Professional Identity Formation, Intersectionality and Equity in Medical Education

A great many factors interlink to produce barriers, opportunities and enablers at every stage of the education continuum that produce considerable potential for inequity.1,2 While one individual may receive privilege in terms of financial, support and educator guidance, the other may face financial hardship and discrimination in the journey to reach the same objective of being a healthcare practitioner. Even at an organizational level medical training dynamically constitutes many different models of education that help define the features of learners, setting the path for their future careers.3 The impact of this variety of experience has been particularly noticeable in 2020 as the events of the year in relation to under‐represented individuals have caused shockwaves throughout the world that have sharply called into question the ways in which health professional education addresses race and ethnic inequalities

Many-body perturbation-theory of frequency-dependent polarizabilities and van der Waals coefficients - application to H2O-H2O and Ar-NH3

Correlation contributions to the multipole moments and frequency dependent polarizabilities of molecules are described within the framework of time-dependent coupled Hartree-Fock and many-body perturbation theory. Computationally feasible expressions are given for the "true" correlation contributions to the multipole moments and frequency dependent polarizabilities. The polarizabilities of argon, ammonia and water and the van der Waals induction and dispersion coefficients of H2O-H2O and Ar-NH3 are presented

Conserved developmental processes and the formation of evolutionary novelties: examples from butterfly wings

The origin and diversification of evolutionary novelties—lineage-specific traits of new adaptive value—is one of the key issues in evolutionary developmental biology. However, comparative analysis of the genetic and developmental bases of such traits can be difficult when they have no obvious homologue in model organisms. The finding that the evolution of morphological novelties often involves the recruitment of pre-existing genes and/or gene networks offers the potential to overcome this challenge. Knowledge about shared developmental processes obtained from extensive studies in model organisms can then be used to understand the origin and diversification of lineage-specific structures. Here, we illustrate this approach in relation to eyespots on the wings of Bicyclus anynana butterflies. A number of spontaneous mutations isolated in the laboratory affect eyespots, lepidopteran-specific features, and also processes that are shared by most insects. We discuss how eyespot mutants with disturbed embryonic development may help elucidate the genetic pathways involved in eyespot formation, and how venation mutants with altered eyespot patterns might shed light on mechanisms of eyespot development

Gait analysis in a <i>Mecp2</i> knockout mouse model of Rett syndrome reveals early-onset and progressive motor deficits

Rett syndrome (RTT) is a genetic disorder characterized by a range of features including cognitive impairment, gait abnormalities and a reduction in purposeful hand skills. Mice harbouring knockout mutations in the &lt;i&gt;Mecp2&lt;/i&gt; gene display many RTT-like characteristics and are central to efforts to find novel therapies for the disorder. As hand stereotypies and gait abnormalities constitute major diagnostic criteria in RTT, it is clear that motor and gait-related phenotypes will be of importance in assessing preclinical therapeutic outcomes. We therefore aimed to assess gait properties over the prodromal phase in a functional knockout mouse model of RTT. In male &lt;i&gt;Mecp2&lt;/i&gt; knockout mice, we observed alterations in stride, coordination and balance parameters at 4 weeks of age, before the onset of other overt phenotypic changes as revealed by observational scoring. These data suggest that gait measures may be used as a robust and early marker of &lt;i&gt;Mecp2&lt;/i&gt;-dysfunction in future preclinical therapeutic studies

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN USIA PERTAMA KALI PEMBERIAN MAKANAN PENDAMPING ASI (MP-ASI) PADA ANAK USIA 6-24 BULAN DI WILAYAH KERJA PUSKESMAS REMBOKEN

