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Geopressure drives fluid flow and is important for hydrocarbon exploration, carbon sequestration, and designing safe and economical wells. This concise guide explores the origins of geopressure and presents a step-by-step approach to characterizing and predicting pressure and least principal stress in the subsurface. The book emphasizes how geology, and particularly the role of flow along permeable layers, drives the development and distribution of subsurface pressure and stress. Case studies, such as the Deepwater Horizon blowout, and laboratory experiments, are used throughout to demonstrate methods and applications. It succinctly discusses the role of elastoplastic behaviour, the full stress tensor, and diagenesis in pore pressure generation, and it presents workflows to predict pressure, stress, and hydrocarbon entrapment. It is an essential guide for academics and professional geoscientists and petroleum engineers interested in predicting pressure and stress, and understanding the role of geopressure in geological processes, well design, hydrocarbon entrapment, and carbon sequestration.
Psychotropics are overprescribed for adults with intellectual disabilities; there are few studies in children and young people.
Aims
To investigate antipsychotic and antidepressant prescribing in children and young people with and without intellectual disabilities, and prescribing trends.
Method
Scotland's annual Pupil Census, which identifies pupils with and without intellectual disabilities, was record-linked to the Prescribing Information System. Antidepressant and antipsychotic data were extracted. Logistic regression was used to analyse prescribing between 2010 and 2013.
Results
Of the 704 297 pupils, 16 142 (2.29%) had a record of intellectual disabilities. Antipsychotic and antidepressant use increased over time, and was higher in older pupils; antipsychotic use was higher in boys, and antidepressant use was higher in girls. Overall, antipsychotics were prescribed to 281 (1.74%) pupils with intellectual disabilities and 802 (0.12%) without (adjusted odds ratio 16.85, 95% CI 15.29–18.56). The higher use among those with intellectual disabilities fell each year (adjusted odds ratio 20.19 in 2010 v. 14.24 in 2013). Overall, 191 (1.18%) pupils with intellectual disabilities and 4561 (0.66%) without were prescribed antidepressants (adjusted odds ratio 2.28, 95% CI 2.03–2.56). The difference decreased each year (adjusted odds ratio 3.10 in 2010 v. 2.02 in 2013).
Conclusions
Significantly more pupils with intellectual disabilities are prescribed antipsychotics and antidepressants than are other pupils. Prescribing overall increased over time, but less so for pupils with intellectual disabilities; either they are not receiving the same treatment advances as other pupils, or possible overprescribing in the past is changing. More longitudinal data are required.
Lung cancer is the most commonly diagnosed cancer in Canada and the leading cause of cancer-related mortality in both men and women in North America. Surgery is usually the primary treatment option for early-stage non-small cell lung cancer (NSCLC). However, for patients who may not be suitable candidates for surgery, stereotactic body radiation therapy (SBRT) is an alternative method of treatment. SBRT has proven to be an effective technique for treating NSCLC patients by focally administering high radiation dose to the tumour with acceptable risk of toxicity to surrounding healthy tissues. The goal of this comprehensive retrospective dosimetric study is to compare the dosimetric parameters between three-dimensional conformal radiation therapy (3DCRT) and volumetric-modulated arc therapy (VMAT) lung SBRT treatment plans for two prescription doses.
Methods:
We retrospectively analysed and compared lung SBRT treatment plans of 263 patients treated with either a 3DCRT non-coplanar or with 2–3 VMAT arcs technique at 48 Gy in 4 fractions (48 Gy/4) or 50 Gy in 5 fractions (50 Gy/5) prescribed to the planning target volume (PTV), typically encompassing the 80% isodose volume. All patients were treated on either a Varian 21EX or TrueBeam linear accelerator using 6-MV or 10-MV photon beams.
Results:
The mean PTV V95% and V100% for treatment plans at 48 Gy/4 are 99·4 ± 0·6% and 96·0 ± 1·0%, respectively, for 3DCRT and 99·7 ± 0·4% and 96·4 ± 3·4%, respectively, for VMAT. The corresponding mean PTV V95% and V100% at 50 Gy/5 are 99·0 ± 1·4% and 95·5 ± 2·5% for 3DCRT and 99·5 ± 0·8% and 96·1 ± 1·6% for VMAT. The CIRI and HI5/95 for the PTV at 48 Gy/4 are 1·1 ± 0·1 and 1·2 ± 0·0 for 3DCRT and 1·0 ± 0·1 and 1·2 ± 0·0 for VMAT. The corresponding CIRI and HI5/95 at 50 Gy/5 are 1·1 ± 0·1 and 1·3 ± 0·1 for 3DCRT and 1·0 ± 0·1 and 1·2 ± 0·0 for VMAT. The mean R50% and D2cm at 48 Gy/4 are 5·0 ± 0·8 and 61·2 ± 7·0% for 3DCRT and 4·9 ± 0·8 and 57·8 ± 7·9% for VMAT. The corresponding R50% and D2cm at 50 Gy/5 are 4·7 ± 0·5 and 65·5 ± 9·4% for 3DCRT and 4·7 ± 0·7 and 60·0 ± 7·2% for VMAT.
Conclusion:
The use of 3DCRT or VMAT technique for lung SBRT is an efficient and reliable method for achieving dose conformity, rapid dose fall-off and minimising doses to the organs at risk. The VMAT technique resulted in improved dose conformity, rapid dose fall-off from the PTV compared to 3DCRT, although the magnitude may not be clinically significant.
