Characterization of Mentorship Programs in Departments of Surgery in the United States

Importance Mentorship is considered a key element for career satisfaction and retention in academic surgery. Stakeholders of an effective mentorship program should include the mentor, the mentee, the department, and the institution. Objective The objective of this study was to characterize the status of mentorship programs in departments of surgery in the United States, including the roles of all 4 key stakeholders, because to our knowledge, this has never been done. Design, Setting, and Participants A survey was sent to 155 chairs of departments of surgery in the United States in July 2014 regarding the presence and structure of the mentorship program in their department. The analysis of the data was performed in November 2014 and December 2014. Main Outcomes and Measures Presence and structure of a mentorship program and involvement of the 4 key stakeholders. Results Seventy-six of 155 chairs responded to the survey, resulting in a 49% response rate. Forty-one of 76 of department chairs (54%) self-reported having an established mentorship program. Twenty-five of 76 departments (33%) described no formal or informal pairing of mentors with mentees. In 62 (82%) and 59 (78%) departments, no formal training existed for mentors or mentees, respectively. In 42 departments (55%), there was no formal requirement for the frequency of scheduled meetings between the mentor and mentee. In most departments, mentors and mentees were not required to fill out evaluation forms, but when they did, 28 of 31 were reviewed by the chair (90%). In 70 departments (92%), no exit strategy existed for failed mentor-mentee relationships. In more than two-thirds of departments, faculty mentoring efforts were not recognized formally by either the department or the institution, and only 2 departments (3%) received economic support for the mentoring program from the institution. Conclusions and Relevance These data show that only half of departments of surgery in the United States have established mentorship programs, and most are informal, unstructured, and do not involve all of the key stakeholders. Given the importance of mentorship to career satisfaction and retention, development of formal mentorship programs should be considered for all academic departments of surgery

Genes in glucose metabolism and association with spina bifida.

The authors test single nucleotide polymorphisms (SNPs) in coding sequences of 12 candidate genes involved in glucose metabolism and obesity for associations with spina bifida. Genotyping was performed on 507 children with spina bifida and their parents plus anonymous control DNAs from Hispanic and Caucasian individuals. The transmission disequilibrium test was performed to test for genetic associations between transmission of alleles and spina bifida in the offspring (P \u3c .05). A statistically significant association between Lys481 of HK1 (G allele), Arg109Lys of LEPR (G allele), and Pro196 of GLUT1 (A allele) was found ( P = .019, .039, and .040, respectively). Three SNPs on 3 genes involved with glucose metabolism and obesity may be associated with increased susceptibility to spina bifida

Nanoscopic diffusion of water on a topological insulator.

The microscopic motion of water is a central question, but gaining experimental information about the interfacial dynamics of water in fields such as catalysis, biophysics and nanotribology is challenging due to its ultrafast motion, and the complex interplay of inter-molecular and molecule-surface interactions. Here we present an experimental and computational study of the nanoscale-nanosecond motion of water at the surface of a topological insulator (TI), Bi[Formula: see text]Te[Formula: see text]. Understanding the chemistry and motion of molecules on TI surfaces, while considered a key to design and manufacturing for future applications, has hitherto been hardly addressed experimentally. By combining helium spin-echo spectroscopy and density functional theory calculations, we are able to obtain a general insight into the diffusion of water on Bi[Formula: see text]Te[Formula: see text]. Instead of Brownian motion, we find an activated jump diffusion mechanism. Signatures of correlated motion suggest unusual repulsive interactions between the water molecules. From the lineshape broadening we determine the diffusion coefficient, the diffusion energy and the pre-exponential factor.Blavatnik Foundation TU Graz Open Access Publishing Fund Aarhus University Research Foundation VILLUM FONDEN SPP1666 of the DFG (Grant No. HO 5150/1-2) FWF (Austrian Science Fund) within the projects J3479-N20 and P29641-N36 Ramón Areces foundation the Center of Materials Crystallography (CMC) Danish National Research Foundation (DNRF93

Reading for Charles Burchfield

Featuring poets who participated in the March 8th Heat Waves in a Swamp workshop

Monitoring of alcohol consumption in primary care among adults with bipolar disorder:A cross-sectional and retrospective cohort study

