581 research outputs found
Survey of self-assessed preparedness for clinical practice in one Croatian medical school
<p>Abstract</p> <p>Background</p> <p>The Croatian higher education system is in the process of reforming its medical curricula to comply with European Union standards. We conducted a survey of students enrolled at the University of Zagreb (Croatia) asking them to rate their perception of preparedness for clinical practice prior to initiation of the reform process. The purpose of the survey was to identify self-perceived deficiencies in education and to establish a reference point for the later assessment of ongoing educational reform.</p> <p>Findings</p> <p>One-hundred and forty seven (N = 147) graduates reported the levels of perceived preparedness on 30 items grouped into 8 educational domains. Main domains were: understanding science, practical skills/patient management, holistic care, prevention, interpersonal skills, confidence/coping skills, collaboration, and self-directed learning. For each item, graduates self assessed their preparedness on a scale ranging from 1 to 4, with 1 = "Very inadequate", 2 = "Somewhat inadequate", 3 = "Somewhat adequate", and 4 = "Very adequate". In 7 out of 8 domains the achieved median score was ≥ 3. Students expressed low confidence (defined when ≥ 25% of respondents supplied a rating for the survey question as: "very inadequate" or "somewhat inadequate") with interpersonal skills (discussing terminal disease, counseling distraught patients, balancing professional and personal life), and in performing certain basic semi-invasive or invasive procedures.</p> <p>Conclusion</p> <p>Zagreb medical graduates identified several deficiencies within educational domains required for standard clinical practice. Ongoing educational efforts need to be directed towards the correction of these deficiencies in order to achieve standards required by the European Union.</p
Polarization and relaxation of radon
Investigations of the polarization and relaxation of Rn by spin
exchange with laser optically pumped rubidium are reported. On the order of one
million atoms per shot were collected in coated and uncoated glass cells.
Gamma-ray anisotropies were measured as a signal of the alignment (second order
moment of the polarization) resulting from the combination of polarization and
quadrupole relaxation at the cell walls. The temperature dependence over the
range 130C to 220C shows the anisotropies increasing with
increasing temperature as the ratio of the spin exchange polarization rate to
the wall relaxation rate increases faster than the rubidium polarization
decreases. Polarization relaxation rates for coated and uncoated cells are
presented. In addition, improved limits on the multipole mixing ratios of some
of the main gamma-ray transitions have been extracted. These results are
promising for electric dipole moment measurements of octupole-deformed
Rn and other isotopes, provided sufficient quantities of the rare
isotopes can be produced.Comment: 4 pages, 4 figure
Biological Effects Within No-Take Marine Reserves: A global Synthesis
The study and implementation of no-take marine reserves have increased rapidly over the past decade, providing ample data on the biological effects of reserve protection for a wide range of geographic locations and organisms. The plethora of new studies affords the opportunity to reevaluate previous findings and address formerly unanswered questions with extensive data syntheses. Our results show, on average, positive effects of reserve protection on the biomass, numerical density, species richness, and size of organisms within their boundaries which are remarkably similar to those of past syntheses despite a near doubling of data. New analyses indicate that (1) these results do not appear to be an artifact of reserves being sited in better locations; (2) results do not appear to be driven by displaced fishing effort outside of reserves; (3) contrary to often-made assertions, reserves have similar if not greater positive effects in temperate settings, at least for reef ecosystems; (4) even small reserves can produce significant biological responses irrespective of latitude, although more data are needed to test whether reserve effects scale with reserve size; and (5) effects of reserves vary for different taxonomic groups and for taxa with various characteristics, and not all species increase in response to reserve protection. There is considerable variation in the responses documented across all the reserves in our data set—variability which cannot be entirely explained by which species were studied. We suggest that reserve characteristics and context, particularly the intensity of fishing outside the reserve and inside the reserve before implementation, play key roles in determining the direction and magnitude of the reserve response. However, despite considerable variability, positive responses are far more common than no differences or negative responses, validating the potential for well designed and enforced reserves to serve as globally important conservation and management tools
Semi-parametric modeling of SARS-CoV-2 transmission in Orange County, California using tests, cases, deaths, and seroprevalence data
Mechanistic modeling of SARS-CoV-2 transmission dynamics and frequently
estimating model parameters using streaming surveillance data are important
components of the pandemic response toolbox. However, transmission model
parameter estimation can be imprecise, and sometimes even impossible, because
surveillance data are noisy and not informative about all aspects of the
mechanistic model. To partially overcome this obstacle, we propose a Bayesian
modeling framework that integrates multiple surveillance data streams. Our
model uses both SARS-CoV-2 diagnostics test and mortality time series to
estimate our model parameters, while also explicitly integrating seroprevalence
data from cross-sectional studies. Importantly, our data generating model for
incidence data takes into account changes in the total number of tests
performed. We model transmission rate, infection-to-fatality ratio, and a
parameter controlling a functional relationship between the true case incidence
and the fraction of positive tests as time-varying quantities and estimate
changes of these parameters nonparameterically. We apply our Bayesian data
integration method to COVID-19 surveillance data collected in Orange County,
California between March, 2020 and March, 2021 and find that 33-62% of the
Orange County residents experienced SARS-CoV-2 infection by the end of
February, 2021. Despite this high number of infections, our results show that
the abrupt end of the winter surge in January, 2021, was due to both behavioral
changes and a high level of accumulated natural immunity.Comment: 37 pages, 16 pages of main text, including 5 figures, 1 tabl
Experimental Models of Short Courses of Liposomal Amphotericin B for Induction Therapy for Cryptococcal Meningitis.
