Prediction of success at UK Specialty Board Examinations using the mandatory postgraduate UK surgical examination

Acknowledgements The authors acknowledge I. Targett from the Royal College of Surgeons of England and J. Wylie from the Joint Committee on Intercollegiate Examinations for their help with data collection, and both L. Smith and G. Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project. This study was funded by the Royal Colleges of Surgeons of England, Ireland and Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow. Disclosure: The authors declare no conflict of interest..Peer reviewedPublisher PD

Impact of performance in a mandatory postgraduate surgical examination on selection into specialty training

Acknowledgements The authors acknowledge I. Targett from the Royal College of Surgeons of England for his help with data collection, and both L. Smith and G. Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project. This study was funded by the Royal Colleges of Surgeons of England, Ireland and Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow.Peer reviewedPublisher PD

Unified analysis of terminal-time control in classical and quantum systems

Many phenomena in physics, chemistry, and biology involve seeking an optimal control to maximize an objective for a classical or quantum system which is open and interacting with its environment. The complexity of finding an optimal control for maximizing an objective is strongly affected by the possible existence of sub-optimal maxima. Within a unified framework under specified conditions, control objectives for maximizing at a terminal time physical observables of open classical and quantum systems are shown to be inherently free of sub-optimal maxima. This attractive feature is of central importance for enabling the discovery of controls in a seamless fashion in a wide range of phenomena transcending the quantum and classical regimes.Comment: 10 page

Acoustic risk balancing by marine mammals : anthropogenic noise can influence the foraging decisions by seals

Funding: Natural Environment Research Council (Grant Number(s): NE/J004251/1, NE/R015007/1)1. Avoidance of anthropogenic sounds has been measured in many species. The results, which are typically based on observations in limited exposure contexts, are frequently used to inform policy and the regulation of industrial activities. However, the occurrence and magnitude of avoidance may be a consequence of complex risk-balancing decisions made by animals. The importance of the factors in decision-making, such as perceived risks associated with the sounds or prey quantity and quality during sound exposure, is unknown. 2. Here we address this knowledge gap by measuring the relative influence of perceived –risk of a sound (silence, pile driving, and a tidal turbine) and prey patch quality on decision-making and foraging success in grey seals Halichoerus grypus. 3. Seals were given access to two underwater ‘prey patches’ in an experimental pool where fish were delivered at controlled rates to simulate a low-density (LD) and a high-density (HD) prey patch. Acoustic playbacks were made using an underwater speaker above one of the prey patches (randomised during the study), and three decision and foraging metrics (foraging duration, foraging effort allocation between the prey patches, and foraging success) were measured. 4. Foraging success was highest during silent controls and was similar regardless of speaker location (LD/HD). Under the tidal turbine and pile-driving treatments, foraging success was similar to the controls when the speaker was located at the HD prey patch but was significantly reduced (~16%–28% lower) when the speaker was located at the LD prey patch. Foraging decisions by the seals were consistent with a risk/profit balancing approach. Avoidance rates depend on the quality of the prey patch as well as the perceived risk. 5. Policy implications. The results suggest that foraging context is important when interpreting avoidance behaviour and should be considered when predicting the effects of anthropogenic activities. For example, sound exposure in different prey patch qualities may result in markedly different avoidance behaviour, potentially leading to contrasting predictions of impact in Environmental Assessments. We recommend future studies explicitly consider foraging context, and other contextual factors such as behavioural state (e.g. foraging or travelling) and habitat quality.Publisher PDFPeer reviewe

Hydrolysis optimization and characterization study of preparing fatty acids from Jatropha curcas seed oil

<p>Abstract</p> <p>Background</p> <p>Fatty acids (FAs) are important as raw materials for the biotechnology industry. Existing methods of FAs production are based on chemical methods. In this study potassium hydroxide (KOH)-catalyzed reactions were utilized to hydrolysis <it>Jatropha curcas </it>seed oil.</p> <p>Results</p> <p>The parameters effect of ethanolic KOH concentration, reaction temperature, and reaction time to free fatty acid (FFA%) were investigated using D-Optimal Design. Characterization of the product has been studied using Fourier transforms infrared spectroscopy (FTIR), gas chromatography (GC) and high performance liquid chromatography (HPLC). The optimum conditions for maximum FFA% were achieved at 1.75M of ethanolic KOH concentration, 65°C of reaction temperature and 2.0 h of reaction time.</p> <p>Conclusions</p> <p>This study showed that ethanolic KOH concentration was significant variable for <it>J. curcas </it>seed oil hydrolysis. In a 18-point experimental design, FFA% of hydrolyzed <it>J. curcas </it>seed oil can be raised from 1.89% to 102.2%, which proved by FTIR and HPLC.</p

Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review

Background: Q fever is a common cause of febrile illness and community-acquired pneumonia in resource-limited settings. Coxiella burnetii, the causative pathogen, is transmitted among varied host species, but the epidemiology of the organism in Africa is poorly understood. We conducted a systematic review of C. burnetii epidemiology in Africa from a “One Health” perspective to synthesize the published data and identify knowledge gaps.&lt;p&gt;&lt;/p&gt; Methods/Principal Findings: We searched nine databases to identify articles relevant to four key aspects of C. burnetii epidemiology in human and animal populations in Africa: infection prevalence; disease incidence; transmission risk factors; and infection control efforts. We identified 929 unique articles, 100 of which remained after full-text review. Of these, 41 articles describing 51 studies qualified for data extraction. Animal seroprevalence studies revealed infection by C. burnetii (&#8804;13%) among cattle except for studies in Western and Middle Africa (18–55%). Small ruminant seroprevalence ranged from 11–33%. Human seroprevalence was &#60;8% with the exception of studies among children and in Egypt (10–32%). Close contact with camels and rural residence were associated with increased seropositivity among humans. C. burnetii infection has been associated with livestock abortion. In human cohort studies, Q fever accounted for 2–9% of febrile illness hospitalizations and 1–3% of infective endocarditis cases. We found no studies of disease incidence estimates or disease control efforts.&lt;p&gt;&lt;/p&gt; Conclusions/Significance: C. burnetii infection is detected in humans and in a wide range of animal species across Africa, but seroprevalence varies widely by species and location. Risk factors underlying this variability are poorly understood as is the role of C. burnetii in livestock abortion. Q fever consistently accounts for a notable proportion of undifferentiated human febrile illness and infective endocarditis in cohort studies, but incidence estimates are lacking. C. burnetii presents a real yet underappreciated threat to human and animal health throughout Africa.&lt;p&gt;&lt;/p&gt

The Many Faces of Fear: Comparing the Pathways and Impacts of Nonconsumptive Predator Effects on Prey Populations

Background: Most ecological models assume that predator and prey populations interact solely through consumption: predators reduce prey densities by killing and consuming individual prey. However, predators can also reduce prey densities by forcing prey to adopt costly defensive strategies. Methodology/Principal Findings: We build on a simple Lotka-Volterra predator-prey model to provide a heuristic tool for distinguishing between the demographic effects of consumption (consumptive effects) and of anti-predator defenses (nonconsumptive effects), and for distinguishing among the multiple mechanisms by which anti-predator defenses might reduce prey population growth rates. We illustrate these alternative pathways for nonconsumptive effects with selected empirical examples, and use a meta-analysis of published literature to estimate the mean effect size of each pathway. Overall, predation risk tends to have a much larger impact on prey foraging behavior than measures of growth, survivorship, or fecundity. Conclusions/Significance: While our model provides a concise framework for understanding the many potential NCE pathways and their relationships to each other, our results confirm empirical research showing that prey are able to partially compensate for changes in energy income, mitigating the fitness effects of defensive changes in time budgets. Distinguishing the many facets of nonconsumptive effects raises some novel questions, and will help guide both empirica

Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant

<p>Abstract</p> <p>Background</p> <p>'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity.</p> <p>Methods</p> <p>Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours.</p> <p>Results</p> <p>The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively.</p> <p>Conclusion</p> <p>This study indicates preliminary support for the validity of the caring for country concept and a questionnaire designed to measure it. This study also highlights the importance of investigating Indigenous-asserted health promotion activities. Further studies in similar populations are merited to test the generalisability of this questionnaire and to explore associations with other important Indigenous health outcomes.</p

Reduced total energy expenditure and physical activity in cachectic patients with pancreatic cancer can be modulated by an energy and protein dense oral supplement enriched with n-3 fatty acids

The aim of the study was to assess the total energy expenditure (TEE), resting energy expenditure (REE) and physical activity level (PAL) in home-living cachectic patients with advanced pancreatic cancer. The influence of an energy and protein dense oral supplement either enriched with or without the n-3 fatty acid eicosapentaenoic acid (EPA) and administered over an 8-week period was also determined. In total, 24 patients were studied at baseline. The total energy expenditure was measured using doubly labelled water and REE determined by indirect calorimetry. Patients were studied at baseline and then randomised to either oral nutritional supplement. Measurements were repeated at 8 weeks. At baseline, REE was increased compared with predicted values for healthy individuals (1387(42) vs 1268(32) kcal day-1, P=0.001), but TEE (1732(82) vs 1903(48) kcal day-1, P=0.023) and PAL (1.24(0.04) vs 1.50) were reduced. After 8 weeks, the REE, TEE and PAL of patients who received the control supplement did not change significantly. In contrast, although REE did not change, TEE and PAL increased significantly in those who received the n-3 (EPA) enriched supplement. In summary, patients with advanced pancreatic cancer were hypermetabolic. However, TEE was reduced and this was secondary to a reduction in physical activity. The control energy and protein dense oral supplement did not influence the physical activity component of TEE. In contrast, administration of the supplement enriched with EPA was associated with an increase in physical activity, which may reflect improved quality of life