932 resultados para Medical Negligence and Failure to Warn


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Visual content is a critical component of everyday social media, on platforms explicitly framed around the visual (Instagram and Vine), on those offering a mix of text and images in myriad forms (Facebook, Twitter, and Tumblr), and in apps and profiles where visual presentation and provision of information are important considerations. However, despite being so prominent in forms such as selfies, looping media, infographics, memes, online videos, and more, sociocultural research into the visual as a central component of online communication has lagged behind the analysis of popular, predominantly text-driven social media. This paper underlines the increasing importance of visual elements to digital, social, and mobile media within everyday life, addressing the significant research gap in methods for tracking, analysing, and understanding visual social media as both image-based and intertextual content. In this paper, we build on our previous methodological considerations of Instagram in isolation to examine further questions, challenges, and benefits of studying visual social media more broadly, including methodological and ethical considerations. Our discussion is intended as a rallying cry and provocation for further research into visual (and textual and mixed) social media content, practices, and cultures, mindful of both the specificities of each form, but also, and importantly, the ongoing dialogues and interrelations between them as communication forms.

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Radiation therapy (RT) plays currently significant role in curative treatments of several cancers. External beam RT is carried out mostly by using megavoltage beams of linear accelerators. Tumor eradication and normal tissue complications correlate to dose absorbed in tissues. Normally this dependence is steep and it is crucial that actual dose within patient accurately correspond to the planned dose. All factors in a RT procedure contain uncertainties requiring strict quality assurance. From hospital physicist´s point of a view, technical quality control (QC), dose calculations and methods for verification of correct treatment location are the most important subjects. Most important factor in technical QC is the verification that radiation production of an accelerator, called output, is within narrow acceptable limits. The output measurements are carried out according to a locally chosen dosimetric QC program defining measurement time interval and action levels. Dose calculation algorithms need to be configured for the accelerators by using measured beam data. The uncertainty of such data sets limits for best achievable calculation accuracy. All these dosimetric measurements require good experience, are workful, take up resources needed for treatments and are prone to several random and systematic sources of errors. Appropriate verification of treatment location is more important in intensity modulated radiation therapy (IMRT) than in conventional RT. This is due to steep dose gradients produced within or close to healthy tissues locating only a few millimetres from the targeted volume. The thesis was concentrated in investigation of the quality of dosimetric measurements, the efficacy of dosimetric QC programs, the verification of measured beam data and the effect of positional errors on the dose received by the major salivary glands in head and neck IMRT. A method was developed for the estimation of the effect of the use of different dosimetric QC programs on the overall uncertainty of dose. Data were provided to facilitate the choice of a sufficient QC program. The method takes into account local output stability and reproducibility of the dosimetric QC measurements. A method based on the model fitting of the results of the QC measurements was proposed for the estimation of both of these factors. The reduction of random measurement errors and optimization of QC procedure were also investigated. A method and suggestions were presented for these purposes. The accuracy of beam data was evaluated in Finnish RT centres. Sufficient accuracy level was estimated for the beam data. A method based on the use of reference beam data was developed for the QC of beam data. Dosimetric and geometric accuracy requirements were evaluated for head and neck IMRT when function of the major salivary glands is intended to be spared. These criteria are based on the dose response obtained for the glands. Random measurement errors could be reduced enabling lowering of action levels and prolongation of measurement time interval from 1 month to even 6 months simultaneously maintaining dose accuracy. The combined effect of the proposed methods, suggestions and criteria was found to facilitate the avoidance of maximal dose errors of up to even about 8 %. In addition, their use may make the strictest recommended overall dose accuracy level of 3 % (1SD) achievable.

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In 2015, Victoria passed laws removing the time limit in which a survivor of child sexual abuse can commence a civil claim for personal injury. The law applies also to physical abuse, and to psychological injury arising from those forms of abuse. In 2016, New South Wales made almost identical legal reforms. These reforms were partly motivated by the recommendations of inquiries into institutional child abuse. Of particular relevance is that the Australian Royal Commission Into Institutional Responses to Child Sexual Abuse recommended in 2015 that all States and Territories remove their time limits for civil claims. This presentation explores the problems with standard time limits when applied to child sexual abuse cases (whether occurring within or beyond institutions), the scientific, ethical and legal justifications for lifting the time limits, and solutions for future law reform.

