreak despite the fact that technical guidance have been provided to these countries. It is now clear more than any given time before that health systems should be adequately built in all such countries. National governments of these countries are required to prove the commitment to implementation of IHR (2005). Availing adequate or even the minimally required capacities to cope with any PHEIC in a country is the major determinant of the final outcome. This also could be concluded from the recent experience of response to current PHEIC. Despite the huge efforts that paid by international community represented by the United Nation Mission for Ebola Emergency Response 3.In this brief discussion, it is clear that Public Health Emergencies of International Concern occurs in countries with weak health systems and internal conflicts then threatening the whole globe. International collaborative work is required to contain the event and mobilize resources/capacities between countries. Public health surveillance systems as core capacity for IHR (2005) should be strengthened globally aiming for timely detection of potential PHEIC events in the future. Building capacities for implementation of IHR in war/turmoil stricken countries with low resources, weak and fragile health systems will guarantee early detection, response and control and PHEIC in other parts of the world.


The purpose of this paper is to demonstrate the relationship between food preservation and reducing consumer waste is of value in developing sustainable meal options. The research reports insights into Austrian marketplace for frozen and fresh foods that have been obtained from a consumer survey.The consumer survey methodologies indicate how preservation can change meal planning and lower food waste across frozen and fresh and ambient food purchases using freezing preservation methods.The results show food waste can be reduced by six-fold when frozen foods are compared with fresh foods.This study highlights the requirement for a greater understanding of the probability that specific foods will be wasted with respect to the frequency of purchase. This is a limitation of the current study that has been investigated by other researchers.This research has enabled the identification of different food waste amounts for different food product categories. The data presented could be used to guide food product development so that less consumer waste is produced.The research suggests a decision matrix approach can be used to can guide new product development and a model of this matrix is presented so that it may provide fit-for-purpose food preservation options for consumers.This paper will continue to highlight the overlooked value of food preservation during processing and manufacturing of foods and their preparation in households. Consumers produce the greatest amount of food waste and loss in the food supply chains of developing and developed economies .Previous food waste reduction initiatives have typically focussed outside of this consumer arena and they have focussed on manufacturing and retail food losses. They have been successful at designing out food waste using the right-weighting of food products (portion control) and light-weighting of packaging . Their success has been made possible through cooperative actions across the food industry that have developed joint responsibility for food waste. It is essential that these initiatives now act to reduce the food that consumers purchase but do not eat . While tThere has been an emergence of re-distribution schemes and community focussed actions that have been successful at removing food waste from supply chains. Redistribution of foods that are close to shelf-life limits and schemes that facilitate providing food to consumers such as “community fridges” have an exceptionally important role to play in waste reduction particularly where communities experience limited accessibility and affordability of foods. The redistribution of foods from retailers and manufacturers that are close to shelf life limits or charitable donations has also seen the impact of using on-line communication technologies that connect providers with consumers of redistributed foods . A more Schemes that engage and redistribute resources to reduce food waste do not fully address the issue of food and drink products being wasted by consumers because they are not designed to reduce food waste. They redistribute food that would otherwise be waste; the study reported here focusses on reducing the wastage of food that is purchased with the intention of using it. The preservation of foods and types of food preservation methods available to consumers can facilitate this because it reduces food degradation and improves the utilisation of food in the domestic environment. This is a principle that has remained largely unconsidered even though the production of food waste increases greenhouse gas emissions or the carbon footprint of food consumption . It is cIn this study, it is demonstrated how frozen preservation can provide greater utilisation of food by consumers and reduce household food waste. It is not intended to show frozen is the only option for reducing consumer food waste. It is hoped that the research will highlight the use of preservation methods in reducing consumer food waste and that there are several factors that must work together in food waste reduction is to be successful. Previous research carried out in the UK market compared fresh and frozen food use in households and the amount of consumer food waste was dependent on food preservation method. The study showed a 47 per cent reduction in household food waste for frozen products compared to fresh products .Frozen food in this study is defined by all food that is frozen via quick freezing; this ensures the cell intactness and preserves the nutritional value of the food. The process of freezing food in this household focussed study is defined as non-frozen food which gets frozen via a standard freezer (at home), as such this is slow freezing where cell structure is not maintained and it is less beneficial than quick freezing but adds to shelf life significantly. The definition of fresh food in this study is all non-frozen and non-freezing food.Working with frozen foods not only gives us an opportunity to consider the value of food preservation in households but we must also consider manufacturing factories providing efficient use of resources and continual availability . This prFrozen foods have played a pivotal role in enabling the global food supply chain to evolve and without that food losses would be increased in agriculture and processing. Many of the food supply chain issues highlighted in current food loss and food waste research do not exist with frozen foods because quick freezing leads to the extended shelf life gains that many waste reduction initiatives seek . The “clThe Austrian market research reported in this paper allows us to extend current understanding of the utilisation of frozen foods. It also leads us to consider the broader issue of what incentivises consumers to eat a more sustainable diet. Austrian households currently produce around 369,000 tons of packed and unpacked food waste each year and there is over 23.4 million tonnes of food waste produced by households across the EC member nations . The datThe Austrian market data was collected via an online survey carried out by the Institute of Marketing & Innovation, University of Natural Resources and Life Sciences, Vienna (BOKU) and Gesellschaft für Konsumforschung (GfK SE) during July 2015 . The surThe survey participants were selected to represent the typical Austrian population with regard to age and educational level. The selection made for geographic distribution across the Federal States was proportional to the population in each Federal State. The selection to the panel of 2,800 was made using the GfK market survey methods used for market research. GfK are a commercial and international company that provided the survey panel of 2,800 households. GfK’s services are routinely used by the food sector by manufacturers and retailers to develop business activities and identify food and drink trends. The participants used in this survey bought food and drink for their household and were asked how much food they wasted across six food groups as a percentage of the total amount of the food they purchased. The six food groups were selected because they were important food categories in Austria that have both frozen and fresh options. Notably this included bread where the offer and purchasing of frozen bread rolls is typical for Austrian consumers.What percentage of fresh food from your household purchases do you throw away?What percentage of the frozen food from your household purchases do you throw away?What percentage of fresh food from your household purchases do you throw away per following product groups?What percentage of frozen food from your household purchases do you throw away per following product groups?The participants of the survey were asked to consider their household food waste in a week from the food they purchased, partly utilised food, leftovers (plate waste) and preparation residues. The core questions of the survey that asked participants to report their proportion of food purchased that was wasted as a percentage were as follows:The food groups were fruit; vegetables (including specific questions for potatoes and spinach); bread (fresh only); pasta; meat; and, fish . The core questions were developed in terms of what food product groups were wasted in households. The survey also collected demographic information so that the 2,800 participants reflected a typical sample of the Austrian population and this was determined using GfK’s demographic methods.The amount of food waste produced in the sample of 2,800 Austrian households is shown in The goal of the research reported is to show how food waste behaviours connect many sustainability issues across the complex food choices consumers make when meals are prepared. Our research shows food manufacturers and food retailers occupy critical points in supply that can determine how these food consumption behaviours can be transformed into more sustainable ones. An important way of achieving this is through reducing the food waste associated with every meal.Notably, the fresh to frozen ratio of specific food products , includeThe reduction of food waste and correct meal portioning of specific food products are important because when they align and work together they can reduce food waste. This means data collected from consumers regarding what they consider to be the correct portion size in a meal is exceptionally valuable in waste reduction actions and it is rarely done. Obtaining such data is a challenge future research into food waste will need to address so that it can be transferred to food product development operations for maximum impact. The data collected here does not consider correct portion size data specifically but it does indicate its importance. The Austrian research reported here has shown that the fresh food thrown away per household per person for this sample was 37.48 kg each year while the frozen food thrown away per household per person was 6.46 kg and per year. The nutritional losses associated with food waste have yet to be fully characterised but they are an important component of food waste projections (While we can determine the environmental impact of consuming foods in terms of their carbon footprint, it is the impact of wasting foods as an outcome of consumption that concerns us here. This is important because assessment of the environmental value of foods requires considerable investment of finance, knowledge and skills. It seems futile to make this investment if the assessed foods are wasted downstream in the food supply chain as they are prepared and consumed. New supply chain models are required to promote the value of reducing food waste and guide processes such as freezing that can reduce food waste. The data presented in Current carbon footprinting methods show us that agri-production and global distribution can be the least of our problems because food wastage can be up to 20 per cent of food purchases and food losses across the supply chain can be far greater than this (These ideas lead us to summarise the research presented here as a decision matrix model . The decThe research reported here shows purchased fresh foods have a six-fold greater food waste compared to purchased frozen food in a survey of 2,800 Austrian households. The research supports previous research conducted in the UK where a 47 per cent food waste reduction was demonstrated for frozen foods compared to fresh foods. This relationship shows maximal resource use is achieved for frozen food products that are manufactured for the convenience of being included in meals. The conclusion is that food manufacturers, food retailers and policy makers must consider the role of food preservation in delivering a sustainable diet. The decision matrix approach here provides initial guidance in new product development a basis for doing this and it is supported by data sets that have now been obtained in the Austrian and UK markets.


