Search Results (3)

Study Design: Injuries sustained in war-zones are variable and constantly developing according to the nature of the ongoing conflict. Soft tissue involvement of the extremities, head and neck often necessitates reconstructive expertise. However, current training to manage injuries in such settings is heterogenous. This study involves a systematic review. Objective: To evaluate interventions in place to train Plastic and Maxillofacial surgeons for war-zone environments so that limitations to current training can be addressed. Methods: A literature search of Medline and EMBase was performed using terms relevant to Plastic and Maxillofacial surgery training and war-zone environments. Articles that met the inclusion criteria were scored then educational interventions described in included literature were categorised according to their length, delivery style and training environment. Between-group ANOVA was performed to compare training strategies. Results: 2055 citations were identified through this literature search. Thirty-three studies were included in this analysis. The highest scoring interventions were over an extended time-frame with an action-oriented training approach, using simulation or actual patients. Core competencies addressed by these strategies included technical and non-technical skills necessary when working in war-zone type settings. Conclusions: Surgical rotations in trauma centers and areas of civil strife, together with didactic courses are valuable strategies to train surgeons for war-zones. These opportunities must be readily available globally and be targeted to the surgical needs of the local population, anticipating the types of combat injuries that often occur in these environments. Full article

Empirical investigation suggests that conflict is path-dependent, i.e., current conflict leads to more conflict in the future. However, there is very little formal theory for why conflict path dependence exists. We propose a mathematical model to explore one possible pathway to explain the persistence of conflict once it starts. In this model, there are three types of cultures in two boundedly rational populations. The two populations are State Actors and Insurgents. The three cultures are Peaceable, Warring, or Bargainers. The distribution of these types is different in each population. Evolutionary dynamics determine which of these three cultures might predominate. Our simulations suggest that it is rational for people to learn to be warlike even in environments where State Actors are willing to give large side payments to “buy” peace to avoid bargaining failure. War can also be learned when State Actors and Insurgents are extremely patient and, therefore, potentially committed to Pareto improving peace deals. The outcomes of these simulations suggest that cultural learning can be a hitherto ignored explanation for why conflict is path dependent. If culture is indeed a possible cause for conflict, the best intentions of technocratic peacemakers trying to build frameworks for resource sharing and/or institutional building may fail, simply because such structures are not suited to local conditions. On the flip side, our model also provides theoretical reasoning for the observation that conflict is not a deterministic outcome of bargaining and commitment failures. Full article

Background: Familial Mediterranean Fever (FMF) is a genetic disorder characterized by recurrent episodes of fever and abdominal pain. Mutations in the Mediterranean fever (MEFV) gene are localized on the p arm of chromosome 16. Over 333 MEFV sequence variants have been identified so far in FMF patients, which occur mostly in the 2nd and 10th exons of the gene. Methods: In this study, 296 unrelated patients with clinical suspicion of FMF, which were admitted during January–December 2017, were retrospectively reviewed to identify the frequency of MEFV gene mutations by using next generation sequencing. Results: Eighteen different mutations, 45 different genotypes and a novel exon 4 (I423T) mutation were identified in this study. This mutation is the fourth mutation identified in exon 4.The most frequent mutation was R202Q, followed by M694V, E148Q, M680I, R761H, V726A and R354W. Conclusions: One of the most important aims of this study is to investigate the MEFV mutation type and genotype of migrants coming to Sanliurfa after the civil war of Syria. This study also examines the effect of the condition on the region’s gene pool and the distribution of different types of mutations. Our results indicated that MEFV mutations are highly heterogeneous in our patient population, which is consistent with the findings of other studies in our region. Previously used methods, such as Restriction Fragment Length Polymorphism (RFLP), do not define uncommon or especially novel mutations. Therefore, Next Generation Sequencing (NGS) analysis of the MEFV gene could be useful for finding novel mutations, except for those located on exon 2 and 10. Full article