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The addition reactions of alcohols, ROH (R = CH3, C2H5 n-C3H7, i-C3H7 and t-C4H9), to p-bromophenylisothiocyanate show that the rates decrease in the order, CH3OH> C2H5OH> n-C3H7OH> i-C3H7OH> t-C4H9OH, although the basicities of the alcohols vary in the reverse order. The results indicate the greater importance of steric factors as compared with polar factors. Evidence is also presented for the formation of a complex between the isothiocyanate and the alcohol in the first stage of the addition reaction. In the addition of aniline to substituted phenylisothiocyanates the rate data give a satisfactory linear correlation with Hammett σ constants and the results clearly show that electron-withdrawing groups favour the addition reaction. The addition of aniline to alkyl isothiocyanates have been studied in order to find out the nature of alkyl group interaction in these derivatives. Kinetic studies on the addition of substituted anilines to phenylisothiocyanate show that the rate of reaction increases with the electron-donating ability of the substituents on the aniline as also the basicity of the aniline.

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In this paper, we have first given a numerical procedure for the solution of second order non-linear ordinary differential equations of the type y″ = f (x;y, y′) with given initial conditions. The method is based on geometrical interpretation of the equation, which suggests a simple geometrical construction of the integral curve. We then translate this geometrical method to the numerical procedure adaptable to desk calculators and digital computers. We have studied the efficacy of this method with the help of an illustrative example with known exact solution. We have also compared it with Runge-Kutta method. We have then applied this method to a physical problem, namely, the study of the temperature distribution in a semi-infinite solid homogeneous medium for temperature-dependent conductivity coefficient.

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Tau is mainly distributed in cytoplasm and also found to be localized in the nucleus. There is limited data on DNA binding potential of Tau.We provide novel evidence on nicking of DNA by Tau. Tau nicks the supercoiled DNA leading to open circular and linear forms. The metal ion magnesium (a co-factor for endonuclease) enhanced the Tau DNA nicking ability, while an endonuclease specific inhibitor,aurinetricarboxylic acid (ATA) inhibited the Tau DNA nicking ability Further, we also evidenced that Tau induces B-C-A mixed conformational transition in DNA and also changes DNA stability. Tau-scDNA complex is more sensitive to DNAse I digestion indicating stability changes in DNA caused by Tau. These findings indicate that Tau alters DNA helicity and integrity and also nicks the DNA. The relevance of these novel intriguing findings regarding the role Tau in neuronal dysfunction is discussed. (C) 2010 Elsevier Ltd. All rights reserved.

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Isoselenocyanates derived from Boc/Z-amino acids are prepared by the reaction of the corresponding isonitriles with selenium powder in presence of triethylamine at reflux. The utility of these new classes of isoselenocyanates in the preparation of selenoureidodipeptidomimetics possessing both amino as well as carboxy termini has been accomplished. The H-1 NMR analysis confirmed that the protocol involving the conversion of isonitriles to isoselenocyanates and their use as coupling agents in assembling selenour-eido derivatives is free from racemization. (C) 2010 Elsevier Ltd. All rights reserved.

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A solution for the stresses and displacements in an radially infinite thick plate having a circular hole, one face of which resting on a smooth rigid bed and the other face subjected to axisymmetric normal loading is given. The solution is obtained in terms of Fourier-Bessel series and integral for the Love's stress function. Numerical results are presented for one particular ratio of thickness of plate to the hole radius and loading. It is also shown that the Poisson's ratio has a predominant effect on certain stresses and displacements. The solution would be useful in the stress analysis of bolted joints.Eine Lösung für die Spannungen und Verschiebungen in einer radial, unendlich ausgedehnten, dicken Platte mit einem kreisförmigen Loch, wobei eine Seite auf einer ebenen, starren Unterlage aufliegt, die andere Seite durch eine achsensymmetrische Vertikallast belastet ist, wird angegeben. Die Lösung wird in Form von Fourier-Bessel-Reihen und Integralen der Loveschen Spannungsfunktion angegeben. Numerische Ergebnisse werden für ein bestimmtes Verhältnis der Plattendicke zum Lochradius sowie zur Belastung angegeben. Es wird auch gezeigt, daß das Poisssonsche Verhältnis einen besonderen Einfluß auf bestimmte Spannungen und Verschiebungen hat. Die Lösung ist anwendbar für die Spannungsermittlung von Bolzenverbindungen.