Thinking the roof will collapse because you feel anxious). Exaggerated use of negative feelings as source for judging danger  has been demonstrated to have clinical relevance both as maintenance factor  and thinking  have always been viewed in interaction. One way our feelings interact with our thinking is through judgments we make about external situations based on how we feel about them rather than on objective facts. We may conclude that we will get a salary raise because we feel good about the letter we received rather than on the facts that suggest the raise  which serves as input for further thinking . In other scenarios, only objective danger information was presented. After being presented scenarios that included information about feelings, participants judged the probability of danger as higher than after scenarios without information about feelings. Arntz and colleagues also asked participants to “evaluate these events as if they are happening to you.…try to identify yourself with the description as much as possible” . Furthermore, if simulations of feelings are important for the effect of feelings on higher cognition, then the properties resulting from FaEI  will both be recognizable and necessary to see such an effect.Affective forecasting refers to estimations of how one will feel in the future . The results showed that people who were depressed and had higher pre-treatment EMG zygomatic values when they imagined positive feelings respond better to antidepressant treatment  in emotional disorders. Analogous to measures of vividness of kinaesthetic imagery (in which participants are asked to rate the clarity of imagining the sensation of movement), studies may measure the vividness of imagining feelings by asking participants to rate the clarity of imagining emotional states.In line with studies that have investigated the imagery of emotional events (Holmes et al., The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


C. elegans  are kinds of reactive chemicals mainly formed in mitochondria as byproduct of normal metabolism of oxygen  is known as the herbicide and is often used as ROS inducer in biomedical studies (Castello et al., The excessive response may be a preparation for unpredictable and harder conditions forthcoming. If the extent of the response is only appropriate but not excessive, the organism will be killed immediately by worse environmental factors before it has time to motivate stronger protective mechanisms. Such kind of response may also exist in other cellular processes besides ROS metabolism. It is well known that physical activity is beneficial for health in terms of prevention of heart disease and cancer, fat control, and maintenance of mental function (Berra et al.,


