The National Pediatric Surgery Simulation Program in France: A tool to develop resident training in pediatric surgery

BACKGROUND/PURPOSE: To implement resident curriculum in France based on theoretical teaching and bed side training, the national council known as the "Collège Hospitalier et Universitaire de Chirurgie Pédiatrique" examined the relevance and feasibility of systematically introducing simulation program in the pediatric surgery resident training. MATERIAL AND METHODS: A national simulation training program was developed and took place in a 2-day session organized in 7 simulation centers in France. The program included technical (laparoscopic/suturing technique on low-fidelity models) and nontechnical (6 scenarios for standardized consultation, and a team work scenario based on errors prevention in the operative room) skills. Evaluation of the program (Likert scale from 1 (bad) to 5 (excellent) and notation on 20 points) concerned trainees and trainers. RESULTS: 40 residents (95% of all pediatric surgery French residents) attended with a ratio of trainees/trainer of ½. The training objectives earned a score of 4.46/5. The pedagogical value of the seminar scored 4.7/5, teaching quality 17.95/20, and the overall seminar score was 17.35/20. CONCLUSION: This program, unique nationally, was assessed very favorably by the participating residents and by the involved trainers. To our knowledge, it represents the first mandatory national simulation training program included within a surgical training model. LEVEL OF EVIDENCE: Level IV

Urban Foraging and the Relational Ecologies of Belonging

Through a discussion of urban foraging in Seattle, Washington, USA, we examine how people\u27s plant and mushroom harvesting practices in cities are linked to relationships with species, spaces, and ecologies. Bringing a relational approach to political ecology, we discuss the ways that these particular nature–society relationships are formed, legitimated, and mobilized in discursive and material ways in urban ecosystems. Engaging closely with and as foragers, we develop an ethnographically grounded ‘relational ecologies of belonging’ framework to conceptualize and examine three constituent themes: cultural belonging and identity, belonging and place, and belonging and more-than-human agency. Through this case study, we show the complex ways that urban foraging is underpinned by interconnected and multiple notions of identity, place, mobility, and agency for both humans and more-than-human interlocutors. The focus on relational ecologies of belonging illuminates important challenges for environmental management and public space planning in socioecologically diverse areas. Ultimately, these challenges reflect negotiated visions about how we organize ourselves and live together in cosmopolitan spaces such as cities

ASCR/HEP Exascale Requirements Review Report

This draft report summarizes and details the findings, results, and recommendations derived from the ASCR/HEP Exascale Requirements Review meeting held in June, 2015. The main conclusions are as follows. 1) Larger, more capable computing and data facilities are needed to support HEP science goals in all three frontiers: Energy, Intensity, and Cosmic. The expected scale of the demand at the 2025 timescale is at least two orders of magnitude -- and in some cases greater -- than that available currently. 2) The growth rate of data produced by simulations is overwhelming the current ability, of both facilities and researchers, to store and analyze it. Additional resources and new techniques for data analysis are urgently needed. 3) Data rates and volumes from HEP experimental facilities are also straining the ability to store and analyze large and complex data volumes. Appropriately configured leadership-class facilities can play a transformational role in enabling scientific discovery from these datasets. 4) A close integration of HPC simulation and data analysis will aid greatly in interpreting results from HEP experiments. Such an integration will minimize data movement and facilitate interdependent workflows. 5) Long-range planning between HEP and ASCR will be required to meet HEP's research needs. To best use ASCR HPC resources the experimental HEP program needs a) an established long-term plan for access to ASCR computational and data resources, b) an ability to map workflows onto HPC resources, c) the ability for ASCR facilities to accommodate workflows run by collaborations that can have thousands of individual members, d) to transition codes to the next-generation HPC platforms that will be available at ASCR facilities, e) to build up and train a workforce capable of developing and using simulations and analysis to support HEP scientific research on next-generation systems.Comment: 77 pages, 13 Figures; draft report, subject to further revisio

THE COST STRUCTURE OF MICROFINANCE INSTITUTIONS IN EASTERN EUROPE AND CENTRAL ASIA

Microfinance institutions are important, particularly in developing countries, because they expand the frontier of financial intermediation by providing loans to those traditionally excluded from formal financial markets. This paper presents the first systematic statistical examination of the performance of MFIs operating in Eastern Europe and Central Asia. A cost function is estimated for MFIs in the region from 1999-2004. First, the presence of subsidies is found to be associated with higher MFI costs. When output is measured as the number of loans made, we find that MFIs become more efficient over time and that MFIs involved in the provision of group loans and loans to women have lower costs. However, when output is measured as volume of loans rather than their number, this last finding is reversed. This may be due to the fact that such loans are smaller in size; thus for a given volume more loans must be made.http://deepblue.lib.umich.edu/bitstream/2027.42/40195/3/wp809.pd

