The case for surgical skills centres in Sub Saharan Africa: The benefits and the challenges.

The purpose of this paper is to describe the educational and practice utilities of establishing Surgical Skills Centres. The paper also defines significant obstacles to the establishment of such centres in Sub- Saharan Africa. In 1996, the Royal College of Physicians and Surgeons Canada responded to the evolving roles and obligations of medical specialists by implementing a framework of core competencies called the “CanMEDS Roles” which define surgeons as medical experts, communicators, collaborators, managers, health advocates, scholars and professionals. A key competency expected of the medical expert is the demonstration of proficiency in procedural skills2

Fixed Price Approximability of the Optimal Gain From Trade

Bilateral trade is a fundamental economic scenario comprising a strategically acting buyer and seller, each holding valuations for the item, drawn from publicly known distributions. A mechanism is supposed to facilitate trade between these agents, if such trade is beneficial. It was recently shown that the only mechanisms that are simultaneously DSIC, SBB, and ex-post IR, are fixed price mechanisms, i.e., mechanisms that are parametrised by a price p, and trade occurs if and only if the valuation of the buyer is at least p and the valuation of the seller is at most p. The gain from trade is the increase in welfare that results from applying a mechanism; here we study the gain from trade achievable by fixed price mechanisms. We explore this question for both the bilateral trade setting, and a double auction setting where there are multiple buyers and sellers. We first identify a fixed price mechanism that achieves a gain from trade of at least 2/r times the optimum, where r is the probability that the seller's valuation does not exceed the buyer's valuation. This extends a previous result by McAfee. Subsequently, we improve this approximation factor in an asymptotic sense, by showing that a more sophisticated rule for setting the fixed price results in an expected gain from trade within a factor O(log(1/r)) of the optimal gain from trade. This is asymptotically the best approximation factor possible. Lastly, we extend our study of fixed price mechanisms to the double auction setting defined by a set of multiple i.i.d. unit demand buyers, and i.i.d. unit supply sellers. We present a fixed price mechanism that achieves a gain from trade that achieves for all epsilon > 0 a gain from trade of at least (1-epsilon) times the expected optimal gain from trade with probability 1 - 2/e^{#T epsilon^2 /2}, where #T is the expected number of trades resulting from the double auction

Longitudinal and lateral-directional static aerodynamic characteristics of an unpowered escape system extraction rocket model

An escape system extraction rocket proposed for use on the Rotor Systems Research Aircraft was tested at Mach numbers of 0.1 and 0.3 through an angle of attack range from -2 deg to 102 deg and an angle of sideslip range from 0 deg to 15 deg in the Langley 7- by 10-foot high speed tunnel

Urbanization and its implications for food and farming

This paper discusses the influences on food and farming of an increasingly urbanized world and a declining ratio of food producers to food consumers. Urbanization has been underpinned by the rapid growth in the world economy and in the proportion of gross world product and of workers in industrial and service enterprises. Globally, agriculture has met the demands from this rapidly growing urban population, including food that is more energy-, land-, water- and greenhouse gas emission-intensive. But hundreds of millions of urban dwellers suffer under-nutrition. So the key issues with regard to agriculture and urbanization are whether the growing and changing demands for agricultural products from growing urban populations can be sustained while at the same time underpinning agricultural prosperity and reducing rural and urban poverty. To this are added the need to reduce greenhouse gas emissions and to build resilience in agriculture and urban development to climate change impacts. The paper gives particular attention to low- and middle-income nations since these have more than three-quarters of the world's urban population and most of its largest cities and these include nations where issues of food security are most pressing

Human tribbles-1 controls proliferation and chemotaxis of smooth muscle cells via MAPK signaling pathways

Migration and proliferation of smooth muscle cells are key to a number of physiological and pathological processes, including wound healing and the narrowing of the vessel wall.Previous work has shown links between inflammatory stimuli and vascular smooth muscle cell proliferation and migration through mitogen activated protein kinase (MAPK) activation, though the molecular mechanisms of this process are poorly understood. Here we report that tribbles-1, a recently described modulator of MAPK activation controls vascular smooth muscle cell proliferation and chemotaxis via the Jun Kinase pathway. Our findings demonstrate that this regulation takes place via direct interactions between tribbles-1 and MKK4/SEK1, a Jun activator kinase. The activity of this kinase is dependent on tribbles-1 levels, whilst the activation and the expression of MKK4/SEK1 is not. In addition, tribbles-1 expression is elevated in human atherosclerotic arteries compared to non-atherosclerotic controls, suggesting that this protein may pay a role in disease in vivo. In summary, the data presented here suggest an important regulatory role for trb-1 in vascular smooth muscle cell biology

Engineering interfacial silicon dioxide for improved metal-insulator-semiconductor silicon photoanode water splitting performance

Silicon photoanodes protected by atomic layer deposited (ALD) TiO2 show promise as components of water splitting devices that may enable the large-scale production of solar fuels and chemicals. Minimizing the resistance of the oxide corrosion protection layer is essential for fabricating efficient devices with good fill factor. Recent literature reports have shown that the interfacial SiO2 layer, interposed between the protective ALD-TiO2 and the Si anode, acts as a tunnel oxide that limits hole conduction from the photoabsorbing substrate to the surface oxygen evolution catalyst. Herein, we report a significant reduction of bilayer resistance, achieved by forming stable, ultrathin (<1.3 nm) SiO2 layers, allowing fabrication of water splitting photoanodes with hole conductances near the maximum achievable with the given catalyst and Si substrate. Three methods for controlling the SiO2 interlayer thickness on the Si(100) surface for ALD-TiO2 protected anodes were employed: (1) TiO2 deposition directly on an HF-etched Si(100) surface, (2) TiO2 deposition after SiO2 atomic layer deposition on an HF-etched Si(100) surface, and (3) oxygen scavenging, post-TiO2 deposition to decompose the SiO2 layer using a Ti overlayer. Each of these methods provides a progressively superior means of reliably thinning the interfacial SiO2 layer, enabling the fabrication of efficient and stable water oxidation silicon anodes

Future therapeutic targets in rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by persistent joint inflammation. Without adequate treatment, patients with RA will develop joint deformity and progressive functional impairment. With the implementation of treat-to-target strategies and availability of biologic therapies, the outcomes for patients with RA have significantly improved. However, the unmet need in the treatment of RA remains high as some patients do not respond sufficiently to the currently available agents, remission is not always achieved and refractory disease is not uncommon. With better understanding of the pathophysiology of RA, new therapeutic approaches are emerging. Apart from more selective Janus kinase inhibition, there is a great interest in the granulocyte macrophage-colony stimulating factor pathway, Bruton's tyrosine kinase pathway, phosphoinositide-3-kinase pathway, neural stimulation and dendritic cell-based therapeutics. In this review, we will discuss the therapeutic potential of these novel approaches