Screening for albuminuria in diabetes:the need to do more

Aims: To reassess the utilisation rate of urinary albumin to creatinine ratio (ACR) screening in our centre; and the rate of repeat testing, where appropriate. To look at risk factors for albuminuria in our outpatient population. Methods: All patients attending one of our two weekly diabetes outpatient clinics in 2011–2012 were enrolled in this study. Demographic and relevant clinical data were extracted from electronic care records and analysed using SPSS 21. Results: Our study cohort comprised 998 people (51.4% men;59.6% White, 30.5% Southeast Asian, 9.9% Afro-Caribbean),most of whom had Type 2 diabetes (82.6%). The ACR testing rate in our centre was 62.8% (2012–2013 data; previously 62.4%). The incidence of initial albuminuria was 32.2% in women vs42.8% in men. Just 48.7% of patients (44.4% of women, 51.8% of men) with initial albuminuria were retested: 36.4% of women and 19.7% of men with initial albuminuria had no evidence of this on follow-up. Logistic regression modelling confirmed an association of high systolic blood pressure with albuminuria [odds ratio1.92 (1.01–3.70 in women, 1.08–3.57 in men)]. Treatment with anangiotens in converting enzyme inhibitor (ACEi) or angiotens in 2 receptor blocker (A2RB) was negatively associated with albuminuria in men [odds ratio 0.42 (0.20–0.89)], but not in women. Conclusions: A relatively high, albeit suboptimal, albuminuria screening rate in our outpatient population has been sustained.High systolic blood pressure was confirmed as a risk factor foralbuminuria. The incidence of albuminuria was higher in men, who had a lower rate of negative repeat testing and appeared to benefit more from ACEi/A2RB therapy. More rigorous screening for albuminuria is warranted to identify at-risk individuals.

(Table 3) Reduced inorganic sulphur, d34S and nickel content of ODP Leg 165 sites

Leg 165 of the Ocean Drilling Program afforded a unique opportunity to investigate organic and inorganic geochemistry across a wide gradient of sediment compositions and corresponding chemical pathways. The solid fractions at Sites 998, 999, 1000, and 1001 reveal varying proportions of reactive carbonate species, a labile volcanic ash fraction occurring in discrete layers and as a dispersed component, and detrital fluxes that derive from continental weathering. The relative proportions and reactivities of these end-members strongly dictate the character of the diagenetic profiles observed during the pore-water work of Leg 165. In addition, alteration of the well-characterized basaltic basement at Site 1001 has provided a strong signal that is reflected in many of the dissolved components. The relative effects of basement alteration and diagenesis within the sediment column are discussed in terms of downcore relationships for dissolved calcium and magnesium. With the exception of Site 1002 in the Cariaco Basin, the sediments encountered during Leg 165 were uniformly deficient in organic carbon (typically <0.1 wt%). Consequently, rates of organic oxidation were generally low and dominated by suboxic pathways with subordinate levels of bacterial sulfate reduction and methanogenesis. The low rates of organic remineralization are supported by modeled rates of sulfate reduction. Site 1000 provided an exception to the generally low levels of microbially mediated redox cycling. At this site the sediment is slightly more enriched in organic phases, and externally derived thermogenic hydrocarbons appear to aid in driving enhanced levels of redox diagenesis at great depths below the seafloor. The entrapment of these volatiles corresponds with a permeability seal defined by a pronounced Miocene minimum in calcium carbonate concentration recognized throughout the basin and with a dramatic downcore increase in the magnitude of limestone lithification. The latter has been tentatively linked to increases in alkalinity associated with microbial oxidation of organic matter and gaseous hydrocarbons. Recognition and quantification of previously unconstrained large volumes and frequencies of Eocene and Miocene silicic volcanic ash within the Caribbean Basin is one of the major findings of Leg 165. High frequencies of volcanic ash layers manifest as varied but often dominant controls on pore-water chemistry. Sulfur isotope results are presented that speak to secondary metal and sulfur enrichments observed in ash layers sampled during Leg 165. Ultimately, a better mechanistic understanding of these processes and the extent to which they have varied spatially and temporally may bear on the global mass balances for a range of major and minor dissolved components of seawater.

