Use of practice tracks in the medical specialties.

OBJECTIVES: To evaluate the use of practice tracks by each of the 24 medical specialty boards and to compare this with the experience in emergency medicine (EM). METHODS: Scripted telephone surveys were conducted with representatives of each of the specialty boards. RESULTS: Of 24 specialties currently recognized by the American Board of Medical Specialties (ABMS), 14 (58%) reported a history of a practice track. Eight boards reported never having a practice track and 2 were unsure. All practice tracks have been limited in duration, most commonly closing after a specified period. The mean duration of the practice tracks was 9.8 years, the median was 7.5 years, and the range was 3-27 years. The practice track in EM was open for 9 years. CONCLUSIONS: Practice tracks were common in the early years of most specialties and most were limited by duration. The history of the practice track in EM is not dissimilar to those of other specialties

Serological Survey of Pigs From a Slaughterhouse in Jakarta, Indonesia

Maksud dan tujuan dari survey ini ialah untuk mempelajari akan kemungkinannya he­wan-hewan babi memegang peranan sebagai reservoir ataupun amplifier dari penyakit-penyakit zoonotic di Pulau Jawa. Survey ini di­jalankan bersama-sama dengan Namru-2 di Jakarta. Sebagian besar specimens yang berupa darah, berasal dari babi babi yang akan dipotong dirumah pemotongan hewan babi di Jakarta Barat, babi-babi tersebut ada yang berasal dari Jawa Tengah, Jawa Barat, serta sebagian lagi berasal dari babi-babi milik rakyat di daerah Kapok. Pengambilan specimens dilakukan sehari sebelum babi-babi tadi dipotong. Setiap pagi lebih kurang 150 ekor babi dipotong, dimana umurnya berkisar antara enam hingga 24 bulan. Pada survey ini telah dikumpulkan 399 specimens, sebanyak 227 specimens berasal dari babi-babi betina, 159 specimens berasal dari babi-babi jantan, serta 13 specimens berasal dari babi-babi jantan kebiri. Hasil Pemeriksaan Laboratorium. Pemeriksaan terhadap Toxoplasma. Dari 166 sera yang berasal dari babi-babi Jawa Barat sebanyak 46 (28 percent) me-nunjukan hasil positif (titer 1 : 8 atau lebih j Sedangkan 235 sera berasal dari babi-babi Jawa Tengah , hany a sebanyak 17(7percent yang menunjukan hasil positif (titer 1 : 8). Titer yang lebih tinggi (1 : 1024) juga di­temukan pada babi-babi yang berasal dari Jawa Barat.Pemeriksaan terhadap Brucella suis. Titer 1 : 320 masih diketemukan pada semua group, akan tetapi sebagian besar serum me­nunjukan hasil negatip. Sebagian kecil sera yang berasal dari babi-babi tua dari Jawa-Barat menunjukan adanya anti­body yang lebih tinggi dari pada babi-babi muda.Pemeriksaan terhadap penyakit Japanese Encephalitis. Pada semua golongan umur dari geographical-group dari babi-babi menunjuk­an adanya anti-body terhadap J.E. Sera yang negatip lebih banyak berasal dari babi-babi Jawa Tengah.Pemeriksaan terhadap penyakit Influenza. Titer yang menyolok terhadap penyakit Influenza A2 Hongkong terdapat pada babi-babi golongan muda maupun tua baik yang berasal dari Jawa Tengah maupun yang ber­asal dari Jawa-Barat. Meskipun demikian, babi-babi dari Jawa Barat lebih banyak menunjukan hasil yang positip dari pada berasal dari Jawa Tengah.Pemeriksaan terhadap Leptospira. Kebanyakan serum menunjukan adanya anti-body terhadap L. sentot L. pomona dan L. bangkinang. Sebagian besar serum yang positip berasal dari babi-babi Jawa Tengah

Phase Change Induced Magnetic Switching through Metal-insulator Transition in VO2/TbFeCo Films

