Exploiting opportunities for leadership development of surgeons within the operating theatre

AbstractIt is increasingly recognised that leadership skills are a key requirement in being successful in surgery, regardless of speciality and at all levels of experience and seniority. Where the emphasis was previously on technical ability, knowledge and diagnostic acumen, we now know that non-technical skills such as communication and leadership contribute significantly to patient safety, experience and outcomes, and should be valued.The operating theatre is a unique micro-environment which is often busier, noisier, more stressful and more physically demanding than the clinic or ward setting. As a result surgeons and their trainers, who are striving to develop leadership skills require an in-depth awareness of the challenges in this environment and the opportunities that arise from them to develop leadership effectively. This article outlines why leadership learning is so beneficial in the operating theatre, both for the team and the patient as well as what elements of daily routine activity such as the WHO checklist use, list-planning and audit can be exploited to transform the average busy operating theatre into a rich, learning environment for future leaders in surgery

Possible Jurassic age for part of Rakaia Terrane: implications for tectonic development of the Torlesse accretionary prism

Greywacke sandstone and argillite beds comprising Rakaia Terrane (Torlesse Complex) in mid Canterbury, South Island, New Zealand, are widely regarded as Late Triassic (Norian) in age based on the occurrence of Torlessia trace fossils, Monotis, and other taxa. This paleontological age assignment is tested using published 40Ar/39Ar mica and U-Pb zircon ages for these rocks and published and new zircon fission track (FT) ages. The youngest U-Pb zircon ages in the Rakaia Terrane rocks in mid Canterbury are Norian, whereas 10-20% of the 40Ar/39Ar muscovite ages are younger than Norian. Numerical modelling of these mica ages shows that they cannot have originated from partial thermal overprinting in the Torlesse prism if the thermal maximum was short-lived and early in the prism history (210-190 Ma), as commonly inferred for these rocks. The young component of mica ages could, however, be explained by extended residence (200-100 Ma) at 265-290deg.C in the prism. Early Jurassic (c. 189 Ma) zircon FT ages for sandstone beds from Arthur's Pass, the Rakaia valley, and the Hermitage (Mt Cook) are interpreted not to have experienced maximum temperatures above 210deg.C, and therefore cannot have been reduced as a result of partial annealing in the Torlesse prism. This is based on identification of a fossil Cretaceous, zircon FT, partial annealing zone in low-grade schists to the west, and the characteristics of the age data. The Early Jurassic zircon FT ages and the young component of 40Ar/39Ar mica ages are regarded therefore as detrital ages reflecting cooling in the source area, and constrain the maximum depositional age of parts of the Rakaia Terrane in mid Canterbury. The zircon FT data also show the initiation (c. 100 Ma) of marked and widespread Late Cretaceous cooling of Rakaia Terrane throughout Canterbury, which is attributed to uplift and erosion of inboard parts of the Torlesse prism due to continuing subduction accretion at its toe. The critical wedge concept is proposed as a new framework for investigating the development of the Torlesse Complex. The Rakaia Terrane may have formed the core of an accretionary wedge imbricated against the New Zealand margin during the Middle or Late Jurassic. Late Jurassic nonmarine sediments (e.g., Clent Hills Formation) accumulated upon the inner parts of the prism as it enlarged, emerged, and continued to be imbricated. Exhumation of Otago Schist from c. 135 Ma may mark the development of a balance (steady state) between sediments entering the prism at the toe and material exiting at the inboard margin. The enlargement of the area of exhumation to all of Canterbury from c. 100 Ma may reflect a dynamic response to widening of the prism through the accretion of Cretaceous sediments. The model of a dynamic critical wedge may help to explain the various expressions of the Rangitata Orogeny

Argon behaviour in an inverted Barrovian sequence, Sikkim Himalaya: the consequences of temperature and timescale on ⁴⁰Ar/³⁹Ar mica geochronology

