Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Servitude et grandeur militaires

Ġabra ta’ poeżiji u proża li tinkludi: Notturn op. 9 nru 2 ta’ Beverly Agius – Naf ta’ Carmel Azzopardi – Ħsejjes ħajja ta’ Clifton Azzopardi – Il-ġrajja t’għasfur stramb ta’ Mario Azzopardi – Tektik...u għana ta’ Rena Balzan – Kun af li f’qiegħ għajnejk ta’ Charles Bezzina – Il-qalb imwebbsa ta’ Ġorġ Borg – Bħal ħuta mġewħa ta’ Louis Briffa – Taħt il-Mezquita, Cordòba ta’ Norbert Bugeja – Il-maskarat ta’ Alfred Degabriele – Trid mara ta’ Leanne Ellul – Id-dgħajsa ta’ Victor Fenech – Ilħna ta’ Joe Friggieri – Roulette ta’ Joe Friggieri – Għera ta’ Joe P. Galea – Ħġieġa ta’ Maria Grech Ganado – Ġenna qatt mirbuħa ta’ Karmenu Mallia – Il-fantażma tal-mara mqarba ta’ Albert Marshall – Daħlet Qorrot ta’ Daniel Massa – Granada, parque central ta’ Immanuel Mifsud – Waħda mara ta’ Immanuel Mifsud – Mors ta’ Therese Pace – Għada ta’ Alfred Palma – Emmint xejn ma jintemm ta’ Ġorġ Peresso – Tuffieħa bl-imsiemer tal-qronfol ta’ John Peter Portelli – Lil Karmenu Vassallo ta’ Andrew Sciberras – Irrid il-qamar jiddi ta’ Carmel Scicluna – Din il-biċċa ħuta ta’ Steve Borg – Karta li taret mar-riħ ta’ Lina Brockdorff – Nixtieq, u kemm nixtieq! ta’ J. J. Camilleri – Caterina ta’ Sandro Mangion – L-għajta tal-pappagall ta’ Pierre J. Mejlak – Id-destin ta’ Laurence Mizzi – L-arloġġ tal-bozza ta’ Rita Saliba – Kurżità ta’ Alfred Sant – Il-ġeneral ta’ Vincent Vella – Mirja ta’ Trevor Żahra – L-adulteri ta’ Golan Haji, traduzzjoni ta’ Clare Azzopardi u Albert Gatt – L-istennija ta’ Berislav Blagojević, traduzzjoni ta’ Kit Azzopardi – Il-qattus ta’ Ghassan Kanafani, traduzzjoni ta’ Walid Nabhan – L-iben addottat ta’ Guy de Maupassant, traduzzjoni ta’ Josette Attard – Sunett nru. 18 ta’ William Shakespeare, traduzzjoni ta’ Alfred Palma – Llanto por Ignacio Sánchez Mejías ta’ Federico Garcia Lorca, traduzzjoni ta’ Therese Pace – Servitude et grandeur militaires ta’ Alfred de Vigny, traduzzjoni ta’ Paul Zahra.peer-reviewe

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Divergence among an international population of Trichophyton tonsurans isolates

Trichophyton tonsurans is a widely distributed pathogen that demonstrates a significant degree of genetic and phenetic heterogeneity. To date, the degree of genetic relatedness among geographically segregated isolates has not been explored. This investigation evaluates the extent of genetic variation among an international population of T. tonsurans isolates and examines the relatedness of isolates within and between countries. Molecular strain typing was performed on 198 isolates obtained from 14 countries. A mixed-marker strategy utilizing 27 sequence variations in 13 gene loci was applied to all isolates and cluster analysis was performed to examine the relationship between strains. Phylogenetic analysis was used to corroborate the findings of the cluster analysis with T. equinum strains serving as an out-group. In total, 47 distinct strain types were identified represented by seven clusters and one singleton. There appeared to be a moderate degree of clustering among isolates obtained from North America, Asia and Australia, although European isolates were uniformly distributed among the majority of clusters. The degree of genetic variation observed in this study coupled with the geographic localization would support the argument for allopatric divergence within this species. © Springer Science+Business Media B.V. 2009