The high service burden for acute admissions and referrals via rapid access chest pain clinics for evaluation of possible coronary artery disease means that many patients are now undergoing an investigation such as stress echocardiography as part of their evaluation. We aimed to see if the reassurance provided by negative stress echocardiography correlates with long-term event free survival.A cohort of all patients who were referred at a single centre for stress echocardiography for diagnosis of coronary artery disease between January 1st 1999 and December 31st 2000 were followed up at least 10 years following theirs stress echocardiogram for further major cardiovascular events and mortality.A total of 64 patients were identified where records could be obtained for analysis. There were 16 positive scans, 37 negative scans and 11 inconclusive scans. The indeterminacy rate of scans was 17%, the sensitivity rate for detecting significant disease as indexed to invasive angiography was 88 % and the specificity rate compared with angiography was 75%. There were no myocardial infarctions or new diagnoses of heart failure in the negative echocardiogram group. There were seven deaths in the total population and only one death from cardiovascular causes in the negative echocardiogram group.Stress echocardiography even in this small group predicts long-term outcomes as well as invasive coronary angiography. Stress echocardiography was initially developed approximately 20 years after the initial introduction of cardiac ultrasound in 1979 and was limited by poor technical apparatus [Since then there has been rapid development in terms of techniques, indications and the accuracy of the test with thousands of people undergoing stress echocardiography each year. This rapid expansion in testing has rested on numerous works showing that stress echocardiography has evidence in predicting cardiovascular outcomes .More specifically what has been shown in a meta-analysis of available work with a follow up period of approximately 33 months is that a negative stress echocardiogram, very strongly confers a low likelihood of future major adverse cardiovascular events  and theyThe role of imaging in cardiology is increasing year on year and the current recommendations from the European society of Cardiology suggest usages for echocardiography which covers a very large proportion of patients .In the United Kingdom (UK), the recently published guidance from the national institute for clinical excellence (NICE) has clarified the role for stress echocardiography in the assessment of people with stable chest pain . As streMost hospitals in the United Kingdom are unlikely to have access to cardiac magnetic resonance imaging or myocardial perfusion single photon emission computed tomography, which are the two other recommended options in the moderate risk group. We therefore felt that as our centre is a non-specialist centre as our the majority of centers in the UK, we needed to clarify how useful a negative a result would be for the people seen and assessed by stress echocardiography.What we aimed to establish with this audit was whether the strong negative predictive value of stress echocardiography for future events in the short term was replicated in the long term.The patient list was formed from a list of patients kept by the department of cardiology who underwent stress echocardiography between January 1st 1999 and December 31st 2000. All patients were referred for stress echocardiography from within Aintree University Hospitals NHS Foundation Trust to a single operator. All patients who were referred for the assessment of possible ischaemic heart disease were included, patients with known disease undergoing viability assessments or those with valvular pathology being further assessed were not included in the analysis.As part of the ongoing service evaluation and audit process, it was not felt that this work required referral to the national ethics system. This work was however formally approved by the audit department university hospital Aintree NHS foundation trust.Patients were admitted to the department following the omission of all rate limiting drugs or caffeine containing products for 48 hours. Patients were put on continuous electrocardiographic monitoring and regular blood pressure monitoring. Patients were given a pharmacological stressor either arbutamine  in standAn examination was considered to have reached the required heart rate for examination at the discretion of the operator but normally a level of at least 85% of age related maximum was used. The images were then analysed offline by a single experienced operator (AA-consultant cardiologist). Examinations were considered diagnostic of ischaemia and therefore positive when 2 or more adjacent regions became hypokinetic with stress in line with published guidelines .Results were collated in terms of the age, sex and risk factor distribution of the patients scanned. We then collated the number of positive, negative and inconclusive echocardiograms recorded and then the sensitivity and specificity of the test by comparing the echocardiograms where there was an invasive coronary angiogram after and if that showed significant flow limiting disease. We also made a record of the percentage of age predicted maximum heart rate that was achieved where that information was available.We then collated how many patients went on to develop myocardial infarctions, heart failure and who died from all cause and cardiovascular causes . Follow up was performed using the patient’s casenotes, electronic data and if needed by correlation with the general practitioner’ s records.In all we found 64 patients who had stress echocardiography performed in the period from the 1st of January 1999 to the 31st of December 2000 for the attempted primary diagnosis of myocardial ischaemia.The average age of patients presenting was 56 (95% CI 54 to 58) with fifty one percent being female.The average heart rate as a percentage of the age predicted maximum reached for all stress echocardiograms performed was 83% (95% CI 81 to 85).The risk factor profile of the patients involved in the study is shown below in In our cohort of 64 patients there were16 positive scans, 37 negative scans and 11 inconclusive scans.The indeterminacy rate in our collection of echocardiograms was 17% and the sensitivity of stress echocardiography in our cohort was 88% and the specificity 75% using the standard method.The primary outcome measurements were in all cause and cardiovascular mortality and major adverse cardiovascular events .In all there 7 deaths, 2 in the positive echocardiogram group from cardiovascular causes, 1 in the inconclusive echocardiogram group from cardiovascular causes and four in the negative echocardiogram group.In this negative echocardiogram group there were 2 deaths not related to cardiovascular causes and 1 death from cardiovascular causes (witnessed ventricular fibrillation- with no obtainable post mortem report). The cause for one patient could not be determined due to a lack of correct address and general practitioner details.This equates over the minimum ten year follow up to a 0.27% per year risk of death from a cardiovascular cause following a negative stress echocardiogram.The results for the patients developing major adverse events such as heart failure and myocardial infarction are shown below .Using a Mid P exact test, there was no significant difference between the all cause and cardiovascular mortality rates in the positive and negative echocardiogram groups, owing to the low numbers involved.Using a Yates corrected Chi-Squared test there was a significant difference between myocardial infarction and rates of heart failure between the positive stress echocardiograms and the negative stress echocardiogram (P < 0.001).What this studies expands on compared to previous work is that high reassurance provided by a stress echocardiogram in the short term  is repliWhen compared to a negative invasive coronary angiogram the per year risk of cardiovascular death rate of 0.51% [Our sample is a small sample with a single operator and as such is open to biases associated with smaller studies. We also assumed invasive coronary angiography to be the gold standard and that luminographical analysis when negative excluded significant disease. There is more and more work using intravascular ultrasound that suggests that unstable plaques and varying plaque morphology may be more significant than operators may appreciate with traditional angiography . This maThe final limitation to our study is that because all the echocardiograms were analysed by one highly experienced reader, there is an inherent expert bias in terms of the accuracy of the results. It maybe that when replicated with less experienced readers that the interpretation of the echocardiograms may not be as accurate and the outcomes not as favourable.As our results fit in broadly with in terms of sensitivity, specificity and previously reported mortality rate and adverse event rates published in the shorter follow up period for new referrals , we feelAs ever cost effectiveness is a major aspect of all work performed in the national health service and stress echocardiography has been shown to a very cost effective way of reducing the need for invasive angiography  and now It would of course be interesting to repeat this work in a larger group with more operators to see if our results are replicated. With improvements in the scanner technology behind stress echocardiography, we expect the accuracy and the predictive value to improve. We suggest also that correlation between positive echocardiograms and apparently normal angiography be repeated with intravascular ultrasound or optical coherence tomography to more accurately visualise vessels and plaque.Negative stress echocardiography is as good a negative predictor of cardiovascular mortality.


