Analysis of the Workforce and Workplace for Rheumatology, and the Research Activities of Rheumatologists Early in Their Careers

[Excerpt] The scope and scale of clinical research is unknown for any medical or surgical specialty beyond snapshots of the broad aims and expenditures of research programs sponsored by federal agencies or the pharmaceutical industry. As a consequence, the workforce and workplace for clinical investigation is enigmatic and unexamined even after explicit warnings that an essential arm for advancing clinical practice has been disabled. The present study was designed to assess the workforce and workplace for rheumatology, and the extent and type of research prevailing among rheumatologists early in their careers. Our findings provide fresh insights about the workforce and the workplace for rheumatology, and justify interventions to address gaps in both the scope and scale of clinical research in arthritis and rheumatism

The Scope and Scale of Clinical Research Accomplished by Rheumatologists Early in Their Careers

[Excerpt] The scope and scale of clinical research is unknown for any medical or surgical specialty beyond snap shots of the broad aims and expenditures of research programs sponsored by federal agencies or the pharmaceutical industry. As a consequence, the workforce and workplace for clinical investigation is enigmatic and unexamined even after explicit warnings that an essential arm for advancing clinical practice is disabled. The present study was designed to examine the nature and extent of investigative activity prevailing among rheumatologists early in their careers. This assessment provides a lens on: i) the fraction of early career rheumatologists who engage in investigative rheumatology, ii) the scope and scale of research in musculoskeletal diseases, iii) funding available for investigative work, iv) the impact of research-intensive institutions, and NIH-K-series awards on research, and v) the demographic backgrounds of early career rheumatologists. The results provide important new insights about the early career workforce for discovery and innovation in rheumatology. The findings integrate demographic, normative, and predictive data to provide the first estimate of the scope and scale of clinical investigation within rheumatology. The results also justify interventions for promoting investigative work, and ultimately advancing the clinical practice of rheumatology

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

Biogenesis of phagolysosomes proceeds through a sequential series of interactions with the endocytic apparatus

We have examined the modifications occurring during the transformation of phagosomes into phagolysosomes in J-774 macrophages. The use of low density latex beads as markers of phagosomes (latex bead compartments, LBC) allowed the isolation of these organelles by flotation on a simple sucrose gradient. Two-dimensional gel electrophoresis, immunocytochemistry, and biochemical assays have been used to characterize the composition of LBC at different time points after their formation, as well as their interactions with the organelles of the endocytic pathway. Our results show that LBC acquire and lose various markers during their transformation into phagolysosomes. Among these are members of the rab family of small GTPases as well as proteins of the lamp family. The transfer to the LBC of lamp 2, a membrane protein associated with late endocytic structures, was shown to be microtubule dependent. Videomicroscopy showed that newly formed phagosomes were involved in rapid multiple contacts with late components of the endocytic pathway. Collectively, these observations suggest that phagolysosome formation is a highly dynamic process that involves the gradual and regulated acquisition of markers from endocytic organelles

Approche pour l'identification des causes de la mauvaise décantation des solides biologiques