40Ar/39Ar dating of metamorphic rocks sometimes yields complicated datasets which are difficult to interpret in terms of timescales of the metamorphic cycle. Single-grain fusion and step-heating data were obtained for rocks sampled through a major thrust-sense shear zone (the Main Central Thrust) and the associated inverted metamorphic zone in the Sikkim region of the eastern Himalaya. This transect provides a natural laboratory to explore factors influencing apparent 40Ar/39Ar ages in similar lithologies at a variety of metamorphic pressure and temperature (P–T) conditions. The 40Ar/39Ar dataset records progressively younger apparent age populations and a decrease in within-sample dispersion with increasing temperature through the sequence. The white mica populations span ~ 2–9 Ma within each sample in the structurally lower levels (garnet grade) but only ~ 0–3 Ma at structurally higher levels (kyanite-sillimanite grade). Mean white mica single-grain fusion population ages vary from 16.2 ± 3.9 Ma (2σ) to 13.2 ± 1.3 Ma (2σ) from lowest to highest levels. White mica step-heating data from the same samples yields plateau ages from 14.27 ± 0.13 Ma to 12.96 ± 0.05 Ma. Biotite yield older apparent age populations with mean single-grain fusion dates varying from 74.7 ± 11.8 Ma (2σ) at the lowest structural levels to 18.6 ± 4.7 Ma (2σ) at the highest structural levels; the step-heating plateaux are commonly disturbed. Temperatures > 600 °C at pressures of 0.4–0.8 GPa sustained over > 5 Ma, appear to be required for white mica and biotite ages to be consistent with diffusive, open-system cooling. At lower temperatures, and/or over shorter metamorphic timescales, more 40Ar is retained than results from simple diffusion models suggest. Diffusion modelling of Ar in white mica from the highest structural levels suggests that the high-temperature rocks cooled at a rate of ~ 50–80 °C Ma− 1, consistent with rapid thrusting, extrusion and exhumation along the Main Central Thrust during the mid-Miocene

Germline-dependent gene expression in distant non-gonadal somatic tissues of Drosophila

<p>Abstract</p> <p>Background</p> <p><it>Drosophila </it>females commit tremendous resources to egg production and males produce some of the longest sperm in the animal kingdom. We know little about the coordinated regulation of gene expression patterns in distant somatic tissues that support the developmental cost of gamete production.</p> <p>Results</p> <p>We determined the non-gonadal gene expression patterns of <it>Drosophila </it>females and males with or without a germline. Our results show that germline-dependent expression in the non-gonadal soma is extensive. Interestingly, gene expression patterns and hormone titers are consistent with a hormone axis between the gonads and non-gonadal soma.</p> <p>Conclusions</p> <p>The germline has a long-range influence on gene expression in the <it>Drosophila </it>sexes. We suggest that this is the result of a germline/soma hormonal axis.</p

Proton-coupled electron hopping in Ru-modified P. aeruginosa azurin

We constructed two artificial multiple-step electron transfer (hopping) systems based on Pseudomonas aeruginosa azurin where a tyrosine (YOH) is situated between Ru(2,2′-bipyridine)_2(imidazole)(histidine) and the native copper site: RuH107YOH109 and RuH124-YOH122. We investigated the rates of Cu^I oxidation by flash-quench generated Ru^(III) over a range of conditions that probed the role of proton-coupled oxidation/reduction of YOH in the reaction. Rates of Cu^I oxidation were enhanced over single-step electron transfer by factors between 3 and 80, depending on specific scaffold and buffer conditions

Bidirectional KCNQ1:β-catenin interaction drives colorectal cancer cell differentiation.

The K+ channel KCNQ1 has been proposed as a tumor suppressor in colorectal cancer (CRC). We investigated the molecular mechanisms regulating KCNQ1:β-catenin bidirectional interactions and their effects on CRC differentiation, proliferation, and invasion. Molecular and pharmacologic approaches were used to determine the influence of KCNQ1 expression on the Wnt/β-catenin signaling and epithelial-to-mesenchymal transition (EMT) in human CRC cell lines of varying stages of differentiation. The expression of KCNQ1 was lost with increasing mesenchymal phenotype in poorly differentiated CRC cell lines as a consequence of repression of the KCNQ1 promoter by β-catenin:T-cell factor (TCF)-4. In welldifferentiated epithelial CRC cell lines, KCNQ1 was localized to the plasma membrane in a complex with β-catenin and E-cadherin. The colocalization of KCNQ1 with adherens junction proteins was lost with increasing EMT phenotype. ShRNA knock-down of KCNQ1 caused a relocalization of β-catenin from the plasma membrane and a loss of epithelial phenotype in CRC spheroids. Overexpression of KCNQ1 trapped β-catenin at the plasma membrane, induced a patent lumen in CRC spheroids, and slowed CRC cell invasion. The KCNQ1 ion channel inhibitor chromanol 293B caused membrane depolarization, redistribution of β-catenin into the cytosol, and a reduced transepithelial electrical resistance, and stimulated CRC cell proliferation. Analysis of human primary CRC tumor patient databases showed a positive correlation between KCNQ1:KCNE3 channel complex expression and disease-free survival. We conclude that the KCNQ1 ion channel is a target gene and regulator of the Wnt/β-catenin pathway, and its repression leads to CRC cell proliferation, EMT, and tumorigenesis