BACKGROUND: Screening for alcohol use disorders is an important priority in the healthcare of people with bipolar disorder, incentivised in UK primary care since 2011, through the Quality and Outcomes Framework (QOF). The extent of alcohol monitoring in primary care, and impact of QOF, is unknown. The aim was to examine recording of alcohol consumption in primary care.  METHODS: Poisson regression of biennial alcohol recording rates between 2000 and 2013 among 14,051 adults with bipolar disorder and 90,023 adults without severe mental illness (SMI), from 484 general practices contributing to The Health Improvement Network UK-wide primary care database.  RESULTS: Alcohol recording rates among people with bipolar disorder increased from 88.6 records per 1000 person-years (95% confidence interval 81.2-96.6) in 2000/2002 to 837.4 records per 1000 person-years (817.4-858.0) in 2011/2013; a more than nine-fold increase, mainly occurring after the introduction of the QOF incentive in 2011. In 2000/2002 alcohol recording levels among people with bipolar disorder were not statistically significantly different from those without SMI (adjusted rate ratio 0.96, 0.88-1.05). By 2011/2013, people with bipolar disorder were over four times as likely to have an alcohol record: adjusted rate ratio 4.45 (4.15-4.77).  LIMITATIONS: The routinely collected data may be incomplete. Alcohol data entered as free-text was not captured.  CONCLUSIONS: The marked rise in alcohol consumption recording highlights what can be achieved. It is most likely attributable to QOF, suggesting that QOF, or similar schemes, can be powerful tools in promoting aspects of healthcare

Erratum: "Rotation, spectral variability, magnetic geometry and magnetosphere of the Of?p star CPD -28° 2561"

Este documento es una errata de "Rotation, spectral variability, magnetic geometry and magnetosphere of the Of?p star CPD -28° 2561" (ver documento relacionado).Instituto de Astrofísica de La Plat

Self-reported neurological symptoms in relation to CO emissions due to problem gas appliance installations in London: a cross-sectional survey

Background: Previous research by the authors found evidence that up to 10% of particular household categories may be exposed to elevated carbon monoxide (CO) concentrations from poor quality gas appliance installations. The literature suggests certain neurological symptoms are linked to exposure to low levels of CO. This paper addresses the hypothesis that certain self-reported neurological symptoms experienced by a householder are linked to an estimate of their CO exposure.Methods: Between 27 April and 27 June 2006, 597 homes with a mains supply of natural gas were surveyed, mainly in old, urban areas of London. Qualified gas engineers tested all gas appliances (cooker, boiler, gas fire, and water heater) and reported, according to the Gas Industry Unsafe Situations Procedure, appliances considered At Risk (AR), Immediately Dangerous (ID) or Not to Current Standards (NCS). Five exposure risk categories were defined based on measurement of CO emitted by the appliance, its features and its use, with "high or very high" exposure category where occupants were considered likely to be exposed to levels greater than 26 ppm for one hour. The prevalence of symptoms at each level of exposure was compared with that at lowest level of exposure.Results: Of the households, 6% were assessed as having a "high or very high" risk of exposure to CO. Of the individuals, 9% reported at least one neurological symptom. There was a statistically significant association between "high or very high" exposure risk to CO and self-reported symptoms compared to "no exposure" likelihood, for households not in receipt of benefit, controlling for "number of residents" and presence of pensioners, OR = 3.23 (95% CI: 1.28, 8.15). Risk ratios across all categories of exposure likelihood indicate a dose-response pattern. Those households in receipt of benefit showed no dose-response pattern.Conclusion: This study found an association between risk of CO exposure at low concentration, and prevalence of self-reported neurological symptoms in the community for those households not in receipt of benefit. As health status was self-reported, this association requires further investigation

Rotation, spectral variability, magnetic geometry and magnetosphere of the Of?p star CPD -28° 2561

We report magnetic and spectroscopic observations and modelling of the Of?p star CPD-28° 2561. Using more than 75 new spectra, we have measured the equivalent width variations and examined the dynamic spectra of photospheric and wind-sensitive spectral lines. A period search results in an unambiguous 73.41 d variability period. High-resolution spectropolarimetric data analysed using least-squares deconvolution yield a Zeeman signature detected in the mean Stokes V profile corresponding to phase 0.5 of the spectral ephemeris. Interpreting the 73.41 d period as the stellar rotational period, we have phased the equivalent widths and inferred longitudinal field measurements. The phased magnetic data exhibit a weak sinusoidal variation, with maximum of about 565 G at phase 0.5, and a minimum of about -335 G at phase 0.0, with extrema approximately in phase with the (double-wave) Hα equivalent width variation. Modelling of the Hα equivalent width variation assuming a quasi-3D magnetospheric model produces a unique solution for the ambiguous couplet of inclination and magnetic obliquity angles: (i, β) or (β, i) = (35°, 90°). Adopting either geometry, the longitudinal field variation yields a dipole polar intensity Bd = 2.6 ± 0.9 kG, consistent with that obtained from direct modelling of the Stokes V profiles. We derive a wind magnetic confinement parameter η* ≃ 100, leading to an Alfvén radius RA ≃ 3-5R*, and a Kepler radius RK ≃ 20R*. This supports a physical scenario in which the Hα emission and other line variability have their origin in an oblique, corotating 'dynamical magnetosphere' structure resulting from a magnetically channelled wind. Nevertheless, the details of the formation of spectral lines and their variability within this framework remain generally poorly understood.Este documento tiene una corrección (ver documento relacionado).Instituto de Astrofísica de La Plat

