An audit of clinical training exposure amongst junior doctors working in Trauma & Orthopaedic Surgery in 101 hospitals in the United Kingdom.

BackgroundThere are concerns regarding early years' training for junior doctors in Trauma & Orthopaedic Surgery (T&O) in the United Kingdom. Our primary objective was to audit the clinical activities undertaken by junior doctors working in Trauma & Orthopaedic (T&O) surgery in the National Health Service (NHS) in a typical workweek. A secondary objective was to audit the clinical exposure of junior surgeons in training to the Joint Committee on Surgical Training (JCST) standards for minimum weekly clinical exposure in T&O surgery.MethodsWe recruited collaborators in 101 T&O surgery departments in NHS hospitals to participate in this study. Clinical activity diaries from 935 doctors working in T&O surgery in the 101 participating NHS hospitals were involved. All junior doctors covering the junior on call tier were included. Collaborators collected clinical activity data from 08:00 18/01/2015 to 20:00 22/01/2015. Clinical activities recorded in sessions (morning, afternoon, evening) depending on what activity that doctor undertook for the majority of that session. Clinical activities were grouped into operating theatre/room, outpatient clinic, on call, "not in work" (i.e. leave, sickness), teaching, and ward cover sessions. The weekly clinical activity of Core Surgical Trainees (CSTs) were analyzed in accordance to two JCST standards for minimum weekly clinical exposure.ResultsOverall, junior doctors working in T&O surgery attended a theatre list session 8.5% of the time, an outpatient clinic 3.2%, were on call 14.8%, a teaching session 1.7%, providing ward cover 34.6%, and on a zero session 20.7% of the time. Only 5% of core surgical trainees (n = 200) met both the JCST standards for minimum weekly clinical exposure in the specialty.ConclusionsJunior surgeons in training, working in Trauma & Orthopaedic surgery in the United Kingdom are not meeting the minimum weekly clinical sessions laid out by the JCST. Further work to develop models allowing for enhanced training experiences and improved clinical exposure to operating lists and outpatient clinics would be beneficial

Gynaecological issues in Adolescence Do Paediatricians and Paediatric Residents feel comfortable about it?

info:eu-repo/semantics/publishedVersio

Dand5 is involved in zebrafish tailbud cell movement

Funding Information: This work was supported by the Fundação para a Ciência e a Tecnologia (FCT-ANR/BEX-BID/0153/2012 research grant and by the Project LysoCil funded by the European Union Horizon 2020 research and innovation under grant agreement No. 811087. SSL was funded by an FCT CEEC contract for Principal Investigator reference 2018CEECIND/02170/2018 and CB was funded by a FCT SFRH/BD/141034/2018 PhD fellowship. NMS and IGC Fish Facilities were supported from the research infrastructure Congento, co-financed by Lisboa Regional Operational Programme (Lisboa 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF) and FCT under the project LISBOA-01-0145-FEDER-022170. Publisher Copyright: Copyright © 2023 Bota, Martins and Lopes.During vertebrate development, symmetry breaking occurs in the left-right organizer (LRO). The transfer of asymmetric molecular information to the lateral plate mesoderm is essential for the precise patterning of asymmetric internal organs, such as the heart. However, at the same developmental time, it is crucial to maintain symmetry at the somite level for correct musculature and vertebrae specification. We demonstrate how left-right signals affect the behavior of zebrafish somite cell precursors by using live imaging and fate mapping studies in dand5 homozygous mutants compared to wildtype embryos. We describe a population of cells in the vicinity of the LRO, named Non-KV Sox17:GFP+ Tailbud Cells (NKSTCs), which migrate anteriorly and contribute to future somites. We show that NKSTCs originate in a cluster of cells aligned with the midline, posterior to the LRO, and leave that cluster in a left-right alternating manner, primarily from the left side. Fate mapping revealed that more NKSTCs integrated somites on the left side of the embryo. We then abolished the asymmetric cues from the LRO using dand5−/− mutant embryos and verified that NKSTCs no longer displayed asymmetric patterns. Cell exit from the posterior cluster became bilaterally synchronous in dand5−/− mutants. Our study revealed a new link between somite specification and Dand5 function. The gene dand5 is well known as the first asymmetric gene involved in vertebrate LR development. This study revealed a new link for Dand5 as a player in cell exit from the maturation zone into the presomitic mesoderm, affecting the expression patterns of myogenic factors and tail size.publishersversionpublishe

Hypereosinophilia and Severe Bone Disease in an African Child: An Unexpected Diagnosis

