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The Countering Violent Extremism (CVE) field is evolving in Canada, with CVE teams offering psychosocial disengagement interventions in the provinces of Alberta, British Columbia, Manitoba, Ontario, Saskatchewan and Quebec. This article is written as a case study to detail the evolution of the city of Toronto’s CVE program, called Estimated Time of Arrival (ETA), housed in the community mental health centre Yorktown Family Services (“Yorktown”). Toronto – the largest Canadian city, provincial capital of Ontario, and one of the most multicultural cities in the world – has seen several high-profile cases of violent extremism and terrorism over the past few years. For example, there were two “Incel” attacks that together killed eleven people, including nine women, in 2018 and 2020. In 2022, hate crime occurrences reported to the Toronto Police Service were 74% higher than pre-pandemic levels, and 40% higher than the 10-year average. Clearly, there was a need for a structured and multi-sectoral response which led to the inception of ETA in 2020. Against this backdrop, this paper outlines ETA’s program components and operational design. Various data points such as client age range, ideological affiliation, and services rendered are provided to demonstrate trends for the period of April 2022 to March 2023. As this paper will demonstrate, ETA’s services are grounded in engagement, outreach, case management (multi-agency service delivery), psychotherapy, religious counselling, peer support and forensic consultation, which is reflected in the evolving CVE literature and evidence-base.

Abstract Here, we establish a CT-radiomics based method for application in invasive, orthotopic rodent brain tumour models. Twenty four NOD/SCID mice were implanted with U87R-Luc2 GBM cells and longitudinally imaged via contrast enhanced (CE-CT) imaging. Pyradiomics was employed to extract CT-radiomic features from the tumour-implanted hemisphere and non-tumour-implanted hemisphere of acquired CT-scans. Inter-correlated features were removed (Spearman correlation > 0.85) and remaining features underwent predictive analysis (recursive feature elimination or Boruta algorithm). An area under the curve of the receiver operating characteristic curve was implemented to evaluate radiomic features for their capacity to predict defined outcomes. Firstly, we identified a subset of radiomic features which distinguish the tumour-implanted hemisphere and non- tumour-implanted hemisphere (i.e, tumour presence from normal tissue). Secondly, we successfully translate preclinical CT-radiomic pipelines to GBM patient CT scans (n = 10), identifying similar trends in tumour-specific feature intensities (E.g. ‘glszm Zone Entropy’), thereby suggesting a mouse-to-human species conservation (a conservation of radiomic features across species). Thirdly, comparison of features across timepoints identify features which support preclinical tumour detection earlier than is possible by visual assessment of CT scans. This work establishes robust, preclinical CT-radiomic pipelines and describes the application of CE-CT for in-depth orthotopic brain tumour monitoring. Overall we provide evidence for the role of pre-clinical ‘discovery’ radiomics in the neuro-oncology space.

We present a genome assembly from an individual male Martes martes (the European pine marten; Chordata; Mammalia; Carnivora; Mustelidae). The genome sequence is 2,484.6 megabases in span. Most of the assembly is scaffolded into 20 chromosomal pseudomolecules, including the X and Y sex chromosomes. The mitochondrial genome has also been assembled and is 16.57 kilobases in length.

Abstract Molecular tools are increasingly applied for assessing and monitoring biodiversity and informing conservation action. While recent developments in genetic and genomic methods provide greater sensitivity in analysis and the capacity to address new questions, they are not equally available to all practitioners: There is considerable bias across institutions and countries in access to technologies, funding, and training. Consequently, in many cases, more accessible traditional genetic data (e.g., microsatellites) are still utilized for making conservation decisions. Conservation approaches need to be pragmatic by tackling clearly defined management questions and using the most appropriate methods available, while maximizing the use of limited resources. Here we present some key questions to consider when applying the molecular toolbox for accessible and actionable conservation management. Finally, we highlight a number of important steps to be addressed in a collaborative way, which can facilitate the broad integration of molecular data into conservation.