Les procédés d'épuration biologique à culture libre (boues activées) comprennent habituellement un décanteur qui permet de concentrer les solides biologiques en vue de leur recirculation en tête du réacteur biologique. Lorsque ce décanteur fonctionne mal on observe une perte de solides biologiques (SB), ce qui se traduit par une augmentation de la concentration des matières en suspension (MES) dans l'effluent du décanteur secondaire et par une baisse des performances du procédé d'épuration. Lorsque la concentration de MES dans l'effluent du décanteur secondaire est trop élevée on mesure l'indice de volume des boues (IVB). Un IVB faible indique que les solides biologiques ont de bonnes caractéristiques de décantation de sorte que la cause de la mauvaise efficacité du décanteur est d'ordre physique et peut être identifiée facilement. Lorsque l'IVB est élevé, la mauvaise décantation est alors causée par un désordre de l'écosystème qui se traduit le plus souvent par une croissance excessive d'organismes filamenteux. Les causes et les solutions d'un tel problème sont alors difficiles à identifier. Pour ce travail, les auteurs ont réalisé une importante revue bibliographique dont les résultats sont présentés sous la forme d'un cheminement critique (fig. 1). Dans cette figure, les cases numérotées de 1 à 48 sont liées par des énoncés logiques. Ainsi, en répondant à des questions simples, il est possible de cheminer dans la figure 1 et d'identifier les causes les plus probables du déséquilibre microbiologique ainsi que les solutions qui ont déjà été apportées avec succès. De plus les auteurs ont associé à chaque case une fiche technique (portant le même numéro que la case) sur laquelle sont présentées des explications et la liste des références consultées.Activated sludge is a microbiological aerated sewage treatment process which includes a secondary clarifier to separate the treated effluent from the biological solids. Part of the concentrated solids is recirculated to maintain an adequate concentration of mixed liquor suspended solids (MLSS) In the aerated basin. When the secondary clarifier malfunctions, some biological solids are lost to the effluent : the process efficiency drops and the concentration of suspended solids (SS) increases. When the SS in the effluent is too high the sludge volume index (SVI) must be measured. A low SVI means that the biological solids have good sedimentation characteristics : the problem is thon physical in nature and is easily identified. When the SVI is high, the problem is due to a disturbance of the microbiological ecosystem, which is at the origin of excessive filamentous organism growth. The origins and solutions of such a problem are much harder to find. To this end the authors proceeded with an important review of the literature, the results of which are summarized through a critical path, in figure 1. Files from 1 to 48 are linked by logical statements in such a way that by answering simple questions, one can proceed through the files and identify the must probable cause of the biological disturbance as well as the solution which has already proven successful. Furthermore, the authors have linked each file to a technical file which bears the same number and on which an explanation and references are found.Before proceeding with figure 1 to identify a problem in real life, one must obtain information, resulting from an analysis and observations, with regard to plant effluent, primary clarifier effluent and activated sludge characteristics, including the MLSS concentration. One must also know the chemical oxygen demand (COD), the soluble and total biochemical oxygen demand (BOD5), as well as the nitrogen and phosphorus concentrations in the plant influent. Furthermore, one must also be told of the presence of toxic material or industrial wastes in the sewage and of the fraction of pollution load which is in the form of particulates. Whether sudden changes in the quality of the plant influent have occurred is worth knowing. The concentration of oxygen or hydrogen sulfide in the primary clarifier is also important. One must also gather data related to the activated sludge treatment itself : type of reactor (completely mixed or plug flow), mixed liquor volatile suspended solids (MLVSS) concentration, dissolved oxygen concentration, rate of oxygen uptake and pH. Finally, the results of a microbiological analysis of the sludge are very useful.To illustrate the use of figure 1, let us say that we have the following data :a) Many filamentous microorganisms are present in the MLSS, in particular Microthrix parvicella, type 0092, and Thiothrix sp;b) The rate of dissolved oxygen uptake is 12 mg O2/g of SS - h;c) The rate of COD removal is 0,48 Kg/Kg of SS -d;d) There are no toxic substances in the plant influent;e) There are no abrupt changes in plant influent quality;f) The pHs of the plant influent and of the MLSS are 7,0 and 6,8 respectively;g) The ammonia nitrogen concentration of the plant influent is 1,2 mg/L (N);h) The phosphorus concentration of the plant influent is 4,4 mg/L (P);i) The total and soluble BOD5 concentrations of the plant influent are 400 and 80 mg/L respectively.With this information, we are ready to proceed through figure 1. From file one, one goes to file 2, since the rate of oxygen uptake is sufficient. Otherwise, we would have proceeded to file 32. The reactor being completely mixed, the next step is file 3, where it is said that, because of the low soluble BOD5 concentration one must go to file 9, where we find a fast of filamentous microarganisms which may be responsible for the disturbance. Since two of these microorganisms are effectively present in the mixed liquor suspended solids (MLSS), Microthrox parvicella and type 0092, we are invited to go to file 35, where it is stated that someone has already solved a similar problem by creating a modified contact zone to increase the substrats (organic matter) concentration around the microbiological flocs. The third filamentous microorganism is not identified in file 9. As a second possibility one may assume, in file 2. That the mixing is not complete, which is often the case. With the help of information and results of analyses already available, we proceed, through file 4, 14, 15 and 16, to file 20 where Thiothrixsp is included in the microorganisms listed. File 20 is linked to file 41, where it is said that the controlled addition of nitrogen in the plant influent has already been used to solve this type of problem.The critical path presented in this article is the result of an elaborate study. It may be used as a tool to identify the causes of bad biological flocs sedimentation in the secondary clarifier and select solutions that have already been used successfully

Lack of strong ellipticity in Euclidean quantum gravity

Recent work in Euclidean quantum gravity has studied boundary conditions which are completely invariant under infinitesimal diffeomorphisms on metric perturbations. On using the de Donder gauge-averaging functional, this scheme leads to both normal and tangential derivatives in the boundary conditions. In the present paper, it is proved that the corresponding boundary value problem fails to be strongly elliptic. The result raises deep interpretative issues for Euclidean quantum gravity on manifolds with boundary.Comment: 14 pages, Plain Tex, 33 KB, no figure

Existence of global strong solutions to a beam-fluid interaction system

We study an unsteady non linear fluid-structure interaction problem which is a simplified model to describe blood flow through viscoleastic arteries. We consider a Newtonian incompressible two-dimensional flow described by the Navier-Stokes equations set in an unknown domain depending on the displacement of a structure, which itself satisfies a linear viscoelastic beam equation. The fluid and the structure are fully coupled via interface conditions prescribing the continuity of the velocities at the fluid-structure interface and the action-reaction principle. We prove that strong solutions to this problem are global-in-time. We obtain in particular that contact between the viscoleastic wall and the bottom of the fluid cavity does not occur in finite time. To our knowledge, this is the first occurrence of a no-contact result, but also of existence of strong solutions globally in time, in the frame of interactions between a viscous fluid and a deformable structure

Global Properties of Neutral Hydrogen in Compact Groups

Compact groups of galaxies provide a unique environment to study the evolution of galaxies amid frequent gravitational encounters. These nearby groups have conditions similar to those in the earlier universe when galaxies were assembled and give us the opportunity to witness hierarchical formation in progress. To understand how the compact group environment affects galaxy evolution, we examine the gas and dust in these groups. We present new single-dish GBT neutral hydrogen (HI) observations of 30 compact groups and define a new way to quantify the group HI content as the HI-to-stellar mass ratio of the group as a whole. We compare the HI content with mid-IR indicators of star formation and optical [g-r] color to search for correlations between group gas content and star formation activity of individual group members. Quiescent galaxies tend to live in HI-poor groups, and galaxies with active star formation are more commonly found in HI-rich groups. Intriguingly, we also find "rogue" galaxies whose star formation does not correlate with group HI content. In particular, we identify three galaxies (NGC 2968 in RSCG 34, KUG 1131+202A in RSCG 42, and NGC 4613 in RSCG 64) whose mid-IR activity is discrepant with the HI. We speculate that this mismatch between mid-IR activity and HI content is a consequence of strong interactions in this environment that can strip HI from galaxies and abruptly affect star-formation. Ultimately, characterizing how and on what timescales the gas is processed in compact groups will help us understand the interstellar medium in complex, dense environments similar to the earlier Universe.Comment: Accepted to A