A Virtual Joystick as a Novel Interaction Modality for Surgeon-Computer Interaction During Computer-Assisted Surgical Procedures

Interacting with a computer system in the operating room (OR) can be a frustrating experience for a surgeon, who currently has to verbally delegate to an assistant every computer interaction task. This indirect mode of interaction is time consuming, error prone and can lead to poor usability of OR computer systems. This thesis describes the design and evaluation of a joystick-like device that allows direct surgeon control of the computer in the OR. The device was tested extensively in comparison to a mouse and delegated dictation with seven surgeons, eleven residents, and five graduate students. The device contains no electronic parts, is easy to use, is unobtrusive, has no physical connection to the computer and makes use of an existing tool in the OR. We performed a user study to determine its effectiveness in allowing a user to perform all the tasks they would be expected to perform on an OR computer system during a computer-assisted surgery. Dictation was found to be superior to the joystick in qualitative measures, but the joystick was preferred over dictation in user satisfaction responses. The mouse outperformed both joystick and dictation, but it is not a readily accepted modality in the OR.

'A Kind of Logic, A Kind of Dominant Logic': Navigating Colonialism, Honoring Black Mobility, and Thinking on Moving Through

My thesis thinks through the ways Newtonian logics require linear mobility in order to produce narratives of progress. I argue that this linear mobility, and the resulting logics, potentially erases the chaotic and non-linear motions that are required to navigate a colonial landscape. I suggest that these non-linear movements produce important critiques of the seeming stasis of colonial constructs and highlight the ways these logics must appear neutral and scientific in an attempt to conceal the constant and complex adjustments these frameworks require. In order to make room for these complex motions, I develop a quantum intervention. Specifically, I use quantum physics as a metaphor to think through the significance of black life, the double-consciousness ofland, and the intricate motions of sound. In order to put forth this intervention, I look at news coverage of Hurricane Katrina, Du Bois’s characterization of land in Souls of Black Folks, and the aural mobilities of blackness articulated in an academic discussion and interview about post- humanism.

Governmentality gone wild: How the separation of sex workers from 'communities' contributes to violence against sex workers

Sex workers are members of our communities, whether they are local or national communities. In law, mainstream media representations, and research sex workers are positioned as outside of or in opposition to communities. Even within marginalized communities sex workers are excluded when appeals to respectability politics are made. In this thesis I analyze three analytic sites from three areas of social life. The first chapter performs a textual analysis of The Bedford Decision (2013) and the resulting Protection of Communities and Exploited Persons Act (2014) as an examination of law. The second chapter is an analysis of filmic discourse on community, sex workers, and violence in the mainstream film London Road (2015) as an examination of mainstream media. The third chapter draws upon empirical research, i.e. in-depth interviews with three current and former sex workers in Ottawa, Canada and analyzes the transcripts using interpretative phenomenological analysis (IPA) to center how sex workers’ understanding of their work, community, and the laws and policies that are supposed govern and protect them. In my preface and conclusion I discuss some of the ethical dilemmas I encountered while conducting this research. My findings suggest that sex workers are being positioned and understood as outside of communities in ways that contribute to violence against sex workers. The implications of this research suggest that people who speak in the name of communities—communities in the sense of local neighborhood communities, activist communities, and national communities—need to recognize that sex workers are part of their communities and be accountable to ensuring they are treated as members. Researchers who conduct research on sex work and sex workers need to be accountable to their participants and the impacts their research may have on laws and policies. Sex workers are an over-researched population yet their voices are largely misappropriated or silenced in popular research and policy debates.

British Romantic Criticism and the Fine Arts: A Study in Philosophical Theories of Literary Unity

This dissertation is an exploration of how a small but important group of Romantic critics, finding fault in the ideal of three unities developed by neoclassical Academicians and wrongly attributed to Aristotle, turned to the terminology and practices of the fine arts to emphasize their conception of organic unity in literature. The Romantic analogy to painting in particular enables a philosophical criticism of literature to present the aesthetic semblance of painting, the comprehension of a multitude of details in a harmonious whole that is a natural unity to its medium, as a paradigm of modern-romantic poetry and its aspirations to similar complexity, particularity, and imaginative colour. Further, in extension of the French Querelle des anciens et des modernes of the seventeenth century, the division of ancient and romantic art by Romantic critics like August Schlegel, Samuel Taylor Coleridge, and William Hazlitt not only establishes an ethnological and historical difference between the artistic productions of these two cultural periods but also allows, unlike the neoclassical unities, a non-anachronistic philosophical vocabulary of whole and parts or of the general and particular in the criticism of poetry, which involution provides a “rule” more consonant with the laws of the imagination rather than with the rhetorical and absolutist dicta that were thither available in the literary canon.