Cryptococcal meningoencephalitis is a rapidly lethal infection in immunocompromised patients. Induction regimens are usually administered for 2-weeks. The shortest effective period of induction therapy with liposomal amphotericin B (LAmB) is unknown. The pharmacodynamics of LAmB were studied in murine and rabbit models of cryptococcal meningoencephalitis. The concentrations of LAmB in plasma and brain of mice were measured using HPLC. Histopathological changes were determined. The penetration of LAmB into the brain was determined by immunohistochemistry using an antibody directed to amphotericin B. A dose-dependent decline in fungal burden was observed in the brain of mice with near-maximal efficacy achieved with LAmB 10-20 mg/kg/day. The terminal elimination half-life in brain was 133 hours. The pharmacodynamics of a single dose of 20 mg/kg was the same as 20 mg/kg/day administered for 2 weeks. Changes in quantitative counts were reflected by histopathological changes in the brain. Three doses of LAmB 5 mg/kg/day in rabbits were required to achieve fungicidal activity in cerebrospinal fluid (cumulative AUC 2500 mg.h/L). Amphotericin B was visible in the intra- and perivascular spaces, leptomeninges and choroid plexus. The prolonged mean residence time of amphotericin B in the brain suggest abbreviated induction regimens of LAmB are possible for cryptococcal meningoencephalitis
LSST Science Book, Version 2.0
A survey that can cover the sky in optical bands over wide fields to faint
magnitudes with a fast cadence will enable many of the exciting science
opportunities of the next decade. The Large Synoptic Survey Telescope (LSST)
will have an effective aperture of 6.7 meters and an imaging camera with field
of view of 9.6 deg^2, and will be devoted to a ten-year imaging survey over
20,000 deg^2 south of +15 deg. Each pointing will be imaged 2000 times with
fifteen second exposures in six broad bands from 0.35 to 1.1 microns, to a
total point-source depth of r~27.5. The LSST Science Book describes the basic
parameters of the LSST hardware, software, and observing plans. The book
discusses educational and outreach opportunities, then goes on to describe a
broad range of science that LSST will revolutionize: mapping the inner and
outer Solar System, stellar populations in the Milky Way and nearby galaxies,
the structure of the Milky Way disk and halo and other objects in the Local
Volume, transient and variable objects both at low and high redshift, and the
properties of normal and active galaxies at low and high redshift. It then
turns to far-field cosmological topics, exploring properties of supernovae to
z~1, strong and weak lensing, the large-scale distribution of galaxies and
baryon oscillations, and how these different probes may be combined to
constrain cosmological models and the physics of dark energy.Comment: 596 pages. Also available at full resolution at
http://www.lsst.org/lsst/sciboo
Inhibition of profibrotic microRNA-21 affects platelets and their releasate.
Fibrosis is a major contributor to organ disease for which no specific therapy is available. MicroRNA-21 (miR-21) has been implicated in the fibrogenetic response, and inhibitors of miR-21 are currently undergoing clinical trials. Here, we explore how miR-21 inhibition may attenuate fibrosis using a proteomics approach. Transfection of miR-21 mimic or inhibitor in murine cardiac fibroblasts revealed limited effects on extracellular matrix (ECM) protein secretion. Similarly, miR-21-null mouse hearts showed an unaltered ECM composition. Thus, we searched for additional explanations as to how miR-21 might regulate fibrosis. In plasma samples from the community-based Bruneck Study, we found a marked correlation of miR-21 levels with several platelet-derived profibrotic factors, including TGF-β1. Pharmacological miR-21 inhibition with an antagomiR reduced the platelet release of TGF-β1 in mice. Mechanistically, Wiskott-Aldrich syndrome protein, a negative regulator of platelet TGF-β1 secretion, was identified as a direct target of miR-21. miR-21-null mice had lower platelet and leukocyte counts compared with littermate controls but higher megakaryocyte numbers in the bone marrow. Thus, to our knowledge this study reports a previously unrecognized effect of miR-21 inhibition on platelets. The effect of antagomiR-21 treatment on platelet TGF-β1 release, in particular, may contribute to the antifibrotic effects of miR-21 inhibitors
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