The surgical workforce shortage and successes in retaining surgical trainees in Ethiopia: a professional survey

BACKGROUND: Medical workforce shortages represent a major challenge in low- and middle-income countries, including those in Africa. Despite this, there is a dearth of information regarding the location and practice of African surgeons following completion of their training. In response to the call by the WHO Global Code of Practice on the International Recruitment of Health Personnel for a sound evidence base regarding patterns of practice and migration of the health workforce, this study describes the current place of residence, practice and setting of Ethiopian surgical residency graduates since commencement of their surgical training in Ethiopia or in Cuba. METHODS: This study presents data from a survey of all Ethiopian surgical residency training graduates since the programme’s inception in 1985. RESULTS: A total of 348 Ethiopians had undergone surgical training in Ethiopia or Cuba since 1985; data for 327 (94.0 %) of these surgeons were collected and included in the study. The findings indicated that 75.8 % of graduates continued to practice in Ethiopia, with 80.9 % of these practicing in the public sector. Additionally, recent graduates were more likely to remain in Ethiopia and work within the public sector. The average total number of surgeons per million inhabitants in Ethiopia was approximately three and 48.0 % of Ethiopian surgeons practiced in Addis Ababa. CONCLUSIONS: Ethiopian surgeons are increasingly likely to remain in Ethiopia and to practice in the public sector. Nevertheless, Ethiopia continues to suffer from a drastic surgical workforce shortage that must be addressed through increased training capacity and strategies to combat emigration and attrition

CMB observations with the Jodrell Bank - IAC interferometer at 33 GHz

The paper presents the first results obtained with the Jodrell Bank - IAC two-element 33 GHz interferometer. The instrument was designed to measure the level of the Cosmic Microwave Background (CMB) fluctuations at angular scales of 1 - 2 degrees. The observations analyzed here were taken in a strip of the sky at Dec = +41 deg with an element separation of 16.7 lambda, which gives a maximum sensitivity to ~1.6 deg structures on the sky. The data processing and calibration of the instrument are described. The sensitivity achieved in each of the two channels is 7 micro K per resolution element. A reconstruction of the sky at Dec = +41 deg using a maximum entropy method shows the presence of structure at a high level of significance. A likelihood analysis, assuming a flat CMB spatial power spectrum, gives a best estimate of the level of CMB fluctuations of Delta Tl = 43 (+13,-12) micro K for the range l = 109 +/- 19; the main uncertainty in this result arises from sample variance. We consider that the contamination from the Galaxy is small. These results represent a new determination of the CMB power spectrum on angular scales where previous results show a large scatter; our new results are in agreement with the theoretical predictions of the standard inflationary cold dark matter models.Comment: 11 pages, 11 figures. Web site at http://www.jb.man.ac.uk/research/cmb/ Accepted for publication in MNRA

The GUCY2C Tumor Suppressor is the Nexus of a Paracrine Hormone Axis Preventing Radiotherapy-Induced Gastrointestinal (GI) Toxicity

Purpose/Objective: Radiation-induced GI toxicity is the primary dose limitation compromising therapy in cancer patients treated with radiation therapy. GUCY2C is the intestinal receptor for diarrheagenic bacterial enterotoxins and the endogenous paracrine hormones guanylin and uroguanylin. Following genomic insult, cyclic (c)GMP produced by ligand activation of GUCY2C enhances DNA damage sensing and repair in intestinal cells. Here, we show that the GUCY2C-cGMP axis mediates p53-dependent radioprotection of intestinal epithelial cells. American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting October 31 - November 4, San Diego, C

The Radio - 2 mm Spectral Index of the Crab Nebula Measured with GISMO

We present results of 2 mm observations of the Crab Nebula, obtained using the Goddard-IRAM Superconducting 2 Millimeter Observer (GISMO) bolometer camera on the IRAM 30 m telescope. Additional 3.3 mm observations with the MUSTANG bolometer array on the Green Bank Telescope are also presented. The integrated 2 mm flux density of the Crab Nebula provides no evidence for the emergence of a second synchrotron component that has been proposed. It is consistent with the radio power law spectrum, extrapolated up to a break frequency of log(nu_{b} [GHz]) = 2.84 +/- 0.29 or nu_{b} = 695^{+651}_{-336} GHz. The Crab Nebula is well-resolved by the ~16.7" beam (FWHM) of GISMO. Comparison to radio data at comparable spatial resolution enables us to confirm significant spatial variation of the spectral index between 21 cm and 2 mm. The main effect is a spectral flattening in the inner region of the Crab Nebula, correlated with the toroidal structure at the center of the nebula that is prominent in the near-IR through X-ray regime.Comment: Accepted for publication in the Ap

90GHz and 150GHz observations of the Orion M42 region. A sub-millimeter to radio analysis

We have used the new 90GHz MUSTANG camera on the Robert C. Byrd Green Bank Telescope (GBT) to map the bright Huygens region of the star-forming region M42 with a resolution of 9" and a sensitivity of 2.8mJy/beam. 90GHz is an interesting transition frequency, as MUSTANG detects both the free-free emission characteristic of the HII region created by the Trapezium stars, normally seen at lower frequencies, and thermal dust emission from the background OMC1 molecular cloud, normally mapped at higher frequencies. We also present similar data from the 150GHz GISMO camera taken on the IRAM telescope. This map has 15" resolution. By combining the MUSTANG data with 1.4, 8, and 21GHz radio data from the VLA and GBT, we derive a new estimate of the emission measure (EM) averaged electron temperature of Te = 11376K by an original method relating free-free emission intensities at optically thin and optically thick frequencies. Combining ISO-LWS data with our data, we derive a new estimate of the dust temperature and spectral emissivity index within the 80" ISO-LWS beam toward OrionKL/BN, Td = 42K and Beta=1.3. We show that both Td and Beta decrease when going from the HII region and excited OMC1 interface to the denser UV shielded part of OMC1 (OrionKL/BN, Orion S). With a model consisting of only free-free and thermal dust emission we are able to fit data taken at frequencies from 1.5GHz to 854GHz.Comment: 18 pages, 8 figures, submitted to the Astrophysical Journa