Rethinking Care Through Social Reproduction: Articulating Circuits of Migration

Care has come to dominate much feminist research on globalized migrations and the transfer of labor from the South to the North, while the older concept of reproduction had been pushed into the background but is now becoming the subject of debates on the commodification of care in the household and changes in welfare state policies. This article argues that we could achieve a better understanding of the different modalities and trajectories of care in the reproduction of individuals, families, and communities, both of migrant and nonmigrant populations by articulating the diverse circuits of migration, in particular that of labor and the family. In doing this, I go back to the earlier North American writing on racialized minorities and migrants and stratified social reproduction. I also explore insights from current Asian studies of gendered circuits of migration connecting labor and marriage migrations as well as the notion of global householding that highlights the gender politics of social reproduction operating within and beyond households in institutional and welfare architectures. In contrast to Asia, there has relatively been little exploration in European studies of the articulation of labor and family migrations through the lens of social reproduction. However, connecting the different types of migration enables us to achieve a more complex understanding of care trajectories and their contribution to social reproduction.

Anclaje, dinámicas e impactos territoriales de la cadena global de cítricos dulces en el nordeste argentino

El artículo analiza firmas insertas en circuitos globalizados de exportación de frutas frescas, así como la interfase empresas-territorios. Se focaliza en la producción argentina de cítricos dulces y particularmente en un espacio productivo, y se interesa por cómo se traduce la construcción de los circuitos globales en los espacios y actores locales. Para ello, desarrolla una tipología de empresas e indicadores de anclaje y recurre a una combinación de fuentes cuantitativas y cualitativas, con vistas a desentrañar la “caja negra” del comportamiento empresarial. Se concluye que existen diferentes grados de anclaje territorial y combinaciones variables de fijación y movilidad por parte de las empresas. La adopción de una modalidad de agricultura empresarial multilocalizada, orientada al aprovechamiento de las peculiaridades de los diferentes ambientes locales, conduce a la desarticulación de espacios en función de sus características productivas y de sus diversos contextos sociales e institucionales. De esta forma se promueve la conformación de agentes de características flexibles, transformando su reproducción en contingente.

A state-of-the-art review and feasibility analysis of high altitude wind power in Northern Ireland

In many countries wind energy has become an indispensable part of the electricity generation mix. The opportunity for ground based wind turbine systems are becoming more and more constrained due to limitations on turbine hub heights, blade lengths and location restrictions linked to environmental and permitting issues including special areas of conservation and social acceptance due to the visual and noise impacts. In the last decade there have been numerous proposals to harness high altitude winds, such as tethered kites, airfoils and dirigible based rotors. These technologies are designed to operate above the neutral atmospheric boundary layer of 1,300 m, which are subject to more powerful and persistent winds thus generating much higher electricity capacities. This paper presents an in-depth review of the state-of-the-art of high altitude wind power, evaluates the technical and economic viability of deploying high altitude wind power as a resource in Northern Ireland and identifies the optimal locations through considering wind data and geographical constraints. The key findings show that the total viable area over Northern Ireland for high altitude wind harnessing devices is 5109.6 km2, with an average wind power density of 1,998 W/m2 over a 20-year span, at a fixed altitude of 3,000 m. An initial budget for a 2MW pumping kite device indicated a total cost £1,751,402 thus proving to be economically viable with other conventional wind-harnessing devices.

CURB-65 and Other Markers of Illness Severity in Community-Acquired Pneumonia Among HIV-Positive Patients

As the relative burden of community-acquired bacterial pneumonia among HIV-positive patients increases, adequate prediction of case severity on presentation is crucial. We sought to determine what characteristics measurable on presentation are predictive of worse outcomes. We studied all admissions for community-acquired bacterial pneumonia over one year at a tertiary centre. Patient demographics, comorbidities, HIV-specific markers and CURB-65 scores on Emergency Department presentation were reviewed. Outcomes of interest included mortality, bacteraemia, intensive care unit admission and orotracheal intubation. A total of 396 patients were included: 49 HIV-positive and 347 HIV-negative. Mean CURB-65 score was 1.3 for HIV-positive and 2.2 for HIV-negative patients (p < 0.0001), its predictive value for mortality being maintained in both groups (p = 0.03 and p < 0.001, respectively). Adjusting for CURB-65 scores, HIV infection by itself was only associated with bacteraemia (adjusted odds ratio [AOR] 7.1, 95% CI [2.6-19.5]). Patients with < 200 CD4 cells/µL presented similar CURB-65 adjusted mortality (aOR 1.7, 95% CI [0.2-15.2]), but higher risk of intensive care unit admission (aOR 5.7, 95% CI [1.5-22.0]) and orotracheal intubation (aOR 9.1, 95% CI [2.2-37.1]), compared to HIV-negative patients. These two associations were not observed in the > 200 CD4 cells/µL subgroup (aOR 2.2, 95% CI [0.7-7.6] and aOR 0.8, 95% CI [0.1-6.5], respectively). Antiretroviral therapy and viral load suppression were not associated with different outcomes (p > 0.05). High CURB-65 scores and CD4 counts < 200 cells/µL were both associated with worse outcomes. Severity assessment scales and CD4 counts may both be helpful in predicting severity in HIV-positive patients presenting with community-acquired bacterial pneumonia.

