Peter Sleight

Professor Peter Sleight M.D.(Cantab.), D.M. (Oxon.) FRCP FACC (27 June 1929 – 7 October 2020) was a distinguished internationally known research cardiologist and an Honorary Consultant Physician at the John Radcliffe Hospital in Oxford and the Oxford University Radcliffe NHS Trust. Consultant physician/cardiologist firstly at the Radcliffe Infirmary in Oxford since 1964. Sleight was Emeritus Field Marshal Alexander Professor of Cardiovascular Medicine at the University of Oxford and an Emeritus Fellow of Exeter College, Oxford.
Overview.
Peter Sleight was a consultant physician/cardiologist in Oxford from 1964. He retired from the British Heart Foundation (BHF)-sponsored Field Marshal Alexander Chair of Cardiovascular Medicine in 1994, but continued to work at the John Radcliffe Hospital in Oxford. He was Deputy Chairman of the HPS Steering Committee.
Sleight was a Fellow of the American College of Cardiology and an authority in the field of cardiology research. He served on the editorial board for many cardiology journals in the world such as "Cardiovascular Research", "Cardiovascular Risk", "Circulation", "Hypertension", the "British Heart Journal", "Clinical & Experimental Physiology & Pharmacology", and the "Journal of Ambulatory Monitoring". He peer reviewed articles and co-authored scientific papers on topics such as blood pressure monitoring and control, autonomic control of the circulation, prognostic value of measures of heart rate variability, and pathophysiology of ischaemic heart disease, heart failure, and hypertension in journals such as "The Lancet", "New England Journal of Medicine", "Circulation", "Heart", "European Heart Journal", the "British Medical Journal" and "Clinical Science".
Sleight was considered to be among world leading eminent cardiologists and co-authored over 500 papers. His work according to Microsoft Academic Search has been cited in over 40,000 papers and in hundreds of text books in the field of cardiology.
Sleight was President of the World Hypertension League and served as chair of the ISIS group steering committee and the related coronary prevention studies coordinated by the Clinical Trials Service Unit in Oxford. Previously, he was a consultant physician/cardiologist in Oxford beginning in 1964.
Sleight died on 7 October 2020.
Education.
Sleight was educated at Leeds Grammar School and Gonville and Caius College, Cambridge. Studied Medicine at Cambridge University and at St Bartholomew's Hospital Medical School.)
Career.
Medical career.
In 1964, Consultant Cardiologist Dr Peter Sleight in conjunction with Cardiac Surgeon Dr Alf Gunning from South Africa performed one of the first pioneering operations to install an external Lucas cardiac pacemaker on a patient in her early 30s at the Radcliffe Infirmary in Oxford. This involved attaching circular coils internally to the patient's heart and with coils aligned on the outside skin of the patient to transfer the electrical charge from the Artificial cardiac pacemaker connected to external batteries. The patient had previously spent many months connected to a filing cabinet size artificial heart machine known as the "fire engine" because of its red colour .
Sleight completed over 50 years service working for the National Health Service.
Research career.
Sleight is accredited for being the first to carry out studies of the effect of Aspirin on cardiac function and stroke prevention in the early 1970s. Sleight is Emeritus Professor of Cardiovascular Medicine at Oxford University. Sleight and his research team at Oxford led the way and formed the foundation for the research into the use of aspirin in the prevention of other medical conditions.
Sleight was an active leading contributor to the field of cardiology research. As chair of the ISIS group steering committee he was involved in several significant international trials in cardiology, such as the use of Aspirin (ISIS-2), Thrombolysis (ISIS 2&3), ACE Inhibitors (HOPE) and Statins (HPS). He served on several data monitoring committees of major clinical trials, including Gusto, ECLA, ASCOT, ADVANCE, EUCLID, MODEST, CREATE, OASIS 5-7, COMMIT, VALUE, PACE, SCOUT, RELY, ORIGIN, GISSI-HF, ONTARGET, TRANSCEND and PrOFESS.
Recent research has assessed the prognostic value of measures of heart rate variability, and pathophysiological processes underlying the changes found in patients prone to ischaemic heart disease, heart failure, and hypertension.
Awards.
Peter Sleight received a number of awards, including the American College of Cardiology (ACC) Young Investigator's Award in 1963, the Evian Award for Medicine and Science, International Society of Hypertension - MSD Award for distinguished research, the Galen Medal for Therapeutics 2000 (Society of Apothecaries), the Mackenzie Medal, British Cardiac Society, Louis Bishop Lecturer American College of Cardiology, the Alberto Zanchetti Lifetime Achievement Award, Gold Medal European Society of Hypertension and a Lifetime Research Award, Russian Federation of Cardiology, Bayer International Aspirin (R) Senior Award 2000.


Tg-rasH2 mouse

A Tg-rasH2 mouse is an innovative transgenic mouse, developed in Central Institute for Experimental Animals (CIEA), carrying the three copies of human prototype c-Ha-ras oncogenes with endogenous promoter and enhancer in tandem. Under Alternative Carcinogenicity Testing (ACT) project conducted by International Life Sciences Institute (ILSI) and ILSI Health and Environmental Sciences Institute (HESI), comprehensive evaluation studies on the Tg-rasH2 mouse bioassay system were performed and the usefulness of the system was validated for carcinogenicity studies by 23 international pharmaceutical companies. In the studies, it was confirmed that Tg-rasH2 mice are sensitive to both genotoxic and non-genotoxic human carcinogens and show no response to non-carcinogens. As a consequence, the Tg-rasH2 mice have been accepted as a short-term carcinogenicity study system enabling to reduce the conventional two-year study period to 26 weeks.


Intraarticular sternocostal ligament

The Intraarticular sternocostal ligament is a horizontal fibrocartilaginous plate in the center of the second sternocostal joint. It connects the tip of the costal cartilage to the fibrous junction between the manubrium and the body of the sternum, dividing the joint into two parts.


Chris Oliver (surgeon)

Chris Oliver is an Edinburgh orthopaedic surgeon and professor. He was King James IV Professor at the Royal College of Surgeons of Edinburgh 2019-20, and has been Associate Research Fellow at the School of Engineering and Built Environment, Transport Research Institute, Edinburgh Napier University since 2018. He was an honorary Professor in Physical Activity for Health at the Physical Activity for Health Research Centre, University of Edinburgh between 2015 and 2018 and a consultant trauma orthopaedic and hand surgeon at Royal Infirmary of Edinburgh from 1997 to 2017.
Education.
In 1992, Oliver completed a doctorate (MD) from University College London in spinal muscle physiology and artificial intelligence.
Career.
Oliver retired in 2018 from the Royal Infirmary of Edinburgh as a consultant trauma orthopaedic surgeon in the Department of Trauma and Orthopaedics, University of Edinburgh. Career was profiled by the British Medical Journal, Careers in July 2018.
Between 2015-2018 he was honorary Professor of Physical Activity for Health to Physical Activity for Health Research Centre (PAHRC) at the University of Edinburgh.
In October 2016, along with other academics, he signed a letter to the Medical Schools Council and the General Medical Council to highlight the lack of lifestyle education in undergraduate medical curricula across the United Kingdom.
Published work.
Oliver claims to have authored over 400 publications and presentations. He has written about medical informatics, assessment in medical education, physical activity and orthopaedic surgery.
He was a section editor in the multi-author major trauma section of "Oxford Textbook of Fundamentals of Surgery". published in July 2016.
Personal life.
Oliver gained excessive weight during his adult life and at his heaviest was 171 kg (27 stone). In February 2007, he had a LapBand fitted laparascopically and, by 2011, his weight reduced to 102 kg (12 stone). In 2014, the band snapped and it was later removed. In November 2020, he had an endoscopic gastric bypass.
Oliver is an avid endurance cyclist. In 2013, he cycled 3,415 miles from Los Angeles to Boston, USA, with his daughter, Catherine.


Miami Project to Cure Paralysis

The Miami Project to Cure Paralysis is a spinal cord injury research center and a designated Center of Excellence at the University of Miami Miller School of Medicine. It was co-founded in 1985 by Barth A. Green, M.D. and Pro Football Hall of Fame linebacker Nick Buoniconti after Buoniconti's son, Marc, sustained a spinal cord injury during a college football game. Today, The Miami Project’s international team is housed in the Lois Pope LIFE Center and includes more than 250 scientists, researchers and clinicians.
Clinical trials.
In July 2012, The Miami Project was granted approval by the FDA to proceed with a Schwann cell implantation clinical trial. In November 2012, doctors from the University of Miami implanted the first patient with his own Schwann cells, initiating phase 1 of the trial, a test of the safety and efficacy of the technique.
Buoniconti Fund.
The Buoniconti family established The Buoniconti Fund to Cure Paralysis in 1992, a non-profit organization devoted to assisting The Miami Project.
Lois Pope LIFE Center.
The Center is located in the Schoninger research quadrangle at the University of Miami/Jackson Memorial Medical Center. It was named in honor of Lois Pope, who donated $10 million toward its construction, and of her charity Leaders in Furthering Education (LIFE). The building opened on October 26, 2000. Pope's gift also funds 20 LIFE Fellows for neurological research. The six-story building cost $28 million and was designed by MGE Architects. The block of NW 11th Avenue in front of the building has been named Buoniconti Drive.