Implications of a High Angular Resolution Image of the Sunyaev-Zel'dovich Effect in RXJ1347-1145

The most X-ray luminous cluster known, RXJ1347-1145 (z=0.45), has been the object of extensive study across the electromagnetic spectrum. We have imaged the Sunyaev-Zel'dovich Effect (SZE) at 90 GHz (3.3 mm) in RXJ1347-1145 at 10" resolution with the 64-pixel MUSTANG bolometer array on the Green Bank Telescope (GBT), confirming a previously reported strong, localized enhancement of the SZE 20" to the South-East of the center of X-ray emission. This enhancement of the SZE has been interpreted as shock-heated (> 20 keV) gas caused by an ongoing major (low mass-ratio) merger event. Our data support this interpretation. We also detect a pronounced asymmetry in the projected cluster pressure profile, with the pressure just east of the cluster core ~1.6 times higher than just to the west. This is the highest resolution image of the SZE made to date.Comment: 9 pages, 7 figures; accepted for publication in The Astrophysical Journa

MUSTANG: 90 GHz Science with the Green Bank Telescope

MUSTANG is a 90 GHz bolometer camera built for use as a facility instrument on the 100 m Robert C. Byrd Green Bank radio telescope (GBT). MUSTANG has an 8 by 8 focal plane array of transition edge sensor bolometers read out using time-domain multiplexed SQUID electronics. As a continuum instrument on a large single dish MUSTANG has a combination of high resolution (8") and good sensitivity to extended emission which make it very competitive for a wide range of galactic and extragalactic science. Commissioning finished in January 2008 and some of the first science data have been collected.Comment: 9 Pages, 5 figures, Presented at the SPIE conference on astronomical instrumentation in 200

Measuring and Correcting Wind-Induced Pointing Errors of the Green Bank Telescope Using an Optical Quadrant Detector

Wind-induced pointing errors are a serious concern for large-aperture high-frequency radio telescopes. In this paper, we describe the implementation of an optical quadrant detector instrument that can detect and provide a correction signal for wind-induced pointing errors on the 100m diameter Green Bank Telescope (GBT). The instrument was calibrated using a combination of astronomical measurements and metrology. We find that the main wind-induced pointing errors on time scales of minutes are caused by the feedarm being blown along the direction of the wind vector. We also find that wind-induced structural excitation is virtually non-existent. We have implemented offline software to apply pointing corrections to the data from imaging instruments such as the MUSTANG 3.3 mm bolometer array, which can recover ~70% of sensitivity lost due to wind-induced pointing errors. We have also performed preliminary tests that show great promise for correcting these pointing errors in real-time using the telescope's subreflector servo system in combination with the quadrant detector signal.Comment: 17 pages, 11 figures; accepted for publication in PAS

The Atacama Cosmology Telescope: Physical Properties of Sunyaev-Zel'dovich Effect Clusters on the Celestial Equator

We present the optical and X-ray properties of 68 galaxy clusters selected via the Sunyaev-Zel'dovich Effect at 148 GHz by the Atacama Cosmology Telescope (ACT). Our sample, from an area of 504 square degrees centered on the celestial equator, is divided into two regions. The main region uses 270 square degrees of the ACT survey that overlaps with the co-added ugriz imaging from the Sloan Digital Sky Survey (SDSS) over Stripe 82 plus additional near-infrared pointed observations with the Apache Point Observatory 3.5-meter telescope. We confirm a total of 49 clusters to z~1.3, of which 22 (all at z>0.55) are new discoveries. For the second region the regular-depth SDSS imaging allows us to confirm 19 more clusters up to z~0.7, of which 10 systems are new. We present the optical richness, photometric redshifts, and separation between the SZ position and the brightest cluster galaxy (BCG). We find no significant offset between the cluster SZ centroid and BCG location and a weak correlation between optical richness and SZ-derived mass. We also present X-ray fluxes and luminosities from the ROSAT All Sky Survey which confirm that this is a massive sample. One of the newly discovered clusters, ACT-CL J0044.4+0113 at z=1.1 (photometric), has an integrated XMM-Newton X-ray temperature of kT_x=7.9+/-1.0 keV and combined mass of M_200a=8.2(-2.5,+3.3)x10^14 M_sun/h70 placing it among the most massive and X-ray-hot clusters known at redshifts beyond z=1. We also highlight the optically-rich cluster ACT-CL J2327.4-0204 (RCS2 2327) at z=0.705 (spectroscopic) as the most significant detection of the whole equatorial sample with a Chandra-derived mass of M_200a=1.9(-0.4,+0.6)x10^15 M_sun/h70, comparable to some of the most massive known clusters like "El Gordo" and the Bullet Cluster.Comment: 18 pages, 12 figures. Accepted to the Astrophysical Journal. New version includes minor changes in the accepted pape