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\"Gottlob Frege (1848-1925) was unquestionably one of the most important philosophers of all time. He trained as a mathematician, and his work in philosophy started as an attempt to provide an explanation of the truths of arithmetic, but in the course of this attempt he not only founded modern logic but also had to address fundamental questions in the philosophy of language and philosophical logic. Frege is generally seen (along with Russell and Wittgenstein) as one of the fathers of the analytic method, which dominated philosophy in English-speaking countries for most of the twentieth century. His work is studied today not just for its historical importance but also because many of his ideas are still seen as relevant to current debates in the philosophies of logic, language, mathematics and the mind. The Cambridge Companion to Frege provides a route into this lively area of research\"-- Provided by publisher.

Geochemical analyses of sedimentary barites (barium sulfates) in the geological record have yielded fundamental insights into the chemistry of the Archean environment and evolutionary origin of microbial metabolisms. However, the question of how barites were able to precipitate from a contemporary ocean that contained only trace amounts of sulfate remains controversial. Here we report dissolved and particulate multi-element and barium-isotopic data from Lake Superior that evidence pelagic barite precipitation at micromolar ambient sulfate. These pelagic barites likely precipitate within particle-associated microenvironments supplied with additional barium and sulfate ions derived from heterotrophic remineralization of organic matter. If active during the Archean, pelagic precipitation and subsequent sedimentation may account for the genesis of enigmatic barite deposits. Indeed, barium-isotopic analyses of barites from the Paleoarchean Dresser Formation are consistent with a pelagic mechanism of precipitation, which altogether offers a new paradigm for interpreting the temporal occurrence of barites in the geological record. The question of how significant barite deposits were able to form from early Earth’s low-sulfate seas remains controversial. Here, the authors show pelagic barite precipitation within a strongly barite-undersaturated ecosystem, highlighting the importance of particle-associated microenvironments.

Limited surgeon-specific outcomes data are currently released to the public. Existing schemes generally result from the recommendations of public enquiries, addressing breaches to patient safety and malpractice. We found limited evidence in the literature about patients' or orthopaedic surgeons' wishes regarding the release of such data to the public. We surveyed 80 joint replacement patients and 41 orthopaedic surgeons regarding their wishes concerning collection and release of individual surgeon data to the public. Of 80 patients, 30% (24/80) were aware of data on the NHS-My Choices website, 16% (13/80) had reviewed data prior to operation and 95% (76/80) wanted data concerning surgeons' experience, length of stay and complications including revisions. Patients expected more current monitoring of data than occurs. Of 41 surgeons, 20% (8/41) thought national joint registry (NJR) derived data accurately reflected their NHS work. Surgeons did not think this data improved patient outcomes (34%, 14/41), and that it reduced innovation (61%, 25/41) and training (75%, 31/41) and increased risk of adverse behaviour (61%, 25/41). Surgeons wanted a minimal data set accurately presented and risk adjusted. In the future, it is likely that more individual surgeon data will be released to the public. There needs to be an agreed, accurate minimum dataset collected, reviewed in local clinical governance meetings and published with explanatory notes regarding the interfering variables and what conclusions can be drawn regarding the ability of the surgeon. This process needs to be overseen by an independent body trusted by the public.

IntroductionShoulder arthroplasty (SA) procedures are increasing in number worldwide. Medical complications (MC) following SA have not been widely documented in the literature. Knowledge of these complications is needed to obtain informed consent.MethodsThe aim of this review article was to summarise the literature regarding systemic complications and mortality after SA to aid the consenting process.FindingsWe found that the literature regarding MC after SA was variable in quality. The rate of MC was 12% and the rate of mortality was 0.01%. The most common MC were cardiovascular, genitourinary and respiratory. The patients most at risk were the elderly, females, fracture patients and those with HIV or hepatitis C. During inpatient stay, reverse arthroplasty and blood transfusion were associated with MC. We recommend that our data are used to obtain informed consent for SA.ConclusionsTo reduce risk, we encourage optimisation of patients prior to surgery with correction of anaemia, arranging necessary clinician reviews and appropriate postoperative nursing care.