King Edward VII Welsh National Memorial Association

The King Edward VII Welsh National Memorial Association or WNMA was a Welsh voluntary association set up to combat tuberculosis.
The lord mayor of Cardiff, alderman John Chappell, convened a meeting in Shrewsbury on 30 September 1910 to decide what form the Welsh national memorial to King Edward VII should take. The meeting decided that the memorial should be an organised campaign to eradicate tuberculosis in Wales and Monmouthshire. £300,000 was raised by the public, half of which was donated by philanthropist David Davies of Llandinam, the Liberal MP for Montgomeryshire, who had a special interest in the fight against tuberculosis. He later became the first president of the WNMA, which was incorporated on 17 May 1912. He invited Thomas Jones, a lifelong friend and guide, to be the WNMA's first secretary.
The Public Health (Tuberculosis) Act 1921 required local authorities to treat and prevent tuberculosis. However, in Wales the WNMA already existed. The Act gave them statutory responsibility for fighting tuberculosis in Wales.


Education in Montreal

With access to six universities and twelve junior colleges in an 8 kilometre (5 mi) radius, Montreal, Quebec (Canada) has the highest proportion of post-secondary students of all major cities in North America. This represents roughly 248,000 post-secondary students, one of the largest numbers in the world.
College.
High school graduates who wish to go on to university must first complete two years of college (as an alternative, some students spend two years in American prep school)
Primary and secondary schools.
Currently 17 school districts are secular and based on linguistic communities:
Prior to 1998 school districts were formed on religious lines, with the school boards having both Francophone and Anglophone schools:
Montreal also has French-language and English-language private schools. Anglophone private schools receiving subsidies from the provincial government must abide by the French Language Charter and restrict enrollment of students to eligible parties.
Miscellaneous education.
The Montreal Hoshuko School, a Japanese language supplemental school, holds its classes at the Trafalgar School for Girls.
The Chinese language supplemental school JiaHua School of Montreal (, ) operates in Montreal. As of 2004 it has 800 students, who attend francophone and anglophone day schools, and 51 teachers. It offers mathematics, French, and English remedial classes in addition to Chinese classes. Most of the teachers are parents who have university degrees; they volunteer at the school.


Secretary of State for Health and Social Care

The secretary of state for health and social care, also referred to as the health secretary, is a secretary of state position within the Government of the United Kingdom, as well as the leader of the Department of Health and Social Care (DHSC). The officeholder has responsibility for all health and social care matters in England, including England's National Health Service (NHS). Alongside the chief medical officer for England, the officeholder serves as the principal adviser to the prime minister of the United Kingdom on all health matters. The office forms part of the Cabinet of the United Kingdom.
The position can trace its roots back to the nineteenth century. It has had different names in the past, and has been a secretary of state position since 1968. For 30 years, from 1988 to 2018, the position was titled Secretary of State for Health, before prime minister Theresa May added Social Care to the title in the 2018 British cabinet reshuffle.
The postholder has two principal deputies: the minister of state for health and the minister of state for social care.
The current secretary of state for health and social care is Matt Hancock, since his appointment by then–Prime Minister Theresa May in July 2018. Hancock retained his position upon the elevation of Boris Johnson to Prime Minister.
Responsibilities.
Corresponding to what is generally known as a health minister in many other countries, the health secretary's remit includes the following:
History.
The first Boards of Health were created by Orders in Council dated 21 June, 14 November and 21 November 1831. In 1848, a General Board of Health was created with the First Commissioner of Woods and Forests as its president. In 1854, this board was reconstituted and the president appointed separately. However, the board was abolished in 1858 and its function of overseeing the local boards was transferred to a new Local Government Act Office within the Home Office. From 1871, that function was transferred to the new Local Government Board.
The Ministry of Health was created in by the Ministry of Health Act 1919 as a reconstruction of the Local Government Board. Local government functions were eventually transferred to the Minister of Housing and Local Government, leaving the Health Ministry in charge of Health proper.
From 1968, it was amalgamated with the Ministry of Social Security under the secretary of state for social services, until a de-merger of the Department of Health and Social Security on 25 July 1988.
Since devolution in 1999, the position holder's responsibility for the NHS is mainly restricted to the health service in England, with the holder's counterparts in Scotland and Wales responsible for the NHS in Scotland and Wales. Prior to devolution, the secretaries of state for Scotland and Wales had those respective responsibilities, but the Department of Health had a larger role than now in the co-ordination of health policy across Great Britain. Health services in Northern Ireland have always had separate arrangements from the rest of the UK, and are currently the responsibility of the health minister in the Northern Ireland Executive.
A small number of health issues remain reserved matters, that is, they are not devolved.
List of ministers.
Colour key (for political parties):


Competitor Group

Competitor Group, Inc. (CGI) is a privately held, for-profit, sports marketing and management company based in Mira Mesa, San Diego, California. The company owns and operates over 40 large scale running, cycling, and triathlon events; of which includes the Rock 'n' Roll Marathon Series.
History.
Competitor Group was formed by Falconhead Capital at the end of 2007 when the firm acquired Elite Racing, an operator of running events in the United States, as well as La Jolla Holding Group, LLC ("Triathlete" magazine) and Competitor Publishing. In 2008, Falconhead Capital acquired Inside Communications, Inc., owners of "VeloNews", "Inside Triathlon", adding them to the CGI business portfolio.
With the acquisition of Elite Racing, CGI rapidly expanded its event production with the Rock 'n' Roll Marathon Series. In addition to the races already produced under Elite Racing, CGI has purchased under-performing marathon and half-marathon races as well as starting new races around the United States, sometimes receiving large tax breaks in the process.
In January 2014, Competitor Group announced that it would cease publication of "Inside Triathlon". Originally called "Triathlon Today", the magazine was first owned by Inside Communication in 1993, a competitor to La Jolla Holding Group's "Triathlete" magazine. With both magazine now under one ownership the emphasis of CGI was placed on "Triathlete". Later, in July 2014, CGI announced their desire to focus on the running portion of their product portfolio. As a result, they were exploring opportunities to sell their "Velo", VeloPress and TriRock brands, but planned to retain "Triathlete" magazine.
CGI was bought by a private equity firm, Calera Capital in 2012 and then sold to the Chinese conglomerate Wanda Group in 2017; which owned the World Triathlon Corporation (WTC), operators of the Ironman Triathlon brand. With the acquisition, CGI was placed under the sphere of WTC's Ironman Group. In October 2017, WTC subsequently sold CGI publications "Triathlete", "VeloNews" and "Women's Running" to the Pocket Outdoor Media division of Pocket Ventures, which owns "SpaceNews." At that same time its "Competitor" magazine ceased publication due to its failing viability. In early 2020, Wanda Group sold CGI, as part of its ownership of WTC, to the privately held Advance Publications.


Bone collar

The bone collar is a cuff of periosteal bone that forms around the diaphysis of the hyaline cartilage model in developing long bones. The bone collar appears during endochondral bone development to support the growing bone and help it retain its shape.