The increasing demand for energy and the need for clean and affordable energy in Nigeria have necessitated the need for renewable energy resource assessment and subsequent determination of suitable sites within the country. One of the promising renewable energy resources with good potentials of meeting the energy requirements is wind. One of the main challenges of wind power development in Nigeria is lack of scientific data for policy formulation and decision making that will aid the development of wind power utilization. The data presented in this article were obtained with proper evaluation of the wind resource while taking into consideration environmental, social, and economic factors. The information from the data could be useful for taking optimal site selection decision by the policy makers, government, engineers etc. This will ensure optimal investment and return on investment for wind farm developers. Specifications TableValue of the data•Discoveries from the data set could draw the attention of the government to the most suitable states for wind farm establishment for grid integration.•The data set could serve as a tool for estimating wind energy potential in the country and development of renewable energy map.•The data set could serve as a reference for the utilization of wind resource for energy generation by investors and energy companies.•The data and findings could serve as a reference for government policies and planning.•The data set could be used for educational and instructional purposes.1The data contained in this paper comprises of proposed wind farm sites data obtained from wind farm site evaluation in Nigeria. The data includes wind farm suitability map for Nigeria , maps of2The average annual wind speed data for 28 locations obtained from Nigeria Meteorological Agency (NIMET), Oshodi, Lagos, Nigeria was gotten from a previous work The criteria weights generated , togethe


The authors of a recently published article entitled, “Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment” by Carroll et al.  examinedResearch on psychiatric disorders and suicide risk among active duty personnel and military veterans tends to focus on traumas related to the military service –7. HowevThe results of studies by Blosnich et al.  and AfifThere are a lot of research observations of the effects of ACE on the psychobiological development of children and adolescents. Considerable evidence suggests that the brain development of children is likely to be affected in by their ACE –21. EarlMilitary service may subject individuals with a history of trauma to additional trauma such as combat, which may additively increase risks of psychiatric disorders and suicidal behavior. If some military recruits have trauma-related psychological abnormalities that predispose to psychiatric disorders when they enter the military, then we have to seriously question the screening that goes into allowing persons to enter the military . PossiblIt is important to address early trauma histories in addition to more recent traumatic experiences because the psychobiological impact of early trauma is different from psychobiological effects of trauma during adulthood , 33. StuClinicians, researchers, and health policy makers should work to reduce the stigma of revealing ACE and apportion funds for epidemiologic studies and the development of new treatment modalities to tackle problems related to ACE among military personnel and veterans .The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Prefrontal cortex (PFC) has long been known to be a region of the brain crucially important for cognitive processes. Major progress has been made in understanding the functions of this part of the brain however when it comes to brain organization there are still unanswered questions. In particular, if we compare known prefrontal cortex organization to that seen in sensory cortices, it is not currently clear whether PFC organization is essentially the same or different. This research topic focuses on the structural and functional organization of the prefrontal cortex in rodents and primates and makes a contribution to current research and debate within this field of neuroscience.Bedwell et al.; Bedwell et al., neuroanatomical tracers were employed to investigate PFC cortical connections. These studies illuminate a connectional feature common to PFC and other cortical regions: topological/topographical organization of connections. In addition, these studies provided evidence at a fine microscopic resolution for both reciprocal and non-reciprocal PFC connections. The finding of fine-scale non-reciprocity is unexpected, especially when one considers that other cortical regions (such as sensory cortices) are well-known for their detailed reciprocity. The study by Nguyen et al. uses electrophysiological approaches to explore important functional questions about the anatomical connections between PFC and primary visual cortex. Such links may be important for mediating attentional and other top-down signals. The experiments provided evidence for a functional link between infralimbic and prelimbic cortex and V1, but they found that this link was not mediated strongly via basalo-cortical cholinergic projections. Another feature of anatomical organization is the columnar organization present in PFC and in other regions of the mammalian cerebral cortex. Several previous anatomical studies have provided evidence for columnar or modular organization within PFC, in this topic Opris et al. investigated the functional aspects of this organization during exposure to cocaine. The results help to show how cocaine interrupts complex cognitive processing within columns and layers of the monkey prefrontal cortex.In the articles by Funahashi in this research topic, the interpretation of delay period activity in relation to visual memory tasks in primates is explored. The article presents previous and historical findings on the subject and discusses different interpretations of these important results. Another important function ascribed to the PFC is fear processing. PFC is known to have strong anatomical links with the amygdala, which is an important structure for mediating fear responses. This research topic features two articles which indicate that PFC plays a role in the processing of fear-related stimuli . Sharpe and Killcross investigated how cues modulate conditioned fear using inactivation of the rat prelimbic cortex. The authors found evidence for a prelimbic cortex role in the processing of these behavioral cues so that responses can be modulated accordingly. Shiba et al. explored how PFC lesions alter innate fear in the primate brain. Here the authors found that lesions to either ventrolateral PFC and orbitofrontal PFC caused heightened fear in response to predatory stimuli.Prefrontal cortex is perhaps best well-known for its role in cognitive function. The classic experiments of Funahashi and colleagues in the late 1980s and early 1990s  in reorienting attention was investigated. In this study a patient with MFG resection was compared to healthy volunteers and the results showed that, in certain tasks, the patient found it difficult in switching to top-down attentional control. In the review article by Cassaday et al., PFC studies involving attention are discussed in relation to the methodology employed and the results from different regions of PFC. This article covers studies of both rodent and primate PFC and outlines the evidence for distinct PFC regions having a role in both attention and executive processes. Remaining on the subject of methodology is the field of optogenetics which has become an increasingly important approach used in the arena of cognitive neuroscience. In the review article by Riga et al., the subject of how optogenetic tools have been used to study the prefrontal cortex in animal models is explored and discussed. The article highlights how these tools have been used to effectively study the functional circuitry of PFC in rodents. Optogenetics continues to be developed rapidly and successfully combined with existing techniques, such as fMRI (Liang et al., Another crucial cognitive function is attention and there is substantial and increasing evidence for the role of PFC in attention. In the imaging case study by This research topic provides a snapshot of current PFC research and highlights some of the progress made in understanding PFC anatomy and function. Many of these studies also point to the important role of PFC microcircuitry in cognitive processing. Clearly there are still important and fundamental gaps in our understanding of PFC structure and function. There are many similarities between the anatomical organization of PFC and other cortical regions yet functionally PFC may be unique, possibly having a multifunctional role which is difficult to define Duncan, . We stilThe author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Hemispatial neglect refers to the defective ability of patients to explore or act upon the side of space contralateral to the lesion and to attend to stimuli presented in that portion of space. Evidence from animal models suggests that many of the behavioural sequelae associated with visual neglect may result not solely from the size of the lesion, but also from a pathological state of increased inhibition exerted on the damaged hemisphere by the contralesional hemisphere. On the basis of these potential mechanisms underlying neglect, in this review we discuss therapeutic approaches, focusing particularly on recent research using transcranial magnetic stimulation (TMS). This technique, besides representing an ideal tool to investigate visuo-spatial attentive mechanisms in humans, has shown promising beneficial effects that might have an impact on clinical practice.


