382 research outputs found

    Becoming an accredited medical teacher in the UK

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    Teaching and training are integral to the different, core roles of a trainee. Therefore, there is a shift in the medical profession towards credentialing teaching and training skills. Postgraduate qualifications in medical education are likely to be more important for professional development. In recent years, the number of medical education awards and training programmes has increased rapidly. This pluralism, however, may become a source of confusion for those considering enrolment on such programmes. This article summarises the nomenclature, awarding bodies, levels of qualification, programmes and positions available for those wishing to advance their educational practice. The article will focus on opportunities available to UK-based doctors and particularly for doctors in training

    Intrinsic Domain and Loop Dynamics Commensurate with Catalytic Turnover in an Induced-Fit Enzyme

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    SummaryArginine kinase catalyzes reversible phosphoryl transfer between ATP and arginine, buffering cellular ATP concentrations. Structures of substrate-free and -bound enzyme have highlighted a range of conformational changes thought to occur during the catalytic cycle. Here, NMR is used to characterize the intrinsic backbone dynamics over multiple timescales. Relaxation dispersion indicates rigid-body motion of the N-terminal domain and flexible dynamics in the I182–G209 loop, both at millisecond rates commensurate with kcat, implying that either might be rate limiting upon catalysis. Lipari-Szabo analysis indicates backbone flexibility on the nanosecond timescale in the V308–V322 loop, while the rest of the enzyme is more rigid in this timescale. Thus, intrinsic dynamics are most prominent in regions that have been independently implicated in conformational changes. Substrate-free enzyme may sample an ensemble of different conformations, of which a subset is selected upon substrate binding, with critical active site residues appropriately configured for binding and catalysis

    Removing subordinate species in a biodiversity experiment to mimic observational field studies

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    Background: Positive effects of plant species richness on community biomass in biodiversity experiments are often stronger than those from observational field studies. This may be because experiments are initiated with randomly assembled species compositions whereas field communities have experienced filtering. Methods: We compared aboveground biomass production of randomly assembled communities of 2–16 species (controls) with experimentally filtered communities from which subordinate species were removed, resulting in removal communities of 1–8 species. Results: Removal communities had (1) 12.6% higher biomass than control communities from which they were derived, that is, with double species richness and (2) 32.0% higher biomass than control communities of equal richness. These differences were maintained along the richness gradient. The increased productivity of removal communities was paralleled by increased species evenness and complementarity. Conclusions: Result (1) indicates that subordinate species can reduce community biomass production, suggesting a possible explanation for why the most diverse field communities sometimes do not have the highest productivity. Result (2) suggests that if a community of S species has been derived by filtering from a pool of 2S randomly chosen species it is more productive than a community derived from a pool of S randomly chosen species without filtering

    Weight change and ovarian steroid profiles in young women

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    Objective: To investigate possible short-term effects of voluntary weight loss on ovarian steroid proïŹles in young women, in light of better established long-term effects in older women. Design: We tested for an association of voluntary weight change over the course of a menstrual cycle with salivary E2 and P proïŹles in the same menstrual cycle. Setting: Students were recruited in a college residence hall, and they provided daily saliva samples to a researcher living nearby. Patient(s): The 65 women who participated were all college students and ranged in age between 18 and 23 years. Intervention(s): None. Main Outcome Measure(s): Weight was assessed in the ïŹrst week of the menstrual cycle and ïŹrst week of the following menstrual cycle. Estradiol and P were measured by radioimmunoassay in daily saliva samples. Result(s): We did not detect a suppressive effect of weight loss on the overall level of either hormone. However, we did ïŹnd evidence for more distinct follicular and luteal E2 peaks in women who gained weight. Peak luteal P also arrived about 2 days earlier in women who gained weight. Conclusion(s): This ïŹnding adds to evidence that short-term response of ovarian function to weight loss in young women is less pronounced than long-term response in older women.AnthropologyHuman Evolutionary Biolog

    Testing the Link between Functional Diversity and Ecosystem Functioning in a Minnesota Grassland Experiment

