Comparison of ophthalmic training in 6 English-speaking countries

OBJECTIVE: To compare key characteristics of ophthalmology training programs in 6 different English-speaking countries: Australia, New Zealand, Canada, Ireland, the United Kingdom, and the United States. PARTICIPANTS: Seven ophthalmologists with personal knowledge of all 6 systems contributed. METHODS: The main features examined were career pathway, duration of training, surgical training, governing bodies, and examination structure. Data were collected from the literature, online resources, and personal experience. RESULTS: Several differences were highlighted, including length of training (ranging from 4 to 9 years after medical school), number of surgical procedures such as cataracts (ranging from minimum 86 to approximately 600), and structure of fellowship training. CONCLUSIONS: As trainees increasingly seek international experience to enhance their knowledge and skills, the similarities and differences between training programs in different countries have become more relevant. Some of these differences may reflect differing needs of different patient populations and different healthcare delivery systems across the globe. However, these differences should also prompt educators to more carefully scrutinize their own training system and search for potential improvements

Five-year publication rate of clinical presentations at the open and closed American shoulder and elbow surgeons annual meeting from 2005–2010

© 2016, The Author(s). Background: The purpose of this study was to evaluate the five-year publication rate of papers presented at both the open and closed American Shoulder and Elbow Surgeons’ (ASES) annual meetings from 2005 to 2010. Methods: Online abstracts of the presentations at the open and closed ASES annual meetings were independently screened for clinical studies and graded for quality using level of evidence. The databases PubMed (MEDLINE), Ovid (MEDLINE), and EMBASE were comprehensively searched for full-text publications corresponding to these presentations and any paper published within five years of the presentation date was counted. Results: Overall, 131/266 papers corresponding to the meeting presentations were identified for a five-year publication rate of 49.2 %. Sixty two (48 %) of the papers were published in The Journal of Shoulder and Elbow Surgeons, 23 (18 %) were published in The American Journal of Sports Medicine, and 20 (16 %) were published in The Journal of Bone and Joint Surgery. The mean patient sample size included in presentations with a subsequent full-text publication was higher (154; standard error =27) than the presentations not published (93; standard error = 13) (p = 0.039). There was no correlation (p = 0.248) between the publication rate and the level of evidence of the presentations. Conclusions: The publication rate of presentations at ASES meetings from 2005 to 2010 is similar to that reported from other orthopaedic meetings. Studies with large sample sizes should continue to be encouraged, and high quality presentations must consistently be followed up with full-text manuscript preparation in order to maximize the future clinical impact

Changes in chemical attributes during ripening of traditional fermented sausage, "Pirot ironed"

"Pirot ironed" is a traditional Serbian dry-fermented sausage manufactured in the southeast of Serbia. The changes in the chemical attributes of Pirot ironed sausage were followed during ripening. Samples were taken on the processing days 0, 7, 14, 21 and 28. Pirot ironed sausage was produced from the most valuable cuts of beef and chevon, without addition of starter cultures or fat tissues. Sausages were manufactured in a traditional drying/ripening chamber, where they were pressed every two days to acquire the typical flat form and to speed up the drying. The final water activity was 0.839. The lowest pH value recorded was 5.30 on the processing day 28. During ripening, the water content decreased significantly from 74.72% to 40.32%, while the protein and the fat amounts increased significantly from 19.12% to 45.79% and from 1.22% to 6.21%, respectively. Up to now, the properties of Pirot ironed sausage have not been recognized or published in scientific literature in spite of the long tradition and popularity of this meat product in Serbia

Morphology of two dimensional fracture surface

We consider the morphology of two dimensional cracks observed in experimental results obtained from paper samples and compare these results with the numerical simulations of the random fuse model (RFM). We demonstrate that the data obey multiscaling at small scales but cross over to self-affine scaling at larger scales. Next, we show that the roughness exponent of the random fuse model is recovered by a simpler model that produces a connected crack, while a directed crack yields a different result, close to a random walk. We discuss the multiscaling behavior of all these models.Comment: slightly revise

Widespread sex differences in gene expression and splicing in the adult human brain