Abstract Cities can host significant biological diversity. Yet, urbanisation leads to the loss of habitats, species, and functional groups. Understanding how multiple taxa respond to urbanisation globally is essential to promote and conserve biodiversity in cities. Using a dataset encompassing six terrestrial faunal taxa (amphibians, bats, bees, birds, carabid beetles and reptiles) across 379 cities on 6 continents, we show that urbanisation produces taxon-specific changes in trait composition, with traits related to reproductive strategy showing the strongest response. Our findings suggest that urbanisation results in four trait syndromes (mobile generalists, site specialists, central place foragers, and mobile specialists), with resources associated with reproduction and diet likely driving patterns in traits associated with mobility and body size. Functional diversity measures showed varied responses, leading to shifts in trait space likely driven by critical resource distribution and abundance, and taxon-specific trait syndromes. Maximising opportunities to support taxa with different urban trait syndromes should be pivotal in conservation and management programmes within and among cities. This will reduce the likelihood of biotic homogenisation and helps ensure that urban environments have the capacity to respond to future challenges. These actions are critical to reframe the role of cities in global biodiversity loss.

In this article, we explore how tourism in Xinjiang is politically weaponised. Commodifying Uyghur cultural heritage for tourism allows the Chinese Communist Party (CCP) to insist it is not committing cultural genocide, but actually “conserving” Uyghur culture. This directly bears on the CCP’s internment of Muslim minorities in “re-education” camps, ostensibly to target Islamic “extremism.” We explore how tourism to Xinjiang is presented as a “success” of the camps and conscripted into the “Sinicisation” of the region and the secularising of minorities’ cultures. Places and practices are deconstructed as cultural heritage, and reconstructed to provide tourists with “exotic” experiences of “wonderful Xinjiang.” This transforms the “tourist gaze” into a “testimonial” one: tourists to Xinjiang are made into witnesses that “Xinjiang is beautiful” and Uyghurs are “happy.” In this, touristic development and tourists themselves are key agents in the CCP’s territorialisation of Xinjiang, the sinicisation of Uyghur culture, and the legitimation of the violence of the camps.

Abstract Improving the effectiveness of conservation practice requires better use of evidence. Since 2004, researchers from the Conservation Evidence group (University of Cambridge) have engaged with over 1100 named practitioners, policymakers, funders and other academics from across the world to identify needs and develop a range of principles, tools and resources to embed evidence in decision making. The goal of this engagement (the Conservation Evidence Programme) was to deliver improved conservation practice leading to benefits for nature and society. Together, we developed a theory of change with five key strategies for delivering change, alongside a freely available Evidence Toolkit to support decision makers in achieving that change. The authors describe the toolkit, a collection of freely available tools and resources developed by the collaborative programme, and how co‐design, employing different levels of partner engagement, enabled its development. Reflecting on our experiences highlighted a number of insights and recommendations, including the need to identify where deep engagement is a necessary condition for success; the importance of collective agreement of the roles of different partners; the need to consider how to facilitate uptake of new tools or practices, particularly where that requires changes to organisational practices or culture; and the importance of establishing processes/channels for ongoing engagement with stakeholders, with a willingness to be flexible and open to incorporating new suggestions and perspectives as needed. The Conservation Evidence Programme has enabled practitioners, funders and policymakers to become part of a network of forward‐thinking organisations that is working collaboratively to help drive more effective conservation practice through improved evidence use.