Galaxy And Mass Assembly (GAMA)

The GAMA survey aims to deliver 250,000 optical spectra (3--7Ang resolution) over 250 sq. degrees to spectroscopic limits of r_{AB} <19.8 and K_{AB}<17.0 mag. Complementary imaging will be provided by GALEX, VST, UKIRT, VISTA, HERSCHEL and ASKAP to comparable flux levels leading to a definitive multi-wavelength galaxy database. The data will be used to study all aspects of cosmic structures on 1kpc to 1Mpc scales spanning all environments and out to a redshift limit of z ~ 0.4. Key science drivers include the measurement of: the halo mass function via group velocity dispersions; the stellar, HI, and baryonic mass functions; galaxy component mass-size relations; the recent merger and star-formation rates by mass, types and environment. Detailed modeling of the spectra, broad SEDs, and spatial distributions should provide individual star formation histories, ages, bulge-disc decompositions and stellar bulge, stellar disc, dust disc, neutral HI gas and total dynamical masses for a significant subset of the sample (~100k) spanning both the giant and dwarf galaxy populations. The survey commenced March 2008 with 50k spectra obtained in 21 clear nights using the Anglo Australian Observatory's new multi-fibre-fed bench-mounted dual-beam spectroscopic system (AAOmega).Comment: Invited talk at IAU 254 (The Galaxy Disk in Cosmological Context, Copenhagen), 6 pages, 5 figures, high quality PDF version available at http://www.eso.org/~jliske/gama

Music models aberrant rule decoding and reward valuation in dementia.

Aberrant rule- and reward-based processes underpin abnormalities of socio-emotional behaviour in major dementias. However, these processes remain poorly characterized. Here we used music to probe rule decoding and reward valuation in patients with frontotemporal dementia (FTD) syndromes and Alzheimer's disease (AD) relative to healthy age-matched individuals. We created short melodies that were either harmonically resolved ('finished') or unresolved ('unfinished'); the task was to classify each melody as finished or unfinished (rule processing) and rate its subjective pleasantness (reward valuation). Results were adjusted for elementary pitch and executive processing; neuroanatomical correlates were assessed using voxel-based morphometry. Relative to healthy older controls, patients with behavioural variant FTD showed impairments of both musical rule decoding and reward valuation, while patients with semantic dementia showed impaired reward valuation but intact rule decoding, patients with AD showed impaired rule decoding but intact reward valuation and patients with progressive non-fluent aphasia performed comparably to healthy controls. Grey matter associations with task performance were identified in anterior temporal, medial and lateral orbitofrontal cortices, previously implicated in computing diverse biological and non-biological rules and rewards. The processing of musical rules and reward distils cognitive and neuroanatomical mechanisms relevant to complex socio-emotional dysfunction in major dementias

GAMA: towards a physical understanding of galaxy formation

The Galaxy And Mass Assembly (GAMA) project is the latest in a tradition of large galaxy redshift surveys, and is now underway on the 3.9m Anglo-Australian Telescope at Siding Spring Observatory. GAMA is designed to map extragalactic structures on scales of 1kpc - 1Mpc in complete detail to a redshift of z~0.2, and to trace the distribution of luminous galaxies out to z~0.5. The principal science aim is to test the standard hierarchical structure formation paradigm of Cold Dark Matter (CDM) on scales of galaxy groups, pairs, discs, bulges and bars. We will measure (1) the Dark Matter Halo Mass Function (as inferred from galaxy group velocity dispersions); (2) baryonic processes, such as star formation and galaxy formation efficiency (as derived from Galaxy Stellar Mass Functions); and (3) the evolution of galaxy merger rates (via galaxy close pairs and galaxy asymmetries). Additionally, GAMA will form the central part of a new galaxy database, which aims to contain 275,000 galaxies with multi-wavelength coverage from coordinated observations with the latest international ground- and space-based facilities: GALEX, VST, VISTA, WISE, HERSCHEL, GMRT and ASKAP. Together, these data will provide increased depth (over 2 magnitudes), doubled spatial resolution (0.7"), and significantly extended wavelength coverage (UV through Far-IR to radio) over the main SDSS spectroscopic survey for five regions, each of around 50 deg^2. This database will permit detailed investigations of the structural, chemical, and dynamical properties of all galaxy types, across all environments, and over a 5 billion year timeline.Comment: GAMA overview which appeared in the October 2009 issue of Astronomy & Geophysics, ref: Astron.Geophys. 50 (2009) 5.1