An identity crisis: the need for core competencies in undergraduate medical education

A medical student perspective on the role of core competencies in undergraduate medical education in light of medical education reform associated with recent Flexner II

Saturation Spectroscopy of Iodine in Hollow-core Optical Fibre

We present high-resolution spectroscopy of Iodine vapour that is loaded and trapped within the core of a hollow-core photonic crystal fibre (HC-PCF). We compare the observed spectroscopic features to those seen in a conventional iodine cell and show that the saturation characteristics differ significantly. Despite the confined geometry it was still possible to obtain sub-Doppler features with a spectral width of ~6 MHz with very high contrast. We provide a simple theory which closely reproduces all the key observations of the experiment.Comment: 12 pages, 7 figure

Intermediate layer formation between inclusion and matrix during synthesis of unidirectional fibrous composite

The problem of transient layer formation in given composition between inclusions and matrix can be solved using mathematical modeling. This paper suggests a suitable model taking into account multi staging of chemical conversion. Numerical realization of this model allows studying the dynamics of transient layer formation at varying temperature and pressure. As a result, the phase structure and thickness of a transient zone depending on synthesis conditions are obtained

Electronic Nose To Detect Volatile Compound Profile and Quality Changes in 'Spring Belle' Peach (Prunus persica L.) during Cold Storage in Relation to Fruit Optical Properties Measured by Time-Resolved Reflectance Spectroscopy

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Scale effects in tribological properties of solid-lubricating composites made of ultra-high molecular weight polyethylene filled with calcium stearate particles

Friction properties being influenced by scale effects are simulated in the paper by the example of polymer composite material made from Ultra High-Molecular Weight Polyethylenes (UHMWPE) filled by calcium stearate (C[36]H[70]CaO[4]). Of interest are the composites whose mechanical properties and tribotechnical characteristics do not depend monotonically on filler (inclusions) weight fraction. In order to describe the influence of scale effects onto frictional properties the model based on Reiss averaging (model of "weak phase") is employed. It is also suggested that when gradient elasticity theory is applicable the formal analogy between effective friction coefficient for surface heterogeneous structures and effective mechanical properties (compliances) for heterogeneous material can take place. Theoretical dependence to describe nonmonotonic change of effective friction coefficient versus filler concentration was obtained for the polymer composites under study. The suggested expressions might be useful for the sake of properties prognosis of antifriction polymeric materilas

Dynamics of Solid Proteins by Means of Nuclear Magnetic Resonance Relaxometry

Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 668119 (project “IDentIFY”).Peer reviewedPublisher PD

Effects of a Commercial Insurance Policy Restriction on Lumbar Fusion in North Carolina and the Implications for National Adoption

Analysis of the State Inpatient Database of North Carolina, 2005–2012, and the Nationwide Inpatient Sample, including all inpatient lumbar fusion admissions from non-federal hospitals

Surgical versus nonsurgical therapy for lumbar spinal stenosis.

BACKGROUND: Surgery for spinal stenosis is widely performed, but its effectiveness as compared with nonsurgical treatment has not been shown in controlled trials. METHODS: Surgical candidates with a history of at least 12 weeks of symptoms and spinal stenosis without spondylolisthesis (as confirmed on imaging) were enrolled in either a randomized cohort or an observational cohort at 13 U.S. spine clinics. Treatment was decompressive surgery or usual nonsurgical care. The primary outcomes were measures of bodily pain and physical function on the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 6 weeks, 3 months, 6 months, and 1 and 2 years. RESULTS: A total of 289 patients were enrolled in the randomized cohort, and 365 patients were enrolled in the observational cohort. At 2 years, 67% of patients who were randomly assigned to surgery had undergone surgery, whereas 43% of those who were randomly assigned to receive nonsurgical care had also undergone surgery. Despite the high level of nonadherence, the intention-to-treat analysis of the randomized cohort showed a significant treatment effect favoring surgery on the SF-36 scale for bodily pain, with a mean difference in change from baseline of 7.8 (95% confidence interval, 1.5 to 14.1); however, there was no significant difference in scores on physical function or on the Oswestry Disability Index. The as-treated analysis, which combined both cohorts and was adjusted for potential confounders, showed a significant advantage for surgery by 3 months for all primary outcomes; these changes remained significant at 2 years. CONCLUSIONS: In the combined as-treated analysis, patients who underwent surgery showed significantly more improvement in all primary outcomes than did patients who were treated nonsurgically. (ClinicalTrials.gov number, NCT00000411 [ClinicalTrials.gov].)