Management of the thrombotic risk associated with COVID-19:guidance for the hemostasis laboratory

Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations

Toward a Deeper Understanding of the Meaning of Marriage Among Black Men

Black men benefit from healthy, satisfying marriages in domains of physical, psychological, and financial well-being. Yet marriage among Black men has declined and remains elusive for many. One gap in the research concerns the positive meaning that Black men find in their marriages. Prior research has failed to collect in-depth accounts of Black men’s experiences of marriage. The purpose of this qualitative study is to explore the meaning of marriage among 52 Black men, using interview data. Findings highlight four themes in the meaning of marriage—secure emotional support, lifelong commitment, enhanced life success, and secure attachment. Two themes emerged from the data related to important influences on the construction of meaning relative to marriage—faith, and the dynamics of give and take. Responses among the men concerning the change in marriage over time related to transitions in American marriages and a deepened respect for marriage. Implications are discussed

A Stealth Supersymmetry Sampler

The LHC has strongly constrained models of supersymmetry with traditional missing energy signatures. We present a variety of models that realize the concept of Stealth Supersymmetry, i.e. models with R-parity in which one or more nearly-supersymmetric particles (a "stealth sector") lead to collider signatures with only a small amount of missing energy. The simplest realization involves low-scale supersymmetry breaking, with an R-odd particle decaying to its superpartner and a soft gravitino. We clarify the stealth mechanism and its differences from compressed supersymmetry and explain the requirements for stealth models with high-scale supersymmetry breaking, in which the soft invisible particle is not a gravitino. We also discuss new and distinctive classes of stealth models that couple through a baryon portal or Z' gauge interactions. Finally, we present updated limits on stealth supersymmetry in light of current LHC searches.Comment: 45 pages, 16 figure

Measurement of Exclusive rho^0 rho^0 Production in Two-Photon Collisions at High Q^2 at LEP

Exclusive rho rho production in two-photon collisions involving a single highly virtual photon is studied with data collected at LEP at centre-of-mass energies 89GeV < \sqrt{s} < 209GeV with a total integrated luminosity of 854.7pb^-1 The cross section of the process gamma gamma^* -> rho rho is determined as a function of the photon virtuality, Q^2 and the two-photon centre-of-mass energy, Wgg, in the kinematic region: 1.2GeV^2 < Q^2 < 30GeV^2 and 1.1GeV < Wgg < 3GeV

Measurement of the lepton charge asymmetry in W-boson decays produced in p-pbar collisions

We describe a measurement of the charge asymmetry of leptons from W boson decays in the rapidity range 0 enu, munu events from 110+/-7 pb^{-1}of data collected by the CDF detector during 1992-95. The asymmetry data constrain the ratio of d and u quark momentum distributions in the proton over the x range of 0.006 to 0.34 at Q2 \approx M_W^2. The asymmetry predictions that use parton distribution functions obtained from previously published CDF data in the central rapidity region (0.0<|y_l|<1.1) do not agree with the new data in the large rapidity region (|y_l|>1.1).Comment: 13 pages, 3 tables, 1 figur

Search for Chargino-Neutralino Associated Production at the Fermilab Tevatron Collider

We have searched in $p \bar{p}$ collisions at $\sqrt{s}$ = 1.8 TeV for events with three charged leptons and missing transverse energy. In the Minimal Supersymmetric Standard Model, we expect trilepton events from chargino-neutralino (\chione \chitwo) pair production, with subsequent decay into leptons. We observe no candidate $e^+e^-e^\pm$, $e^+e^-\mu^\pm$, $e^\pm\mu^+\mu^-$ or $\mu^+\mu^-\mu^\pm$ events in 106 pb$^{-1}$ integrated luminosity. We present limits on the sum of the branching ratios times cross section for the four channels: \sigma_{\chione\chitwo}\cdot BR(\chione\chitwo\to 3\ell+X) 81.5 \mgev\sp and M_\chitwo > 82.2 \mgev\sp for $\tan\beta=2$, $\mu =-600$~\mgev\sp and M_\squark= M_\gluino.Comment: 9 pages and 3 figure