Exploring the Impact of New Medical Technology on Workforce Planning

This paper considers the manner in which technology is diffused, with a particular emphasis on the impact on workforce composition as it matures. The lack of quantitative evidence of technology on the medical labour-force limits our knowledge of the full impact of technological change in the healthcare sector. We examine the diffusion of PTCA as it replaces CABG in the treatment of cardiovascular disease in England, estimating the degree to which the workforce reacts to the introduction of the newer technology, through calculating elasticity of supply measures. Using administrative data we trace the complementarity between CABG and PTCA during the mature phase of technology adoption, mapped against an increasing employment of cardiologists over cardiothoracic surgeons. Our findings show evidence of indication creep as PTCA is increasingly expanded to older and sicker patients, and that cardiothoracic surgery, other than CABG, increases in a manner consistent with replacement activity and cardiothoracic employment

Expected and Unexpected Features of the Newly Discovered Bat Influenza A-like Viruses

Citation: Ma, W. J., Garcia-Sastre, A., & Schwemmle, M. (2015). Expected and Unexpected Features of the Newly Discovered Bat Influenza A-like Viruses. Plos Pathogens, 11(6), 6. doi:10.1371/journal.ppat.1004819Influenza A viruses (IAVs) are important zoonotic pathogens that cause epidemic outbreaks in poultry, wild birds, swine, and other mammals. In humans, IAVs cause severe respiratory illness, and zoonotic transmission of IAVs from avian reservoirs poses a constant threat to the public health, as exemplified by the recent outbreak of an avian IAV of the H7N9 subtype [1]. Aquatic birds are considered to be the major reservoir of IAVs, and 16 hemagglutinin (HA) and nine neuraminidase (NA) viral subtypes have been isolated from avian species to date. It is now well documented that from time to time IAVs overcome the species barrier and establish new lineages in other animals, including domestic animals, sea mammals, and humans (Fig 1). Our understanding of IAVs was recently challenged by the identification of two novel genome sequences of influenza A-like viruses from bat specimens by next-generation sequencing. These viruses were provisionally designated "H17N10" (from yellow-shouldered fruit bats [Sturnira lilium] in Guatemala) and "H18N11" (from flat-faced fruit bats [Artibeus planirostris] in Peru) [2,3], which might signal an expansion of IAV host range (Fig 1)

A Gravitational Wave Background from Reheating after Hybrid Inflation

The reheating of the universe after hybrid inflation proceeds through the nucleation and subsequent collision of large concentrations of energy density in the form of bubble-like structures moving at relativistic speeds. This generates a significant fraction of energy in the form of a stochastic background of gravitational waves, whose time evolution is determined by the successive stages of reheating: First, tachyonic preheating makes the amplitude of gravity waves grow exponentially fast. Second, bubble collisions add a new burst of gravitational radiation. Third, turbulent motions finally sets the end of gravitational waves production. From then on, these waves propagate unimpeded to us. We find that the fraction of energy density today in these primordial gravitational waves could be significant for GUT-scale models of inflation, although well beyond the frequency range sensitivity of gravitational wave observatories like LIGO, LISA or BBO. However, low-scale models could still produce a detectable signal at frequencies accessible to BBO or DECIGO. For comparison, we have also computed the analogous gravitational wave background from some chaotic inflation models and obtained results similar to those found by other groups. The discovery of such a background would open a new observational window into the very early universe, where the details of the process of reheating, i.e. the Big Bang, could be explored. Moreover, it could also serve in the future as a new experimental tool for testing the Inflationary Paradigm.Comment: 22 pages, 18 figures, uses revtex

Tablero de altar y elementos constructivos tardoantiguos del yacimiento de Nuestra Señora del Buen Suceso, término municipal de Aznalcóllar (Sevilla)

9 páginas, 10 figuras.[EN]During the archaeological excavation of the site Nuestra Señora del Buen Suceso (Aznalcóllar, Sevilla), elements corresponding to various phases of occupation, from Roman times to present times, were documented. Integrated in a 17th. century AD building, a marble fragment was recovered,identified as an altar panel, with a chronology between the 5th. and 7th. centuries AD. The revision of the archaeological record of the excavaction has allowed the identification, also found in Modern contexts, of other constructive elements of the same chronology.[ES]Durante el proceso de excavación del yacimiento de Nuestra Señora del Buen Suceso, Aznalcóllar (Sevilla), fueron documentados restos correspondientes a diversas fases de ocupación, desde época romana a la actualidad. Integrado en un edificio del siglo XVII d.C. se recuperó un fragmento de mármol que se ha identificado como tablero de altar, con una cronología entre los siglos V y VII d.C. La revisión del registro arqueológico ha permitido identificar, encontrados también en contextos modernos, otros elementos constructivos de la misma cronología.Peer reviewe

Differential contribution of PB1-F2 to the virulence of highly pathogenic H5N1 influenza A virus in mammalian and avian species

Highly pathogenic avian influenza A viruses (HPAIV) of the H5N1 subtype occasionally transmit from birds to humans and can cause severe systemic infections in both hosts. PB1-F2 is an alternative translation product of the viral PB1 segment that was initially characterized as a pro-apoptotic mitochondrial viral pathogenicity factor. A full-length PB1-F2 has been present in all human influenza pandemic virus isolates of the 20(th) century, but appears to be lost evolutionarily over time as the new virus establishes itself and circulates in the human host. In contrast, the open reading frame (ORF) for PB1-F2 is exceptionally well-conserved in avian influenza virus isolates. Here we perform a comparative study to show for the first time that PB1-F2 is a pathogenicity determinant for HPAIV (A/Viet Nam/1203/2004, VN1203 (H5N1)) in both mammals and birds. In a mammalian host, the rare N66S polymorphism in PB1-F2 that was previously described to be associated with high lethality of the 1918 influenza A virus showed increased replication and virulence of a recombinant VN1203 H5N1 virus, while deletion of the entire PB1-F2 ORF had negligible effects. Interestingly, the N66S substituted virus efficiently invades the CNS and replicates in the brain of Mx+/+ mice. In ducks deletion of PB1-F2 clearly resulted in delayed onset of clinical symptoms and systemic spreading of virus, while variations at position 66 played only a minor role in pathogenesis. These data implicate PB1-F2 as an important pathogenicity factor in ducks independent of sequence variations at position 66. Our data could explain why PB1-F2 is conserved in avian influenza virus isolates and only impacts pathogenicity in mammals when containing certain amino acid motifs such as the rare N66S polymorphism

Oat Grazing: Forage Composition and Supplementation Response

Oat forage (Avena sativa), which has low soluble carbohydrates (SC) and high soluble protein (SP) content, can reduce liveweight gain of grazing animals; supplementation with grain and low degradability protein may serve to counteract the effect. A grazing trial was carried out on two soils with different nitrogen (NO3 -) availability, from 16 April 1994 to 6 September 1994. Steers were randomly allocated to 3 treatments: low nitrogen (LN), high nitrogen (HN) and high nitrogen with supplementation (HNS). Forage of LN showed lower SP (p\u3c0.05) during the first month of grazing, and higher SC (p\u3c0.05), than HN during the first two months of the trial. Animal liveweight gain was: 892, 909 and 775 g/an/day for LN, HNS and HN, respectively, with animals in HN of significantly lower liveweight gain (p\u3c0.05). Under the conditions of this trial, animals grazing on oat forage with lower SC and higher SP had lower liveweight gain and responded to supplementation