From Discipline to Quality of Care: How Neurologists Can Learn from Decisions of Disciplinary Tribunals

<b><i>Background:</i></b> One of the primary aims of medical disciplinary law is to improve the quality of care. However, the decisions of disciplinary tribunals are not sufficiently analysed to identify the learning elements. <b><i>Aim:</i></b> This study aimed to investigate the frequency and nature of complaints for the specialty neurology which were upheld by the disciplinary tribunals and to learn from disciplinary law through an analysis of which factors contributed to complaints being upheld. <b><i>Design:</i></b> This is a retrospective, observational study. <b><i>Methods:</i></b> All upheld complaints in the field of neurology were collected for the period of January 1, 2010, to January 1, 2020. A qualitative analysis of the decisions was conducted using the usual characteristics set out by disciplinary tribunals in their annual reports. The relevant factors which potentially played a role in the complaint being upheld were identified for more detailed analysis. <b><i>Results:</i></b> In the 10-year period, a complaint was submitted to the disciplinary tribunals against 299 neurologists. Forty-four complaints were upheld (15%). The most common sanction was a warning (70%). A large majority of cases were directly related to patient care, such as decisions about the patient’s diagnosis and the treatment. Recordkeeping (50%), interpretation and discussion of imaging (30%), and involvement of several consultants of one or more specialties (34%) frequently played a role in the successful complaints. <b><i>Conclusion:</i></b> Medical disciplinary cases in the field of neurology are usually about diagnosis- and treatment-related aspects. Recordkeeping, interpretation of neuroimaging, and involvement of several consultants frequently play a role in a complaint being upheld. It is important that specialties evaluate disciplinary decisions on a structural and continuous basis.

Compliance and resistance: How performance measures make and unmake universities

How individuals comply with, and resist performance measures and metrics can be seen as a key concern in management and organization. Recent literature has advanced our understanding of compliance as a social practice which is often related to resistance. Yet, compliance is seen as something we equate with simply yielding to power without any agency. We address this theme with a study of the effects of managerialism on academic work. More specifically, we investigate the introduction of measures and controls to improve PhD completion times in a research-intensive UK university. Our findings show that despite most of our respondents voicing concerns about the reductionist nature of the target and the consequences for quality, the large majority of academics we talked to complied with the measure. We identify three compliance types that demonstrate compliance is an interpretative process. We make two principal contributions with this paper. First, we offer insights into why compliance deserves analytic attention as a social practice in its own right, as something that goes beyond mere consent. Second, we analyze the impact of managerialism on higher education through the lens of compliance. We use these insights to reflect on how compliance was linked to resistance and the effects of different compliance practices on academic work which ranged from shifting responsibilities to challenging academic integrity.

A helicase-tethered ORC flip enables bidirectional helicase loading

Replication origins are licensed by loading two Mcm2‑7 helicases around DNA in a head-to-head conformation poised to initiate bidirectional replication. This process requires ORC, Cdc6, and Cdt1. Although different Cdc6 and Cdt1 molecules load each helicase, whether two ORC proteins are required is unclear. Using colocalization single-molecule spectroscopy combined with FRET, we investigated interactions between ORC and Mcm2‑7 during helicase loading. In the large majority of events, we observed a single ORC molecule recruiting both Mcm2‑7/Cdt1 complexes via similar interactions that end upon Cdt1 release. Between first and second helicase recruitment, a rapid change in interactions between ORC and the first Mcm2-7 occurs. Within seconds, ORC breaks the interactions mediating first Mcm2-7 recruitment, releases from its initial DNA-binding site, and forms a new interaction with the opposite face of the first Mcm2-7. This rearrangement requires release of the first Cdt1 and tethers ORC as it flips over the first Mcm2-7 to form an inverted Mcm2‑7-ORC-DNA complex required for second-helicase recruitment. To ensure correct licensing, this complex is maintained until head-to-head interactions between the two helicases are formed. Our findings reconcile previous observations and reveal a highly-coordinated series of events through which a single ORC molecule can load two oppositely-oriented helicases.

Characteristics of Children Diagnosed With SARS-CoV-2 in the Ambulatory Setting

The objective of this study was to characterize the clinical presentation and outcomes of children and adolescents testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the ambulatory setting. We found that about 8% of children tested positive for SARS-CoV-2, with the large majority being symptomatic (80%). The average age of our population was 12.5 years, and females and males were affected equally. However, African American patients (62%) were substantially more likely to test positive compared with other races. Children in this study tended to have a mild course, mostly presenting with respiratory symptoms, and very few required hospitalization. As the epidemiology of the pandemic evolves, it will be important to monitor the effects that changing variants have on infected children and the impact that vaccination programs have on mitigating infection risk.

