Dissecting the Workforce and Workplace for Clinical Endocrinology, and the Work of Endocrinologists Early in Their Careers

[Excerpt] No national mechanism is in place for an informed, penetrating, and systematic assessment of the physician workforce such as that achieved by the National Science Foundation (NSF) for the periodic evaluation of the nation’s scientists and engineers. Likewise, knowledge of the workforce for clinical research is enigmatic and fragmentary despite the serial recommendations of “blue-ribbon” panels to establish a protocol for the recurrent assessment of clinical investigators early in their careers. Failure to adopt a national system for producing timely, high-quality data on the professional activities of physicians limits the application of improvement tools for advancing clinical investigation and ultimately improving clinical practice. The present study was designed as a pilot project to test the feasibility of using Web-based surveys to estimate the administrative, clinical, didactic, and research work of subspecialty physicians employed in academic, clinical, federal, and pharmaceutical workplaces. Physician members of The Endocrine Society (TES) were used as surrogate prototypes of a subspecialty workforce because of their manageable number and investigative tradition. The results establish that Web-based surveys provide a tool to assess the activities of a decentralized workforce employed in disparate workplaces and underscore the value of focusing on physician work within the context of particular workplaces within a subspecialty. Our report also provides a new and timely snapshot of the amount and types of research performed by clinically trained endocrinologists and offers an evidenced-based framework for improving the investigative workforce in this medical subspecialty

Optimization of the leak conductance in the squid giant axon

We report on a theoretical study showing that the leak conductance density, \GL, in the squid giant axon appears to be optimal for the action potential firing frequency. More precisely, the standard assumption that the leak current is composed of chloride ions leads to the result that the experimental value for \GL is very close to the optimal value in the Hodgkin-Huxley model which minimizes the absolute refractory period of the action potential, thereby maximizing the maximum firing frequency under stimulation by sharp, brief input current spikes to one end of the axon. The measured value of \GL also appears to be close to optimal for the frequency of repetitive firing caused by a constant current input to one end of the axon, especially when temperature variations are taken into account. If, by contrast, the leak current is assumed to be composed of separate voltage-independent sodium and potassium currents, then these optimizations are not observed.Comment: 9 pages; 9 figures; accepted for publication in Physical Review

Oral contraceptive progestins and angiotensin-dependent control of the renal circulation in humans

Oral contraceptive (OC) use is associated with increased intra-renal renin-angiotensin-aldosterone system (RAA System) activity and risk of nephropathy, though the contribution of progestins contained in the OC in the regulation of angiotensin-dependent control of the renal circulation has not been elucidated. Eighteen OC users (8 non-diabetic, 10 Type 1 diabetic) were studied in high salt balance, a state of maximal RAA System suppression. Progestational and androgenic activity of the progestin in each OC was standardized to that of the reference progestin norethindrone. Renal plasma flow (RPF) was measured by paraaminohippurate clearance at baseline and in response to angiotensin converting enzyme (ACE)-inhibition. There was a positive correlation between OC progestational activity and the RPF response to ACE-inhibition (r=0.52, p=0.03). Similar results were noted with OC androgenic activity (r=0.54, p=0.02). On subgroup analysis, only non-diabetic subjects showed an association between progestational activity and angiotensin-dependent control of the renal circulation (r=0.71, p=0.05 non-diabetic; r=0.14, p=0.7 diabetic; p=0.07 between groups). Similar results were noted with respect to androgenic activity (r=0.88, p=0.005 non-diabetic; r=−0.33, p=0.3 diabetic; p=0.002 between groups). Our results suggest that the OC progestin component is a significant influence on the degree of angiotensin-dependent control of the renal circulation, though these findings may not apply to women with diabetes

A laser-driven target of high-density nuclear polarized hydrogen gas

We report the best figure-of-merit achieved for an internal nuclear polarized hydrogen gas target and a Monte Carlo simulation of spin-exchange optical pumping. The dimensions of the apparatus were optimized using the simulation and the experimental results were in good agreement with the simulation. The best result achieved for this target was 50.5% polarization with 58.2% degree of dissociation of the sample beam exiting the storage cell at a hydrogen flow rate of $1.1\times 10^{18}$ atoms/s.Comment: Accepted as a Rapid Communication article in Phys. Rev.