Objective Noninvasive ventilation (NIV) improves survival and quality of life in motor neuron disease (MND), but many patients fail to receive effective ventilation. This study aimed to map the respiratory clinical care for MND patients at a service and individual healthcare professional (HCP) level to understand where attention may be needed to ensure all patients receive optimal care. Methods Two online surveys of HCPs working with MND patients in the UK were conducted. Survey 1 targeted HCPs providing specialist MND care. Survey 2 targeted HCPs working in respiratory/ventilation services and community teams. Data were analysed using descriptive and inferential statistics. Results Responses from 55 HCPs providing specialist MND care who worked at 21 MND care centres and networks and 13 Scotland Health Boards were analysed from Survey 1. Responses from 85 HCPs from respiratory/ventilation services and 73 HCPs from community teams, representing 97 services, were analysed from Survey 2. Significant differences in practice were identified at each stage of the respiratory care pathway as well as evidence of the need for improvement. This included when patients were referred to respiratory services, the time taken waiting to commence NIV, the availability of sufficient NIV equipment and provision of services, particularly out of hours. Conclusion We have highlighted significant disparity in MND respiratory care practices. Increased awareness of the factors that influence NIV success and the performance of individuals and services is important for optimal practice.

Urbanisation leading to habitat change and fragmentation is a recognised global threat to biodiversity. However, it may also offer opportunities for some species. Genetic diversity, one of the three components of biodiversity, is often overlooked in conservation planning and policy. In the present study, we used a panel of seven microsatellite markers to compare the genetic structure of 34 common frog (Rana temporaria) populations residing in urban and suburban drainage ponds in Inverness (Scotland) with populations from rural surroundings. As a main finding, the levels of genetic variation were indiscernible between (sub)urban and rural populations. Significant isolation-by-distance was observed only for rural populations, with measures of pairwise genetic differentiation (Fst) that were, on average, lower than those in urban and suburban areas. The mean numbers of alleles remained stable between two temporal sets of samples collected at intervals broadly representing one R. temporaria generation, but with a tendency of decreasing allelic richness, irrespectively of the site characteristics. Taking these results together, our study revealed that the elevated levels of differentiation between R. temporaria populations inhabiting (sub)urban drainage ponds did not lead to increased levels of genetic erosion. Our findings support the importance of well-designed blue–green infrastructure in urban landscapes for the retention of within-species genetic diversity and can help to inform future biodiversity management policies.

Quinta Monroy is an award-winning co-designed settlement for 93 families on half a hectare of land at Iquique in northern Chile. Neighbors' complaints about the disorderly settlement peaked after the landowner's death and provoked untenured residents to seek government subsidies to redevelop the settlement. From 2003, a government social housing project was coordinated by the “Elemental” architecture firm with US$10,000 per household. With the resident's temporary relocation, 93 modular and interlinked apartments were built around a series of courtyards. These apartments, which were designed as “half-houses,” were subsequently co-opted by residents adding rooms in locations planned in advance by Elemental. Many households have since doubled the size of their apartment and reformed the settlement in ways not anticipated by Elemental.This paper details a spatial and ethnographic study of the Quinta Monroy settlement since redevelopment to identify opportunities and risks that accompany this type of social housing model. The study reveals evidence that residents' capacities to enlarge apartments commonly exceeds the architect's expectations and that unregulated expansions often compromise the settlement's livability. This research anticipates further opportunities for expansion in this semi-regulated settlement and investigates possibilities that another contested slum settlement may emerge.

Abstract The health of the world's oceans is intrinsically linked to the biodiversity of the ecosystems they sustain. The importance of protecting and maintaining ocean biodiversity has been affirmed through the setting of the UN Sustainable Development Goal 14 to conserve and sustainably use the ocean for society's continuing needs. The decade beginning 2021–2030 has additionally been declared as the UN Decade of Ocean Science for Sustainable Development. This program aims to maximize the benefits of ocean science to the management, conservation, and sustainable development of the marine environment by facilitating communication and cooperation at the science–policy interface. A central principle of the program is the conservation of species and ecosystem components of biodiversity. However, a significant omission from the draft version of the Decade of Ocean Science Implementation Plan is the acknowledgment of the importance of monitoring and maintaining genetic biodiversity within species. In this paper, we emphasize the importance of genetic diversity to adaptive capacity, evolutionary potential, community function, and resilience within populations, as well as highlighting some of the major threats to genetic diversity in the marine environment from direct human impacts and the effects of global climate change. We then highlight the significance of ocean genetic diversity to a diverse range of socioeconomic factors in the marine environment, including marine industries, welfare and leisure pursuits, coastal communities, and wider society. Genetic biodiversity in the ocean, and its monitoring and maintenance, is then discussed with respect to its integral role in the successful realization of the 2030 vision for the Decade of Ocean Science. Finally, we suggest how ocean genetic diversity might be better integrated into biodiversity management practices through the continued interaction between environmental managers and scientists, as well as through key leverage points in industry requirements for Blue Capital financing and social responsibility.