Arthroplasty procedures are commonly performed in the UK. Informed consent is required for each procedure. To obtain informed consent the patient and their surgeon should discuss the risks and benefits of the proposed operation. This discussion should include both regional and systemic complication rates. Regional complications of arthroplasty are generally well documented in the literature. Systemic medical complications are less well described. This lack of accurate data could make it difficult for the treating surgeon to obtain valid consent. The aim of this paper was to review and compare the literature regarding the rate of systemic medical complications after common arthroplasty procedures. A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Studies regarding the systemic medical complications and mortality rate of joint replacement were included. We found that systemic complications were more frequent than regional complications following arthroplasty. The systemic complication rates were: hip, 5.1%; knee, 6.9%; ankle, 3.0%; shoulder, 11.2%; elbow, 8.5%; and wrist, 0%. Mortality rates for arthroplasty procedures were: hip, 0.3%; knee, 0.2%; ankle, 0.3%; shoulder, 0.3%; elbow, 0.2%; and wrist, 0%. The most common systemic medical complication following arthroplasty was venous thromboembolism. Preoperative comorbidity was the most important risk factor for both postoperative mortality and systemic medical complications following arthroplasty procedures. We recommend that to obtain informed consent the given rates of systemic medical complications of joint replacement should be discussed and documented.

Purpose Private retail and brand-driven sustainable procurement standards are influencing global agri-food markets, shifting trade and export priorities and reshaping food supply chains. Using the case of Australian beef, the authors construct and evaluate three procurement activity “portfolios” and evaluate how these activity sets pull towards or against diverse organisational goals and/or science-based sustainability objectives. Design/methodology/approach A review of the academic and practitioner literature identified three key pillars for sustainable Australian beef procurement: animal welfare, environmental management and climate change (i.e. emissions). A subset of sustainable beef production activities (n = 100) was identified through this review plus semi-structured interviews with Australian beef retailers and industry bodies. This activity set was filtered (n = 40) and scored by a panel of science experts via a series of workshops and an additional survey. Using these data, the authors use a k-means cluster analysis (k = 3) to consider the strong or weak contributions of each activity portfolio towards typical sustainable beef goals. Findings A portfolio-based view of sustainable procurement puts the trade-offs between activities and the need for clear sustainability prioritisation into sharp focus. The authors find that individual strategies may be singularly more or less impactful, complex or popular, but when combined as a suite of activities enacted towards a particular goal or set of goals, essential for success. The authors find that obtaining balance across sustainable beef pillars versus within specific pillars can narrow the optimal set of activities that can succeed against multiple sustainability goals. Practical implications For procurement managers, the balance between clear focus and multidimensional progress is a difficult challenge. It requires the bold identification and articulation of an organisation’s interlocking corporate, industry or environmental objectives and flexibility on the strategies, tools and resources required. The authors posit that shifting away from a focus on rigid metrics may be useful in breaking the impasse on meaningful action. Social implications Using a set of known activities and strategies that a procurement manager might draw from in operationalising sustainability goals, the authors cluster activities into three discrete activity portfolios. Each portfolio requires differing levels of effort, implementation complexity and potential for within-pillar and cross-pillar impact (i.e. co-benefits). Assessing the evidence and potential for cross-pillar impacts of individual strategies is a complex undertaking, indicative of the systems and tangled interactions that characterise sustainability science more broadly. Originality/value By assessing how the procurement function can be leveraged and operationalised towards sustainability goals through a lens of optimal portfolio management, the authors provide a way forward for the procurement managers working within large retailers and agri-food businesses to progress towards multiple sustainability pillars simultaneously.

