Pediatric thyroid disease: when is surgery necessary, and who should be operating on our children?

Surgical diseases of the thyroid in the pediatric population represent a diverse set of both benign and malignant conditions. Overall, incidence is rare. Benign conditions include Graves' disease, toxic adenomas, congenital hyperthyroidism, and goiter. Differentiated thyroid cancer (DTC) and medullary thyroid carcinoma (MTC), with its related familial cancer syndromes, are the most common malignancies. Near-total or total thyroidectomy is the appropriate surgery for thyroid cancer, with/out central lymph node dissection. Emerging practice guidelines from professional societies are helpful, although they generally have not addressed surgical management of the pediatric patient. Thyroidectomy in children is associated with a higher rate of complications, such as recurrent laryngeal nerve injury and hypoparathyroidism, as compared to the surgery in adults. Therefore, it is essential that pediatric thyroidectomy be performed by high-volume thyroid surgeons, regardless of specialty. Case volume to support surgical expertise usually must be borrowed from the adult experience, given the relative paucity of pediatric thyroidectomies at an institutional level. These surgeons should work as part of a multidisciplinary team that includes pediatric endocrinologists and anesthesiologists, pediatricians, nuclear medicine physicians, and pathologists to afford children the best clinical outcomes

The adaptation challenges of foreign students in TPU from the perspective of cross-cultural communication

The goal of Russian universities is to join the international scientific community. This aim is closely connected with the attraction of foreign students to study in Russia. TPU is one of the greatest centres to attract foreign students in our region. There are different programs of the adaptation to life in Tomsk and university life for foreign students. For our research it was important to learn about the features of the adaptation of foreign students who are away from home. We held a survey with 22 foreign students. In our research we identified important problems faced by foreign students: problem with communication; the problem of isolation living in separate hostels and studying; climate component in the process of the adaptation. In conclusion, we can say that Tomsk can be considered prosperous and hospitable zone for foreign students. Задача российских вузов - выйти в международное пространство и прочно утвердиться в нем. Эта цель тесно связана с привлечением иностранных студентов для обучения в России. ТПУ представляет собой один из крупнейших центров по привлечению иностранных студентов в своем регионе. Для иностранных студентов университетом предусматриваются различные программы адаптации к жизни в городе и к университетской жизни. Для нашей работы представлялось важным узнать об особенностях адаптации иностранных студентов, находящихся вдали от дома. Мы провели анкетирование 22 иностранных студентов. В нашей работе по опросу были выявлены важные проблемы, с которыми сталкиваются иностранные студенты: проблема с коммуникацией; проблема социальной замкнутости: отдельное проживание и обучение; климатическая составляющая процесса адаптации. В заключение мы можем сказать, что Томск может считаться процветающей и гостеприимной зоны для иностранных студентов

A qualitative process evaluation using the behaviour change wheel approach: Did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

PURPOSE: The aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic. METHODS: We used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated. RESULTS: It was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions 'Education', 'Persuasion' and 'Enablement'; behaviour change techniques '1.2 Problem solving', '2.6 Biofeedback', '2.7 Feedback on outcomes of behaviour' and '7.1 Prompts and cues'; and theoretical domains framework domains 'Knowledge' and 'Behavioural regulation'. CONCLUSIONS: Our process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed

Provincial Devonian spores from South China, Saudi Arabia and Australia

A spore assemblage from Maoshan, Luquan County, Yunnan Province, South China includes well known Mid Devonian spores including Archaeozonotriletes variabilis, Cirratriradites monogrammos, Grandispora libyensis, Geminospora lemurata, Cymbosporites magnificus and Ancyrospora spp. which constrain the age to Givetian (late Mid Devonian). There are also elements that occur in the Givetian of South China and Australia such as Archaeoperisaccus indistinctus (senior synonym of A. rhacodes) that also occur very rarely in Saudi Arabia. The Maoshan assemblage moreover contains species of Rotaspora. In the Adavale Basin of Australia and Saudi Arabia there is a similar plexus of provincial species of Rotaspora but of Emsian age. In addition, there is the morphologically distinct spore Tribojasporites, a genus that was only known previously from the Emsian of Australia. The converse also occurs with spores such as Dictyotriletes biornatus, only previously known from the late Pragian to mid Emsian of Saudi Arabia, found as rare specimens in Maoshan. This demonstrates that the Maoshan spore assemblage contains spores that are restricted to the northern margin of Gondwana but with younger ranges and represent relict populations that survived in isolation on the South China terrane. Blooms of the hydrodictyacean chlorococcalean alga Musivum gradzinskii previously known only from Poland and Saudi Arabia are also present at Maoshan

On the effective depth of viral sequence data.

Genome sequence data are of great value in describing evolutionary processes in viral populations. However, in such studies, the extent to which data accurately describes the viral population is a matter of importance. Multiple factors may influence the accuracy of a dataset, including the quantity and nature of the sample collected, and the subsequent steps in viral processing. To investigate this phenomenon, we sequenced replica datasets spanning a range of viruses, and in which the point at which samples were split was different in each case, from a dataset in which independent samples were collected from a single patient to another in which all processing steps up to sequencing were applied to a single sample before splitting the sample and sequencing each replicate. We conclude that neither a high read depth nor a high template number in a sample guarantee the precision of a dataset. Measures of consistency calculated from within a single biological sample may also be insufficient; distortion of the composition of a population by the experimental procedure or genuine within-host diversity between samples may each affect the results. Where it is possible, data from replicate samples should be collected to validate the consistency of short-read sequence data

A qualitative process evaluation using the behaviour change wheel approach : did a whole genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 within UK hospitals operate as anticipated?

Purpose The aim of this study was to conduct a process evaluation of a whole-genome sequence report form (SRF) used to reduce nosocomial SARS-CoV-2 through changing infection prevention and control (IPC) behaviours within the COVID-19 pandemic. Methods We used a three-staged design. Firstly, we described and theorized the purported content of the SRF using the behaviour change wheel (BCW). Secondly, we used inductive thematic analysis of one-to-one interviews (n = 39) to explore contextual accounts of using the SRF. Thirdly, further deductive analysis gauged support for the intervention working as earlier anticipated. Results It was possible to theorize the SRF using the BCW approach and visualize it within a simple logic model. Inductive thematic analyses identified the SRF's acceptability, ease of use and perceived effectiveness. However, major challenges to embedding it in routine practice during the unfolding COVID-19 crisis were reported. Notwithstanding this insight, deductive analysis showed support for the putative intervention functions ‘Education’, ‘Persuasion’ and ‘Enablement’; behaviour change techniques ‘1.2 Problem solving’, ‘2.6 Biofeedback’, ‘2.7 Feedback on outcomes of behaviour’ and ‘7.1 Prompts and cues’; and theoretical domains framework domains ‘Knowledge’ and ‘Behavioural regulation’. Conclusions Our process evaluation of the SRF, using the BCW approach to describe and theorize its content, provided granular support for the SRF working to change IPC behaviours as anticipated. However, our complementary inductive thematic analysis highlighted the importance of the local context in constraining its routine use. For SRFs to reach their full potential in reducing nosocomial infections, further implementation research is needed