Pemberian makanan selain ASI dalam hal ini Makanan Pendamping ASI (MP-ASI) harus diberikan secara bertahap mengikuti pertambahan usia anak karena dapat mempengaruhi pertumbuhan anak yang berdampak pada status gizi anak. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan usia pertama kali pemberian makanan pendamping ASI (MP-ASI) pada anak usia 6-24 bulan di Wilayah Kerja Puskesmas Remboken. Jenis penelitian ini adalah survei analitik dengan rancangan cross-sectional. Penelitian ini dilakukan pada bulan Juli sampai Agustus 2017 di Wilayah Kerja Puskesmas Remboken. Populasi dalam penelitian ini adalah semua anak usia 6-24 bulan di Wilayah Kerja Puskesmas Remboken yang berjumlah 207 anak dengan sampel sebanyak 137 sampel. Instrumen yang digunakan adalah kuesioner. Analisis data menggunakan analisis univariat dan bivariat menggunakan uji chi-square. Hasil penelitian menunjukkan, terdapat hubungan antara pengetahuan (p-value=0,030) dengan usia pertama kali pemberian MP-ASI dan tidak terdapat hubungan antara pendidikan (p-value=0,502), pekerjaan (p-value=0,284), usia (p-value=0,590), dukungan keluarga (p-value=0,703) dan status ekonomi (p-value=0,749) dengan usia pertama kali pemberian MP-ASI. Kesimpulan penelitian ini yaitu, terdapat hubungan yang signifikan antara pengetahuan dengan usia pertama kali pemberian MP-ASI dan tidak terdapat hubungan yang signifikan antara pendidikan, pekerjaan, usia, dukungan keluarga, dan status ekonomi dengan usia pertama kali pemberian MP-ASI.Kata Kunci: Pendidikan, Pekerjaan, Usia, Pengetahuan, Dukungan Keluarga, Status Ekonomi, Makanan Pendamping ASIABSTRACTGiving of food other than breastfeeding in this complementary feeding of the breastfed child must be given in stages following the increase of the age of the baby because it can affect the growth of babies that have an impact on the nutritional status of infants. This research was conducted to find out the factors that are related with the age of the first complementary feeding of the breastfed child in children aged 6-24 months in the working area of Remboken Public Health Centre. This research is a type of analytic survey with cross-sectional design. This research was conducted in July to August 2017 in working area of Remboken Public Health Centre. The population in this research is all the children aged 6-24 months in working area of Remboken public health centre totalling 207 children. The sample in this research as much as 137 samples. The instruments used are questionnaire. Data analysis using univariate analysis and bivariat use chi-square test. The results showed, there is a relationship between knowledge (p-value = 0.030) with the age of the first compelemntary breastfeeding and there was no relationship between education (p-value = 0,502), work (p-value = 0,284), age (p-value = 0,590), family support (p-value = 0,703) and economic status (p-value = 0.749) with the age of the first complementary feeding of the breastfed child. Conclusion: the conclusion is, there is a significant relationship between knowledge with the age of the first complementary feeding of the breastfed child and there was no significant relationship between education, occupation, age, family support, and economic status with age of the first complementary feeding of the breastfed child.Keywords: Education, Occupation, Age, Knowledge, Family Support, The Economic Status, Complementary Feeding of the Breastfed Chil

Geometric Second Order Field Equations for General Tensor Gauge Fields

Higher spin tensor gauge fields have natural gauge-invariant field equations written in terms of generalised curvatures, but these are typically of higher than second order in derivatives. We construct geometric second order field equations and actions for general higher spin boson fields, and first order ones for fermions, which are non-local but which become local on gauge-fixing, or on introducing auxiliary fields. This generalises the results of Francia and Sagnotti to all representations of the Lorentz group.Comment: 34 pages, LaTeX. Reference adde

Dietary fat and total energy intake modifies the association of genetic profile risk score on obesity: evidence from 48 170 UK Biobank participants

