The Challenges Facing Training in Pediatric Surgery Worldwide

Like most specialties, pediatric surgery is becoming more complex, and changes to health systems have not always been in the best interests of trainees or their surgical teachers. This paper outlines four of the current challenges faced by training boards in pediatric surgery worldwide, and documents their implications for the future training of pediatric surgeons

The effect of bedrest on various parameters of physiological function. part xii- the effect of bedrest on bone mass and calcium balance

Bed rest effect on various parameters of physiological functions - bone mass and calcium balanc

Cost-effectiveness of Interventions to Increase HPV Vaccine Uptake

OBJECTIVES: We sought to prioritize interventions for increasing human papillomavirus (HPV) vaccination coverage based on cost-effectiveness from a US state perspective to inform decisions by policy makers. METHODS: We developed a dynamic simulation model of HPV transmission and progression scaled to a medium-sized US state (5 million individuals). We modeled outcomes over 50 years comparing no intervention to a one-year implementation of centralized reminder and recall for HPV vaccination, school-located HPV vaccination, or quality improvement (QI) visits to primary care clinics. We used probabilistic sensitivity analysis to assess a range of plausible outcomes associated with each intervention. Cost-effectiveness was evaluated relative to a conservative willingness-to-pay threshold; $50 000 per quality-adjusted life-year (QALY) . RESULTS: All interventions were cost-effective, relative to no intervention. QI visits had the lowest cost and cost per QALY gained ($1538 versus no intervention). Statewide implementation of centralized reminder and recall cost $28 289 per QALY gained versus QI visits. School-located vaccination had the highest cost but was cost-effective at$18 337 per QALY gained versus QI visits. Scaling to the US population, interventions could avert 3000 to 14 000 future HPV cancers. When varying intervention cost and impact over feasible ranges, interventions were typically preferred to no intervention, but cost-effectiveness varied between intervention strategies. CONCLUSIONS: Three interventions for increasing HPV vaccine coverage were cost-effective and offered substantial health benefits. Policy makers seeking to increase HPV vaccination should, at minimum, dedicate additional funding for QI visits, which are consistently effective at low cost and may additionally consider more resource-intensive interventions (reminder and recall or school-located vaccination)

The Role of Parvalbumin-positive Interneurons in Auditory Steady-State Response Deficits in Schizophrenia

© The Author(s) 2019. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Despite an increasing body of evidence demonstrating subcellular alterations in parvalbumin-positive (PV+) interneurons in schizophrenia, their functional consequences remain elusive. Since PV+ interneurons are involved in the generation of fast cortical rhythms, these changes have been hypothesized to contribute to well-established alterations of beta and gamma range oscillations in patients suffering from schizophrenia. However, the precise role of these alterations and the role of different subtypes of PV+ interneurons is still unclear. Here we used a computational model of auditory steady-state response (ASSR) deficits in schizophrenia. We investigated the differential effects of decelerated synaptic dynamics, caused by subcellular alterations at two subtypes of PV+ interneurons: basket cells and chandelier cells. Our simulations suggest that subcellular alterations at basket cell synapses rather than chandelier cell synapses are the main contributor to these deficits. Particularly, basket cells might serve as target for innovative therapeutic interventions aiming at reversing the oscillatory deficits.Peer reviewe

Multi-marker immunofluorescent staining and pd-l1 detection on circulating tumour cells from ovarian cancer patients

Detection of ovarian cancer (OC) circulating tumour cells (CTCs) is primarily based on targeting epithelial markers, thus failing to detect mesenchymal tumour cells. More importantly, the immune checkpoint inhibitor marker PD-L1 has not been demonstrated on CTCs from OC patients. An antibody staining protocol was developed and tested using SKOV-3 and OVCA432 OC cell lines. We targeted epithelial (cytokeratin (CK) and EpCAM), mesenchymal (vimentin), and OC-specific (PAX8) markers for detection of CTCs, and CD45/16 and CD31 were used for the exclusion of white blood and vascular endothelial cells, respectively. PD-L1 was used for CTC characterisation. CTCs were enriched using the Parsortix™ system from 16 OC patients. Results revealed the presence of CTCs in 10 (63%) cases. CTCs were heterogeneous, with 113/157 (72%) cells positive for CK/EpCAM (epithelial marker), 58/157 (37%) positive for vimentin (mesenchymal marker), and 17/157 (11%) for both (hybrid). PAX8 was only found in 11/157 (7%) CTCs. In addition, 62/157 (39%) CTCs were positive for PD-L1. Positivity for PD-L1 was significantly associated with the hybrid phenotype when compared with the epithelial (p = 0.007) and mesenchymal (p = 0.0009) expressing CTCs. Characterisation of CTC phenotypes in relation to clinical outcomes is needed to provide insight into the role that epithelial to mesenchymal plasticity plays in OC and its relationship with PD-L1