A Systematic Review of Blockchain Technology and Its Applications

Blockchain technology could radically transform our business environment in the decades to come. It has the power to redefine our views of business processes and may even impact our overall economy. The works comprehensively document the implementation of blockchain applications in various sectors. Our goal is to determine what state blockchain technology is in and what kinds of applications it has. A large majority of the current blockchain-related research is dedicated to crypto currencies, such as Bitcoin. Only a small percentage of work is dedicated to exploring the wide range of potential blockchain technology applications. Blockchain technology has multiple applications across multiple industries. This study attempts to determine the opportunities and threats presented by Blockchain Technology for current or future applications. The number of published studies that were studied carefully and critically and added to the Block chain’s body of knowledge was large.

A new way of understanding the relationship between men and the gods: Socrates, gods and wealth

A careful methodology can enable us to be confident in the idea, largely neglected by historiography, that Socrates understood the relationships between men, the gods and wealth, in a very different manner to that of the large majority of his contemporaries. While the latter thought that the rites could lead the gods to bring them prosperity, that wealth was a blessing, Socrates was convinced of the opposite: wealth was not, in his view, a blessing, and had nothing to do with the gods. This was able to draw a few Athenians to think that philosophy could threaten the practice of religious rituals.

Scientific Management Practices Followed by Sheep Rearing Farmers in Raichur District of Karnataka, India

Livestock is one of the most remunerative enterprises among the farming community the present study was undertaken to know the scientific sheep management practices by sheep owners in Raichur and Lingasugur taluks of Raichur district. For this purpose, 6 villages from each taluks were selected on the basis of highest sheep population. Ten respondents drawn from each selected village with 120 sample size. The data was collected through structured schedule and the data were analyzed by using appropriate statistical methods. The findings of the study indicated that a large majority of the sheep owners (85.00%) administer the drugs for de worming in lamb management, followed by providing of fresh and clean water (83.33%) and proper bedding material (80.00%) in winter season. With regards feeding management of the sheep, a large majority of the respondents (85.00%) allowed their sheep for grazing in community land Nearly one fifth of the respondents provided green fodder throughout the year as their land comes under the canal irrigation provision, in addition to bore well facilities. Further, 100% of the respondents had proper floor space for the sheep size with cleaning padlock regularly in housing management practices. It is worth to note that 83.00 per cent of them monitor heat detection in sheep and provided treatment to the animals which were suffering from reproductive disorder (87.50%).This is mainly due to the availability of veterinary services in the locality. With regards health management practices, cent percent of the respondents check up the health of the sheep regularly and administer vaccination as scheduled (4/annum) and disinfection of the padlock in order to prevent the disease.

The influence of WSR-88D intra-volume scanning strategies on thunderstorm observations and warnings in the dual-polarization radar era: 2011-2020

The Weather Surveillance Radar - 1988 Doppler (WSR-88D) network has undergone several improvements in the last decade with the upgrade to dual-polarization capabilities and the ability for forecasters to re-scan the lowest levels of the atmosphere more frequently through the use of Supplemental Adaptive Intra-volume Scanning (SAILS). SAILS reduces the revisit period for scanning the lowest 1 km of the atmosphere but comes at the cost of a longer delay between scans at higher altitudes. This study quantifies how often radar Volume Coverage Patterns (VCPs) and all available SAILS options are used during the issuance of 148,882 severe thunderstorm and 18,263 tornado warnings, and near 10,474 tornado, 58,934 hail, and 127,575 wind reports in the dual-polarization radar era. A large majority of warnings and storm reports were measured with a VCP providing denser low-level sampling coverage. More frequent low-level updates were employed near tornado warnings and reports compared to severe thunderstorm warnings and hail or wind hazards. Warnings issued near a radar providing three extra low-level scans (SAILSx3) were more likely to be verified by a hazard with a positive lead time than warnings with fewer low-level scans. However, extra low-level scans were more frequently used in environments supporting organized convection as shown using watches issued by the Storm Prediction Center. Recently, the number of mid-level radar elevation scans is declining per hour, which can adversely affect the tracking of convective polarimetric signatures, like ZDR columns, which were found above the 0.5° elevation angle in over 99% of cases examined.

The Social Sustainability Barometer 2017–2019: Survey Data on the Energiewende

A large majority of citizens supports the German transition toward clean energy production (Energiewende). Yet, the Energiewende involves a large suite of aspects that determine the support. The social sustainability barometer provides a comprehensive data base on a large variety of questions related to the Energiewende that was collected in three survey waves spanning from 2017 to 2019 among more than 6000 household heads.