The attribution of biodiversity trends to the action of individual drivers is a first step in developing strategies to conserve, enhance and restore that diversity. One approach to that identification is to link information on species trends with information on ecological preferences that relate to the drivers. Long-term and short-term occupancy trends for 326 bryophyte species (1972–2015 and 2005–2015, respectively) and 437 lichen species (1971–2015 and 2005–2015, respectively) for Scotland were linked with appropriate indicators to assess the action of specific drivers. Bryophyte species of heathlands and woodlands showed positive trends, whilst lichen species from these habitats showed negative trends. Bryophytes and lichens of drier habitats and locations tended to have more positive trends whilst those of wetter habitats tended to be negative. Similarly, evidence suggested that bryophytes and lichens of open areas had more negative trends than those of shadier habitats and that species from both groups of higher fertility habitats had more positive trends than those of less fertile ones. Bryophyte species from warmer areas tended to increase in range. Opposite trends for bryophytes and lichens in heathlands and woodlands suggest competition for space or opposite reactions to other drivers, but it is clear that they should not be lumped into a single functional grouping. There were clear trends for suggesting that increased temperatures (bryophytes only), cumulative nitrogen pollution and reduced land use intensity were shifting assemblages. The overall predominance of negative trends for lichens suggests that many species have lost habitat through decreasing light availability and increased dryness, and potentially through competition with bryophytes. Given the international importance of Scotland for both these groups, these trends for lichens are of concern.

Abstract Many types of guidance documents inform conservation by providing practical recommendations for the management of species and habitats. To ensure effective decisions are made, such guidance should be based upon relevant and up‐to‐date evidence. We reviewed conservation guidance for mitigation and management of species and habitats in the United Kingdom and Ireland, identifying 301 examples produced by over 50 organizations. Of these, only 29% provided a reference list, of which only 32% provided reference(s) relevant to justify the recommended actions (9% of the total). Furthermore, even this guidance was often outdated, lacked a methodology for production, or did not highlight uncertainty in the key evidence that supported the recommendations. These deficiencies can lead to misguided and ineffective conservation practices, policies, and decisions, and a waste of resources. Based on this review and co‐design by experts from 14 organizations, we present a set of principles for ensuring sufficient and relevant evidence is transparently incorporated into future conservation guidance. Producing evidence‐based guidance in line with these principles would enable more effective conservation outcomes.

Abstract The Coalition for Conservation Genetics (CCG) brings together four eminent organizations with the shared goal of improving the integration of genetic information into conservation policy and practice. We provide a historical context of conservation genetics as a field and reflect on current barriers to conserving genetic diversity, highlighting the need for collaboration across traditional divides, international partnerships, and coordinated advocacy. We then introduce the CCG and illustrate through examples how a coalition approach can leverage complementary expertise and improve the organizational impact at multiple levels. The CCG has proven particularly successful at implementing large synthesis‐type projects, training early‐career scientists, and advising policy makers. Achievements to date highlight the potential for the CCG to make effective contributions to practical conservation policy and management that no one “parent” organization could achieve on its own. Finally, we reflect on the lessons learned through forming the CCG, and our vision for the future.

