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This article concludes that the Pluscarden rising is more than the localised protest that previous historians have accepted, and that it was a planned Royalist rising. The story of the rising is outlined before a detailed approach is taken to the people involved. The international context of Royalist planning is examined. A new analysis of the reasons for the rising is then put forward.

Urolithiasis is a global phenomenon. Cystolithiasis is common in parts of Africa due to low protein intake and dehydration from endemic diarrhoeal illnesses. Nephrolithiasis is less prevalent than in high-income countries, probably due to a variety of lifestyle issues, such as a more elemental diet, higher physical activity, and less obesity. Although renal stones are less common in low- and middle-income countries (LMICs), the social and economic impacts of nephrolithiasis are still considerable; many stones present late or with complications such as upper urinary tract obstruction or urosepsis. These may lead to the development of chronic kidney disease, or end-stage renal failure in a small proportion of cases, conditions for which there is very poor provision in most LMICs. Early treatment of nephrolithiasis by the least invasive method possible can, however, reduce the functional consequences of urinary stone disease. Although extracorporeal lithotripsy is uncommon, and endoscopic interventions for stone are not widespread in most of Africa, percutaneous nephrolithotomy and ureteroscopic renal surgery are viable techniques in those regional centres with infrastructure to support them. Longitudinal mentoring has been shown to be a key step in the adoption of these minimally invasive procedures by local surgeons, something that has been difficult during the coronavirus disease 2019 (COVID-19) pandemic due to travel restriction. Augmented reality (AR) technology is an alternative means of providing remote mentoring, something that has been trialled by Urolink, the MediTech Trust and other global non-governmental organisations during this period. Our preliminary experience suggests that this is a viable technique for promulgating skills in LMICs where appropriate connectivity exists to support remote communication. AR may also have long-term promise for decreasing the reliance upon short-term surgical visits to consolidate competence, thereby reducing the carbon footprint of global surgical education.

One of the widest variations in contemporary surgical practice between high and low, or low-middle, income countries is the utilisation of endoscopy as a means of treating urological pathology. The endoscopic management of lower urinary tract problems such as benign prostatic hypertrophy, bladder cancer and urethral strictures was established in the UK in the late 1970s, whilst its adoption into everyday practice in sub-Saharan Africa (SSA) has been significantly retarded. It is still neither a major feature of urological training in those countries nor widely available to the patients that established consultants treat. Likewise, the explosion of less invasive technologies for treating upper tract stone disease in the 1980s, particularly the management of renal stone disease, has also lagged behind practice established in the UK over the last 40 years. This is not due to a lack of patients who could be treated endoscopically or restricted by the abilities of the surgeons in SSA. The restraint in assumption of these less-invasive management options is rather due to the physical availability of trained specialist surgeons, their access to basic infrastructure such as electricity and water, access to endoscopes and the peripheral equipment necessary to successfully deploy them, and the ability of patients to afford the disposable items required for less-invasive forms of management. Some endoscopic procedures are viable in resource-poor settings. However, they are largely dependent upon the supply of equipment from non-governmental organisations in high-income countries, frugal innovation to reduce individual procedure costs, adequately skilled mentors, and maintenance and supply chains to make them a durable option in patient management. Urolink and the Medi Tech Trust present their experience of how endoscopic surgery can be taught, and used sustainably, in a resource-poor healthcare environment.

This paper presents a multiobjective optimization approach for path planning of autonomous surface vehicles (ASVs). A unique feature of the technique is the unification of the Convention on the International Regulations for Preventing Collisions at Sea (COLREGs) with good seamanship's practice along with hierarchical (rather than simultaneous) inclusion of objectives. The requirements of collision avoidance are formulated as mathematical inequalities and constraints in the optimization framework and thus collision-free manoeuvres and COLREGs-compliant behaviours are provided in a seafarer-like way. Specific expert knowledge is also taken into account when designing the multiobjective optimization algorithm. For example, good seamanship reveals that if allowed, an evasive manoeuvre with course changes is always preferred over one with speed changes in practical maritime navigation. As a result, a hierarchical sorting rule is designed to prioritize the objective of course/speed change preference over other objectives such as path length and path smoothness, and then incorporated into a specific evolutionary algorithm called hierarchical multiobjective particle swarm optimization (H-MOPSO) algorithm. The H-MOPSO algorithm solves the real-time path planning problem through finding solutions of the formulated optimization problem. The effectiveness of the proposed H-MOPSO algorithm is demonstrated through both desktop and high-fidelity networked bridge simulations.