The aim of this in vitro study was to assess the validity and reproducibility of the ICDAS II (International Caries Detection and Assessment System) criteria in primary teeth. Three trained examiners independently examined 112 extracted primary molars, ranging from clinically sound to cavitated, set up in groups of 4 to mimic their anatomical positions. The most advanced caries on the occlusal and approximal surfaces was recorded. Subsequently the teeth were serially sectioned and histological validation was undertaken using the Downer and Ekstrand-Ricketts-Kidd (ERK) scoring systems. For occlusal surfaces at the D 1 /ERK 1 threshold, the mean specificity was 90.0%, with a sensitivity of 75.4%. For approximal surfaces, the specificity and sensitivity were 85.4 and 66.4%, respectively. For occlusal surfaces at ICDAS code ≥3 (ERK 3 threshold), the mean specificity and sensitivity were 87.0 and 78.1%, respectively. For approximal surfaces, the equivalent values were 90.6 and 75.3%. At the D 3 threshold for occlusal surfaces, the mean specificity and sensitivity were 92.8 and 63.1%, and for approximal surfaces 94.2 and 58.3%, respectively. Mean intraexaminer reproducibility (Cohen’s kappa) ranged from 0.78 to 0.81 at the ICDAS code ≥1 cut-off and at the ICDAS code ≥3 cut-off from 0.74 to 0.76. Interexaminer reproducibility was lower, ranging from 0.68 to 0.70 at the ICDAS code ≥1 cut-off and from 0.66 to 0.73 at the ICDAS code ≥3 cut-off. In conclusion, the validity and reproducibility of the ICDAS II criteria were acceptable when applied to primary molar teeth.

Aim: The aim of this study was to assess inter- and intra-examiner reproducibility and accuracy in the detection and assessment of occlusal caries in extracted human teeth using a newly developed visual method for caries diagnosis (International Caries Detection and Assessment System, ICDAS-II). Serial sectioning and microscopy were used as the ‘gold standard’. Methods: The occlusal surfaces of 100 teeth were examined by 4 dentists using the ICDAS-II graded scores 0–6. Thereafter the teeth were serially sectioned and assessed for depth of the lesion with two histological classification systems. Results: The weighted kappa values for inter- and intra-examiner reproducibility for the ICDAS-II examination were 0.62–0.83. There was a moderate relationship between the visual and both histological examinations (r s = 0.43–0.72). At the D1 diagnostic threshold (enamel and dentine lesions) specificity was 0.74–0.91 and sensitivity was 0.59–0.73. At the D3 diagnostic threshold (dentine lesions) specificity was 0.82–0.94 and sensitivity was 0.48–0.83 for the 4 examiners. Conclusion: The ICDAS-II system has demonstrated reproducibility and diagnostic accuracy for the detection of occlusal caries at varying stages of the disease process which are comparable to previously reported data using similar visual classification systems.

Background: Modern surgical staplers should provide precise placement and transection, especially in tight spaces and on thick tissue. Ideally, a stapler would move to accommodate variations in the tissue and anatomy instead of having to move the tissue around to fit the stapler. This study was undertaken to evaluate the performance characteristics of the new Echelon 3000 Stapler (ECH3). Use of the ECH3 was compared to another marketed stapler, including tests for access, seal strength, staple formation in thick tissue, and end effector stability. Methods: Pelvic anatomy measurements were used to construct a virtual model of a Low Anterior Resection (LAR). Monte Carlo simulations were performed on the staplers to compare the probability of completing a transection with one or two firings. Using water infusion of stapled porcine ileum, pressure at first leak and percentage of leaks at critical pressures were measured. Rate of malformed staples was measured in thick tissue. End effector stability while firing and under moderate pressure were compared between staplers. After use, surgeons were surveyed on the functionality of the device. Results: ECH3 had a markedly higher probability of completing an LAR transection in one or two firings than the comparator stapler. Median initial leak pressure of stapled ileum was significantly higher, and rate of leaks was lower at 40 and 50 mmHg. ECH3 had fewer malformed staples for both 3.3- and 4.0-mm thick tissue. The end effector exhibited less angular movement during firing, and less deflection under a moderate load. Surgeons agreed the ECH3 provided precise placement and easy one-handed operation. Conclusion: The Echelon 3000 Stapler demonstrated improved access capability, tighter seals, fewer malformed staples, and greater end effector stability. These advantages were recognized by surgeons who evaluated the use of the device preclinically. Keywords: stapler, access, pelvis, maneuverability, powered articulation