The ability to manipulate spins in magnetic materials is essential in designing spintronics devices. One method for magnetic switching is through strain. In VO2 on TiO2 thin films, while VO2 remains rutile across the metal-insulator transition, the in-plane lattice area expands going from low temperature insulating phase to high temperature conducting phase. In a VO2/TbFeCo bilayer, the expansion of the VO2 lattice area exerts tension on the amorphous TbFeCo layer. Through the strain effect, magnetic properties, including the magnetic anisotropy and magnetization, of TbFeCo can be changed. In this work, the changes in magnetic properties of TbFeCo on VO2/TiO2(011) are demonstrated using anomalous Hall effect measurements. Across the metal-insulator transition, TbFeCo loses perpendicular magnetic anisotropy, and the magnetization in TbFeCo turns from out-of-plane to in-plane. Using atomistic simulations, we confirm these tunable magnetic properties originating from the metal-insulator transition of VO2. This study provides the groundwork for controlling magnetic properties through a phase transition.Comment: To be published in Nanomaterial

SYMPOSIUM: 2013 LIMB LENGTHENING AND RECONSTRUCTION SOCIETY What Risk Factors Predict Usage of Gastrocsoleus Recession During Tibial Lengthening?

Abstract Background Tibial lengthening is frequently associated with gastrocsoleus contracture and some patients are treated surgically. However, the risk factors associated with gastrocsoleus contracture severe enough to warrant surgery during tibial lengthening and the consistency with which gastrocsoleus recession (GSR) results in a plantigrade foot in this setting have not been well defined. Questions/purposes We compared patients treated with or without GSR during tibial lengthening with respect to (1) clinical risk factors triggering GSR use, (2) ROM gains and patient-reported outcomes, and (3) complications after GSR. Methods Between 2002 and 2011, 95 patients underwent tibial lengthenings excluding those associated with bone loss; 82 (83%) were available for a minimum followup of 1 year. According to our clinical algorithm, we performed GSR when patients had equinus contractures of greater than 10°while lengthening or greater than 0°before or after lengthening. Forty-one patients underwent GSR and 41 did not. Univariate analysis was performed to assess independent associations between surgical characteristics and likelihood of undergoing GSR. A multivariate regression model and receiver operating characteristic curves were generated to adjust for confounders and to establish risk factors and any threshold for undergoing GSR. Chart review determined ROM, patient-reported outcomes, and complications. Results Amount and percentage of lengthening, age, and etiology were risk factors for GSR. Patients with lengthening of greater than 42 mm (odds ratio [OR]: 4.13; 95% CI: 1.82, 9.40; p = 0.001), lengthening of greater than 13% of lengthening (OR: 3.88; 95% CI: 1.66, 9.11; p = 0.001), and congenital etiology (OR: 1.90; 95% CI: 0.86, 4.15; p = 0.109) were more likely to undergo GSR. Adjusting for all other variables, increased amount lengthened (adjusted OR: 1.05; 95% CI: 1.02, 1.07; p \ 0.001) and age (adjusted OR: 1.02; 95% CI: 0.99, 1.05; p = 0.131) were associated with undergoing GSR. Patients gained 24°of ankle dorsiflexion after GSR. Selfreported functional outcomes were similar between patients with or without GSR. Complications included stretch injury to the posterior tibial nerve leading to temporary and partial loss of plantar sensation in two patients

Deletion of parasite immune modulatory sequences combined with immune activating signals enhances vaccine mediated protection against filarial nematodes

<p>Background: Filarial nematodes are tissue-dwelling parasites that can be killed by Th2-driven immune effectors, but that have evolved to withstand immune attack and establish chronic infections by suppressing host immunity. As a consequence, the efficacy of a vaccine against filariasis may depend on its capacity to counter parasite-driven immunomodulation.</p> <p>Methodology and Principal Findings: We immunised mice with DNA plasmids expressing functionally-inactivated forms of two immunomodulatory molecules expressed by the filarial parasite Litomosoides sigmodontis: the abundant larval transcript-1 (LsALT) and cysteine protease inhibitor-2 (LsCPI). The mutant proteins enhanced antibody and cytokine responses to live parasite challenge, and led to more leukocyte recruitment to the site of infection than their native forms. The immune response was further enhanced when the antigens were targeted to dendritic cells using a single chain Fv-αDEC205 antibody and co-administered with plasmids that enhance T helper 2 immunity (IL-4) and antigen-presenting cell recruitment (Flt3L, MIP-1α). Mice immunised simultaneously against the mutated forms of LsALT and LsCPI eliminated adult parasites faster and consistently reduced peripheral microfilaraemia. A multifactorial analysis of the immune response revealed that protection was strongly correlated with the production of parasite-specific IgG1 and with the numbers of leukocytes present at the site of infection.</p> <p>Conclusions: We have developed a successful strategy for DNA vaccination against a nematode infection that specifically targets parasite-driven immunosuppression while simultaneously enhancing Th2 immune responses and parasite antigen presentation by dendritic cells.</p&gt