Abstract Making the reasoning and evidence behind conservation management decisions clear and transparent is a key challenge for the conservation community. Similarly, combining evidence from diverse sources (e.g., scientific and local knowledge) into decision‐making is also difficult. Our group of conservation researchers and practitioners has co‐produced an intuitive tool and template (Evidence‐to‐Decision [E2D] tool: www.evidence2decisiontool.com) to guide practitioners through a structured process to transparently document and report the evidence and reasoning behind decisions. The tool has three major steps: (1). Define the Decision Context; (2). Gather Evidence; and (3). Make an Evidence‐Based Decision. In each step, practitioners enter information (e.g., from the scientific literature, practitioner knowledge and experience, and costs) to inform their decision‐making and document their reasoning. The tool packages this information into a customized downloadable report (or is documented if using the offline template), which we hope can stimulate the exchange of information on decisions within and between organizations. By enabling practitioners to revisit how and why past decisions were made, and integrate diverse forms of evidence, we believe our open‐access tool's template can help increase the transparency and quality of decision‐making in conservation.

TGFβ has a role in cancer immunosuppression but the exact mechanisms haven’t been fully elucidated. Here, using mouse models deficient in TGFβ-signaling, the authors show that loss of ALK5 in CD8 + T cells enhances their tumour trafficking and cytotoxicity suggesting that ALK5 inhibitors may have clinical utility.

Recent advancements in person-portable instrumentation have resulted in the potential to provide contemporaneous results through rapid in-field analyses. These technologies can be utilised in emergency response scenarios to aid first responders in appropriate site risk assessment and management. Large metropolitan fires can pose great risk to human and environmental health due to the rapid release of hazardous compounds into the atmosphere. Understanding the release of these hazardous organics is critical in understanding their associated risks. Person-portable gas chromatography-mass spectrometry (GC-MS) was evaluated for its potential to provide rapid on-site analysis for real-time monitoring of hazardous organic compounds at fire scenes. Air sampling and analysis methods were developed for scenes of this nature. Controlled field testing demonstrated that the portable GC-MS was able to provide preliminary analytical results on the volatile organic compounds present in air samples collected from both active and extinguished fires. In-field results were confirmed using conventional laboratory-based air sampling and analysis procedures. The deployment of portable instrumentation could provide first responders with a rapid on-site assessment tool for the appropriate management of scenes, thereby ensuring environmental and human health is proactively protected and scientifically informed decisions are made for the provision of timely advice to stakeholders.

Building and factory fires pose a great risk to human and environmental health, due to the release of hazardous by-products of combustion. These hazardous compounds can dissipate into the environment through fire water run-off, and the impact can be immediate or chronic. Current laboratory-based methods do not report hazardous compounds released from a fire scene at the time and location of the event. Reporting of results is often delayed due to the complexities and logistics of laboratory-based sampling and analysis. These delays pose a risk to the health and wellbeing of the environment and exposed community. Recent developments in person-portable instrumentation have the potential to provide rapid analysis of samples in the field. A portable gas chromatograph-mass spectrometer (GC-MS) was evaluated for the on-site analysis of water samples for the identification of hazardous organic compounds at fire scenes. The portable GC-MS was capable of detecting and identifying a range of volatile and semi-volatile organic compounds in fire water run-off, and can be used in conjunction with conventional laboratory analysis methods for a comprehensive understanding of hazardous organics released at fire scenes. Deployment of this portable instrumentation provides first responders with a rapid, on-site screening tool to appropriately manage the run-off water from firefighting activities. This ensures that environmental and human health is proactively protected.