Andrea Natale

Andrea Natale is an Italian-born American cardiologist and electrophysiologist, i.e. a heart rhythm specialist. Natale is known for his work in atrial fibrillation ablation, and he is currently the executive director at the Texas Cardiac Arrhythmia Institute.
Education.
Natale received his medical degree from the University of Florence Medical School, Florence, Italy and later attended the Catholic University School of Cardiology, Rome, Italy. He then attended Methodist Hospital, Baylor College, Houston, Texas as a research fellow. Subsequently, he completed his Residency (Cardiology and Electrophysiology) at Western Ontario University in Canada and University of Wisconsin, Milwaukee.
Prior to his appointment as Executive Medical Director of the Texas Cardiovascular Arrhythmia Institute at St. David's Medical Center in Austin, Natale was faculty at Duke University, then Director of the Electrophysiology Section of the University of Kentucky in Lexington and Section Head for the Department of Cardiac Pacing and Electrophysiology and Medical Director for the Cleveland Clinic’s Center for Atrial Fibrillation.
Career.
Natale has been active in the Heart Rhythm Society since its inception, where he has been recognized as a Founders Member in 2004, at Chairman Level in 2005 and at Ambassador Level in 2010. He has been member of several HRS committees (Relation with Industry, Reimbursement and Regulatory Affairs, Atrial Fibrillation Consensus Statement ). From 2005 through 2008, he has been a member of the Annual Meeting Program Committee and since 2011 a Trustee in the HRS Board.
Natale is a faculty member at various universities and scientific and medical institutions, including Stanford University and Case Western University. He is the author, co-author or editor of hundreds of published articles and various books on pacing and electrophysiology. He serves or has served on the editorial boards of numerous medical journals including the Heart Rhythm Journal, Journal of the American College of Cardiology, American Journal of Cardiology, Journal of Cardiovascular Electrophysiology, American Heart Journal, Circulation, Journal of Electrocardiology and is the editor-in-chief of the Journal of Atrial Fibrillation. Besides Venice Arrhythmias, he is the creator of EPLIVE, the first fully interactive meeting of his genre, where EP experts from various countries are invited to share their experience while observing live cases being performed in the state-of-the-art laboratories of TCAI in Austin, Texas.
Research and clinical achievements.
Natale pioneered a circumferential ultrasound vein-ablation system to correct atrial fibrillation and performed the procedure on the world's first patients. He also developed some of the current catheter-based cure strategies for atrial fibrillation, and was the first electrophysiologist in the US to perform percutaneous epicardial radiofrequency ablation, which is a treatment for people who fail conventional ablation. He has authored milestone papers on pivotal projects, such as PABA and RAAFT.
Appointments.
Natale serves as the Executive Medical Director at Texas Cardiac Arrhythmia Institute at St. David’s Medical Center in Austin, Texas. Since 2007 he has been appointed Senior Director of the Arrhythmia Center at California Pacific Medical Center in San Francisco. In 2012 he also became Director of Interventional Electrophysiology at the Scripps Clinic in La Jolla, California, directed by Dr. Paul Tierstein and Dr. Eric Topol. Since April 2013 he is also Executive Director of the Al Sabah Arrhythmia institute at St Luke's -Roosevelt Medical Center, in New York.
He is a member, in charge of new technologies, for the Task Force on Atrial Fibrillation
Personal life.
Natale has a daughter named Veronica. In September 2020, he claimed that his daughter was "attacked" by Black Lives Matter protesters while at a stop light in Baltimore. However, 9-1-1 emergency call recordings and police body camera footage indicated that squeegee boys offered to clean the daughter's car windows, and that her boyfriend engaged the teens in a physical and verbal assault after threatening them with a knife. Natale later doubled down on his claims before deleting his Twitter account and issuing an apology.
Honors.
Natale has received many awards for his clinical work and commitment to teaching, including the following:


Franklin Hudson

Franklin Hudson (1864–1918) was a 19th/20th century American-born photographer and osteopath and medical author, living in Scotland.
Life.
He was born in Andalusia, Alabama on 20 September 1864. His first job was as a boat pilot for Aaron Richey (founder of Port Richey, Florida).
In 1891 he moved to Paris, Texas, then working as a photographer. Here he trained as an osteopath and became one of the original members of the American Osteopathic Association in 1897.
He emigrated to Scotland in 1903. He lived at 12 Lansdowne Crescent in western Edinburgh, a large terraced Victorian townhouse.
He died of the Spanish flu on 16 November 1918. He is buried near his home, in Dean Cemetery. The simple grave describes as a pioneer of osteopathy. It lies in the south-east section of the first northern extension.
Family.
In 1893 he was married to the then 16 year old Lucy Rivers Sullivan (b.1876), daughter of Knott Sullivan. She outlived him.


Vascular access

Vascular access refers to a rapid, direct method of introducing or removing devices or chemicals from the bloodstream. In hemodialysis, vascular access is used to remove the patient's blood so that it can be filtered through the dialyzer. Three primary methods are used to gain access to the blood: an intravenous catheter, an arteriovenous fistula (AV) or a synthetic graft. In the latter two, needles are used to puncture the graft or fistula each time dialysis is performed.
The type of vascular access created for patients on hemodialysis is influenced by factors such as the expected time course of a patient's kidney failure and the condition of his or her vasculature. Patients may have multiple accesses, usually because an AV fistula or graft is maturing and a catheter is still being used. The creation of all these three major types of vascular accesses requires surgery.
Catheter.
Catheter access, sometimes called a CVC (central venous catheter), consists of a plastic catheter with two lumens (or occasionally two separate catheters) which is inserted into a large vein (usually the vena cava, via the internal jugular vein or the femoral vein) to allow large flows of blood to be withdrawn from one lumen, to enter the dialysis circuit, and to be returned via the other lumen. However, blood flow is almost always less than that of a well functioning fistula or graft.
Catheters are usually found in two general varieties, tunnelled and non-tunnelled.
Non-tunnelled catheter access is for short-term access (up to about 10 days, but often for one dialysis session only), and the catheter emerges from the skin at the site of entry into the vein.
Tunnelled catheter access involves a longer catheter, which is tunnelled under the skin from the point of insertion in the vein to an exit site some distance away. It is usually placed in the internal jugular vein in the neck and the exit site is usually on the chest wall. The tunnel acts as a barrier to invading microbes, and as such, tunnelled catheters are designed for short- to medium-term access (weeks to months only), because infection is still a frequent problem.
Aside from infection, venous stenosis is another serious problem with catheter access. The catheter is a foreign body in the vein and often provokes an inflammatory reaction in the vein wall. This results in scarring and narrowing of the vein, often to the point of occlusion. This can cause problems with severe venous congestion in the area drained by the vein and may also render the vein, and the veins drained by it, useless for creating a fistula or graft at a later date. Patients on long-term hemodialysis can literally 'run out' of access, so this can be a fatal problem.
Catheter access is usually used for rapid access for immediate dialysis, for tunnelled access in patients who are deemed likely to recover from acute kidney injury, and for patients with end-stage kidney failure who are either waiting for alternative access to mature or who are unable to have alternative access.
Catheter access is often popular with patients, because attachment to the dialysis machine doesn't require needles. However, the serious risks of catheter access noted above mean that such access should be contemplated only as a long-term solution in the most desperate access situation.
AV fistula.

AV (arteriovenous) fistulas are recognized as the preferred access method. To create a fistula, a vascular surgeon joins an artery and a vein together through anastomosis. Since this bypasses the capillaries, blood flows rapidly through the fistula. One can feel this by placing one's finger over a mature fistula. This is called feeling for "thrill" and produces a distinct 'buzzing' feeling over the fistula. One can also listen through a stethoscope for the sound of the blood "whooshing" through the fistula, a sound called "bruit".
Fistulas are usually created in the nondominant arm and may be situated on the hand (the 'snuffbox' fistula'), the forearm (usually a radiocephalic fistula, or so-called Brescia-Cimino fistula, in which the radial artery is anastomosed to the cephalic vein), or the elbow (usually a brachiocephalic fistula, where the brachial artery is anastomosed to the cephalic vein). Though less common, fistulas can also be created in the groin, though the creation process differs. Placement in the groin is usually done when options in the arm and hands are not available due to anatomy or the failure of fistulas previously created in the arms/hands. A fistula will take a number of weeks to mature, on average perhaps 4–6 weeks.
During treatment, two needles are inserted into the vein, one to draw blood and one to return it. The orientation of the needles takes the normal flow of the blood into account. The "arterial" needle draws blood from the "upstream" location while the "venous" needle returns blood "downstream". This sequence prevents partial recycling of the same blood through the dialysis machine, which would lead to less effective treatment.
The advantages of the AV fistula use are lower infection rates, because no foreign material is involved in their formation, higher blood flow rates (which translates to more effective dialysis), and a lower incidence of thrombosis. The complications are fewer than with other access methods. If a fistula has a very high blood flow and the vasculature that supplies the rest of the limb is poor, a steal syndrome can occur, where blood entering the limb is drawn into the fistula and returned to the general circulation without entering the limb's capillaries. This results in cold extremities of that limb, cramping pains, and, if severe, tissue damage. One long-term complication of an AV fistula can be the development of an aneurysm, a bulging in the wall of the vein where it is weakened by the repeated insertion of needles over time. To a large extent the risk of developing an aneurysm can be reduced by carefully rotating needle sites over the entire fistula, or using the "buttonhole" (constant site) technique. Aneurysms may necessitate corrective surgery and may shorten the useful life of a fistula. Fistulas can also become blocked due to blood clotting or infected if sterile precautions are not followed during needle insertion at the start of dialysis. Because of the high volume of blood flowing through the fistula, excessive bleeding can also occur. This is most common soon after a dialysis treatment. Pressure must be applied to the needle holes to induce clotting. If that pressure is removed prematurely or a patient engages in physical activity too soon after dialysis, the needle holes can open up.
To prevent damage to the fistula and aneurysm or pseudoaneurysm formation, it is recommended that the needle be inserted at different points in a rotating fashion. Another approach is to cannulate the fistula with a blunted needle, in exactly the same place. This is called a 'buttonhole' approach. Often two or three buttonhole places are available on a given fistula. This also can prolong fistula life and help prevent damage to the fistula.
A recent study that was published in The American Journal of Pathology, provides information about the mechanisms underlying failure of the most common type of hemodialysis vascular access, the arteriovenous fistula. In spite of AV Fistula being one of the most preferred methods of Vascular access, the researchers observed that, up to 60% of newly created fistulas never become usable for dialysis because they fail to mature (meaning the vessels do not enlarge enough to support the dialysis blood circuit.). This study suggests that, the impairment in responsiveness to nitric oxide that occurs in some patients with end-stage renal disease may result in hyperplasia (excessive growth) of the innermost layer of the blood vessels or reduced ability of the vessels to dilate. Either abnormality can limit the maturation and viability of the arteriovenous fistula. This research raises the possibility that therapeutic restoration of nitric oxide responsiveness through manipulation of local mediators may prevent fistula maturation failure in patients and potentially contribute to their ability to remain on hemodialysis.
AV graft.
AV (arteriovenous) grafts are much like fistulas in most respects, except that an artificial vessel is used to join the artery and vein. The graft usually is made of a synthetic material, often PTFE, but sometimes chemically treated, sterilized veins from animals are used. Grafts are inserted when the patient's native vasculature does not permit a fistula. They mature faster than fistulas, and may be ready for use several weeks after formation (some newer grafts may be used even sooner). However, AV grafts are at high risk to develop narrowing, especially in the vein just downstream from where the graft has been sewn to the vein. Narrowing often leads to thrombosis (clotting). As foreign material, they are at greater risk for becoming infected. More options for sites to place a graft are available, because the graft can be made quite long. Thus a graft can be placed in the thigh or even the neck (the 'necklace graft').
Fistula First project.
AV fistulas have a much better access patency and survival than do venous catheters or grafts. They also produce better patient survival and have far fewer complications compared to grafts or venous catheters. For this reason, the Centers for Medicare & Medicaid (CMS) has set up a Fistula First Initiative, whose goal is to increase the use of AV fistulas in dialysis patients. This initiative has had many successes, but fistula is not always the superior strategy when it comes to the elderly.
There is ongoing research to make bio-engineered blood vessels, which may be of immense importance in creating AV fistulas for patients on hemodialysis, who do not have good blood vessels for creation of one. It involves growing cells which produce collagen and other proteins on a biodegradable micromesh tube followed by removal of those cells to make the 'blood vessels' storable in refrigerators.