INTRODUCTION AND OBJECTIVE:Surgical medical missions allow for the global transfer of surgical skills, knowledge, and resources between high and low to middle-income countries to the benefit of bot...

Massive inguinoscrotal hernias containing the bladder are rare but can present with significant complications such as obstructive uropathy and urinary sepsis. A comorbid 71-year-old gentleman presented with an enlarging inguinoscrotal mass and an acute kidney injury (AKI). Imaging revealed a large inguinoscrotal hernia containing the bladder, and bilateral hydronephrosis. Renal function improved on urethral catheterization. Admitted under general surgery originally, the patient declined any surgical intervention and had his catheter removed as an outpatient, without urological follow up. He represented 6 months later with urinary sepsis and a new AKI. Repeat imaging revealed a progression of the bilateral hydronephrosis. Subsequently admitted under urology, bilateral nephrostomies as well as a catheter were inserted. Once stable, he was discharged with both as part of his long-term management. Non-operative management of this condition may occasionally be necessary, and so requires effective multidisciplinary decision making. Real-world organizational and geographical factors contributed to the challenges in this case.

Objective: To assess the management pathways of ureteric stones within our department and any impact on this as a result of the pandemic. Patients and methods: Retrospective data were collected at two different time points defined as ‘pre-COVID-19’, during April and May 2019, and ‘peri-COVID-19’, during April and May 2020 of all patients with ureteric stones. Results: Similar patient numbers presented with ureteric stones pre-COVID-19 (63) and during the pandemic (75). Pre-COVID-19, 31 patients were admitted, of which 48% had primary ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL). The average time to theatre was 1.2 days. During the pandemic, there were 34 admissions with 56% of these patients receiving primary URS/PCNL. The average time to theatre was 1.5 days. Of the patients referred to the virtual stone clinic, pre-COVID-19, 38% were listed for urgent-elective surgery which was performed at an average of 62 days. During the pandemic, 49% were listed for surgery, waiting 144 days for their procedure. Conclusion: Patients who underwent primary surgery during their first admission had their definitive treatment quicker during the pandemic. However, patients listed for elective procedures waited longer in the peri-COVID-19 period. Level of evidence: (Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009)): 2c

From the opening pages of The Vanished Bride, the first of The Bronte Mysteries crime novels by Rowan Coleman writing as Bella Ellis, it is clear we are in the hands of a writer who is not only a m...

Background and Aim COVID-19 has resulted in changes to how the healthcare system in the United Kingdom delivered its emergency care, including renal colic and its management. Our stone team amended its services in order to reduce stone related morbidity and preventable hospital admissions. We aim to review similar time periods in 2019 and 2020 to see how this has changed. Methods A retrospective review of all presentations of acute renal colic with CT confirmed stones were carried out for the months of April to May, 2019 and 2020. Demographics, clinical features and stone characteristics and treatment were noted. Results Seventy nine percent of the 38 patients who present in 2019 had ureteric stones, compared to 85% of the 40 patients in 2020. Distal stones made up 53% in 2019, compared to 56% in 2020. Less patients were noted to be febrile in 2020(13%vs35%). There was an increase in conservative management in 2020 (25% vs 21%). Emergency treatment (stent/nephrostomy) with secondary intervention (Ureterorenoscopy(URS)/Percutaneous Nephrolithotomy (PCNL)) was markedly reduced in 2020(12.5% vs 42%).More patients were also treated with primary interventions (URS/PCNL) within 48 hours (43% in 2020 vs 26%) and 7 days (13% vs 8%). Conclusion More patients were treated with conservative treatments and early primary interventions. This was done in order to combat unnecessary hospital admissions and stays, as well as surgeries and anaesthesia, whilst minimising stone and stent complications. An improved adherence to GIRFT guideless was also noted, providing better patient care and outcome, whilst reducing unnecessary procedures.