Abstract 1. Genetic diversity is important for species persistence and Gene Conservation Units (GCUs) have been implemented for forest trees to protect genetic diversity and evolutionary processes in situ. The Convention on Biological Diversity stipulates the protection of genetic diversity as an Aichi target, and so we explore the potential for GCUs to be implemented more widely. 2. Our global systematic review showed that GCUs are currently implemented primarily for plant species of economic importance (109/158 species studied), but a questionnaire sent to land managers and conservationists (60 U.K. participants) revealed strong support for fully integrating genetic information into conservation management (90% agree), and for creating GCUs for other plant and animal taxa. 3. Using four case studies of U.K. species of conservation importance which vary in genetic threat and population dynamics (two insect species, a fungus and a plant), we highlight that GCU implementation criteria need to be flexible to account for variation in effective breeding population size and geographic extent of target species. The wider uptake of GCUs would ensure that threatened genetic diversity is protected and support evolutionary processes that aid adaptation to changing environments.

Abstract 1. Effective wildlife restoration is a critical requirement of many conservation actions. The outcome of conservation interventions can be optimized through knowledge of species’ habitat requirements, but few studies consider the impact of using explicit evidence from dedicated local research to inform the design phase of habitat management. Furthermore, interventions administered externally from the top down, whilst simpler than those developed in discussion with multiple stakeholders including land managers (i.e. co‐development), run the risk of failing to engage local people. 2. In this study, we focus on interventions in the Scottish Highlands to improve the availability and suitability of breeding ponds for local amphibian assemblages. We collected and analysed data based on 129 ecological variables across 88 reference ponds to quantify the local habitat preferences. We used the findings from these analyses to inform the construction or restoration of 25 intervention ponds co‐developed in partnership with stakeholders (landowners, foresters, citizen scientists and government agencies). Following the interventions, we monitored amphibian communities at these sites over 4 years. We assessed presence and abundance of all five native amphibians (the anurans Rana temporaria and Bufo bufo, and the salamanders Lissotriton helveticus, L. vulgaris and Triturus cristatus) using egg searching, dip‐netting, torching and trapping. 3. The new habitats were overall characterized by ecological conditions more favourable to amphibians than the reference ponds. We recorded a total of 51 colonization events. Within two breeding seasons after construction or restoration, the intervention ponds hosted the full complement of species, mirroring amphibian diversity patterns found in the local reference ponds. 4. Our study shows that ecological research to quantify local habitat requirements and working with commercial landmanagers to ensure equitable benefits prior to designing conservation actions can promote rapid and efficient recovery of wildlife.

Monitoring BCR-ABL1 transcript levels in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is a widely adopted method to assess response to therapy. However, a small minority of Ph+ ALL patients express variant BCR-ABL1 transcript types, usually due to splicing of alternative BCR or ABL1 exons. Whether patients expressing these rare, variant BCR-ABL1 transcripts have a distinct phenotype or response to therapy is not known due to the limited number of reported cases. Here, we report the presenting features of Ph+ ALL in a young adult with a variant e13a3 BCR-ABL1 fusion. Molecular monitoring reflected the disease response from diagnosis through allogeneic stem cell transplantation which resulted in undetectable e13a3 BCR-ABL1 transcripts. This case highlights the value of molecular monitoring in Ph+ ALL patients with variant BCR-ABL1 transcripts and the requirement for standardization of such assays.

Thrombocytopenia is one of the most common hematological abnormalities observed during pregnancy, and in rare cases, this may be the first indicator of an underlying hematological malignancy. Hairy cell leukemia (HCL) is an uncommon B-cell lymphoproliferative disorder of which thrombocytopenia is a recurrent presenting feature. A case of pancytopenia presenting in pregnancy is described in which the thrombocytopenia persisted postpartum coincidental with a vesicular, pustular rash characterised as Sweet’s syndrome. Hematological, histological, immunophenotypic, and molecular investigations confirmed the presence of HCL. The patient was treated with cladribine resulting in resolution of Sweet’s syndrome, hematological remission from HCL, and achievement of a normal platelet count. This case highlights the need to maintain a wide differential diagnosis for presentations of pancytopenia or thrombocytopenia in pregnancy and the requirement for follow-up investigation of unusual cases with a lack of response to steroids or immunoglobulin.