Spinors in Weyl Geometry

We consider the wave equation for spinors in ${\cal D}$-dimensional Weyl geometry. By appropriately coupling the Weyl vector $\phi _{\mu}$ as well as the spin connection $\omega _{\mu a b }$ to the spinor field, conformal invariance can be maintained. The one loop effective action generated by the coupling of the spinor field to an external gravitational field is computed in two dimensions. It is found to be identical to the effective action for the case of a scalar field propagating in two dimensions.Comment: 13 pages, REVTEX, no figure

A survey of UK medical schools' arrangements for early patient contact

Background: Many U.K. medical schools have patient contact in the first two years of the undergraduate course. Aim: To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. Methods: A telephone survey of lead educators in UK medicals schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. Results: The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. Conclusions: Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training

The SASSCAL contribution to climate observation, climate data management and data rescue in Southern Africa

A major task of the newly established "Southern African Science Service Centre for Climate Change and Adaptive Land Management" (SASSCAL; www.sasscal.org) and its partners is to provide science-based environmental information and knowledge which includes the provision of consistent and reliable climate data for Southern Africa. Hence, SASSCAL, in close cooperation with the national weather authorities of Angola, Botswana, Germany and Zambia as well as partner institutions in Namibia and South Africa, supports the extension of the regional meteorological observation network and the improvement of the climate archives at national level. With the ongoing rehabilitation of existing weather stations and the new installation of fully automated weather stations (AWS), altogether 105 AWS currently provide a set of climate variables at 15, 30 and 60 min intervals respectively. These records are made available through the SASSCAL WeatherNet, an online platform providing near-real time data as well as various statistics and graphics, all in open access. This effort is complemented by the harmonization and improvement of climate data management concepts at the national weather authorities, capacity building activities and an extension of the data bases with historical climate data which are still available from different sources. These activities are performed through cooperation between regional and German institutions and will provide important information for climate service related activities

Impacts of a power-law non-thermal electron tail on the ionization and recombination rates

We have investigated the effects of a non-thermal electron population on the ionization and recombination rates. The considered electron distribution is defined as a Maxwellian function below a break energy E_b and as a power-law function of index alpha above this energy. We have calculated the collisional (direct and excitation autoionization) ionization coefficient rates as well as the (radiative and dielectronic) recombination rates. Practical methods are given to calculate these rates in order to be easily included in a computer code. The ionization rates are very sensitive to the non-thermal electron population and can be increased by several orders of magnitude depending on the temperature and parameters of the power-law function (E_b and alpha). The non-thermal electrons have a much weaker effect on the (radiative and dielectronic) recombination rates. We have determined the mean electric charge of elements C, N, O, Ne, Mg, Si, S, Ar, Ca, Fe and Ni for different values of the break energy and power-law index. The ionization balance is affected significantly, whereas the effect is smaller in ionizing plasmas.Comment: 16 pages, 19 figures, accepted for publication in A&

Kripke Semantics for Martin-L\"of's Extensional Type Theory

It is well-known that simple type theory is complete with respect to non-standard set-valued models. Completeness for standard models only holds with respect to certain extended classes of models, e.g., the class of cartesian closed categories. Similarly, dependent type theory is complete for locally cartesian closed categories. However, it is usually difficult to establish the coherence of interpretations of dependent type theory, i.e., to show that the interpretations of equal expressions are indeed equal. Several classes of models have been used to remedy this problem. We contribute to this investigation by giving a semantics that is standard, coherent, and sufficiently general for completeness while remaining relatively easy to compute with. Our models interpret types of Martin-L\"of's extensional dependent type theory as sets indexed over posets or, equivalently, as fibrations over posets. This semantics can be seen as a generalization to dependent type theory of the interpretation of intuitionistic first-order logic in Kripke models. This yields a simple coherent model theory, with respect to which simple and dependent type theory are sound and complete