Hypereosinophilic syndromes are rare in children. Sporadic, mild-severity FIP1L1-platelet-derived growth factor receptor α (PDGFRα) rearrangement cases have been reported, mainly in boys. We present the case of a 5-year-old girl referred from her African country of birth, due to severe constitutional symptoms, multifocal bone pain, headache, gastrointestinal complaints, cardiomyopathy and unexplained hypereosinophilia. She presented multiple end-organ diseases and striking bone involvement. Although she had a positive serology for Strongyloides stercoralis, extensive evaluation detected a FIP1L1-PDGFRA fusion gene. Systemic corticosteroids and low-dose imatinib were started and the child became asymptomatic. After 9 months of treatment, FIP1L1-PDGFRA was no longer detected.info:eu-repo/semantics/publishedVersio

Composite web search

The figure above shows Google’s results page for the query “taylor swift”, captured in March 2016. Assembled around the long-established list of search results is content extracted from various source — news items and tweets merged within the results ranking, images, songs and social media profiles displayed to the right of the ranking, in an interface element that is known as an entity card. Indeed, the entire page seems more like an assembly of content extracted from various sources, rather than just a ranked list of blue links. Search engine result pages have become increasingly diverse over the past few years, with most commercial web search providers responding to user queries with different types of results, merged within a unified page. The primary reason for this diversity on the results page is that the web itself has become more diverse, given the ease with which creating and hosting different types of content on the web is possible today. This thesis investigates the aggregation of web search results retrieved from various document sources (e.g., images, tweets, Wiki pages) within information “objects” to be integrated in the results page assembled in response to user queries. We use the terms “composite objects” or “composite results” to refer to such objects, and throughout this thesis use the terminology of Composite Web Search (e.g., result composition) to distinguish our approach from other methods of aggregating diverse content within a unified results page (e.g., Aggregated Search). In our definition, the aspects that differentiate composite information objects from aggregated search blocks are that composite objects (i) contain results from multiple sources of information, (ii) are specific to a common topic or facet of a topic rather than a grouping of results of the same type, and (iii) are not a uniform ranking of results ordered only by their topical relevance to a query. The most widely used type of composite result in web search today is the entity card. Entity cards have become extremely popular over the past few years, with some informal studies suggesting that entity cards are now shown on the majority of result pages generated by Google. As composite results are used more and more by commercial search engines to address information needs directly on the results page, understanding the properties of such objects and their influence on searchers is an essential aspect of modern web search science. The work presented throughout this thesis attempts the task of studying composite objects by exploring users’ perspectives on accessing and aggregating diverse content manually, by analysing the effect composite objects have on search behaviour and perceived workload, and by investigating different approaches to constructing such objects from diverse results. Overall, our experimental findings suggest that items which play a central role within composite objects are decisive in determining their usefulness, and that the overall properties of composite objects (i.e., relevance, diversity and coherence) play a combined role in mediating object usefulness

Potensi Senyawa Minyak Sereh Wangi (Citronella Oil) Dari Tumbuhan Cymbopogon Nardus L. Sebagai Agen Antibakteri

Bakteri merupakan salah satu mikroorganisme yang secara alami terdapat pada tubuh manusia sehat dan normal, namun pada kondisi tertentu bakteri akan menjadi patogenik. Potensi patogenik bakteri dipengaruhi oleh beberapa faktor, antara lain: lemahnya imunitas tubuh inang (manusia), ukuran patogenitas bakteri (virulensi), dan jumlah bakteri yang mencapai quorum. Penyakit yang disebabkan oleh bakteri patogenik pada manusia merupakan salah satu masalah yang sering ditemui di kehidupan masyarakat. Pola hidup yang tidak teratur, kebersihan makanan dan minuman serta sanitasi lingkungan sangat mendukung untuk seseorang terinfeksi bakteri patogenik. Penggunaan antibiotika adalah salah satu cara yang dilakukan oleh manusia untuk mengobati penyakit akibat infeksi bakteri. Penggunaan antibiotika yang berlebihan dan pemberian dalam jangka waktu yang lama dapat menyebabkan terjadinya resistensi pada bakteri. Senyawa alam yang diperoleh dari tanaman yang berpotensi sebagai zat aktif digunakan untuk menggantikan antibiotika sintesis. Sereh wangi penghasil minyak atsiri Citronella Oil menjadi salah satu komoditas senyawa aktif yang dapat dijadikan sebagai sumber senyawa aktif dari alam yang berpotensi sebagai antibakteri. Sitronellal, geraniol, dan sitronellol adalah kandungan utama pada minyak sereh wangi yang dapat digunakan sebagai antibakteri