Franco Marrucci’s eight-volume academic review of English literature begins with Anglo-Saxon texts and leaves off with novels published within the last ten years. For this journal, we turn specific...

In this paper, a multiobjective optimization framework is proposed for on-line path planning of autonomous surface vehicles (ASVs), where both collision avoidance and COLREGs-compliance are taken into account. Special attention has been paid to situational awareness and risk assessment, particularly when the target ship is in breach of the COLREGs rules defined by the International Maritime Organisation. In order to implement COLREGs, the rules together with physical constraints are formulated as mathematical inequalities. A multiobjective optimization problem based on particle swarm optimization is then solved, the solution of which represents a newly-generated path. It is shown through simulations that the proposed method is able to generate COLREGs-compliant and collision-free paths even for non-cooperative targets i.e. vessels that are in breach of COLREGs.

‘Some people’, observed Winifred Gerin in her 1959 biography of Anne Brontё, ‘interpret gentle as meaning weak’. It has been Anne Brontё’s fate to have her cultural legacy similarly misrepresented....

BACKGROUND Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. OBJECTIVE This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. METHODS An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. RESULTS The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). CONCLUSIONS Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.

Introduction: Patients unfit for general anesthesia who present with renal tract pathology currently have limited options. Many of these patients present in the emergency setting with impe...

Introduction To evaluate the outcomes of retrograde intrarenal surgery (RIRS) and ultra-mini percutaneous nephrolithotomy (umPCNL) in the management of renal calculi. Material and methods Between March 2015 and January 2018, a total of 44 patients were treated with umPCNL. The outcomes of these patients were compared with 75 patients who underwent RIRS for renal calculi during the same time period. Results Median stone size was 9 mm in the umPCNL group and 7 mm in the RIRS group. Stone-free rates after a single procedure were achieved in 85% of patients for the RIRS group and 98% for the umPCNL group. 16% of RIRS patients were left with a ureteric stent, whilst 7% of patients (n = 5) needed a second RIRS. One patient in the umPCNL group was left with a percutaneous nephrostomy; all other patients were left totally tubeless. The mean operative time was 66 minutes in the RIRS group and 55 minutes in the umPCNL group (p = 0.04). The minor complication rates for the RIRS and umPCNL groups were 17% and 15%, respectively. One patient in the RIRS group required postoperative nephrostomy insertion; there were no major complications in the umPCNL group. The median length of stay was 0 days in the RIRS group and 1 day in the umPCNL group. Conclusions The overall study showed that umPCNL has low complication rates and good stone-free rates, with a lower requirement for ancilliary procedures. UmPCNL is an acceptable alternative in selected patients with small- to moderate-sized renal calculi.

Objectives: Ultra-mini percutaneous nephrolithotomy (UMP) is a novel technique recently introduced allowing percutaneous renal access to stones using a specially modified 11 or 13 Fr sheath, a 6 Fr nephroscope, and permits laser fragmentation and stone evacuation. This study aimed to review the early practice of UMP in the UK. Methods: All centres in the UK which had performed UMP were contacted to submit data. Data were submitted to a central database from nine centres around the UK who performed UMP between July 2013 and December 2014. Data were collected on patient, stone, operative factors and outcomes. Results: A total of 32 UMP cases were performed in the contributing centres. Stone size ranged from 7 mm×5 mm to 24 mm×24 mm across the 32 cases, with a mean of 13 mm×10 mm. Stone-free rates were excellent with 31/32 cases stone-free post procedure; 26/32 patients were left without a nephrostomy tube. Complications were uncommon; there were two Clavien 1 complications in this series (6%). Conclusion: This study has shown the efficacy of UMP during its introduction into UK practice. It is likely that UMP will become a useful addition to the armamentarium to treat renal stones, especially smaller stones in the lower pole calyx, and in specialised cases such as paediatric stone disease and in patients with stones in calyceal diverticulae.

