Christian Albert Theodor Billroth, M.D., founding father of abdominal surgery (1829-1894).

In the 1800s, the field of surgery was in its infancy, somewhat primitive and embryonic. The technical nature of surgery was the basis for the dividing line between the disciplines of surgery and internal medicine. Sterilization was not a common practice. Radical surgical resections and experimentation in medicine were shunned. With his boldness equaled only by his innovation and resourcefulness, Theodor Billroth would become a pioneer not only in the development of modern surgery, but also in the advancement of its cultural and historical significance

Emil Theodor Kocher, M.D., and his Nobel Prize (1841-1917).

Major contributions to the advancement of surgery occurred at the turn of the 20th century. Theodor Billroth was in the midst of revolutionizing abdominal surgery, whereas Louis Pasteur and Joseph Lister were making landmark strides in antisepsis, forever changing the foundations of surgical thinking. Undoubtedly, Theodor Kocher’s (Fig. 1) exposure to these and other giants had a major influence on his career and contributed to his success and ascent as the first, and one of only 10, surgeons ever to be awarded the Nobel Prize in Medicine

Constructing Filler-Gap Dependencies in Chinese Possessor Relative Clauses

PACLIC 19 / Taipei, taiwan / December 1-3, 200

Canonical Distribution Law and KCl: Sm2+ Fluorescence: The C2v Paradox

A combination of critical experiments has been carried out in order to elucidate the recent conclusions of Bradbury and Wong, who attributed all the dominant KCl: Sm2+ fluorescence lines to the nearest-neighbor C2v(1,1,0)Sm2+−K+ vacancy site. In an extensive investigation into the radiationless quenching, characteristic lifetimes, excitation spectra, and Zeeman polarization of KCl: Sm2+ fluorescence lines, all the prominent lines are unequivocally attributed to a distribution of three different Sm2+ - K+ vacancy sites. In addition, 18 weak lines are shown to originate from dimeric cluster and O2− compensated sites. The paradoxical C2v interpretations of Bradbury and Wong are shown to be based on incorrect premises, inadequate experimentation, and confusion in the identity of samples with different dopant concentrations

Extreme Thermal Sensitivity and Pain-Induced Sensitization in a Fibromyalgia Patient

During the course of a psychophysical study of fibromyalgia syndrome (FMS), one of the subjects with a long history of headache and facial pain displayed an extraordinarily severe thermal allodynia. Her stimulus-response function for ratings of cutaneous heat pain revealed a sensitivity clearly beyond that of normal controls and most FMS subjects. Specially designed psychophysical methods showed that heat sensitivity sometimes increased dramatically within a series of stimuli. Prior exposure to moderate heat pain served as a trigger for allodynic ratings of series of normally neutral thermal stimulation. These observations document a case of breakthrough pain sensitivity with implications for mechanisms of FMS pain

Virtual Reality in Higher Education

Virtual reality (VR) is an interactive experience which immerses the user in a digital environment through a sense of presence. In the context of providing an active learning experience, virtual reality has the potential to improve learning outcomes for biomedical science students as it allows the visualisation of and interaction with digital representations of dynamic objects and complex concepts. Studies in bioscience and medical education have shown mixed results pertaining to the benefits of VR as a learning tool. This review aims to consolidate how VR succeeded or failed in improving learning outcomes, and assesses the issue of VR scalability for the ever-growing cohorts in tertiary bioscience courses

A new and unusual LBV-like outburst from a Wolf–Rayet star in the outskirts of M33

MCA-1B (also called UIT003) is a luminous hot star in the western outskirts of M33, classified over 20 yr ago with a spectral type of Ofpe/WN9 and identified then as a candidate luminous blue variable (LBV). Palomar Transient Factory data reveal that this star brightened in 2010, with a light curve resembling that of the classic LBV star AF And in M31. Other Ofpe/WN9 stars have erupted as LBVs, but MCA-1B was unusual because it remained hot. It showed a WN-type spectrum throughout its eruption, whereas LBVs usually get much cooler. MCA-1B showed an almost four-fold increase in bolometric luminosity and a doubling of its radius, but its temperature stayed ≳29 kK. As it faded, it shifted to even hotter temperatures, exhibiting a WN7/WN8-type spectrum, and doubling its wind speed. MCA-1B is reminiscent of some supernova impostors, and its location resembles the isolated environment of SN 2009ip. It is most similar to HD 5980 (in the Small Magellanic Cloud) and GR 290 (also in M33). Whereas these two LBVs exhibited B-type spectra in eruption, MCA-1B is the first clear case where a Wolf–Rayet (WR) spectrum persisted at all times. Together, MCA-1B, HD 5980, and GR 290 constitute a class of WN-type LBVs, distinct from S Doradus LBVs. They are most interesting in the context of LBVs at low metallicity, a possible post-LBV/WR transition in binaries, and as likely Type Ibn supernova progenitors