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    The functional diversity of a community can influence ecosystem functioning and reflects assembly processes. The large number of disparate metrics used to quantify functional diversity reflects the range of attributes underlying this concept, generally summarized as functional richness, functional evenness, and functional divergence. However, in practice, we know very little about which attributes drive which ecosystem functions, due to a lack of field-based tests. Here we test the association between eight leading functional diversity metrics (Rao’s Q, FD, FDis, FEve, FDiv, convex hull volume, and species and functional group richness) that emphasize different attributes of functional diversity, plus 11 extensions of these existing metrics that incorporate heterogeneous species abundances and trait variation. We assess the relationships among these metrics and compare their performances for predicting three key ecosystem functions (above- and belowground biomass and light capture) within a long-term grassland biodiversity experiment. Many metrics were highly correlated, although unique information was captured in FEve, FDiv, and dendrogram-based measures (FD) that were adjusted by abundance. FD adjusted by abundance outperformed all other metrics in predicting both above- and belowground biomass, although several others also performed well (e.g. Rao’s Q, FDis, FDiv). More generally, trait-based richness metrics and hybrid metrics incorporating multiple diversity attributes outperformed evenness metrics and single-attribute metrics, results that were not changed when combinations of metrics were explored. For light capture, species richness alone was the best predictor, suggesting that traits for canopy architecture would be necessary to improve predictions. Our study provides a comprehensive test linking different attributes of functional diversity with ecosystem function for a grassland system

    Pulmonary 18F-FDG uptake helps refine current risk stratification in idiopathic pulmonary fibrosis (IPF).

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    PURPOSE: There is a lack of prognostic biomarkers in idiopathic pulmonary fibrosis (IPF) patients. The objective of this study is to investigate the potential of 18F-FDG-PET/ CT to predict mortality in IPF. METHODS: A total of 113 IPF patients (93 males, 20 females, mean age ± SD: 70 ± 9 years) were prospectively recruited for 18F-FDG-PET/CT. The overall maximum pulmonary uptake of 18F-FDG (SUVmax), the minimum pulmonary uptake or background lung activity (SUVmin), and target-to-background (SUVmax/ SUVmin) ratio (TBR) were quantified using routine region-of-interest analysis. Kaplan-Meier analysis was used to identify associations of PET measurements with mortality. We also compared PET associations with IPF mortality with the established GAP (gender age and physiology) scoring system. Cox analysis assessed the independence of the significant PET measurement(s) from GAP score. We investigated synergisms between pulmonary 18F-FDG-PET measurements and GAP score for risk stratification in IPF patients. RESULTS: During a mean follow-up of 29 months, there were 54 deaths. The mean TBR ± SD was 5.6 ± 2.7. Mortality was associated with high pulmonary TBR (p = 0.009), low forced vital capacity (FVC; p = 0.001), low transfer factor (TLCO; p  4.9 was 24 months. Combining PET data with GAP data ("PET modified GAP score") refined the ability to predict mortality. CONCLUSIONS: A high pulmonary TBR is independently associated with increased risk of mortality in IPF patients

    Reducing the risk of criminal exploitation using multi-systemic therapy (the RESET Study) : study protocol for a feasibility study and process evaluation

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    Background Child criminal exploitation is a form of child abuse that poses a serious risk to the welfare, safety, and wellbeing of young people. Multisystemic therapy (MST) is an intensive family and community-based intervention for young people with anti-social behavioral problems, many of whom will be at risk of criminal exploitation. This protocol describes a pilot feasibility study and process evaluation, designed to examine MST for children at risk of criminal exploitation. Methods This pilot feasibility study and process evaluation involves two phases with associated subphases: phase 1.1 involved the collaborative refinement of the logic model adapting MST for children at risk of criminal exploitation; phase 1.2 involved pre-pilot interviews with MST therapists, families, and young people; phase 2.1 is a pilot modeling study of MST for children at risk of criminal exploitation, and; Phase 2.2 is a process evaluation that will involve interviewing stakeholders, MST therapists and employees, families, and young people. The dataset for the process evaluation will include questionnaires completed by parents and young people at baseline, mid-treatment, end of treatment, and 6 months after treatment. We will supplement these data with participant-level data linkage from MST sites and services. Results Accrual to the pilot stage of this project opened on 6th August 2021 and is due to close on 31st May 2022. We aim to publish the results of this feasibility study and process evaluation in 2023. Conclusions The results of this feasibility study and process evaluation will inform the decision as to whether it is advisable to progress to a pilot clinical trial of MST for children at risk of criminal exploitation
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