The teaching of surgery in the undergraduate curriculum – reforms and results

AbstractIn the past decade, the teaching of surgery in the undergraduate curriculum has undergone considerable changes in quantity, mode and method of delivery. This is a result of the radical reforms of higher education, the health service and the undergraduate medical curriculum. These reforms are often interrelated and are occurring in conjunction with major changes in healthcare delivery. In this article we discuss this reorganisation, the rationale behind it and the impact on surgical teaching

Mapping systematic errors in helium abundance determinations using Markov Chain Monte Carlo

Monte Carlo techniques have been used to evaluate the statistical and systematic uncertainties in the helium abundances derived from extragalactic H~II regions. The helium abundance is sensitive to several physical parameters associated with the H~II region. In this work, we introduce Markov Chain Monte Carlo (MCMC) methods to efficiently explore the parameter space and determine the helium abundance, the physical parameters, and the uncertainties derived from observations of metal poor nebulae. Experiments with synthetic data show that the MCMC method is superior to previous implementations (based on flux perturbation) in that it is not affected by biases due to non-physical parameter space. The MCMC analysis allows a detailed exploration of degeneracies, and, in particular, a false minimum that occurs at large values of optical depth in the He~I emission lines. We demonstrate that introducing the electron temperature derived from the [O~III] emission lines as a prior, in a very conservative manner, produces negligible bias and effectively eliminates the false minima occurring at large optical depth. We perform a frequentist analysis on data from several "high quality" systems. Likelihood plots illustrate degeneracies, asymmetries, and limits of the determination. In agreement with previous work, we find relatively large systematic errors, limiting the precision of the primordial helium abundance for currently available spectra.Comment: 25 pages, 11 figure

A self-consistent model of Galactic stellar and dust infrared emission and the abundance of polycyclic aromatic hydrocarbons

We present a self-consistent three-dimensional Monte-Carlo radiative transfer model of the stellar and dust emission in the Milky-Way, and have computed synthetic observations of the 3.6 to 100 microns emission in the Galactic mid-plane. In order to compare the model to observations, we use the GLIMPSE, MIPSGAL, and IRAS surveys to construct total emission spectra, as well as longitude and latitude profiles for the emission. The distribution of stars and dust is taken from the SKY model, and the dust emissivities includes an approximation of the emission from polycyclic aromatic hydrocarbons in addition to thermal emission. The model emission is in broad agreement with the observations, but a few modifications are needed to obtain a good fit. Firstly, by adjusting the model to include two major and two minor spiral arms rather than four equal spiral arms, the fit to the longitude profiles for |l|>30 degrees can be improved. Secondly, introducing a deficit in the dust distribution in the inner Galaxy results in a better fit to the shape of the IRAS longitude profiles at 60 and 100 microns. With these modifications, the model fits the observed profiles well, although it systematically under-estimates the 5.8 and 8.0 microns fluxes. One way to resolve this discrepancy is to increase the abundance of PAH molecules by 50% compared to the original model, although we note that changes to the dust distribution or radiation field may provide alternative solutions. Finally, we use the model to quantify which stellar populations contribute the most to the heating of different dust types, and which stellar populations and dust types contribute the most to the emission at different wavelengths.Comment: Published in A&A. This version has been revised (compared to the published version) to include additional references to previous work. Scripts to reproduce the results in this paper can be found as supplementary material on the A&A site, or at https://github.com/hyperion-rt/paper-galaxy-rt-mode

A New Approach to Systematic Uncertainties and Self-Consistency in Helium Abundance Determinations