This paper reports a case study of acquired surface alexia in Spanish and discusses the most suitable tests to detect this syndrome in a writing system that is very regular for reading at the segmental and supra-segmental levels. Patient MM has surface alexia characterized by quantitatively good performance in reading words and pseudowords; accurate but slow and syllabic reading of words, nonwords and sentences; good performance in lexical decision tasks including words and nonwords; errors in lexical decision with pseudohomophones; and homophone confusions. This pattern of reading can be interpreted as a disorder in the lexical reading route and overdependence on the non-lexical route. We discuss nonlexical impairments and the interpretation of alexia and suggest tasks to identify surface alexia in a shallow orthography.


Pelvic and lower abdominal pain constitutes more than 30% of the referrals to our adolescent medicine and gastroenterology clinics. These cases are responsible for numerous school absences and significant cost to the healthcare system. This article will review the most common causes of lower abdominal and pelvic pain in adolescents, diagnostic and management issues, as well as prevention.


Obesity is associated with increase in mortality and morbidity due to renal dysfunction. Adipocyte cells are able to secrete different protein named adipokines. In obese subjects, the production and secretion of adipokines alter and these may affect renal homeostasis. More study in the effect of adipokines in progression of chronic kidney disease can help us to understand the pathophysiology and better management of kidney disease in obese patients.Journal of Nephropathology” discussed the relationship between obesity and renal function  have been completely observed by author.No funding from any source is directly associated with this manuscript.