Análisis del énfasis en la innovación en la implantación del "Middle-Up-Down Management Model": Un estudio evolutivo en las empresas manufactureras del País Vasco. Aspectos metodológicos y empíricos

Nos encontramos en un momento en el que la competitividad empresarial está fundamentada en el desarrollo de las Tecnologías de Información y Comunicación (TIC), la innovación y las personas. Concretamente, en el País Vasco, que cuenta con un importante número de empresas manufactureras, la globalización, los procesos de deslocalización y de cambio organizacional han forzado aprestar una atención especialmente estratégica al desarrollo de la innovación y de la gestión del conocimiento como fundamentos para el incremento de su capacidad competitiva. El estudio que aquí presentamos analiza, desde un punto de vista evolutivo, la influencia que ejerce el énfasis realizado por las empresas manufactureras vascas en la innovación y en la implantación de sistemas de gestión que favorezcan la generación de nuevo conocimiento. Sistemas de gestión que deberán estar acordes con las propuestas de Nonaka y Takeuchi (1995); Nonaka et al. (2003) y sintetizadas en el llamado Middle-up-down Management Model. Para este análisis, hemos partido de una importante investigación realizada por las doctoras Aramburu, Sáenz1 y Rivera, de la Universidad de Deusto, de San Sebastián, sobre la Medición de la capacidad de aprendizaje organizativo y valoración de su incidencia en los resultados económico-financieros en las empresas manufactureras del País Vasco (2005).

Guia de análises microbiológicas para cortes de aves in natura: elaboração e aplicação prática

An effective hygiene and sanitation inspection of meat and meat products is essential for its production and commercialization. For this reason, the national and international standards responsible for these products quality control employs microbiological analyses methods as quality control tools. In December of 2012, it was included in the Ministério da Agricultura Pecuária e Abastecimento (MAPA) website, a Microbiological Scope of food and water, which presents the replacement of some methods proposed by the Normative Instruction 62. Some of these methodologies are considered rapid, practical and convenient. However, other methodologies were still replaced by conventional ones, which presents disadvantages as incorrect interpretations of the microorganism phenotypical and biochemical characteristics, leading to the misinterpretation of test results. Therefore, the objective of this study is to develop a comprehensive, practical and illustrative guidebook of microbiological analysis for in natura poultry cuts. The methods addressed in this guide are the official standards analysis required by the poultry cuts legislation, which are the Escherichia coli count, the thermotolerant coliforms count, the aerobic plate count and the detection of Salmonella spp. The approached methodologies for these analysis will be the AOAC 998.08, the Normative Instruction 62 and the ISO 4833-1:2013 and ISO 6579:2002, respectively. In these events, it is expected to obtain an enlightening and approved guidebook evaluated by laboratory technicians, which will help reduce the analytical subjectivity leading to a more reliable interpretation of the test results.

Lucretius: the Wonderer

I seek to create a Lucretius text useful for a high school classroom including a commentary on four sections of the poem. The passages include 2.998 – 1047 which explains how the Epicurean atomic theory, 3.912—979 the famous passage that denies the underworld and its tortures, 5.855 – 923 the semi-Darwinian passage detailing the sorts of creatures that can exist in this world, and 5.1194– 1240 about the detrimental effects of humans fearing gods. In addition to writing a commentary on these passages, I will explore the perception of Lucretius though the present day, in hopes of discovering how and why this important and influential author has been so systematically excluded from secondary latin literary studies. My discussion will include an overview of how modern Latin textbooks do or do not mention Lucretius and how his presence in these textbooks compares to his role in university-level Latin course offerings. In addition to writing a commentary on these passages, I will explore the perception of Lucretius though the present day, in hopes of discovering how and why this important and influential author has been so systematically excluded from secondary latin literary studies. My discussion will include an overview of how modern Latin textbooks do or do not mention Lucretius and how his presence in these textbooks compares to his role in university-level Latin course offerings. I am hoping this research will be useful both pedagogically and for learning how decisions about literary content are made in American secondary and higher education in Latin.