Tests of big bang nucleosynthesis and early universe cosmology require precision measurements for helium abundance determinations. However, efforts to determine the primordial helium abundance via observations of metal poor H II regions have been limited by significant uncertainties. This work builds upon previous work by providing an updated and extended program in evaluating these uncertainties. Procedural consistency is achieved by integrating the hydrogen based reddening correction with the helium based abundance calculation, i.e., all physical parameters are solved for simultaneously. We include new atomic data for helium recombination and collisional emission based upon recent work by Porter et al. and wavelength dependent corrections to underlying absorption are investigated. The set of physical parameters has been expanded here to include the effects of neutral hydrogen collisional emission. Because of a degeneracy between the solutions for density and temperature, the precision of the helium abundance determinations is limited. Also, at lower temperatures (T \lesssim 13,000 K) the neutral hydrogen fraction is poorly constrained resulting in a larger uncertainty in the helium abundances. Thus the derived errors on the helium abundances for individual objects are larger than those typical of previous studies. The updated emissivities and neutral hydrogen correction generally raise the abundance. From a regression to zero metallicity, we find Y_p as 0.2561 \pm 0.0108, in broad agreement with the WMAP result. Tests with synthetic data show a potential for distinct improvement, via removal of underlying absorption, using higher resolution spectra. A small bias in the abundance determination can be reduced significantly and the calculated helium abundance error can be reduced by \sim 25%.Comment: 51 pages, 13 figure

Chasing the identification of ASCA Galactic Objects (ChIcAGO): An X-ray survey of unidentified sources in the galactic plane. I : Source sample and initial results

We present the Chasing the Identification of ASCA Galactic Objects (ChIcAGO) survey, which is designed to identify the unknown X-ray sources discovered during the ASCA Galactic Plane Survey (AGPS). Little is known about most of the AGPS sources, especially those that emit primarily in hard X-rays (2-10 keV) within the Fx 10-13 to 10-11 erg cm -2 s-1 X-ray flux range. In ChIcAGO, the subarcsecond localization capabilities of Chandra have been combined with a detailed multiwavelength follow-up program, with the ultimate goal of classifying the >100 unidentified sources in the AGPS. Overall to date, 93 unidentified AGPS sources have been observed with Chandra as part of the ChIcAGO survey. A total of 253 X-ray point sources have been detected in these Chandra observations within 3′ of the original ASCA positions. We have identified infrared and optical counterparts to the majority of these sources, using both new observations and catalogs from existing Galactic plane surveys. X-ray and infrared population statistics for the X-ray point sources detected in the Chandra observations reveal that the primary populations of Galactic plane X-ray sources that emit in the Fx 10-13 to 10-11 erg cm -2 s-1 flux range are active stellar coronae, massive stars with strong stellar winds that are possibly in colliding wind binaries, X-ray binaries, and magnetars. There is also another primary population that is still unidentified but, on the basis of its X-ray and infrared properties, likely comprises partly Galactic sources and partly active galactic nuclei.Peer reviewedSubmitted Versio

Curcuminoid–BF2 complexes: Synthesis, fluorescence and optimization of BF2 group cleavage

Eight difluoroboron complexes of curcumin derivatives carrying alkyne groups containing substituents have been synthesized following an optimised reaction pathway. The complexes were received in yields up to 98% and high purities. Their properties as fluorescent dyes have been investigated. Furthermore, a strategy for the hydrolysis of the BF2 group has been established using aqueous methanol and sodium hydroxide or triethylamine

Influence of Insulin-like Growth Factor I (IGF-I) on the survival and the in vitro development of caprine preantral follicles