The remodelling of the NHS requires a strong general practice nurse (GPN) workforce within general practice. The challenges facing general practice nursing are set within the current policy context and recent available evidence and illustrated by drawing upon the experience of a current GPN working in London. It is argued that there is a need to support the professional development of GPNs and nurture the next generation of potential GPNs if the current shortage of GPNs is to be addressed. General practice nurses (GPN) are integral to effective primary care but they are often neglected in discussions about the development of primary care and its workforce. There is a current shortage of GPNs in London and elsewhere and a third of current GPNs are expected to retire by 2020. The issues affecting the general practice nursing workforce are long standing and need addressing urgently so that its capacity and capabilities are maximised and the current shortfall remediated.The working conditions and professional development of GPNs require attention.The world of general practice nursing is changing. This article will draw on the experiences of a general practice nurse (GPN [CWB]) gained over the last five years through working in ten different general practices within London. GPNs are an essential component of primary care  and withFive Year Forward View  sets outThe Queen’s Nursing Institute (QNI)  surveyedThe QNI  survey aBaird et al.’s  recent sLike many GPNs, CWB’s entry from hospital nursing was serendipitous. CWB was confident and competent in cardiovascular disease and health promotion with her accident and emergency background and recent experience as a Borough smoking cessation advisor but she needed additional training in diabetes, asthma and chronic obstructive pulmonary disease.  A generaThere is little incentive for GPN nurses to do more courses especially independent prescribing which requires practice support and time to complete the required assessments. Independent prescribing would take a GPN to the next level of working as an Advanced Nurse Practitioner (ANP) but there is no guarantee of financial reward. Currently contracts do not routinely reflect the role and responsibilities of the GPN although they should be reviewed with the post-holder as the workload changes.  The exteSupport for continuing professional development (CPD) can be problematic with CW-B’s access to study days in the different practices varying from 0 to 4 while many of the better courses are 4–12 days in length. Further mandatory courses often compete with CPD both with their scheduling and approved absence for study/training. In 2014 the local Health Education England (South London HEE) sponsored free places on the postgraduate Train the Teachers course together with mentoring/coaching to support newly qualified nurses and student nurses in primary care but without recognising the constraints facing GPNs which included attendance at CGC mandatory and core role training before the end of March. The training included safeguarding in childhood and travel vaccinations study days, and updates in cervical cytology, diabetes, asthma, cancer, leg ulceration and mental health including Depot treatment. A GPN’s CPD may be further impeded by the October–March focus on the delivery of the QOF targets with the new national childhood immunisation schedule adding to the workload throughout the year.In order to become a practice teacher (to support student nurse learning) in primary care , a certified nurse teaching qualification must be completed which CWB undertook in her time. But like other CPD, because the GPs contend that as they have not asked for her to do the courses, there is no financial reward despite using her enhanced skill set at every available opportunity such as managing asthma patients. Additional constraints are the costs and scheduling of the courses. There are relevant e-learning courses and those offered through the Local Medical Committees but their cost is more than £500 which GPNs cannot afford. The timetabling of university based courses between October and March is also unhelpful. Few universities run courses over the summer months when GPNs have most availability and their course regulations are inflexible to the needs of those working in overstretched primary care where requirements for supervision of new skill development and certification of attained proficiency is challenging. The lack of accessibility to learning opportunities  underminMany GPNs are lone practitioners in their general practice and working part-time  adds to In some general practices the GPN may undertake minor injury work or surgery such as the removal of lumps and tags following Patient Group Directives. In another general practice the GPN may develop and support Expert Patient groups while in another practice the GPN may undertake work associated with district nursing such as visiting patients with the GP and sometimes on their own if the Patient Group Directives permit lone visits. Some GPNs have an ANP qualification and forget or lose their GPN skills so that an ANP will not test a urine sample referring their patients to the GPN!An added complexity is the power of the receptionist staff who may operate with or without the consent of GPs and may be relatives of key individuals making the organisational politics challenging for an ‘unrelated’ GPN. Indeed Hammond et al.  observedBeing a GPN is a challenging role because it is complex compared to many other nursing roles based in hospitals and other institutional settings. The role exists within an often hidden and mysterious general practice hierarchy with plenty of titles to confuse patients and sometimes the GPNs themselves. The new role of nursing associate  will onlThe time has come for GPs and policy makers to recognise the value of GPNs and establish a system which rewards them appropriately and nurtures their development. Many nurses become GPNs having worked as established hospital nurses with a wealth of knowledge but were unable to combine childcare and other caring responsibilities with hospital shift work. At a time of workforce shortages primary care cannot afford to waste opportunities to recruit a new generation of GPNs to replace those retiring by 2020 nor can primary care afford to ‘squander’ the potential talents of the current GPN workforce. Perhaps supporting ageing GPNs to mentor and provide placements for nursing students  so that The authors have no conflict of interest to declare.


The Trail Making Test and Digit Span are neuropsychological tests widely used to assess executive abilities following stroke. The Trails B and Digits Backward conditions of these tests are thought to be more sensitive to executive impairment related to frontal lobe dysfunction than the Trails A and Digits Forward conditions. Trails B and Digits Backward are also thought to be more sensitive to brain damage in general. Data from the Stroke and Lesion Registry maintained by the Washington University Cognitive Rehabilitation Research Group were analyzed to compare the effects of frontal versus nonfrontal strokes and to assess the effects of stroke severity. Results showed that the performance of patients with frontal and nonfrontal strokes was comparable in each condition of both the Trail Making Test and Digit Span, providing no support for the widely held belief that Trails B and Digits Backward are more sensitive to frontal lobe damage. Further, Trails A was as strongly correlated with stroke severity as Trails B, whereas Digits Backward was more strongly correlated with stroke severity than Digits Forward. Overall, the Trail Making Test and Digit Span are sensitive to brain damage but do not differentiate between patients with frontal versus nonfrontal stroke.