Background Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. Objective This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. Methods An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. Results The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). Conclusions Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.

Several thousand sensors hard-wired to data acquisition units may be used to instrument a gas turbine engine during its development phase. This process of hard-wiring is time-consuming, expensive, and inflexible. A wireless sensor network (WSN) is proposed as a solution for selectively replacing wired sensors with wireless sensors and for adding new sensors. The WSN shall operate between the engine casing and the engine cowling where the presence of metal surfaces results in a complex radio frequency (RF) environment exhibiting severe multipath propagation. Although research has been performed into the use of WSNs for monitoring gas turbine engines, the propagation characteristics of the RF channel and a systematic analysis of the performance of digital modulation techniques within the environment have not been reported in the literature. The aim of this research is to investigate WSN technologies, and their communication challenges, when used to instrument gas turbine engines during their development phase, and to implement and experimentally evaluate a prototype WSN. A fully automated measurement system, utilising software defined radio (SDR) techniques, has been used to perform RF propagation measurements through more than 7,000 individual channels on a static Rolls-Royce Trent 900 engine. The analysis of these measurements are being used to characterise the RF propagation channel and to evaluate the performance of a number of modulation schemes including basic schemes such as phase shift keying (PSK) and more complex schemes such as orthogonal frequency division multiplexing (OFDM). This paper presents an overview of the project including the experimental methodology, the measurement system, and some preliminary results.

Cet article traite des moyens par lesquels les autochtones de Yellowknife controlent leurs identites ethniques a l'carinterieur des contraintes imposees par le pouvoir qui est a l'carorigine ainsi que le pouvoir Euro-canadien, et il explique et analyse en details les consequences politiques qui en decoulent. II est mentionne que, d'carapres le precepte ethnomethodologique, nous creons continuellement les faits sociaux que nous croyons decouvrir. This paper deals with the means whereby native peoples in Yellowknife manage their ethnic identities within constraints imposed by their biographies and Euro-Canadian power, and explicates the political consequences of this management. It is informed by the ethnomethodological precept that we continually create the social facts we think we discover.

Des observations faites a Capetown, quant au com-portement d'elements de la population mixte qui tente de passer pour blanche, indi-quent l'existence dans les relations intergroupes d'un processus au cours duquel ces elements multiplient la necessite pour les autorites de prendre d'innombrables decisions ad hoc a leur sujet. Tous les membres d'autres groupes qui aspirent a une promotion sociale collective se comportent, vraisemblable-ment, de la sorte. Ces decisions cumulatives facilitent le passage de la categorie mixte a celle de la race blanche.

La presente etude porte sur 29 lignes de notes de terrain constituees de la transcription integrate d'une entrevue sur les pratiques chama-nistes nefastes du nord de l'Alberta. Elle a pour but de sensibiliser les ethnographes a certaines possibilites qu'oflrent l'ethnomethodologie et l'analyse du discours pour l'nterpretation des entrevues et des notes de terrain ethnographiques. Elle demontre que le contexte culturel, generalement considere comme facteur externe determinant ou in-fluant sur le comportement, se construit en fait dans la conversation elle-meme, et que la cooperation entre l'enqueteur et rinformateur s'insi-nue dans le discours de facon beaucoup plus profonde que ne semblent generalement le reconnaitre les auteurs d'etudes ethnographiques experimentales reposant sur l'analyse de dialogues. Elle se veut un pendant empirique au discours anthropologique «interpretatif» qui peut devenir completement esoterique faute de s'appuyer sur des enregistrements qui sont des dialogues interculturels authentiques et verifiables. This analysis of 29 lines of fieldnotes, which comprise a verbatim record of an interview concerning “bad medicine” among the Dene-Tha of northern Alberta, is intended to alert ethnographers to some of the ways in which ethnomethodology and conversation analysis can illuminate ethnographic interviews and fieldnotes. It demonstrates that cultural context, commonly assumed to “determine” or “influence” behaviour, is generated within conversation itself. It further demonstrates that cooperation between fieldworker and informant is much more pervasive than writers of “dialogic” experimental ethnographies appear to realize. It constitutes an empirical alternative to esoteric “interpretive” anthropological discourse not securely grounded in inspectable records of actual intercultural talk.

