Urological infections after endourological procedures

In the past two decades, endourological procedures such as ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) have become the mainstay of managing kidney stone disease (KSD), with URS also used for investigating upper urinary tract lesions. Post-endourological infections affect between 1% and 6% of cases. Numerous risk factors have been identified, including longer operative times and indwelling ureteric stents, but the literature is largely heterogeneous. Identification of risk factors preoperatively include the use of pre-operative urine culture, minimizing stent dwell time and targeted antibiotic use. Intraoperatively, efforts need to be made in minimizing operative times and intra-renal pressures. Although rare, urinary tract infections following endourological procedures remain a risk, with a smaller minority developing potentially deadly urosepsis. Clinical decisions on prevention and treatment of severe sepsis have to be individualized based on the risk factors. Machine learning techniques are currently being utilized to build these tools and might provide an answer in the future.     

经皮肾镜气压弹道超声碎石在肾结石中的效果

目的 B超引导经皮肾镜气压弹道超声联合碎石治疗肾结石的临床效果。方法选择2017年9月-2018年9月医院收治的肾结石患者82例,按照抽签法的要求将其平均分成对照组(41例:B超引导经皮肾镜气压弹道超声治疗)与试验组(41例:输尿管软镜治疗),分析手术时间、住院时间、出血量、结石清除率、结石的残留率。结果试验组的手术时间、住院时间、出血量。优于对照组,数据比较有差异性,P<0.05。对照组的结石清除率高于试验组、结石的残留率低于试验组,相互比较有差异性,P<0.05。结论在肾结石实际治疗期,使用输尿管软镜钬激光碎石治疗方式。     

Gender equity: how do the forensic sciences fare?

ABSTRACT

Females are underrepresented in science, technology, engineering and mathematics (STEM) at all levels of society. Fewer females are completing STEM school subjects, graduating with STEM degrees, being employed as STEM professionals, and holding senior leadership and academic positions in STEM. However, unlike almost every other STEM discipline, the overall ratio of females is higher in many forensic science disciplines. For our sector, rather than having difficulty in attracting females, the bigger issue is how we retain and promote female talent. This complex issue is exacerbated by: gender pay gaps; family role expectations; lack of visible role models or mentors; discrimination and harassment; and bias during recruitment and promotion practices. We discuss barriers relevant for women in the forensic industry and offer potential solutions. These include flexible work arrangements, sponsorship programmes, and fostering and practising an inclusive workplace culture. Gender equity programmes and exemplar STEM organizations focused on a commitment to gender parity will be explored. Harnessing untapped female talent is as much a social justice issue as employing best practices for improving the quality, diversity and output of our forensic science workforce, and research and innovation strategies.     

Young children in day and night care: negotiating and constructing belonging during daily arrivals

The paper aims at understanding the processes related to young children's belonging during daily arrivals at day and night care. Two aspects of a child's belonging are considered: membership and sense of belonging. Data were gathered by ethnographic observation of 8 children aged from 20 to 36 months in two Finnish day care centres offering day and night care. Arrival episodes taking place at different times of day were analysed qualitatively based on the children's actions and expressions. During these episodes, the children negotiated and constructed their belonging by interacting with adults, peers and material objects. These interactions took place within varying social and material surroundings and according to different daily routines that sometimes challenged the child's belonging. The results underline the importance of sensitive responsiveness by educators to young children's initiatives in supporting children's belonging during daily arrivals at day and night care.     

内镜柔性器械腱鞘传动模型及实验研究

目的 建立内镜柔性器械腱鞘系统的推力传动模型，研究影响传动效率的关键因素。方法 建立腱鞘系统在器械推送作用下力和位移的传动模型并进行仿真计算；搭建腱鞘系统传动测试的实验平台以验证模型的准确性，研究传动速度、腱鞘直径比、弯曲半径等对传动效率的影响。结果 腱鞘传动过程中存在显著的非线性传递现象，传动模型仿真与实验结果基本符合；传动速度、腱鞘直径比、弯曲半径均对内镜柔性器械的推力传动有较大影响，对位移传动的影响相对小一些。结论 该模型可用于内镜柔性器械中腱鞘系统推力传动的计算，提供给医生器械工作末端的力反馈，以保证器械的安全操作和提高手术效果；在内镜柔性器械的精准控制中需要综合考虑传动速度、腱鞘传动比、弯曲半径等对运动传递的影响。