Advances in tactile cognition and haptics have increased our understanding of the multimodal nature of touch. Haptic data is mostly confined to human performance arising from the flexibility and dexterity of the fingers used to discriminate shapes and objects. Studies with infants indicate that recognition of objects either seen or held in the hand is possible during early periods of infancy. Evidence indicates performance differences between the hands decrease over periods of development, reflecting maturation of the cortical brain system supporting motor skills. Thus ability is not confined to the preferred hand. Tactile process and haptic cognition reflect hand ability. Studies examining manual performance must consider the relevance of haptics in research. Knowing about the evolution of the hands controlled by the cerebral hemispheres is of interest because it is a major contribution to the repertoire of human hand actions. The emergence of RDBM  is an important shift in the development of infant manual skills. Between 4 and 7 months of age, infants begin to manipulate objects using RDBM where one hand stabilized an object while the other hand manipulated the object. Understanding the affordance of a tool is an important cognitive milestone in early sensorimotor period that develops during the second year in full-term infants. This ability has also been demonstrated in preterm infants indicating the emergence of handedness during prenatal periods. Thus a multimodal approach that incorporates studies of tactile processes and hand actions may reveal their interactions with task demands and haptic ability. The subject of cognition in Psychology has evolved from Gestalt views of brain isomorphism to attributing information processing capacities and mental rotation abilities in the brain . StudiesThe study of haptics or active movement in touch , 2008 haFurthermore evidence indicates preattentive sensory processes during tactile searches as in vision, when stimulus characteristics such as sharp edges or angles pop out during contact . PlaisieKnowing about the evolution of hand use is important because it is a major contribution to existing lateralization and the repertoire of human hand actions. It is now established that brain lateralization is no longer confined to the human brain but exists among animals or the vertebrate species  and amonThe division of labor by the two hemispheres predates humankind by half a billion years . These aRecent studies show that there may be subtle functional differences between the hands . These aBy 4 months of age there is a division of labor between the hands, revealing better right hand performance for fine motor movements and left hand performance for spatial arrangement and haptic processing . These fThe emergence of RDBM is an important shift in the development of infant manual skills. In bimanual tasks differing in the precision of the movement required to remove pieces of paper from a stalk, the right hand was used more often than the left not only to grasp the object but also to remove pieces. Though infants do not anticipate the need of their preferred hand to remove pieces, they showed handedness in these coordinated bimanual tasks to a greater degree on those requiring precision grips than whole hand grip, indicating handedness develops early and is related to the precision required from the active hand . UnderstIn summary a multimodal approach that incorporates studies of tactile processes and hand actions may clarify interactive processes in the sense modality of touch. Task demands require interactive processes that are a combination of thought, movement and hand actions to produce the required response. Although tactile sensations are perceived during contact, lateralization and ability of the hand is reflected in the nature of the grip and force applied to the object by its fingers. The problem of producing devices that function like the human hand is mixed with challenges and insights. Since haptics has recently become important in robotics the results of such human-centered studies could be revealing.The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Biometrics has become an emerging field of technology due to its intrinsic security features concerning the identification of individuals by means of measurable biological characteristics. Two of the most promising biometric modalities are iris and retina recognition, which primarily use nonionizing radiation in the infrared region. Illumination of the eye is achieved by infrared light emitting diodes (LEDs). Even if few LED sources are capable of causing direct eye damage as they emit incoherent light, there is a growing concern about the possible use of LED arrays that might pose a potential threat. Exposure to intense coherent infrared radiation has been proven to have significant effects on living tissues. The purpose of this study is to explore the biological effects arising from exposing the eye to near infrared radiation with reference to international legislation.


The purpose of the data presented in this article is to use it in ex post estimations of interest rate decisions by the European Central Bank (ECB), as it is done by Bletzinger and Wieland (2017)  Specifications TableValue of the data•Real-time data of key macroeconomic variables of the euro area which allows an empirical assessment of monetary policy decisions based on data available to policy makers at the time of the decision.•Data is not distorted by later revisions based on hindsight information.•Either the raw data or the constructed data are constant-horizon forecasts of macroeconomic variables which allows an assessment of forward-looking monetary policy decisions.•Two different sources to construct the same set of forecast variables allows to check which data performs better in empirical assessments of policy decisions.1Bletzinger and Wieland 2One important aspect of the analysis by Bletzinger and Wieland The benchmark model in Bletzinger and Wieland The alternative model of Bletzinger and Wieland The full dataset containing the final data for the interest rate, inflation rate (SPF and ECB staff), real output growth rate (SPF and ECB staff) and potential output growth rate which are used in the estimation of Bletzinger and Wieland The projection exercises in Bletzinger and Wieland


To our knowledge, this is the first case of an arterial bleeding as a late complication 3 months after nephron sparing surgery of renal cell cancer, presumably originating from an arteriocalyceal fistula. Superselective embolization of the feeding arterial branch was chosen for treatment of the hemorrhage and proved successful. The high efficacy of superselective embolization as a minimally invasive procedure in this and other cases of bleeding Vessels should be the preferred method instead of open surgery.


The development of durable ventricular assist devices (VADs) has improved mortality rates and quality of life in patients with end stage heart failure. While the use of VADs has increased dramatically in recent years, there is limited experience with VAD implantation in patients with complex congenital heart disease (CHD), despite the fact that the number of patients with end stage CHD has grown due to improvements in surgical and medical care. VAD use has been limited in patients with CHD and end stage heart failure due to anatomic  and physiologic constraints (diastolic dysfunction). The total artificial heart (TAH), which has right and left sided pumps that can be arranged in a variety of orientations, can accommodate the anatomic variation present in CHD patients. This review provides an overview of the potential use of the TAH in patients with CHD. Ventricular assist devices (VADs) have been shown to improve mortality and quality of life in adults with refractory heart failure. This has led to a dramatic increase in VAD use among adults over the last decade , AbioCor , and CARMAT . The history of these devices and their clinical use has recently been reviewed  was developed for use in adults with end-stage heart failure who had a contraindication to LVAD or biventricular VAD (BiVAD)  or congenitally corrected transposition of the great arteries (ccTGA) carry a life-long risk of systemic right ventricular dysfunction  but does so with a low CVP, something rarely seen with VADs or even early after transplantation. It is this immediate improvement in cardiac output in the environment of a decongested venous system that may allow recovery of renal  and adolescents who are too small for the 70 cc TAH. Syncardia® has now developed a 50 cc pump which is 30% smaller by volume and is now enrolling children and adults in a bridge to transplant clinical study Figure . The stuThe last few decades have seen a dramatic improvement in clinical outcomes among patients with CHD. These improvements are most pronounced in young children and those with severe CHD (Moons et al., CV provided conception/design of the review, contributed to critical drafting and revision of the manuscript and provided final approval for the manuscript. DM provided conception/design of the review, contributed to critical drafting and revision of the manuscript and provided final approval for the manuscript.DM has served as a consultant for Syncardia. DM is also a consultant for HeartWare and Berlin Heart.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


There is an error in the last sentence of the Results section. The correct sentence is: Although PTSD was not significantly associated with injury group in the overall models, early amputation had a statistically significant  reduction in the likelihood of PTSD relative to limb salvage only during the first year after injury.