Associations Between Methylation of Paternally Expressed Gene 3 (PEG3), Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer.

Cytology-based screening for invasive cervical cancer (ICC) lacks sensitivity and specificity to discriminate between cervical intraepithelial neoplasia (CIN) likely to persist or progress from cases likely to resolve. Genome-wide approaches have been used to identify DNA methylation marks associated with CIN persistence or progression. However, associations between DNA methylation marks and CIN or ICC remain weak and inconsistent. Between 2008-2009, we conducted a hospital-based, case-control study among 213 Tanzania women with CIN 1/2/3 or ICC. We collected questionnaire data, biopsies, peripheral blood, cervical scrapes, Human papillomavirus (HPV) and HIV-1 infection status. We assessed PEG3 methylation status by bisulfite pyrosequencing. Multinomial logistic regression was used to estimate odds ratios (OR) and confidence intervals (CI 95%) for associations between PEG3 methylation status and CIN or ICC. After adjusting for age, gravidity, hormonal contraceptive use and HPV infection, a 5% increase in PEG3 DNA methylation was associated with increased risk for ICC (OR = 1.6; 95% CI 1.2-2.1). HPV infection was associated with a higher risk of CIN1-3 (OR = 15.7; 95% CI 5.7-48.6) and ICC (OR = 29.5, 95% CI 6.3-38.4). Infection with high risk HPV was correlated with mean PEG3 differentially methylated regions (DMRs) methylation (r = 0.34 p<0.0001), while the correlation with low risk HPV infection was weaker (r = 0.16 p = 0.047). Although small sample size limits inference, these data support that PEG3 methylation status has potential as a molecular target for inclusion in CIN screening to improve prediction of progression. Impact statement: We present the first evidence that aberrant methylation of the PEG3 DMR is an important co-factor in the development of Invasive cervical carcinoma (ICC), especially among women infected with high risk HPV. Our results show that a five percent increase in DNA methylation of PEG3 is associated with a 1.6-fold increase ICC risk. Suggesting PEG3 methylation status may be useful as a molecular marker for CIN screening to improve prediction of cases likely to progress

Recurrent Modification of a Conserved Cis-Regulatory Element Underlies Fruit Fly Pigmentation Diversity

The development of morphological traits occurs through the collective action of networks of genes connected at the level of gene expression. As any node in a network may be a target of evolutionary change, the recurrent targeting of the same node would indicate that the path of evolution is biased for the relevant trait and network. Although examples of parallel evolution have implicated recurrent modification of the same gene and cis-regulatory element (CRE), little is known about the mutational and molecular paths of parallel CRE evolution. In Drosophila melanogaster fruit flies, the Bric-à-brac (Bab) transcription factors control the development of a suite of sexually dimorphic traits on the posterior abdomen. Female-specific Bab expression is regulated by the dimorphic element, a CRE that possesses direct inputs from body plan (ABD-B) and sex-determination (DSX) transcription factors. Here, we find that the recurrent evolutionary modification of this CRE underlies both intraspecific and interspecific variation in female pigmentation in the melanogaster species group. By reconstructing the sequence and regulatory activity of the ancestral Drosophila melanogaster dimorphic element, we demonstrate that a handful of mutations were sufficient to create independent CRE alleles with differing activities. Moreover, intraspecific and interspecific dimorphic element evolution proceeded with little to no alterations to the known body plan and sex-determination regulatory linkages. Collectively, our findings represent an example where the paths of evolution appear biased to a specific CRE, and drastic changes in function were accompanied by deep conservation of key regulatory linkages. © 2013 Rogers et al

