515 research outputs found
Chain governance, sector policies and economic sustainability in cocoa: a comparative analysis of Ghana, Côte d’Ivoire, and Ecuador
Color-coordinate system from a 13th-century account of rainbows.
We present a new analysis of Robert Grosseteste’s account of color in his treatise De iride (On the Rainbow), dating from the early 13th century. The work explores color within the 3D framework set out in Grosseteste’s De colore [see J. Opt. Soc. Am. A 29, A346 (2012)], but now links the axes of variation to observable properties of rainbows. We combine a modern understanding of the physics of rainbows and of human color perception to resolve the linguistic ambiguities of the medieval text and to interpret Grosseteste’s key terms
How was the intern year?: self and clinical assessment of four cohorts, from two medical curricula
BACKGROUND Problem-based curricula have provoked controversy amongst educators and students regarding outcome in medical graduates, supporting the need for longitudinal evaluation of curriculum change. As part of a longitudinal evaluation program at the University of Adelaide, a mixed method approach was used to compare the graduate outcomes of two curriculum cohorts: traditional lecture-based ‘old’ and problem-based ‘new’ learning. METHODS Graduates were asked to self-assess preparedness for hospital practice and consent to a comparative analysis of their work-place based assessments from their intern year. Comparative data were extracted from 692 work-place based assessments for 124 doctors who graduated from the University of Adelaide Medical School between 2003 and 2006. RESULTS Self-assessment: Overall, graduates of the lecture-based curriculum rated the medical program significantly higher than graduates of the problem-based curriculum. However, there was no significant difference between the two curriculum cohorts with respect to their preparedness in 13 clinical skills. There were however, two areas where the cohorts rated their preparedness in the 13 broad practitioner competencies as significantly different: problem-based graduates rated themselves as better prepared in their ‘awareness of legal and ethical issues’ and the lecture-based graduates rated themselves better prepared in their ‘understanding of disease processes’. Work-place based assessment: There were no significant differences between the two curriculum cohorts for ‘Appropriate Level of Competence’ and ‘Overall Appraisal’. Of the 14 work-place based assessment skills assessed for competence, no significant difference was found between the cohorts. CONCLUSIONS The differences in the perceived preparedness for hospital practice of two curriculum cohorts do not reflect the work-place based assessments of their competence as interns. No significant difference was found between the two cohorts in relation to their knowledge and clinical skills. However results suggest a trend in ‘communication with peers and colleagues in other disciplines’ (χ2 (3, N = 596) =13.10, p = 0.056) that requires further exploration. In addition we have learned that student confidence in a new curriculum may impact on their self-perception of preparedness, while not affecting their actual competence.Gillian Laven, Dorothy Keefe, Paul Duggan, and Anne Tonki
Опыт применения криохирургии в гинекологии
Приведены результаты применения низких температур для лечения ряда гинекологических заболеваний и обоснована необходимость широкого внедрения криогенного метода лечения в клиническую практику.The results of low temperature application in treatment of a number of gynecological diseases are presented, the necessity of wide introduction of cryogenic treatment into clinical practice is substantiated
The progression of spermatogenesis in the developing rat testis followed by <sup>31</sup>P MR spectroscopy
To evaluate the use of human testicular 31P MR spectroscopy as a diagnostic tool to differentiate between several stages of male infertility, we have studied the testicular levels of several phosphorus containing compounds in the rat in relation to the condition of spermatogenesis and the cell types present in the seminiferous tubules of the testis. During testicular maturation several characteristic changes occur in the 31P MR spectrum of the testis of male Wistar rats. The phosphomonoester/adenosine triphosphate (PM/ATP) ratio shows a decline from 1.61 to 1.02 between the age of 3 and 12 weeks, whereas the phosphodiester (PD)/ATP ratio increases from 0 to 0.72. The testicular pH increases in the same time from 7.06 to 7.32. Testicular MR data obtained after 12 weeks of age onward do not show significant change anymore. The high PM/ATP ratio is associated by a relative high amount of proliferating spermatogonia and spermatocytes during meiosis in the testis, whereas the PD peak seems to be correlated with the release and maintenance of spermatozoa. The MR spectra show a specific fingerprint in all developmental stages of the rat testis as a result of the different cell types in the testis. © 1992 Academic Press, Inc.</p
Disease surveillance and risk factors affecting mortality of captive cirl buntings (Emberiza cirlus) in a translocation for conservation purposes
Cirl buntings in the UK were translocated over a 5-year period by collecting chicks from the residual population, hand-rearing and releasing them at a site in Cornwall with the aim of establishing a second breeding population. Because mortality and morbidity during captivity restrict the number and fitness of individuals available for release, selected parasites were monitored in the captive chicks, and all deaths were investigated by autopsy, histopathology and bacteriology. Risk factors associated with captive deaths were analysed. Annual mortality during captivity ranged from 4% (3 of 75 chicks in 2006) to 42% (26 of 73 in 2007) of chicks collected. Infectious disease associated with immunosuppression was an important factor in many deaths, and chicks collected with lower body weight were at greater risk of mortality. These findings emphasise the need for rigorous monitoring of all aspects of captive care during passerine translocations and provide evidence-based recommendations for future projects
Association between an AMH promoter polymorphism and serum AMH levels in PCOS patients