Probing radio source environments via HI and OH absorption

We present the results of HI and OH absorption measurements towards a sample of radio sources using the Arecibo 305-m telescope and the GMRT. In total, 27 radio sources were searched for associated 21-cm HI absorption. One totally new HI absorption system was detected against the radio galaxy 3C258, while five previously known HI absorption systems, and one galaxy detected in emission, were studied with improved frequency resolution and/or sensitivity. Our sample included 17 GPS and CSS objects, 4 of which exhibit HI absorption. This detection rate of ~25% compares with a value of ~40% by Vermeulen et al. for similar sources. We detected neither OH emission nor absorption towards any of the sources that were observed at Arecibo, and estimate a limit on the abundance ratio of N(HI)/N(OH)>4x10^6 for 3C258. We have combined our results with those from other available HI searches to compile a heterogeneous sample of 96 radio sources consisting of 27 GPS, 35 CSS, 13 flat spectrum and 21 large sources. The HI absorption detection rate is highest (~45%) for the GPS sources and least for the large sources. We find HI column density to be anticorrelated with source size, as reported earlier by Pihlstr\"om et al. The HI column density shows no significant dependence on either redshift or luminosity, which are themselves strongly correlated. These results suggest that the environments of radio sources on GPS/CSS scales are similar at different redshifts. Further, in accordance with the unification scheme, the GPS/CSS galaxies have an HI detection rate of ~40% which is significantly higher than the detection rate (~20%) towards the GPS/CSS quasars. Also, the principal (strongest) absorption component detected towards GPS sources appears blue-shifted in ~65% of the cases, in agreement with the growing evidence for jet-cloud interactions.Comment: Abridged abstract, 22 pages, 21 figures, moderately revised, accepted for publication in MNRA

Flat-spectrum symmetric objects with ~1 kpc sizes I. The candidates

In order to understand the origin and evolution of radio galaxies, searches for the youngest such sources have been conducted. Compact-medium symmetric objects (CSO-MSOs) are thought to be the earliest stages of radio sources, with possible ages of <10^3 yrs for CSOs (<1 kpc in size) and 10^4-10^5 yrs for MSOs (1-15 kpc). From a literature selection in heterogeneous surveys, we have established a sample of 37 confirmed CSOs. In addition, we only found three confirmed flat-spectrum MSOs in the literature. The typical CSO resides on a z<0.5 galaxy, has a flat radio spectrum (a_thin<0.5; S_v proportional to v^-a), is <0.3 kpc in size, has an arm length ratio <2, and well-aligned (theta<20 deg) opposite lobes with a flux density ratio <10. In order to populate the 0.3-1 kpc size range (large CSOs) and also in order to find more flat-spectrum MSOs, we have built a sample of 157 radio sources with a_{1.40}^{4.85}<0.5 that were resolved with the VLA-A 8.4 GHz. As first results, we have 'rediscovered' nine of the known CSO/MSOs while identifying two new ~14 kpc MSOs and two candidate CSO/MSOs (which only lack redshifts for final classification). We were able to reject 61 of the remaining 144 objects from literature information alone. In the series of papers that starts with this one we plan to classify the remaining 83 CSO/MSO candidates (thanks to radio and optical observations) as well as characterize the physical properties of the (likely) many 0.3-15 kpc flat-spectrum CSO/MSOs to be found.Comment: 19 pages, 14 figures, 6 tables (note that Table 2, in landscape format, has a separate file); accepted by MNRA

Multiple ABC transporters are involved in the acquisition of petrobactin in Bacillus anthracis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91223/1/MMI_8028_sm_FigS1-TabS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/91223/2/j.1365-2958.2012.08028.x.pd