Vitelline cyst


Ernst Fuchs (doctor)

Ernst Fuchs (14 June 1851, Vienna – 21 November 1930, Vienna) was an Austrian ophthalmologist, physician and researcher.
Overview.
The importance of Fuchs' life achievement must surely be based on his discovery and description of numerous ocular diseases and abnormalities. As a result of more than 250 scientific publications, the name Ernst Fuchs became well known throughout the world.
Although his name is commonly recognized in conjunction with various corneal and anterior segment disorders, Ernst Fuchs' contribution to ophthalmology exceeds purely the delineation of ocular diseases and the detailed description of signs. Fuchs' collection of microscopic samples laid the foundation for anatomical and pathological understanding of blood vessels, muscles, and most other tissues of the eye. Additionally, Fuchs was able to pass on his unique knowledge, educating ophthalmologists at an international level. His Textbook of Ophthalmology was, for many decades, the most extensively used reference book in the field of ophthalmology worldwide.
Fuchs' Textbook of Ophthalmology was first published in 1889. During the following 21 years, he edited 12 of the 18 English editions of the textbook himself. The Textbook of Ophthalmology was translated into numerous languages (including Japanese, Chinese, Spanish, French, Russian, and Italian). Between 1892 and 1933, 10 British and American editions were published. Later versions were edited by Maximilian Salzmann, his oldest pupil. In America as well as the Far East, the textbook was considered the bible of ophthalmology for approximately 50 years. The final edition was published in 1945 in German. Other books about normal and pathological anatomy have evolved from Fuchs' textbook.
During his period of clinical practice and education, Austria and particularly Vienna became the centre of ophthalmology worldwide. Fuchs' success was not limited to Austria, but he was known globally and his works were published in Japanese, Chinese and German languages. Fuchs also had many international patients, including the wife of Naser al-Din, the Qajar Shah of Persia and a group of his entourage, who came to Fuchs for treatment of cataracts.
International Recognition.
Fuchs was elected an Honorary Fellow of the Royal College of Surgeons (Edinburgh) in 1905.


Capillary hemangioma

A capillary hemangioma (also known as an Infantile hemangioma, Strawberry hemangioma, and Strawberry nevus) is the most common variant of hemangioma which appears as a raised, red, lumpy area of flesh anywhere on the body, though 83% occur on the head or neck area. These marks occur in about 10% of all births, and usually appear between one and four weeks after birth. It may grow rapidly, before stopping and slowly fading. Some are gone by the age of 2, about 60% by 5 years, and 90–95% by 9 years. Capillary hemangioma is a vascular anomaly.
Capillary hemangiomas occur 5 times more often in female infants than in males, and mostly in Caucasian populations. Additionally, low birthweight infants have a 26% chance of developing a hemangioma.
It is the most common tumor of orbit and periorbital areas in childhood. It may occur in the skin, subcutaneous tissues and mucous membranes of oral cavities and lips as well as in the liver, spleen and kidneys. While this birthmark may be alarming in appearance, physicians generally counsel that it be left to disappear on its own, unless it is in the way of vision or blocking the nostrils.
Diagnosis.
Liver.
Capillary haemangiomas in the liver are found in 16% of all liver haemangiomas. Its sizes are usually less than 1 to 2 cm in diameter. It may show a "flash-filling" phenomenon in which there is the fast enhancement of the contrast material in the lesion instead of slow, centripetal, nodular filling of the lesions in usual haemangiomas. On CT and MRI, it shows rapid filling during arterial phase, with contrast retention in venous and delayed phases.
Treatment.
Oral propranolol appears to be the most effective treatment for reducing the size of capillary hemangiomas in children and is more effective than placebo, observation without intervention, or oral corticosteroids.


Ian Dunbar

Ian Dunbar (born April 15, 1947) is a veterinarian, animal behaviorist, and dog trainer who received his veterinary degree and a Special Honors degree in Physiology & Biochemistry from the Royal Veterinary College (London University) plus a doctorate in animal behavior from the Psychology Department at UC Berkeley, where he researched the development of social hierarchies and aggression in domestic dogs.
He has authored numerous books and DVDs about puppy/dog behavior and training, including "AFTER You Get Your Puppy", "How To Teach A New Dog Old Tricks" and the "SIRIUS Puppy Training" video.
In 1982, Dunbar designed and taught the world's very first off-leash puppy socialization and training classes—SIRIUS Puppy Training. Subsequently, he created and developed the San Francisco SPCA's Animal Behavior Department, the American Kennel Club's Gazette "Behavior" column, which he wrote for seven years, and the K9 GAMES, which were first held in San Francisco in 1993 and continue as annual events in Japan and France. He hosted the popular UK television series Dogs With Dunbar for five seasons and has appeared on numerous radio and television programs, including the Today Show (US) and Dash Village (Japan).
Additionally, Dunbar has consulted on a variety of movies—full-length features, documentaries and animation (including Pixar's UP) and he has twice spoken at the prestigious e.g. Conference.
Over the past 35 years, Dunbar has given over 1000 seminars and workshops around the world for dog trainers and veterinarians in an effort to popularize off-leash puppy socialization classes, temperament modification, and owner-friendly and dog-friendly dog training.
After he founded the Association of Pet Dog Trainers in 1993, Dunbar was inducted into the Dog Fancy Hall of Fame along with four of his heroes, James Herriot, Konrad Lorenz, Lassie, and Balto. Currently, Dunbar is President of the Association of Pet Dog Trainers Foundation, Top Dog of the Center for Applied Animal Behavior and Vice President of dogstardaily, an online, multi-media puppy raising and dog training website.
Biography.
Dunbar was born in England April 1947 and grew up on his family’s farm. He went on to study veterinary medicine at the Royal Veterinary College (London University) and animal behavior at the University of California in Berkeley.
Dunbar joined the Society for Veterinary Ethology (now the International Society for Applied Ethology) over 35 years ago, at which time he was the only member specializing in dog and cat behavior problems. Later, he was involved in the establishment of the American SVE (now the American Veterinary Society of Animal Behavior).
Dunbar has written numerous books, including "How To Teach A New Dog Old Tricks, the Good Little Dog Book" and a series of educational behavior booklets on the most common pet behavior problems. He also developed, and for seven years wrote, the American Kennel Club's Gazette behavior column.
In 1993, Dunbar founded the Association of Pet Dog Trainers (APDT) in Canada and the United States and arranged their first two annual conferences. The APDT is now the largest pet dog training organization in the world. Subsequently, Dunbar helped establish APDTs in the UK, Australia, Japan, France, and Spain. In 1996, he was inducted into the Dog Fancy Hall of Fame. His current project is the creation of the K9 GAMES—a spectator event featuring fast-moving, motivating, competitive games for dogs and owners.
Education.
Dunbar received his veterinary degree and a Special Honours degree in Physiology & Biochemistry from the Royal Veterinary College (London University) and a doctorate in animal behavior from the Psychology Department at the University of California in Berkeley, where he spent ten years researching olfactory communication, the development of hierarchical social behavior, and aggression in domestic dogs.
Associations.
Dunbar is a member of the Royal College of Veterinary Surgeons, the American Veterinary Society of Animal Behavior, the California Veterinary Medical Association, the Sierra Veterinary Medical Association, and the Association of Pet Dog Trainers.
He is also the vice président of the French association MFEC (Mouvement professionnel francophone des éducateurs de chiens de compagnie).
The French association promote friendly and positive training with dog.
For several years, Dunbar has been an honorary member of the International Association of Canine Professionals and has accepted entrance into their Hall of Fame.
Sirius.
In 1980 Dunbar founded Sirius Dog Training, the first off-leash training program specifically for puppies. The program emphasizes the importance of teaching bite inhibition, early socialization, temperament training, and simple solutions for common and predictable behavior problems, as well as basic household manners, to dogs under six months of age.
Currently.
 Dunbar is currently Director of The Center for Applied Animal Behavior in Berkeley, California, where he lives with his wife Kelly, plus dogs Claude, Hugo, and Dune and cats Ugly and Mayhem. He is the founder of the Association of Pet Dog Trainers started in 1993.
Dunbar's former wife, Kelly Dunbar, is a cofounder and the executive editor of Dog Star Dail] and a contributing editor at DogTime.
Dunbar also serves as a dog behaviorist expert and on the advisory board for DogTime.com
Dunbar is also the founder of the K9 Games where he organizes those games at the international level worldwide. He promotes the K9 Games in Europe with Catherine Collignon, director of the company ANIMALIN.