By my reading of the Egyptian evidence, Yhwʒ is one unit in a coalition of forces that Egypt claimed to have fought and defeated, so as to represent each by a bound prisoner with a distinct label. Together with Trbr, Smt, and Pyspys, Yhwʒ belonged to a “Shasu-land,” not a self-given identity but an Egyptian way to characterize the associated groups and to locate them spatially by a logic that is opaque to us beyond the connection of the mobile pastoralist Shasu with land not occupied by the cities of Canaan and their small subordinate kingdoms. This analysis is intended to embrace a range of possible relationships to the “land” that the Egyptians attributed to this connected Shasu population, but the identification of each individual name with a body of people appears unavoidable. These are not topographical features or gods or sacred places unless they gave their names to the Shasu units thus designated. I find no evidence that in the early 14th century, a Shasu-land was restricted to the southern region later identified with Edom and Seir, though a southern location would not affect the larger interpretation of Yhwʒ as a Shasu group, which I define as a “people.”
One thing about Mark Smith’s work on religion is that his analysis of any individual problem always represents just one part of an effort to understand the whole. He has written synthetic studies but no “history of Israelite religion” or book-length examination of El, or Yahweh, or all the gods of Israel. It is particularly interesting to me that Smith’s treatments of Yahweh have the feel of finishing a landscape rather than of isolating a portrait. He has written on Yahweh because he must, in order to address so many different views of biblical and (call it) Israelite religion. I wonder whether he has not made Yahweh his primary object because he has not been certain of having discovered something deeply new about the god, and he is always looking for a fresh line of sight on the material at hand. He tells me, reflecting on what I just wrote, that another factor is “how the biblical material seems to reflect lost knowledge about Yahweh,” or even that Yahweh could have been “an unknown god for Israel in some critical respects to which the biblical authors – and we – no longer have access.”
Going back to the 19th century, scholars observed that if Israel had an origin, its God must as well. In particular, the divine name peculiar to Israel, written with the consonants Yhwh, must have come from outside this people, and the only question was where. Yet there is no certain evidence for a god named Yahweh before the name’s first appearance in a mid-9th century BCE royal inscription from Jordan, where the desecration of his sanctuary at Nebo follows its destruction by the king of Moab. This victory was part of a campaign to expel the rival kingdom of Israel from the region north of Dibon, and Yahweh is identified with that enemy. The question remains nonetheless: How did Israel come to regard Yahweh as its divine patron, to share only with its immediate southern neighbor, the kingdom centered at Jerusalem? To the extent that we could peer behind the biblical tapestry, which renders Yahweh both Israel’s special god and a deity with worldwide reach, we might catch a glimpse of the social landscape within which Israel took form.
After respectful consideration of Amorite evidence for personal names with the Yaḫwi-/Yawi- verbal element, Karel van der Toorn (1999: 914) concludes that “though theoretically possible, it is difficult to believe that the major Israelite deity, venerated in a cult that was imported into Palestine, was originally a deified ancestor.” Gods that originated as human ancestors tend to be worshiped locally, for a restricted group. Having declined this possibility, van der Toorn turns to other composite names, such as Rakib-’el (Charioteer of El) or Malakbel (Messenger of Bel), which represent subordinates to the great gods. Albright, Cross, Dijkstra, and de Moor all proposed explanations that identify Yahweh with El, a deity of unassailable prominence, but van der Toorn (915) finds it unexpected to have the proper name of a major god replaced by an activity attributed to him. More deeply, with two different divine names in play and contrasting associations, the very notion of an original identification raises doubt.
In spite of its frequent application, the Egyptian evidence for Yhwʒ does not supply straightforward support for Yahweh’s origins among peoples of the wilderness south of Israel and Judah. Yhwʒ identifies a major unit of what the Egyptians confronted as a unified “Shasu-land,” a land not yet situated by Egypt in Seir and Edom. As often asserted, nevertheless, the Shasu name does appear to lie behind the deity Yahweh. When Bernhard Grdseloff (1947) discovered the Shasu list, he presented it as confirmation of an already dominant explanation for Yahweh’s origins, what I have called the Midianite Hypothesis. In order to reconsider the implications of this oldest Egyptian evidence, we must examine the Hypothesis in its larger form, and the next two chapters address the main material and arguments. The idea that Yahweh was originally a god of desert peoples from whom Israel learned of him was first based on biblical prose (this chapter). Current renditions now give greater weight to biblical poetry that is considered older than and independent from those prose texts (Chapter 4).
At the center of any evaluation of early evidence for Yahweh must stand a pair of related texts from New Kingdom Egyptian sites in northern Sudan: one from Soleb, during the reign of Amenhotep III (ca. 1390–1352); and the second from ‘Amarah West, during the reign of Ramses II (ca. 1279–1213). Both are monumental inscriptions for display on temples, lists of places and peoples that create a map of Egypt’s world. This material is far older than any potential reference to Yahweh, and if the name Yhwʒ does match the deity rendered as Yhwh, even if it did not yet identify a god, it becomes the chronological starting point for all historical evaluation (Figure 1).
In support of a Midianite Hypothesis, long-standing interpretation of both prose and poetic biblical texts has found in them reflections of Yahweh’s origins outside Israel and Judah among desert peoples that once lived to the south. I have concluded in Chapters 3 and 4 that while both sets of material reflect a persistent and perhaps surprising sense of kinship with such pastoralist neighbors, the texts do not indicate that these were the first peoples to worship Yahweh. Before weighing the biblical material, I undertook in Chapter 2 to reexamine the oldest evidence brought to bear on the name Yahweh, the Yhwʒ component of “Shasu-land” in Egyptian geographical lists from the 14th and 13th centuries. This evidence places us among just such a population evoked by the Bible, though without a particularly southern location, and yet Yhwʒ does not name a god, at least by its primary and only explicit application.