ABCB1 (MDR1) polymorphisms and ovarian cancer progression and survival: A comprehensive analysis from the Ovarian Cancer Association Consortium and The Cancer Genome Atlas

<b>Objective</b> <i>ABCB1</i> encodes the multi-drug efflux pump P-glycoprotein (P-gp) and has been implicated in multi-drug resistance. We comprehensively evaluated this gene and flanking regions for an association with clinical outcome in epithelial ovarian cancer (EOC).<p></p> <b>Methods</b> The best candidates from fine-mapping analysis of 21 <i>ABCB1</i> SNPs tagging C1236T (rs1128503), G2677T/A (rs2032582), and C3435T (rs1045642) were analysed in 4616 European invasive EOC patients from thirteen Ovarian Cancer Association Consortium (OCAC) studies and The Cancer Genome Atlas (TCGA). Additionally we analysed 1,562 imputed SNPs around ABCB1 in patients receiving cytoreductive surgery and either ‘standard’ first-line paclitaxel–carboplatin chemotherapy (n = 1158) or any first-line chemotherapy regimen (n = 2867). We also evaluated ABCB1 expression in primary tumours from 143 EOC patients.<p></p> <b>Result</b> Fine-mapping revealed that rs1128503, rs2032582, and rs1045642 were the best candidates in optimally debulked patients. However, we observed no significant association between any SNP and either progression-free survival or overall survival in analysis of data from 14 studies. There was a marginal association between rs1128503 and overall survival in patients with nil residual disease (HR 0.88, 95% CI 0.77–1.01; p = 0.07). In contrast, <i>ABCB1</i> expression in the primary tumour may confer worse prognosis in patients with sub-optimally debulked tumours.<p></p> <b>Conclusion</b> Our study represents the largest analysis of <i>ABCB1</i> SNPs and EOC progression and survival to date, but has not identified additional signals, or validated reported associations with progression-free survival for rs1128503, rs2032582, and rs1045642. However, we cannot rule out the possibility of a subtle effect of rs1128503, or other SNPs linked to it, on overall survival.<p></p&gt

Ocena prawdopodobieństwa urodzenia dziecka z niezrównoważonym kariotypem oraz ryzyka wystąpienia rożnych patologii ciąży w rodzinach nosicieli translokacji chromosomowych wzajemnych angażujących chromosom 7

Introduction: Carriership of reciprocal chromosomal translocation (RCT) may be the reason the occurrence of congenital malformations in the offspring, early neonatal death, stillbirth, and recurrent miscarriages due to unbalanced karyotype of gametes. The probability rate for individual categories of unfavorable outcomes depends on the kind of chromosome involved and is individually variable. Objectives: The aim of study was to estimate the probability rates for unbalanced offspring and to evaluate the risk for different categories of unfavorable pregnancy outcomes, depending on the size of chromosomal segment with differentiation between maternal/paternal origin of the reciprocal chromosomal translocations involving chromosome 7p (RCT-7p) and 7q (RCT-7q). In addition, the use of the obtained results has been illustrated by the example of a family with unique RCT t(7;9)(p21.3,p23). Material and methods: Empirical and cytogenetic data on 341 pregnancies and offspring of 133 carriers were collected from 69 pedigrees of carriers of RCT-7p and RCT-7q at risk for a single 7 segment imbalance. The probability rates of particular form of pregnancy pathology have been calculated according to the method of Stengel-Rutkowski and Stene, including all forms of meiotic segregation and their survival rates after fertilization to term childbirth. Results: The probability rates for unbalanced offspring for carriers of RCT-7p after 2:2 disjunction and adjacent-1 segregation were calculated as 5.5%±2.2% (6/108); for maternal (MAT) and paternal (PAT) carriers were aboutCel pracy: Celem pracy było opracowanie wskaźników prawdopodobieństwa urodzenia dziecka z niezrównoważonym kariotypem oraz wskaźników ryzyka różnych patologii ciąży w rodzinach nosicieli translokacji chromosomowych wzajemnych angażujących segmenty chromosomu 7 (TCW-7), w zależności od długości pojedynczych segmentów krótkich (TCW-7p) i długich (TCW-7q) ramion chromosomu 7, z uwzględnieniem rodzicielskiego pochodzenia nosicielstwa. Na przykładzie rodziny z nosicielstwem unikatowej t(7;9)(p21.3;p23) zaprezentowano, w jaki sposób praktycznie można wykorzystać uzyskane wskaźniki udzielając porady genetycznej. Materiał i metody: Analizę segregacyjną przeprowadzono w grupie 69 rodowodów nosicieli TCW-7 zawierających dane kliniczne i cytogenetyczne 341 ciąż i urodzeń potomstwa w sześciu grupach oddzielnie w zależności od długości segmentu 7p i 7q wyznaczonej przez położenie punktu złamania TCW: 7p21→pter, 7p14…p15→pter, 7p11…p12…p13→pter oraz 7q33…q34…q35→qter, 7q32 →qter, 7q11…q21.. q22…q31→qter z uwzględnieniem rodzicielskiego pochodzenia TCW. Wyniki: Prawdopodobieństwo urodzenia dziecka z niezrównoważonym kariotypem w przypadku nosicielstwa TCW-7p wynosiło 5.5±2.2% (6/108) (w tym matczyne MAT