The development of acute lymphoblastic leukemia in an existing myeloproliferative neoplasm is rare with historical cases unable to differentiate between concomitant malignancies or leukemic transformation. Molecular studies of coexisting JAK2 V617F-positive myeloproliferative neoplasms and mature B cell malignancies indicate distinct disease entities arising in myeloid and lymphoid committed hematopoietic progenitor cells, respectively. Mutations of CALR in essential thrombocythemia appear to be associated with a distinct phenotype and a lower risk of thrombosis yet their impact on disease progression is less well defined. The as yet undescribed scenario of pro-B cell acute lymphoblastic leukemia arising in CALR mutated essential thrombocythemia is presented. Intensive treatment for the leukemia allowed for expansion of the original CALR mutated clone. Whether CALR mutations in myeloproliferative neoplasms predispose to the acquisition of additional malignancies, particularly lymphoproliferative disorders, is not yet known.

Soluble fibres (non-starch polysaccharides, NSP) from edible plants but particularly plantain banana (Musa spp.), have been shown in vitro and ex vivo to prevent various enteric pathogens from adhering to, or translocating across, the human intestinal epithelium, a property that we have termed contrabiotic. Here we report that dietary plantain fibre prevents invasion of the chicken intestinal mucosa by Salmonella. In vivo experiments were performed with chicks fed from hatch on a pellet diet containing soluble plantain NSP (0 to 200 mg/d) and orally infected with S.Typhimurium 4/74 at 8 d of age. Birds were sacrificed 3, 6 and 10 d post-infection. Bacteria were enumerated from liver, spleen and caecal contents. In vitro studies were performed using chicken caecal crypts and porcine intestinal epithelial cells infected with Salmonella enterica serovars following pre-treatment separately with soluble plantain NSP and acidic or neutral polysaccharide fractions of plantain NSP, each compared with saline vehicle. Bacterial adherence and invasion were assessed by gentamicin protection assay. In vivo dietary supplementation with plantain NSP 50 mg/d reduced invasion by S.Typhimurium, as reflected by viable bacterial counts from splenic tissue, by 98.9% (95% CI, 98.1-99.7; P

The art historical visions of Eugène Delacroix and Paul Chenavard had much in common. Both men saw the achievements of the classical period and the Renaissance as highpoints in the history of art and both decried their contemporaries’ faith in progress, believing that modernity’s materialism, commercialism, and technophilia adversely affected artistic production. Yet while Chenavard argued that present-day artists could only offer inferior variations on the achievements of past masters, Delacroix felt that great geniuses could still rival them. Relying especially on the exchanges between the two artists recorded in Delacroix’s Journal, this paper compares and contrasts the eschatological aspects of the two artists’ understanding of history in order to illuminate their attitudes toward tradition and modernity.

Since the initial report of the BRAF V600E mutation in hairy cell leukemia, numerous investigators have demonstrated the presence of this activating mutation in nearly all cases of this disease. A case of hairy cell leukemia is documented with a classical clinical, morphological, immunophenotypic, and cytochemical profile in which the BRAF V600E was not detected. The diagnostic and therapeutic implications are discussed.