STUDY QUESTION: Do polymorphisms in the anti-Müllerian hormone (AMH) promoter have an effect on AMH levels in patients with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: We have identified a novel AMH promoter polymorphism rs10406324 that is associated with lower serum AMH levels and is suggested to play a role in the mechanism of regulation of AMH gene expression in women. WHAT IS KNOWN ALREADY: Follicle number is positively correlated with serum AMH levels, reflected by elevated AMH levels in women with PCOS. In addition, it is suggested that AMH production per follicle is higher in women with PCOS than in normo-ovulatory women, implying an altered regulation of AMH in PCOS. STUDY DESIGN, SIZE, DURATION: A discovery cohort of 655 PCOS women of Northern European ancestry and both an internal and external validation PCOS cohort (n = 458 and n = 321, respectively) were included in this study. Summary-level data of an AMH genome-wide association study meta-analysis including 7049 normo-ovulatory women was included as a control cohort. A genetic approach was taken through association analysis and in silico analysis of the associated variants in the AMH promoter. In vitro analysis was performed to investigate the functional mechanisms. PARTICIPANTS/MATERIALS, SETTING, METHODS: All common two-allelic single-nucleotide polymorphisms (SNPs) in the region Chr19:2 245 353–2 250 827 bp (Build 37) were selected for the analysis. Linear regression analyses were performed to determine the association between SNPs in the AMH promoter region and serum AMH levels. For the in silico analysis, the webtools ‘HaploReg’ v4.1 for ENCODE prediction weight matrices and ‘atSNP’ were used. In vitro analysis was performed using KK1 cells, a mouse granulosa cell line and COV434 cells, a human granulosa tumor cell line. Cells were transfected with the reference or the variant human AMH promoter reporter construct together with several transcription factors (TFs). Dual-Glo(®) Luciferase Assay was performed to measure the luciferase activity. MAIN RESULTS AND THE ROLE OF CHANCE: Polymorphism rs10406324 was significantly associated with serum AMH levels in all three PCOS cohorts. Carriers of the minor allele G had significantly lower log-transformed serum AMH levels compared to non-carriers (P = 8.58 × 10(−8), P = 1.35 × 10(−3) and P = 1.24 × 10(−3), respectively). This result was validated in a subsequent meta-analysis (P = 3.24 × 10(−12)). Interestingly, rs10406324 was not associated with follicle count, nor with other clinical traits. Also, in normo-ovulatory women, the minor allele of this variant was associated with lower serum AMH levels (P = 1.04 × 10(−5)). These findings suggest that polymorphism rs10406324 plays a role in the regulation of AMH expression, irrespective of clinical background. In silico analysis suggested a decreased binding affinity of the TFs steroidogenenic factor 1, estrogen-related receptor alpha and glucocorticoid receptor to the minor allele G variant, however in vitro analysis did not show a difference in promoter activity between the A and G allele. LIMITATIONS, REASONS FOR CAUTION: Functional analyses were performed in a mouse and a human granulosa cell line using an AMH promoter reporter construct. This may have limited assessment of the impact of the polymorphism on higher order chromatin structures. Human granulosa cells generated from induced pluripotent stem cells, combined with gene editing, may provide a method to elucidate the exact mechanism behind the decrease in serum AMH levels in carriers of the −210 G allele. We acknowledge that the lack of follicle number in the external validation and the control cohort is a limitation of the paper. Although we observed that the association between rs10406324 and AMH levels was independent of follicle number in our discovery and internal validation PCOS cohorts, we cannot fully rule out that the observed effects on serum AMH levels are, in part, caused by differences in follicle number. WIDER IMPLICATIONS OF THE FINDINGS: These results suggest that variations in serum AMH levels are not only caused by differences in follicle number but also by genetic factors. Therefore, the genetic context should be taken into consideration when assessing serum AMH levels in women. This may have clinical consequences when serum AMH levels are used as a marker for the polycystic ovarian morphology phenotype. STUDY FUNDING/COMPETING INTEREST(S): No external funding was used. J.S.E.L. has received consultancy fees from the following companies: Ferring, Roche Diagnostics and Ansh Labs and has received travel reimbursement from Ferring. J.A.V. has received royalties from AMH assays, paid to the institute/lab with no personal financial gain. The other authors declare no competing interests. TRIAL REGISTRATION NUMBER: N/A
Educating a New Generation of Doctors to Improve the Health of Populations in Low- and Middle-Income Countries
Francesca Celletti and colleagues from WHO argue that a transformation in the scale-up of medical education in low- and middle-income countries is needed, and detail what this might look like
Weight Reduction Through a Cognitive Behavioral Therapy Lifestyle Intervention in PCOS: The Primary Outcome of a Randomized Controlled Trial
Objective: Long-term weight loss is important and difficult to achieve
for many women with polycystic ovary syndrome (PCOS). Lifestyle
interventions (LS) in PCOS have shown moderate short-term effects. Three-component LS that combine nutrition advice, exercise,
and cognitive behavioral therapy have not been tested in long-term
interventions.
Methods: Women (N=183) with PCOS who were trying to conceive and
had BMI>25 kg/m2 were assigned to 20 group sessions of cognitive behavioral therapy combined with nutrition advice and exercise (LS with or
without Short Message Service [SMS] via mobile phone) or care as usual
(CAU).
Results: More weight loss was observed in LS than in CAU (P<0.001).
Adding SMS was even more effective (P=0.017). In CAU, 13 of 60 (21.8%)
succeeded in achieving a 5% weight loss, as did 32 of 60 (52.8%) in LS
without SMS and 54 of 63 (85.7%) in LS with SMS. The odds of achieving
a 5% weight loss were 7.0 (P<0.001) in LS compared with CAU. More
than 18 of 60 (29.0%) of the women in CAU gained weight versus 5 of 60
(8.5%) and 2 of 63 (3.1%) in LS without or with SMS, respectively. The
overall dropout rate was 116 of 183 (63.4%).
Conclusions: A three-component LS program resulted in reasonable weight
loss in women with PCOS. Adding SMS resulted in more weight loss
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