Rotation, spectral variability, magnetic geometry and magnetosphere of the Of?p star CPD -28° 2561

We report magnetic and spectroscopic observations and modelling of the Of?p star CPD-28° 2561. Using more than 75 new spectra, we have measured the equivalent width variations and examined the dynamic spectra of photospheric and wind-sensitive spectral lines. A period search results in an unambiguous 73.41 d variability period. High-resolution spectropolarimetric data analysed using least-squares deconvolution yield a Zeeman signature detected in the mean Stokes V profile corresponding to phase 0.5 of the spectral ephemeris. Interpreting the 73.41 d period as the stellar rotational period, we have phased the equivalent widths and inferred longitudinal field measurements. The phased magnetic data exhibit a weak sinusoidal variation, with maximum of about 565 G at phase 0.5, and a minimum of about -335 G at phase 0.0, with extrema approximately in phase with the (double-wave) Hα equivalent width variation. Modelling of the Hα equivalent width variation assuming a quasi-3D magnetospheric model produces a unique solution for the ambiguous couplet of inclination and magnetic obliquity angles: (i, β) or (β, i) = (35°, 90°). Adopting either geometry, the longitudinal field variation yields a dipole polar intensity Bd = 2.6 ± 0.9 kG, consistent with that obtained from direct modelling of the Stokes V profiles. We derive a wind magnetic confinement parameter η* ≃ 100, leading to an Alfvén radius RA ≃ 3-5R*, and a Kepler radius RK ≃ 20R*. This supports a physical scenario in which the Hα emission and other line variability have their origin in an oblique, corotating 'dynamical magnetosphere' structure resulting from a magnetically channelled wind. Nevertheless, the details of the formation of spectral lines and their variability within this framework remain generally poorly understood.Este documento tiene una corrección (ver documento relacionado).Instituto de Astrofísica de La Plat

A Core Outcome Set for the prevention and treatment of fetal GROwth restriction: deVeloping Endpoints: the COSGROVE study.

BACKGROUND: Fetal growth restriction refers to a fetus that does not reach its genetically predetermined growth potential. It is well-recognized that growth-restricted fetuses are at increased risk of both short- and long-term adverse outcomes. Systematic evaluation of the evidence from clinical trials of fetal growth restriction is often difficult because of variation in the outcomes that are measured and reported. The development of core outcome sets for fetal growth restriction studies would enable future trials to measure similar meaningful outcomes. OBJECTIVE: The purpose of this study was to develop core outcome sets for trials of prevention or treatment of fetal growth restriction. STUDY DESIGN: This was a Delphi consensus study. A comprehensive literature review was conducted to identify outcomes that were reported in studies of prevention or treatment of fetal growth restriction. All outcomes were presented for prioritization to key stakeholders (135 healthcare providers, 68 researchers/academics, and 35 members of the public) in 3 rounds of online Delphi surveys. A priori consensus criteria were used to reach agreement on the final outcomes for inclusion in the core outcome set at a face-to-face meeting with 5 healthcare providers, 5 researchers/academics, and 6 maternity service users. RESULTS: In total, 22 outcomes were included in the final core outcome set. These outcomes were grouped under 4 domains: maternal (n=4), fetal (n=1), neonatal (n=12), and childhood (n=5). CONCLUSION: The Core Outcome Set for the prevention and treatment of fetal GROwth restriction: deVeloping Endpoints study identified a large number of potentially relevant outcomes and then reached consensus on those factors that, as a minimum, should be measured and reported in all future trials of prevention or treatment of fetal growth restriction. This will enable future trials to measure similar meaningful outcomes and to ensure that findings from different studies can be compared and combined