Background Hyponatraemia often occurs after subarachnoid haemorrhage (SAH). However, its clinical significance and optimal management are uncertain. We audited the screening, investigation and management of hyponatraemia after SAH.Methods We prospectively identified consecutive patients with spontaneous SAH admitted to neurosurgical units in the United Kingdom or Ireland. We reviewed medical records daily from admission to discharge, 21 days or death and extracted all measurements of serum sodium to identify hyponatraemia (10 days. Associations of hyponatraemia with outcome were assessed using logistic regression with adjustment for predictors of outcome after SAH and admission duration. We assessed hyponatraemia-free survival using multivariable Cox regression.Results 175/407 (43%) patients admitted to 24 neurosurgical units developed hyponatraemia. 5976 serum sodium measurements were made. Serum osmolality, urine osmolality and urine sodium were measured in 30/166 (18%) hyponatraemic patients with complete data. The most frequently target daily fluid intake was >3 L and this did not differ during hyponatraemic or non-hyponatraemic episodes. 26% (n/N=42/164) patients with hyponatraemia received sodium supplementation. 133 (35%) patients were dead or dependent within the study period and 240 (68%) patients had hospital admission for over 10 days. In the multivariable analyses, hyponatraemia was associated with less dependency (adjusted OR (aOR)=0.35 (95% CI 0.17 to 0.69)) but longer admissions (aOR=3.2 (1.8 to 5.7)). World Federation of Neurosurgical Societies grade I–III, modified Fisher 2–4 and posterior circulation aneurysms were associated with greater hazards of hyponatraemia.Conclusions In this comprehensive multicentre prospective-adjusted analysis of patients with SAH, hyponatraemia was investigated inconsistently and, for most patients, was not associated with changes in management or clinical outcome. This work establishes a basis for the development of evidence-based SAH-specific guidance for targeted screening, investigation and management of high-risk patients to minimise the impact of hyponatraemia on admission duration and to improve consistency of patient care.

Total proctocolectomy and ileal pouch-anal anastomosis is the operation of choice for patients with familial adenomatous polyposis. With this operation comes the risk of developing ileal pouch polyps. Although rare, ileal pouch carcinomas may also occur within the pouch. Periodic endoscopic surveillance of the retained rectum and ileal pouch is recommended. Endoscopic polypectomy of medium and large polyps should be performed. Sulindac is effective in the reduction and often in the elimination of numerous smaller pouch polyps. Future studies are necessary to determine the role of sulindac and other chemotherapeutic agents in preventing the development of these polyps. [ABSTRACT FROM AUTHOR]

Despite the innovation of more than 100 surgical procedures for the treatment of complete rectal prolapse, no one procedure is best and applicable to all patients. Traditionally, procedures have been divided into abdominal and perineal approaches. The application of the laparoscopic approach to colon and rectal disease has allowed an additional less invasive method of therapy to treat rectal prolapse successfully. In comparison with conventional approaches, laparoscopy has achieved similar functional results and recurrence rates while reducing postoperative pain and hospital length of stay. [ABSTRACT FROM AUTHOR]

: Background: Despite the known benefits of early postsurgical mobility, there are no clear recommendations on early mobility among uncomplicated postoperative neurosurgical spine patients., Purpose: The purpose of this quality improvement initiative was to establish an NP-led early mobility protocol to reduce uncomplicated postsurgical spine patients' length of stay (LOS) in the hospital and eliminate the variability of postsurgical care. A secondary objective was to educate and empower nursing staff to initiate the early mobility protocol independently and incorporate it in their practice to improve patient care., Methods: Two neurosurgery NPs led an interprofessional team to develop the early mobility protocol. Team members provided preadmission preoperative education to communicate the necessity for early mobility and provide information about the protocol. New nursing guidelines called for patient mobility on the day of surgery, within six hours of arrival on the medical-surgical unit. Nurses were empowered to get patients out of bed independently, without a physical therapy consultation; they also removed urinary catheters and discontinued IV opioids when patients' status permitted., Results: Over a one-year period, implementation of the protocol resulted in a nine-hour reduction in LOS per hospitalization in neurosurgical spine patients who underwent lumbar laminectomies. The protocol also allowed nurses more autonomy in patient care and was a catalyst for patient involvement in their postoperative mobility. Given the success of the protocol, it is being replicated by other surgical services throughout the organization., Conclusions: This low-cost, high-reward initiative aligns with the strategic plan of the organization and ensures that high-quality, patient-centered care remains the priority. NPs in other institutions can modify this protocol to promote postoperative mobility in their organizations.