Background: Obesity is a multifactorial condition influenced by both genetics and lifestyle. The aim of this study was to investigate whether the association between a validated genetic profile risk score for obesity (GPRS-obesity) and body mass index (BMI) or waist circumference (WC) was modified by macronutrient intake in a large general population study. Methods: This study included cross-sectional data from 48 170 white European adults, aged 37–73 years, participating on the UK Biobank. Interactions between GPRS-obesity, and macronutrient intake (including total energy, protein, fat, carbohydrate and dietary fibre intake) and its effects on BMI and WC were investigated. Results: The 93-SNPs genetic profile risk score was associated with a higher BMI (β:0.57 kg.m−2 per standard deviation (s.d.) increase in GPRS, [95%CI:0.53–0.60]; P=1.9 × 10−183) independent of major confounding factors. There was a significant interaction between GPRS and total fat intake (P[interaction]=0.007). Among high fat intake individuals, BMI was higher by 0.60 [0.52, 0.67] kg.m−2 per s.d. increase in GPRS-obesity; the change in BMI with GPRS was lower among low fat intake individuals (β:0.50 [0.44, 0.57] kg.m-2). Significant interactions with similar patterns were observed for saturated fat intake (High β:0.66 [0.59, 0.73] versus Low β:0.49 [0.42, 0.55] kg.m-2, P-interaction=2 × 10-4), and total energy intake (High β:0.58 [0.51, 0.64] versus Low β:0.49 [0.42, 0.56] kg.m−2, P-interaction=0.019), but not for protein intake, carbohydrate intake and fiber intake (P-interaction &gt;0.05). The findings were broadly similar using WC as the outcome. Conclusions: These data suggest that the benefits of reducing the intake of fats and total energy intake, may be more important in individuals with high genetic risk for obesity

Primary biliary cirrhosis: proposal for a new simple histological scoring system

Background &amp; Aims A simple and reproducible evaluation of non diagnostic histological lesions related to prognosis remains crucial in primary biliary cirrhosis (PBC). Presently there is no satisfactory simple scoring system analysing them reliably. We elaborated a semi-quantitative scoring system that assesses fibrosis, lymphocytic interface hepatitis (LIH) and ductopenia, separately. This study was aimed to evaluate its intra/interobserver reproducibility and its correlation with the main biochemical data. Methods Liver biopsies from 33 consecutive newly diagnosed PBC patients were independently analysed by five liver pathologists. Fibrosis was classified into five stages (portal/periportal fibrosis/few septa/numerous septa/cirrhosis) and LIH into four grades. The bile duct ratio (BDR), i.e. ratio of the number of portal tracts with ducts to total number of portal tracts, Ludwig\u27s and Scheuer\u27s stages were evaluated. Intra and interobserver agreements were assessed. Histological results were correlated to the biochemical data. Results Most patients had an early disease on clinical and biological parameters. The biopsies measured 23 mm on average (range 12 – 40 mm). Intraobserver reproducibility was substantial for fibrosis (κ = 0.68), LIH (κ = 0.69) and BDR (ICC = 0.69). Interobserver agreement for fibrosis was fair with the 5-class system (κ = 0.36), moderate with a 4-class system (κ = 0.56). moderate for LIH (κ = 0.59) and BDR (ICC = 0.50). Ludwig\u27s and Scheuer\u27s staging showed a fair interobserver agreement (κ = 0.32, κ = 0.31 respectively). Our system showed better correlations with biochemistry than Ludwig\u27s and Scheuer\u27s systems did. Conclusions This simple scoring system, assessing fibrosis, LIH and BDR separately, has a substantial intraobserver and a moderate interobserver reproducibility. Its prognostic relevance has to be evaluated

Low-lying quadrupole collective states of the light and medium Xenon isotopes

Collective low lying levels of light and medium Xenon isotopes are deduced from the Generalized Bohr Hamiltonian (GBH). The microscopic seven functions entering into the GBH are built from a deformed mean field of the Woods-Saxon type. Theoretical spectra are found to be close to the ones of the experimental data taking into account that the calculations are completely microscopic, that is to say, without any fitting of parameters.Comment: 8 pages, 4 figures, 1 tabl