Uganda Martyrs University School of Medicine

Uganda Martyrs University School of Medicine (UMUSM), whose official name is Mother Kevin Postgraduate Medical School (MKPMS), is the school of medicine of Uganda Martyrs University. , the medical school is the newest medical school in Uganda, having been established in 2010. Currently the school provides postgraduate medical education in the disciplines of Pediatrics, Internal Medicine, Surgery, Obstetrics/Gynecology and Emergency Medicine.
Location.
The school's campus is located on Nsambya Hill, in southern Kampala, Uganda's capital and largest metropolis, approximately , south of the central business district of the city. The school is housed on the premises of St. Francis Hospital Nsambya, a faith based not-for-profit hospital owned by the Roman Catholic Archdiocese of Kampala. The coordinates of the school are:0°18'06.0"N 32°35'07.0"E (Latitude:0.301667; Longitude:32.585289).
Overview.
UMU School of Medicine is the school of medicine of Uganda Martyrs University, with headquarters at Nkozi, Mpigi District. Established in 2010, the school is headed by the Dean. The current dean is Professor Paul D'Arbela. The clinical teaching disciplines of the medical school are integrated with St. Francis Hospital Nsambya, a 540-bed community hospital owned by the Roman Catholic Archdiocese of Kampala and is administered by the Little Sisters of St. Francis.
Departments.
As of February 2015, the following departments constituted Uganda Martyrs University School of Medicine:
1. Department of Internal Medicine 2. Department of Obstetrics and Gynecology 3. Department of Pediatrics & Child Health 4. Department of Surgery and 5. Department of Emergency Medicine.
Undergraduate Courses.
Currently there are no undergraduate courses offered at UMU School of Medicine.
Graduate Courses.
The following postgraduate courses are offered at Uganda Martyrs University School of Medicine:


Helene Fuld Health Foundation


Defence Medical Academy

The Defence Medical Academy is based at DMS Whittington. It is the training centre of Defence Medical Services. It trains military personnel to deal with situations that civilian paramedics would be involved with; i.e. more advanced situations than those which just require first aid.
History.
The organization was formed as the Defence Medical Services Training Centre from the medical training centres for the three services at Keogh Barracks in 1996 and was initially subordinate to the Defence Medical Training Organisation. It became subordinate to the Royal Centre for Defence Medicine in 2008 and moved to Whittington Barracks as the Defence College of Healthcare Education and Training in 2014. It was renamed the Defence Medical Academy in September 2019.
Structure.
The college is a Ministry of Defence Agency that provides Phase 2 training for medical personnel for all three armed forces (Combat Medical Technicians - CMTs and Medical Assistants - MAs), excluding that for medical doctors (from university medical schools). It trains the:
The Museum of Military Medicine is still based at Keogh Barracks.


Medial anterior thalamic vein

The paired (right and left) medial anterior thalamic veins () originate each from the medial anterior part of the thalamus. Benno Shlesinger in 1976 classified these veins as belonging to the central group of thalamic veins ("").


Pool chlorine hypothesis

The pool chlorine hypothesis is the hypothesis that long-term attendance at indoor chlorinated swimming pools by children up to the age of about 6–7 years is a major factor in the rise of asthma in rich countries since the late twentieth century. A narrower version of the hypothesis, i.e. that asthma may be induced by chlorine related compounds from swimming pools, has been stated based on a small numbers of cases at least as early as 1995. An empirically motivated statement of the wider form of the hypothesis is first known to have been published on the basis of tests of the effects of nitrogen trichloride above chlorinated water on the lung as well as epidemiological evidence by a group of medical researchers led by Alfred Bernard of the Department of Public Health in the Catholic University of Louvain in Brussels, Belgium in 2003. In the epidemiological studies, the association between chlorinated swimming pools and asthma was found to be more significant than factors such as age, sex, ethnic origin, socioeconomic status, exposure to domestic animals and passive smoking (in a study in Brussels), and independent of altitude, climate, and GDP per capita (in a Europe-wide study of 21 countries).
Effects of nitrogen trichloride (trichloramine) on the human lung.
Nitrogen trichloride has been directly linked as a factor causing asthma in two lifeguards and a swimming teacher. A study of 624 swimming pool workers found a significant correlation between upper respiratory symptoms and their total exposure to nitrogen trichloride. The study also found an excess risk in the workers for the specific symptoms indicative of asthma. In a study by Alfred Bernard's group, two hours exposure to an average concentration of 0.490 mg/m3 of nitrogen trichloride above a swimming pool was found in both children and adults to significantly increase the levels of the alveolar surfactant associated proteins A and B, which indicate hyperpermeability of lung epithelium. In other words, exposure to nitrogen trichloride was found to weaken the protective nature of the surface of the lungs.
Epidemiological studies.
In a study of 341 schoolchildren, Bernard and his colleagues found that long-term attendance at indoor chlorinated swimming pools by the children up to the age of about 6–7 years was a strong predictor of airway inflammation (measured by exhaled nitric oxide) independently of other factors, while for those children susceptible to allergic problems, as defined by having a blood serum level of immunoglobulin E greater than 100 kIU/L, their total time spent at indoor chlorinated swimming pools was a strong predictor of the probability that they would have asthma.
Relations to demographic and environmental variables.
In the Bernard group's study of 226 children in Brussels and the Ardenne region in 2003, asthma and exercise-induced bronchoconstriction (a test related to potential breathing difficulties) were not found to have any statistically significant correlation with the demographic and environmental factors of age, sex, ethnic origin, socioeconomic status or exposure to pets or passive smoking alone. However, when the time spent at chlorinated swimming pools (modified for pool height as a statistical way to indicate likely concentrations of chlorine related gases) was adjusted for exposure to pets and passive smoking, the significance of the correlations with asthma increased further. The authors describe this saying that a "very strong argument in [favour] of causality [between pool attendance and asthma] comes from the synergistic action of exposure to pets and [passive smoking], two well documented risk factors for asthma, which together considerably increase the strength of the associations, to levels largely above those usually observed in asthma epidemiology."
In a later study by the Bernard group of 190,000 children in 21 countries in Europe, it was found that 13- to 14-year-old children were 2% to 3.5% more likely to have or have had asthma for every additional indoor chlorinated pool per 100,000 inhabitants in their place of residence. Other atopic diseases such as hay fever or atopic dermatitis were found to be not associated with the presence of the pools. The association of asthma with the number of indoor chlorinated swimming pools per 100,000 inhabitants was found by the authors to be independent of altitude, climate, and GDP per capita.
Scientific debate on the epidemiological studies.
After the publication of Bernard's group's 2003 study, B. Armstrong and D. Strachan described the study as "generally well conducted", but stated that some aspects of the statistical analysis and interpretation were "misleading", to the extent that "the epidemiological association of asthma with swimming pool use [was] not as strong as claimed by the authors".
Following publication of Bernard's group's 2006 study, some concerns by P. A. Eggleston and a response by Bernard's group were published. For example, Eggleston argued that if "chlorinated compounds at indoor swimming pools could cause asthma", then "frequent and longer exposures at home" should be even stronger causes of asthma, in contradiction to the available evidence from a single group of children. Bernard's group's response was that while children at an indoor chlorinated pool "actively inhale [the chlorination products] as gases, aerosols, or even water", they are not usually involved in household cleaning tasks, so they could benefit from the hygienic effects of the chlorine based cleaning products while avoiding any significant contact with the related gases. Members of Bernard's group's declared that they had no potentially conflicting financial interests, while Eggleston declared that he had received money from the United States-based group called the Chlorine Chemistry Council. In a "Faculty Disclosure" statement in an asthma-related publication, it was declared that Eggleston is "a consultant for Chlorine Chemistry Council, Church and Dwight, Merck Sharp & Dohme, and Procter & Gamble, and is on the speakers' bureau for AstraZeneca, GlaxoSmithKline, and Merck."
Hypothesised mechanistic explanation.
Alfred Bernard and colleagues argue that what is common to the pool chlorine hypothesis and epidemiological studies associating chlorine based irritants to atopy could be that frequent, long-term disruption of the epithelium of the lung, which normally provides a protective barrier against various pathogens, could allow allergens to cross this barrier. This process would also cause certain proteins from the lung epithelium to have increased blood serum concentrations.