Endurance of SN 2005ip after a decade: X-rays, radio, and H-alpha like SN 1988Z require long-lived pre-supernova mass loss

SN2005ip was a TypeIIn event notable for its sustained strong interaction with circumstellar material (CSM), coronal emission lines, and IR excess, interpreted as shock interaction with the very dense and clumpy wind of an extreme red supergiant. We present a series of late-time spectra of SN2005ip and a first radio detection of this SN, plus late-time X-rays, all of which indicate that its CSM interaction is still strong a decade post-explosion. We also present and discuss new spectra of geriatric SNe with continued CSM interaction: SN1988Z, SN1993J, and SN1998S. From 3-10 yr post-explosion, SN2005ip's H-alpha luminosity and other observed characteristics were nearly identical to those of the radio-luminous SN1988Z, and much more luminous than SNe1993J and 1998S. At 10 yr after explosion, SN2005ip showed a drop in H$\alpha$ luminosity, followed by a quick resurgence over several months. We interpret this variability as ejecta crashing into a dense shell located at around 0.05 pc from the star, which may be the same shell that caused the IR echo at earlier epochs. The extreme H-alpha luminosities in SN2005ip and SN1988Z are still dominated by the forward shock at 10 yr post-explosion, whereas SN1993J and SN1998S are dominated by the reverse shock at a similar age. Continuous strong CSM interaction in SNe~2005ip and 1988Z is indicative of enhanced mass loss for about 1e3 yr before core collapse, longer than Ne, O, or Si burning phases. Instead, the episodic mass loss must extend back through C burning and perhaps even part of He burning.Comment: 14 pages, 8 figs. accepted in MNRA

Distance Traveled and Cross-State Commuting to Opioid Treatment Programs in the United States

This study examined commuting patterns among 23,141 methadone patients enrolling in 84 opioid treatment programs (OTPs) in the United States. Patients completed an anonymous one-page survey. A linear mixed model analysis was used to predict distance traveled to the OTP. More than half (60%) the patients traveled <10 miles and 6% travelled between 50 and 200 miles to attend an OTP; 8% travelled across a state border to attend an OTP. In the multivariate model (n = 17,792), factors significantly (P < .05) associated with distance were, residing in the Southeast or Midwest, low urbanicity, area of the patient's ZIP code, younger age, non-Hispanic white race/ethnicity, prescription opioid abuse, and no heroin use. A significant number of OTP patients travel considerable distances to access treatment. To reduce obstacles to OTP access, policy makers and treatment providers should be alert to patients' commuting patterns and to factors associated with them

SN2013fs and SN2013fr: Exploring the circumstellar-material diversity in Type II supernovae

We present photometry and spectroscopy of SN2013fs and SN2013fr in the first 100 days post-explosion. Both objects showed transient, relatively narrow H$\alpha$ emission lines characteristic of SNeIIn, but later resembled normal SNeII-P or SNeII-L, indicative of fleeting interaction with circumstellar material (CSM). SN2013fs was discovered within 8hr of explosion. Its light curve exhibits a plateau, with spectra revealing strong CSM interaction at early times. It is a less luminous version of the transitional SNIIn PTF11iqb, further demonstrating a continuum of CSM interaction intensity between SNeII-P and IIn. It requires dense CSM within 6.5$\times$10$^{14}$~cm of the progenitor, from a phase of advanced pre-SN mass loss shortly before explosion. Spectropolarimetry of SN2013fs shows little continuum polarization, but noticeable line polarization during the plateau phase. SN2013fr morphed from a SNIIn at early times to a SNII-L. After the first epoch its narrow lines probably arose from host-galaxy emission, but the bright, narrow H$\alpha$ emission at early times may be intrinsic. As for SN2013fs, this would point to a short-lived phase of strong CSM interaction if proven to be intrinsic, suggesting a continuum between SNeIIn and II-L. It is a low-velocity SNII-L, like SN2009kr but more luminous. SN2013fr also developed an IR excess at later times, due to warm CSM dust that require a more sustained phase of strong pre-SN mass loss.Comment: MNRAS accepted. 28 pages, 23 figures, 8 table