This data article represents academic performances of undergraduate students in a select Nigerian Private Tertiary institution from 2008 to 2013. The 2413 dataset categorizes students with respect to their origins (ethnicity), pre-university admission scores and Cumulative Grade Point Averages earned at the end of their study at the university. We present a descriptive statistics showing mean, median, mode, maximum, minimum, range, standard deviation and variance in the performances of these students and a boxplot representation of the performances of these students with respect to their origins. Specifications TableValue of the data•The data provided will shed more light on students learning outcomes based on ethnicity; by providing sample data reflecting students’ academic performance based on ethnic groups.•The data will provide empirical evidence confirming or refuting the impact of culture on students learning outcomes •The data will be useful to advise education stakeholders in Nigeria and West Africa on the influence of ethnicity on students learning outcomes.1The data presents a sample of students with respect to their origins from the six (6) geopolitical zones as identified by 2The data was retrieved from the department of records and the Center for systems and information services at Covenant University.


In this study, we describe an fMRI version of the verbal fluency test. This is the second in a series of fMRI adaptations of classical neuropsychological tests, for which normative samples of functional activation have been collected from unimpaired control subjects and structured in a manner that makes individual patient evaluation possible in terms of familiar z-score distributions. This fMRI protocol is shown to have strong convergent validity with the FAS phonemic fluency test and to elicit activation patterns highly consistent with a large body of previous neuroimaging studies of verbal fluency. We also present a case study, in which we report concurrent data from a patient with selective deficits in verbal processing, using both conventional neuropsychological and fMRI approaches. These analyses reveal striking correspondences between the deficits present in this patient on cognitive performance tests and the equally selective patterns of deviation present in his fMRI data.


The anorexia of aging was first recognized as a physiological syndrome 30 years ago. Its major causes are an alteration in fundal compliance with an increase in antral stretch and enhanced cholecystokinin activity leading to increased satiation.This anorexia leads to weight loss in aging persons and is one of the component causes of the aging related sarcopenia. This physiological anorexia also increases the risk of more severe anorexia when an older person has an increase in inflammatory cytokines such as occurs when they have an illness. This results in an increase in the anorexia due to cachexia in older persons. Anorexia is an important component of the cachexia syndromeFigureThe physiological anorexia of ageing places the older person at increased risk of severe anorexia and weight loss when they develop an illness associated with an increased in inflammatory cytokines or an increase in tumours producing lactate.The central regulation of feeding is a very complicated process.Sarcopenia is defined as the decline in function due to the loss of muscle mass.Persons with the anorexia of ageing are at risk of developing severe anorexia when exposed to high levels of inflammatory cytokines as occurs in the anorexia–cachexia syndrome.The data presented here support the concept that the anorexia of ageing is a major risk factor for older persons developing sarcopenia and/or cachexia. In addition, weight loss together with sarcopenia are major causes of the physical frailty syndrome.The author has no conflict of interest regarding this work.


Postoperative pseudoaneurysm formation is one of the most feared complications of pancreatic leak following pancreaticoduodenectomy (PD). Surgical repair may be compromised due to a persistent enzymatic insult on the repaired vessel; therefore, preventive measures should be adopted. We report a case of ruptured hepatic artery pseudoaneurysm occurring 12 days following PD in a patient with a postoperative pancreatic fistula. Emergency surgery revealed that the pseudoaneurysm was situated at the point of surgical transfixation of the gastroduodenal artery. The pseudoaneurysm was successfully managed by under-running of the bleeding point combined with the direct application of hemostatic products to the bleeding surface (TachoSil and Tisseel to act as a barrier from the pancreatic secretions.


Volume transmission (VT) is the diffusion through the brain extracellular fluid of neurotransmitters released at points that may be remote from the target cells with the resulting activation of extrasynaptic receptors. VT appears to play multiple roles in the brain in normal and abnormal activity, brain plasticity and drug actions. The relevance of VT to pain perception has been explored in this review.


To characterize the velocity slip at the fibrous porous media, data on the anisotropic slip length has been fully analyzed through direct simulations for various geometrical aspects of fiber architecture [2] ). This data article provides detailed slip lengths and slip coefficients in dimensionless form as a function of various geometrical parameters of fibrous porous media including the fiber volume fraction, the dimensionless void length and the normalized permeability. The data is presented for three different fiber packing structures  in both the fiber and normal to fiber directions. Finally a set of curves from the complete fitted equation set are also provided in a single figure that can be used to estimate the slip length and the normalized permeability for a given fibrous porous media. Specifications TableValue of the data•The data provided herein can be used to demonstrate the anisotropic interfacial slip in fibrous porous media in liquid composite molding.•The data provided here can be used to obtain two important characteristic parameters for flows in fibrous porous media: the anisotropic normalized permeability and the anisotropic interfacial slip length (or slip coefficients).•The data provided here can be used to construct the slip length tensor of the Navier-slip model, which replaces actual corrugated fibrous surfaces by an effective smooth boundary at the interface between fibrous porous media and fluid.•1−1] of Beavers and Joseph 2]. For the quadrilateral packing structure, Data in this article provides the dimensionless slip length f fibers . The fib d*=d/L1 , and the2Pressure-driven channel flows between a no-slip wall on the top and a fibrous porous media on the bottom were solved to estimate the slip length and slip coefficient, which is the most important parameter in describing flows within the dual-scale porous media. The Navier–Stokes equation is solved for the two problems: one is the computational solution for the actual fiber arrangement on the bottom and the other is the analytical solution with the effective slip boundary condition on the bottom. The slip length and slip coefficient can be evaluated by comparison of the two solutions. Extensive numerical simulations were performed to obtain the slip coefficient in the longitudinal (fiber) and transverse  directions are presented as a function of various geometrical parameters of fibrous porous media including the fiber packing structure, the fiber volume fraction, the dimensionless void length and the normalized permeability. By the mesh refinement study, the accuracy more than three significant digits were ensured in estimating the slip length and slip coefficient. The three different fiber packing structures are presented in As was discussed in Ref. From the data on the slip length and slip coefficient presented in The normalized permeability in both directions can be fitted also as follows:In the above equations, the symbols