James Haig Ferguson

James Haig Ferguson LLD FRSE FRCPE FRCSEd (18 December 1862 – 2 May 1934) was a prominent Scottish obstetrician and gynaecologist. He served as President of the Royal College of Surgeons of Edinburgh from 1929 to 1931 and was president of the Edinburgh Obstetrical Society. He chaired the Central Midwives Board of Scotland and was manager of Donaldson's School for the Deaf. In 1929 he was a founder member of the British (later Royal) College of Obstetricians and Gynaecologists.
In 1899 he founded the Haig Ferguson Memorial Home for unmarried mothers to give birth without chastisement. It was originally called the Lauriston Home and was renamed following his death; it closed in 1974.
Early life.
He was born on 18 December 1862, in the manse at Fossoway (now known as Crook of Devon), Perthshire, the son of Elizabeth Haig of Dollarfield and Rev. William Ferguson, the local minister. He attended the Collegiate School in Edinburgh before entering the faculty of medicine of the University of Edinburgh. He graduated MB CM in 1884 and in the same year became a Member of the Royal College of Surgeons of England.
Medical career.
He worked as a resident physician under Dr Claude Muirhead at the Royal Infirmary of Edinburgh (RIE) on Lauriston Place, and as resident physician at the Royal Hospital for Sick Children in Edinburgh. He then became private assistant to the obstetrician Dr (later Sir) John Halliday Croom, which marked the start of his career in obstetrics and gynaecology. In 1887 Haig Ferguson became a Member of the Royal College of Physicians of Edinburgh (MRCPE) and two years later he was elected a Fellow (FRCPE). This qualification was regarded as the most appropriate for obstetricians at this time, but it was also advantageous to Haig Ferguson as he conducted a large general practice in addition to his developing obstetric practice. In 1890 he obtained from the University of Edinburgh the degree of Doctor of Medicine (MD) with honours. From 1896 he was Assistant Gynaecologist at theRIE. In 1898 he was appointed gynaecologist to Leith Hospital and assistant physician to the Edinburgh Royal Maternity Hospital one year later.  Realising that gynaecology was becoming increasingly surgical in its practice and in order to establish his surgical credentials he obtained the Fellowship of the Royal College of Surgeons of Edinburgh by examination in 1902 at the age of forty.
During this period he taught obstetrics and gynaecology in the extramural School of Medicine of the Royal Colleges of Edinburgh.
In 1906 Haig Ferguson was appointed assistant gynaecologist to the RIE. During this time, in addition to his RIE practice he served on the governing bodies of the Royal Hospital for Sick Children, Donaldson’s Hospital, Merchiston Castle School and the Queen’s Institute of District Nursing. His  single most important public service was as a member of the Central Midwives Board for Scotland, acting as its chairman for 13 years.
In 1919 he became gynaecologist in charge of wards in the RIE. .One lasting contribution to obstetrics was the invention of the obstetric forceps which bear his name. He described these and their use in 1926. These are described as mid-cavity forceps and are still used in the 21st century. They remained available for purchase in 2019.
In 1928/9 he conducted an extended exchange of correspondence with the Russian gynaecologist Vasily Stroganov in Leningrad. These concerned translation of Stroganov’s book "The Improved Prophylactic Method in the Treatment of Eclampsia" (published New York, 1930).
He retired in 1927.
Awards and honours.
In 1904 he was elected a Fellow of the Royal Society of Edinburgh. His proposers were Sir William Turner, Alexander Crum Brown, Sir Patrick Heron Watson (his father-in-law), and Sir John Halliday Croom. He was president of the Edinburgh Obstetrical Society and in 1929 was elected president of the Royal College of Surgeons of Edinburgh. The University of Edinburgh awarded him the Honorary degree of Doctor of Laws (LLD).,
Family and later life.
In 1889 he married Penelope Gordon Watson (1863-1944), daughter of Patrick Heron Watson. They had two sons , William Haig Ferguson (1891-1928) Patrick Haig W. Ferguson (1898- ) , and three daughters, Elizabeth Barbara Ferguson (1893-), Isobel C. Ferguson (1894), Penelope Dorothy Ferguson (1896) In 1901 the family lived at 25 Rutland Street but later moved to 7 Coates Crescent in Edinburgh’s west end. He suffered from ill-health through most of his retiral and died at home in Coates Crescent on 2 May 1934. His funeral service took place on 4 May in St George’s Parish Church on Charlotte Square (now West Register House). He is buried in Dean Cemetery.
Publications.
"Handbook of Obstetric Nursing" (1889) with Dr F W N Haultain
"A Combined Textbook of Obstetrics and Gynaecology" (1923) (co-author)


Maury Massler

Maury Massler (1912-1990) was a pioneer in developing two dental specialty areas.
He established the Department of Pediatric Dentistry at the University of Illinois at Chicago College of Dentistry, serving as head of the department from 1946 to 1965. A prolific researcher, he co-authored two textbooks, contributed to four others, and published more than 275 papers. Along with Dr. Isaac Schour, he created a chart of tooth development. Dr. Massler shared his expertise with the world, serving as a visiting professor and consultant in Italy, Germany, South America, India, Australia, Scandinavia, South Africa, and Israel. Dr. Massler was one of the creators of the Tel Aviv University postgraduate dentistry program.
After retiring from the UIC College of Dentistry in 1973, he joined Tufts University, where he developed Tufts' geriatric dentistry program.
Dr. Massler and his wife, Hilde, had two daughters, Mary Bewig and Joan Hooper.


Western Provident Association

WPA, or Western Provident Association, is a not-for-profit private medical insurance firm based in Taunton, Somerset. Its subsidiary, WPA Protocol Plc, administers corporate healthcare trusts.
History.
In 1901, a group of workers founded the Reading Work People's Voluntary Hospital Contributory Fund to cover the costs of health care for their members. In 1939, it merged with the Bristol Hospital Fund, and in 1949 it was renamed the Western Provident Association (WPA). In 1992, WPA moved from Bristol to a specially designed building in Taunton, Somerset.
Coinsurance.
WPA was described by the World Health Organization as leading in the development of coinsurance, or "shared responsibility", policies, in which the patient pays a portion of the liability until an agreed limit.
WPA vs. Norwich Union Healthcare.
In 1997, Norwich Union staff falsely claimed over e-mail that WPA was insolvent. WPA sued for defamation. Norwich Union made a High Court apology and paid £450,000 in damages and costs to settle the case. This was a landmark case because it was the first time e-mail was admitted as evidence in a British court.
Cancer Drugs and NHS Top-Up.
In 2007, WPA launched a new insurance plan which provided a health "top-up", supplementing NHS treatment. Subsequently, other insurance companies have entered the top-up market and criticism has been levelled at the products from the union Unison which stated that the products would undermine the values of the NHS and risk creating a two-tier system in health care.
WPA Protocol Plc.
WPA Protocol administers corporate healthcare trusts. This is an alternative arrangement to private medical insurance whereby larger companies, defined by Protocol as usually those with 400 or more members, can use WPA's infrastructure to administer their own healthcare provision. Companies provide the funds from a trust, and WPA Protocol provides bespoke literature and telephone lines, as well as staff, infrastructure and economies of scale.
Trusts are not charged insurance premium tax and staff are considered to be more likely to claim responsibly from their own company as opposed to an insurer. Savings are estimated to be 7% compared to being fully insured.
WPA Healthcare Practice Plc.
The WPA Healthcare Practice Plc is a wholly owned subsidiary of WPA, authorised and regulated by the Financial Conduct Authority. Healthcare Partners (franchisees), either as sole traders or limited companies, are Appointed Representatives of the WPA Healthcare Practice Plc.
Partners buy into the Healthcare Practice franchise model – they market and distribute WPA health insurance products on WPA’s behalf. The Healthcare Practice is WPA’s main distribution channel with responsibilities for the appointment and monitoring of Healthcare Partners.
The Healthcare Practice is formed by a network of Healthcare Partners throughout the UK. Healthcare Partners are the local face of WPA in their community and only advise on WPA’s products and services.