Statistical modelling of biological survey data in relation to remotely mapped environmental variables is a powerful technique for making more effective use of sparse data in regional conservation planning. Application of such modelling to planning in the northeast New South Wales (NSW) region of Australia represents one of the most extensive and longest running case studies of this approach anywhere in the world. Since the early 1980s, statistical modelling has been used to extrapolate distributions of over 2300 species of plants and animals, and a wide variety of higher-level communities and assemblages. These modelled distributions have played a pivotal role in a series of major land-use planning processes, culminating in extensive additions to the region's protected area system. This paper provides an overview of the analytical methodology used to model distributions of individual species in northeast NSW, including approaches to: (1) developing a basic integrated statistical and geographical information system (GIS) framework to facilitate automated fitting and extrapolation of species models; (2) extending this basic approach to incorporate consideration of spatial autocorrelation, land-cover mapping and expert knowledge; and (3) evaluating the performance of species modelling, both in terms of predictive accuracy and in terms of the effectiveness with which such models function as general surrogates for biodiversity.

The European Working Time Directive (EWTD) poses challenges for out of hours management of the acute urological patient. With the introduction of the “Hospital at Night” team or cross specialty cover, there may be limited onsite urological experience out of hours. One of the commonest urological emergencies is acute stone colic. For the on call team to provide a safe and quality service, the BAUS Section of Endourology has produced guidelines for the emergency management of urolithiasis.

An interview in which a Dene Tha man talks about his people's powers (echint'e) and a passage in which an eminent social scientist discusses sociologically theorized power are examined for the methods by which these powers are produced as objective facts. The methods invite comparison; for example, both the Dene Tha and the theorist characterize visible and tangible phenomena as pointing to underlying forces that are invisible and intangible. If only (but not only) because these forces are invisible and intangible, work has to be performed to make them stick. This does not constitute a problem for the Dene Tha, whose procedures need only be adequate for practical purposes, but it is a self- imposed hurdle for social scientists, who require their procedures to pass the test of theoretical adequacy; however, satisfying that test is no less a practical accomplishment than is constituting Dene Tha powers as effective.

Anthropologists normally search for the bases of social order among exotic societies or in extraordinary situations, and so tend to overlook the utterly commonplace but fundamental order which people build into their interaction as it occurs. A short transcript of soldiers’ talk is analysed to demonstrate how this order is produced.

Sidefire coagulation of the prostate has been a very successful introduction of laser technology to the treatment of prostate disease. Although bleeding has been reduced, the delayed relief of urinary obstruction and the postoperative dysuria are of concern. Laser vaporization, on the other hand, is probably as good as electrical incision of the bladder neck and is less likely to produce bleeding. The hybrid technique, a combination of vaporization of the gland substance with laser prostatotomies and coagulation, provides early disobstruction with later bulk removal of prostatic tissue. Interstitial coagulation seems to be effective in treating a greater bulk of gland tissue. Urologists need to subdivide prostates according to their size and configuration for a series of clinical trials of various types of laser prostatectomy and comparison with established treatments.

In 1985, a member of the Canadian judiciary handed down a written judgment in which he distinguished between erotica and obscene matter. The judgment attracted the scorn of some normative sociologists, who complained of the insufficiency of the social psychological research on which it was based. Their reaction prompts a review of the judgment in the light of social constructionism and of ethnomethodology; this, in turn, prompts a comparison of social constructionist and ethnomethodological methodologies, in which the legal judgment serves merely as a test case. It is argued that normative sociology and social constructionism, both being of an essentially ironic cast, occlude the judge's sense-making procedures, the very phenomena they purport to describe. Ethnomethodology, on the other hand, being nonironic, promises to capture those procedures.