The aim of this study was to investigate the effects of the insulin-like growth factor -I (IGF-I) on survival, activation (transition from primordial to primary follicles) and growth of caprine preantral follicles cultured in vitro. Fragments of ovarian cortex were cultured for one and seven days in the absence or presence of IGF-I (0, 50 and 100ng/ml). The non-cultured and cultured tissues were processed and analyzed by histology and transmission electron microscopy. The culture for one day in a medium with 100ng/ml of IGF-I showed 86.7% of morphologically normal follicles. These results were similar (P>0.05) to the percentage of normal follicles found in the control (96.7%). It was also found that this medium increased the percentage of follicular activation (developing follicles) with one day of culture. The oocyte and follicular diameters remained similar to the control by culturing for one day in a medium containing 100ng/ml of IGF-I. The ultrastructural analysis did not confirm the integrity of the follicular fragments in a medium containing IGF-I (100ng/ml) after one and seven days of culture. In conclusion, this study demonstrated that the addition of 100 ng/ml of IGF-I in the culture medium enables the development of preantral follicles of goats with one day of culture. However, it is not sufficient to maintain the follicular integrity and the follicular survival rate after seven days of culture.O objetivo do presente estudo foi investigar os efeitos do fator de crescimento semelhante a insulina-I (IGF-I) na sobrevivência, ativação (transição de folículos primordiais para primários) e crescimento de folículos pré-antrais caprinos cultivados in vitro. Fragmentos de córtex ovariano foram cultivados por um e sete dias na ausência ou presença de IGF-I (0, 50 e 100ng/mL). Os tecidos não cultivados e cultivados foram processados e analisados por histologia e microscopia eletrônica de transmissão. O cultivo por um dia em meio com 100ng/mL de IGF-I apresentou 86,7% de folículos morfologicamente normais. Estes resultados foram semelhantes (P>0,05) ao percentual de folículos normais encontrados no controle (96,7%). Verificou-se ainda que este meio aumentou o percentual de ativação folicular (folículos em desenvolvimento) com um dia de cultivo. Os diâmetros ovocitário e folicular mantiveram-se semelhantes ao controle ao cultivar por um dia em meio contendo 100ng/mL de IGF-I. As análises ultraestruturais não confirmaram a integridade folicular dos fragmentos em meio contendo IGF-I (100 ng/mL) após um e sete dias de cultivo. Em conclusão, esse estudo demonstrou que a adição de 100 ng/mL de IGF-I no meio de cultivo ativa o desenvolvimento de folículos pré-antrais de caprinos com um dia de cultivo. Entretanto, não é suficiente para manter a integridade folicular e a taxa de sobrevivência folicular após sete dias de cultivo

Modulational Instability in Equations of KdV Type

It is a matter of experience that nonlinear waves in dispersive media, propagating primarily in one direction, may appear periodic in small space and time scales, but their characteristics --- amplitude, phase, wave number, etc. --- slowly vary in large space and time scales. In the 1970's, Whitham developed an asymptotic (WKB) method to study the effects of small "modulations" on nonlinear periodic wave trains. Since then, there has been a great deal of work aiming at rigorously justifying the predictions from Whitham's formal theory. We discuss recent advances in the mathematical understanding of the dynamics, in particular, the instability of slowly modulated wave trains for nonlinear dispersive equations of KdV type.Comment: 40 pages. To appear in upcoming title in Lecture Notes in Physic

No Evidence for Circulating Retina Specific Autoreactive T-cells in Latent Tuberculosis-associated Uveitis and Sarcoid Uveitis

Purpose: To detect circulating retina-specific autoreactive CD4+ T-cells and antiretinal antibodies (ARA) in latent tuberculosis (TB)-associated uveitis or sarcoid uveitis patients. Methods: The presence of crude retinal extract (RE) autoreactive CD4+ T-cells was determined by a highly sensitive flowcytometric-based technique examining co-expression of CD25 and CD134 (OX40) on RE stimulated PBMC. The presence of ARA in available matched serum samples was assessed by indirect immunofluorescence. Results: No autoreactive CD4+ T-cells against RE could be detected in either latent TB-associated uveitis or sarcoid uveitis patients, while ARA were detected in the serum of the majority (5/6) of latent TB-associated uveitis and all (3/3) sarcoid uveitis patients. Conclusion: Even with the use of this highly sensitive flowcytometric technique circulating retina-specific autoreactive CD4+ T-cells could not be detected. In contrast, ARA were detected in the majority of patients indicating an adaptive humoral immune response toward retinal antigens had occurred