Design of Experiments for Screening

The aim of this paper is to review methods of designing screening experiments, ranging from designs originally developed for physical experiments to those especially tailored to experiments on numerical models. The strengths and weaknesses of the various designs for screening variables in numerical models are discussed. First, classes of factorial designs for experiments to estimate main effects and interactions through a linear statistical model are described, specifically regular and nonregular fractional factorial designs, supersaturated designs and systematic fractional replicate designs. Generic issues of aliasing, bias and cancellation of factorial effects are discussed. Second, group screening experiments are considered including factorial group screening and sequential bifurcation. Third, random sampling plans are discussed including Latin hypercube sampling and sampling plans to estimate elementary effects. Fourth, a variety of modelling methods commonly employed with screening designs are briefly described. Finally, a novel study demonstrates six screening methods on two frequently-used exemplars, and their performances are compared

System size and energy dependence of near-side di-hadron correlations

Two-particle azimuthal ($\Delta\phi$) and pseudorapidity ($\Delta\eta$) correlations using a trigger particle with large transverse momentum ($p_T$) in $d$+Au, Cu+Cu and Au+Au collisions at $\sqrt{s_{{NN}}}$ =\xspace 62.4 GeV and 200~GeV from the STAR experiment at RHIC are presented. The \ns correlation is separated into a jet-like component, narrow in both $\Delta\phi$ and $\Delta\eta$, and the ridge, narrow in $\Delta\phi$ but broad in $\Delta\eta$. Both components are studied as a function of collision centrality, and the jet-like correlation is studied as a function of the trigger and associated $p_T$. The behavior of the jet-like component is remarkably consistent for different collision systems, suggesting it is produced by fragmentation. The width of the jet-like correlation is found to increase with the system size. The ridge, previously observed in Au+Au collisions at $\sqrt{s_{{NN}}}$ = 200 GeV, is also found in Cu+Cu collisions and in collisions at $\sqrt{s_{{NN}}}$ =\xspace 62.4 GeV, but is found to be substantially smaller at $\sqrt{s_{{NN}}}$ =\xspace 62.4 GeV than at $\sqrt{s_{{NN}}}$ = 200 GeV for the same average number of participants ($\langle N_{\mathrm{part}}\rangle$). Measurements of the ridge are compared to models.Comment: 17 pages, 14 figures, submitted to Phys. Rev.

The Effect of Epstein-Barr Virus Latent Membrane Protein 2 Expression on the Kinetics of Early B Cell Infection

Infection of human B cells with wild-type Epstein-Barr virus (EBV) in vitro leads to activation and proliferation that result in efficient production of lymphoblastoid cell lines (LCLs). Latent Membrane Protein 2 (LMP2) is expressed early after infection and previous research has suggested a possible role in this process. Therefore, we generated recombinant EBV with knockouts of either or both protein isoforms, LMP2A and LMP2B (Δ2A, Δ2B, Δ2A/Δ2B) to study the effect of LMP2 in early B cell infection. Infection of B cells with Δ2A and Δ2A/Δ2B viruses led to a marked decrease in activation and proliferation relative to wild-type (wt) viruses, and resulted in higher percentages of apoptotic B cells. Δ2B virus infection showed activation levels comparable to wt, but fewer numbers of proliferating B cells. Early B cell infection with wt, Δ2A and Δ2B viruses did not result in changes in latent gene expression, with the exception of elevated LMP2B transcript in Δ2A virus infection. Infection with Δ2A and Δ2B viruses did not affect viral latency, determined by changes in LMP1/Zebra expression following BCR stimulation. However, BCR stimulation of Δ2A/Δ2B cells resulted in decreased LMP1 expression, which suggests loss of stability in viral latency. Long-term outgrowth assays revealed that LMP2A, but not LMP2B, is critical for efficient long-term growth of B cells in vitro. The lowest levels of activation, proliferation, and LCL formation were observed when both isoforms were deleted. These results suggest that LMP2A appears to be critical for efficient activation, proliferation and survival of EBV-infected B cells at early times after infection, which impacts the efficient long-term growth of B cells in culture. In contrast, LMP2B did not appear to play a significant role in these processes, and long-term growth of infected B cells was not affected by the absence of this protein. © 2013 Wasil et al