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Uveal melanoma (UM) is the second most common primary intraocular cancer worldwide. It is a relatively rare cancer, but still the second most common type of primary malignant melanoma in humans. UM is a slowly growing tumor, and gives rise to distant metastasis mainly to the liver via the bloodstream. About 40% of patients with UM die of metastatic disease within 10 years of diagnosis, irrespective of the type of treatment. During the last decade, two main lines of research have aimed to achieve enhanced understanding of the metastasis process and accurate prognosis of patients with UM. One emphasizes the characteristics of tumor cells, particularly their nucleoli, and markers of proliferation, and the other the characteristics of tumor blood vessels. Of several morphometric measurements, the mean diameter of the ten largest nucleoli (MLN) has become the most widely applied. A large MLN has consistently been associated with high likelihood of dying from UM. Blood vessels are of paramount importance in metastasis of UM. Different extravascular matrix patterns can be seen in UM, like loops and networks. This presence is associated with death from metastatic melanoma. However, the density of microvessels is also of prognostic importance. This study was undertaken to help understanding some histopathological factors which might contribute to developing metastasis in UM patients. Factors which could be related to tumor progression to metastasis disease, namely nucleolar size, MLN, microvascular density (MVD), cell proliferation, and The Insulin-like Growth Factor 1 Receptor(IGF-1R), were investigated. The primary aim of this thesis was to study the relationship between prognostic factors such as tumor cell nucleolar size, proliferation, extravascular matrix patterns, and dissemination of UM, and to assess to what extent there is a relationship to metastasis. The secondary goal was to develop a multivariate model which includes MLN and cell proliferation in addition to MVD, and which would fit better with population-based, melanoma-related survival data than previous models. I studied 167 patients with UM, who developed metastasis even after a very long time following removal of the eye, metastatic disease was the main cause of death, as documented in the Finnish Cancer Registry and on death certificates. Using an independent population-based data set, it was confirmed that MLN and extravascular matrix loops and networks were unrelated, independent predictors of survival in UM. Also, it has been found that multivariate models including MVD in addition to MLN fitted significantly better with survival data than models which excluded MVD. This supports the idea that both the characteristics of the blood vessels and the cells are important, and the future direction would be to look for the gene expression profile, whether it is associated more with MVD or MLN. The former relates to the host response to the tumor and may not be as tightly associated with the gene expression profile, yet most likely involved in the process of hematogenous metastasis. Because fresh tumor material is needed for reliable genetic analysis, such analysis could not be performed Although noninvasive detection of certain extravascular matrix patterns is now technically possible,in managing patients with UM, this study and tumor genetics suggest that such noninvasive methods will not fully capture the process of clinical metastasis. Progress in resection and biopsy techniques is likely in the near future to result in fresh material for the ophthalmic pathologist to correlate angiographic data, histopathological characteristics such as MLN, and genetic data. This study supported the theory that tumors containing epithelioid cells grow faster and have poorer prognosis when studied by cell proliferation in UM based on Ki-67 immunoreactivity. Cell proliferation index fitted best with the survival data when combined with MVD, MLN, and presence of epithelioid cells. Analogous with the finding that high MVD in primary UM is associated with shorter time to metastasis than low MVD, high MVD in hepatic metastasis tends to be associated with shorter survival after diagnosis of metastasis. Because the liver is the main organ for metastasis from UM, growth factors largely produced in the liver hepatocyte growth factor, epidermal growth factor and insulin-like growth factor-1 (IGF-1) together with their receptors may have a role in the homing and survival of metastatic cells. Therefore the association between immunoreactivity for IGF-1R in primary UM and metastatic death was studied. It was found that immunoreactivity for IGF-IR did not independently predict metastasis from primary UM in my series.