Anthony Askew

Anthony Askew (1722–1774) was an English physician and is best known for having been a book collector. His collection was purchased by the British Museum and books purchased by George III of Great Britain were added to the King's Library.
Life and work.
Askew was born in 1722 in Kendal, Westmorland, the son of Dr. Adam Askew, a well-known physician of Newcastle and Ann Crackenthorp. He was baptised in Kendal on 7 May 1722. The family moved to Newcastle in 1725.
His early education was at Sedbergh School and The Royal Free Grammar School in Newcastle upon Tyne. According to a fellow physician, he was terrified of the formidable Head Master, Richard Dawes.
He was married twice. He first married Margaret Swinburn; they had no children. The second time to Elizabeth Holford, by whom he had twelve children, six girls and six boys. Elizabeth was born in 1734 and died on 2 August 1773.
Medical education and career.
He took the degree of Bachelor of Medicine, Bachelor of Surgery (M.B.) at Emmanuel College, Cambridge in December 1745.
Initially intended for the medical profession, Askew studied for one year at Leiden University in Holland. He then travelled to Hungary, Athens, Constantinople, Italy, and other countries. He began to collect valuable books and manuscripts he laid the foundation of the extensive library, the "Bibliotheca Askeviana."
He started medical practice at Cambridge in 1750, in which year he took his degree of Doctor of Medicine (M.D.), and afterwards established himself in London. He was physician to St. Bartholomew's and Christ's Hospital, and Registrar of the College of Physicians from 1767 until 1774.
On 8 February 1749 he became a member of the Royal Society. On 25 June 1752 he became a candidate of the Royal College of Physicians and one year later became a fellow of the organisation. In 1758 he delivered the Harveian Oration at the Royal College of Physicians.
Book collector.
Askew is best known today as a classical scholar and bibliophile. Aeschylus was his favourite author. He assembled an extensive library, the "Bibliotheca Askeviana", helping to develop the taste for curious manuscripts, scarce editions, and fine copies. Askew's house was crowded with books from the cellar up to the garrets. The collection was chiefly classical, and it was its possessor's aim to have every edition of every Greek author.
In "Thornton's Medical Books, Libraries and Collectors," Alain Besson wrote that Askew's library was replete with "rare manuscripts and choice editions in exquisite bindings". He further stated that Askew made "bibliomania fashionable."
Death.
Askew died 28 February 1774 at Hampstead, London, England.
He was buried at Hampstead church. Henry Askew, Anthony's brother, became the caregiver for the orphaned children.
After the death of Askew, the library of nearly 7,000 books, was sold at an auction which lasted from 13 February to 7 March 1775. William Munk stated that the library collection was sold beginning 19 February 1775 by Baker and Leigh; the sale continued for 19 days. The catalogue of the collection was sold at one shilling and sixpence, with a few copies on royal paper at four shillings... The purchasers of Askew's books at the auction included the anatomist William Hunter, the British Museum and the kings of England and France. Books purchased by George III of England in 1762, and the Second Folio of Shakespeare bought in 1800, were added to the King's Library.
Askew's extensive collection of transcribed inscriptions is at the British Museum. One codex of his collection is named Askew Codex.


Journal of Refractive Surgery

The Journal of Refractive Surgery is a monthly peer-reviewed medical journal covering refractive and lens-based optical surgery. It is published by Slack and is the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology.
History.
The journal was established in 1985 as the "Journal of Refractive Surgery" and renamed "Refractive & Corneal Surgery" in 1989. It was again renamed in 1994 as the "Journal of Refractive & Corneal Surgery", then reverted to its original and current title in 1995.
Abstracting and indexing.
The journal is abstracted and indexed in:
According to the "Journal Citation Reports", the journal has a 2017 impact factor of 2.649.


Margaret Anne Staggers

Margaret Anne "Peggy" Staggers (born January 12, 1945) was a Democratic member of the West Virginia House of Delegates and served as an Assistant Majority Whip. Staggers is an emergency physician.
Early life and education.
Staggers was born on January 12, 1945 at Naval Air Station Patuxent River in St. Mary's County, Maryland and was the eldest child and daughter of Harley Orrin Staggers, Sr. (August 3, 1907 – August 20, 1991) and his wife Mary Casey Staggers. At the time of her birth, Staggers' father was serving as a lieutenant commander in the United States Naval Air Corps in both the European and Pacific theaters during World War II. In 1948, Staggers' father was elected a member of the United States House of Representatives from West Virginia's 2nd congressional district where he served until 1981.
Staggers earned her M.D. in 1969 from the West Virginia University School of Medicine after which she completed her residency in emergency medicine.
Medical career.
Staggers is an emergency room physician practicing at Beckley Appalachian Regional Hospital in Beckley, West Virginia. In addition to her emergency medicine practice, Staggers serves as the medical director of multiple emergency medical services and emergency operations centers in Fayette, Wyoming, Raleigh, and Boone counties in West Virginia.
Staggers briefly considered retiring from emergency medicine at Beckley Appalachian Regional Hospital following a July 7, 2011 incident in which an elderly female patient attacked Staggers as she attempted to provide aid to the woman. The elderly patient scratched Staggers' face, drawing blood. Staggers returned to her legislative duties in Charleston the week after the attack.
Political activities.
In 1978, Staggers served as a delegate to the 1976 Democratic National Convention at Madison Square Garden in New York City where she voted to nominate United States Senator Robert Byrd as the Democratic candidate for the 1976 United States presidential election.
West Virginia House of Delegates tenure.
Staggers was elected to the West Virginia House of Delegates from the 29th district representing Fayette County, West Virginia in 2006. She is currently serving as an Assistant Majority Whip, vice-chairperson on the Roads and Transportation Committee, and a member of the Government Organization Committee, Health and Human Resources Committee, Veterans Affairs/Homeland Security Committee, and the House Select Committee on Redistricting. During the 79th session of the West Virginia Legislature, Staggers served as vice-chairperson of the Committee on Enrolled Bills.
In 2008, Staggers authored legislation extending a tax break to volunteer firefighters excusing them from tax that are due beyond what is already withheld from paychecks.
On the 30th anniversary of the passage of the Staggers Rail Act of 1980 authored by her father, Congressman Harley Orrin Staggers, Sr., Staggers wrote an editorial in the "Charleston Gazette-Mail" praising the bipartisan effort in the United States Congress led by her father to deregulate the United States railroad industry.
Affiliations.
Staggers is a former president of the West Virginia Chapter of the American College of Emergency Physicians, past chairman and member of the West Virginia Chapter of the American Heart Association, and a fellow of the American College of Emergency Physicians and American Academy of Family Physicians.


Richard L. Heschl

Richard Ladislaus Heschl (; July 5, 1824, in Welsdorf bei Fürstenfeld, Steiermark – May 26, 1881, in Vienna) was an Austrian anatomist.
Biography.
In 1849 he received his medical doctorate from the University of Vienna, where in 1850 he became a "first assistant" to Carl von Rokitansky (1804-1878). In 1854 he was appointed professor of anatomy at the medical-surgical school in Olomouc, and during the following year became a professor of pathological anatomy in Krakow. In 1861 he became a professor at the medical-surgical school at Graz (from 1863 a full professor), serving as university rector in 1864–65. In 1875, he returned to the University of Vienna. After his death, his position at Vienna was filled by Hans Kundrat (1845-1893).
Heschl is credited as the first physician to describe the transverse temporal gyrus or "Heschl's gyrus", located in the primary auditory cortex. This anatomical structure processes incoming auditory information.