There is strong evidence to show that men and women differ in terms of neurodevelopment, neurochemistry and susceptibility to neurodegenerative and neuropsychiatric disease. The molecular basis of these differences remains unclear. Progress in this field has been hampered by the lack of genome-wide information on sex differences in gene expression and in particular splicing in the human brain. Here we address this issue by using post-mortem adult human brain and spinal cord samples originating from 137 neuropathologically confirmed control individuals to study whole-genome gene expression and splicing in 12 CNS regions. We show that sex differences in gene expression and splicing are widespread in adult human brain, being detectable in all major brain regions and involving 2.5% of all expressed genes. We give examples of genes where sex-biased expression is both disease-relevant and likely to have functional consequences, and provide evidence suggesting that sex biases in expression may reflect sex-biased gene regulatory structures

Against quantiles: categorization of continuous variables in epidemiologic research, and its discontents

<p>Abstract</p> <p>Background</p> <p>Quantiles are a staple of epidemiologic research: in contemporary epidemiologic practice, continuous variables are typically categorized into tertiles, quartiles and quintiles as a means to illustrate the relationship between a continuous exposure and a binary outcome.</p> <p>Discussion</p> <p>In this paper we argue that this approach is highly problematic and present several potential alternatives. We also discuss the perceived drawbacks of these newer statistical methods and the possible reasons for their slow adoption by epidemiologists.</p> <p>Summary</p> <p>The use of quantiles is often inadequate for epidemiologic research with continuous variables.</p

Time from first presentation in primary care to treatment of symptomatic colorectal cancer:effect on disease stage and survival

BACKGROUND: British 5-year survival from colorectal cancer (CRC) is below the European average, but the reasons are unclear. This study explored if longer provider delays (time from presentation to treatment) were associated with more advanced stage disease at diagnosis and poorer survival. METHODS: Data on 958 people with CRC were linked with the Scottish Cancer Registry, the Scottish Death Registry and the acute hospital discharge (SMR01) dataset. Time from first presentation in primary care to first treatment, disease stage at diagnosis and survival time from date of first presentation in primary care were determined. Logistic regression and Cox survival analyses, both with a restricted cubic spline, were used to model stage and survival, respectively, following sequential adjustment of patient and tumour factors. RESULTS: On univariate analysis, those with <4 weeks from first presentation in primary care to treatment had more advanced disease at diagnosis and the poorest prognosis. Treatment delays between 4 and 34 weeks were associated with earlier stage (with the lowest odds ratio occurring at 20 weeks) and better survival (with the lowest hazard ratio occurring at 16 weeks). Provider delays beyond 34 weeks were associated with more advanced disease at diagnosis, but not increased mortality. Following adjustment for patient, tumour factors, emergency admissions and symptoms and signs, no significant relationship between provider delay and stage at diagnosis or survival from CRC was found. CONCLUSIONS: Although allowing for a nonlinear relationship and important confounders, moderately long provider delays did not impact adversely on cancer outcomes. Delays are undesirable because they cause anxiety; this may be fuelled by government targets and health campaigns stressing the importance of very prompt cancer diagnosis. Our findings should reassure patients. They suggest that a health service's primary emphasis should be on quality and outcomes rather than on time to treatment

A prospective study of peri-diagnostic and surgical wait times for patients with presumptive colorectal, lung, or prostate cancer

The objective of this study was to prospectively measure peri-diagnostic and surgical time intervals for patients with suspected colorectal, lung, or prostate cancer. Prospective eligible patients were referred to a regional hospital in Ottawa, Canada between February 2004 and February 2005 for diagnostic assessment of presumptive colorectal, lung, or prostate cancer. Chart abstractions were used to measure nine time intervals; the primary interval was the date of referral for diagnostic assessment to the date the patient was informed of the diagnosis. Health-related quality-of-life (HRQL) was assessed 5 days following the patient being informed of their diagnosis. The median (IQR) time for the primary interval was 71 (30–110), 37 (29–49), and 81 (56–100) days for colorectal, lung, and prostate patients, respectively (Kruskal–Wallis P=0.0001). This interval was significantly less for colorectal patients diagnosed with cancer than for those without cancer (median difference=59.0 days; Wilcoxon P=0.003). No differences in HRQL existed for patients with cancer and those without. Colorectal and prostate patients wait longer between referral for suspected cancer and being informed of their diagnosis than current recommendations. The shorter diagnostic intervals for colorectal patients with cancer suggest clinicians have an effective process for triaging patients referred for diagnostic assessment