NHS ambulance services

National Health Service ambulance services provide free at the point of use emergency medical care to any person requiring treatment, regardless of immigration or visitor status, within the United Kingdom. These services are provided by National Health Services of England, Scotland, Wales and Northern Ireland. The current system comprises 14 NHS organisations: 11 ambulance services trusts cover the separate regions of England and; individual nationwide services cover Scotland, Wales and Northern Ireland respectively.
As with other emergency services, the public normally access emergency medical services through one of the valid emergency telephone numbers (either 999 or 112). Additionally, some ambulance services are considering trialing a 999 video calling service, in order to be able to visually assess patients whilst crews are en route.
The work of ambulance services included responsibility for patient transport, but in England this is now often covered by separate contractual arrangements, and often delivered by private providers.
History.
The National Health Service Act 1946 gave county (and county borough) councils in England and Wales a statutory responsibility to provide an emergency ambulance service, although they could contract a voluntary ambulance service to provide this.
In 1977/78 ambulance services in the UK cost about £138m. At that time about 90% of the work was transporting patients to and from hospitals.
The Regional Ambulance Officers' Committee reported in 1979 that:
The 142 existing ambulance services in England and Wales were transferred by the National Health Service Reorganisation Act 1973 from local authority to central government control in 1974, and consolidated into 53 services under regional or area health authorities.
In Northern Ireland the service was the responsibility of the Northern Ireland Hospitals Authority before 1974, and was then transferred to the four health and social services boards.
Under the provisions of the National Health Service and Community Care Act 1990 England was covered by 31 ambulance trusts, which were structured as below. In July 2006 the number of ambulance service trusts was reduced to thirteen.
Current ambulance services.
There are currently 14 NHS organisations (ambulance services trusts in England) which provide ambulance services across the UK, which are listed below:
England.
Subcontracting.
In 2019 the Care Quality Commission reported that ambulance services were relying on private providers because of lack of capacity. Some firms had failed to obtain references or carry out criminal record checks and a lack of staff training was leading to serious patient harm. More than £92 million was spent in 2018/9 on private ambulances and taxis.
Targets.
NHS England sets targets for response times to 999 calls, which were first established in the 1970s. Call handlers were, until 2017, given just 60 seconds to decide on the urgency of the call. The clock stopped once a vehicle reached the patient - even if it was not the appropriate vehicle.
Category A (Red 1 and Red 2) were classed as life-threatening and the national standard sets out that a vehicle should reach the scene within eight minutes for 75% of these calls . Red 1 calls are for patients who have suffered cardiac arrest or stopped breathing and require two vehicles. If onward transport is required a suitable vehicle should arrive on the scene within 19 minutes. The number of these rose from 2.5 million in 2011/12 to just under 3.4 million in 2015/16, but response times fell steadily and the 75% target was not met after 2013. Green 1 required a vehicle within 20 minutes, Green 2 within 30 minutes. Green 3 required telephone assessment within 20 minutes and Green 4 telephone assessment within 60 minutes. These targets are only recommended.
In July 2017 a new set of performance targets for the ambulance service were announced after a trial across four different ambulance trusts, looking at more than 1 million patients overseen by Sheffield University. These are to apply to all 999 calls for the first time. Call handlers will be given four minutes to assess the urgency of the call before the clock starts. The target for the most seriously ill patients is now seven minutes. The 'clock' stops when the most appropriate response, not necessarily the first, arrives. There are condition-specific measures which will track time from 999 call to hospital treatment for heart attacks and strokes. 90% of eligible heart attack patients should receive definitive treatment (balloon inflation during angioplasty at a specialist heart attack centre) within 150 minutes by 2022. 90% of stroke patients should also receive appropriate management (thrombolysis for those who require it, and first CT scan for all other stroke patients) within 180 minutes of making a 999 call. For other emergencies the target is for 90% to be seen in 40 minutes. Urgent or non-urgent calls should expect an average response time of 120 and 180 minutes respectively. Extensive trials have shown that fewer patients are classed as life-threatening and fewer vehicles are dispatched, but responses for the most urgent calls improved.
Trusts asked for more resources to meet these targets, in particular the standards for the top 90% of responses. Taking patients to the "right" hospital rather than the nearest, leads to longer journeys. They were supported by a benchmarking exercise undertaken by the National Audit Office.
In July 2018 eight of the ten services in England missed the seven-minute target. A review conducted by Lord Carter of Coles found that the rate of sickness of ambulance staff was the highest in the NHS - 20 days per person. Use of information technology was advancing very slowly. 25% of ambulances, of which there were 32 different types, were more than seven years old. There were large differences in costs and performance between the different trusts, some of which were attributable to local geography and the performance of other parts of the NHS. Responses to the most urgent calls averaged 11 minutes in rural areas in 2018 but 7 minutes in urban areas. The worst waits were around Wells-next-the-Sea.
Funding and activity.
Between 2011-12 and 2015-16 ambulance activity in England rose by 30%. Funding only increased by 16%. In May 2018 several trusts told commissioners that they needed to spend many millions on extra staff and ambulances if they were to meet the response time targets.
Information technology.
In November 2018 NHS Digital launched the National Record Locator Service which gives ambulance staff access to patient records of mental health trusts, initially for the North West, North East, Yorkshire and London Ambulance Services. It is planned to roll it out across England and to include other records.


Ketan Ramanlal Bulsara

Ketan Ramanlal Bulsara was selected to be the Chief of Neurosurgery at the University of Connecticut. He also serves as the Director of Neurovascular/Endovascular Surgery and Director of Skull Base Microsurgery. He thus transitioned from serving in the Yale Department of Neurosurgery where he directed Neuroendovascular surgery and Skull Base Microsurgery.
Background.
Dr. Bulsara is a neurosurgeon who has dual fellowship training in skull base cerebrovascular microsurgery and endovascular neurosurgery. He was a member of the team that led to the identification of GAP-43 and CAP-23 co-expression and its ability to promote regeneration in the central nervous system.
General.
Dr. Bulsara was born in Mumbai, India. He grew up in Zambia, Central Africa and immigrated to the United States in the 1980s. He went to Davidson College for his undergraduate studies. He attended Duke Medical School and graduated with honors. He completed his neurosurgical residency at Duke Medical Center. Dr. Bulsara received his training in microsurgery and endovascular surgery from the pioneers in the field.
Dr. Bulsara is consistently selected as one of the top surgeons/physicians in the United States by the Consumer Research Group of America based in Washington, D.C. Aside from holding numerous leadership positions in national and international neurosurgical societies, Dr. Bulsara was appointed to serve on the National Quality Forum for neurosciences. He has published more than 200 peer reviewed articles and 3 books. In addition, he obtained an MBA from the Yale School of Management. He is a frequently invited national and international lecturer.


Peter Copeman

Peter William Monckton Copeman FRCS (9 April 1932 – 13 July 2018) was an English dermatologist known as "Dr Spot" by his colleagues. He was consultant physician at Westminster Hospital and consulting dermatologist at Chelsea and Westminster Hospital. He treated many celebrities and also helped modernise Qatar’s medical services. He authored over a hundred peer-reviewed articles and pioneered research on allergic vasculitis and malignant melanoma.
Outside medicine, he co-founded the Game Conservancy, where he arranged the regeneration of the British grey partridge.
Early life.
Peter Copeman was born in London on 9 April 1932, the son of William Copeman CBE, a pioneering rheumatologist, and his wife Helen. His grandfather was Sydney Copeman who worked on the refinement of Edward Jenner's smallpox vaccine.
He was brought up in Hampstead and educated at Rottingdean Preparatory School in East Sussex, which was evacuated to the Cornish countryside during the Second World War. Subsequently, he attended Eton College, where he demonstrated skill at shooting and during his final year, was captain of the Eton shooting eight at Bisley.
He completed his undergraduate medical studies at the University of Cambridge before gaining admission to St Thomas' Hospital, London, and qualifying in medicine. He was awarded a gold medal for his PhD thesis on vasculitis and was awarded membership of the Royal College of Physicians (RCP), in January 1962 when the pass rate was less than 6%.
Career.
Copeman originally planned to work in ophthalmology but transferred to dermatology after he was noticed for writing a paper on styes for "The Lancet".
He authored over a hundred peer-reviewed articles and pioneered research on allergic vasculitis. He instituted immunofluorescence and electron microscopy in research in skin disease and paid particular attention to malignant melanoma. Subsequently, he travelled to the Mayo Clinic in Minnesota where he worked alongside Terence Ryan and eminent Dutch dermatologist Rudi Cormane. He later published, with Ryan, a classic paper on "The problems of classification of cutaneous angitis with reference to histopathology and pathogenesis".
In 1965, at a time when leading surgeon Harold Ellis was at Westminster Hospital, Copeman, frequently known as "Dr Spot" by his colleagues, was appointed consultant physician. "He [Copeman] always wore a spotless white coat over a waistcoat and tie, striding the wards with a crocodile of registrars, students and nurses trailing behind."
In the 1970s and 1980s, he helped modernise Qatar's medical services, frequently visiting Qatar as the guest of the Emir. In addition, he had a private practice in Sloane Street.
Between 1991 and 2013, he was the British Association of Dermatologists Willan Librarian.
Until retirement, he was a consulting dermatologist at Chelsea and Westminster Hospital in London and known for treating high profile personalities including Madonna and Diana, Princess of Wales.
Personal and family.
In 1973, he married Lindsey Brims, who was 16 years younger and whom he had met at a ball at Sorn Castle, Ayrshire a year earlier. They had four children.
As chairman of the wine committee at the Athenaeum, he persuaded Eduardo Paolozzi to design the club's wine labels.
He had an appreciation for field sports and was a co-founder of the Game Conservancy, which led him to purchase a 200-acre estate in Abshield near Morpeth, Northumberland, in the 1980s, where he arranged the regeneration of the British grey partridge. The resulting re-landscaping, wildlife corridor hedgerows and several ponds were acknowledged in the finals of the Laurent-Perrier conservation awards, which ran annually by Laurent-Perrier Champagne (UK) Ltd between 1986 and 1998, and was subsequently taken over by James Purdey & Sons.
Death.
Copeman died due to a series of strokes.