A relativistic dissipative hydrodynamic description for systems including particle number changing processes

Relativistic dissipative hydrodynamic equations are extended by taking into account particle number changing processes in a gluon system, which expands in one dimension boost-invariantly. Chemical equilibration is treated by a rate equation for the particle number density based on Boltzmann equation and Grad's ansatz for the off-equilibrium particle phase space distribution. We find that not only the particle production, but also the temperature and the momentum spectra of the gluon system, obtained from the hydrodynamic calculations, are sensitive to the rates of particle number changing processes. Comparisons of the hydrodynamic calculations with the transport ones employing the parton cascade BAMPS show the inaccuracy of the rate equation at large shear viscosity to entropy density ratio. To improve the rate equation, the Grad's ansatz has to be modified beyond the second moments in momentum.Comment: 20 pages, 11 figure

Colleague appraisal of Australian general practitioners in training: an analysis of multisource feedback data

Background: Multisource feedback is an evidence-based and validated tool used to provide clinicians, including those in training, feedback on their professional and interpersonal skills. Multisource feedback is mandatory for participants in the Royal Australian College of General Practitioners Practice Experience Program and for some Australian General Practice Training Registrars. Given the recency of the Practice Experience Program, there are currently no benchmarks available for comparison within the program and to other comparable cohorts including doctors in the Australian General Practice Training program. The aim of this study is to evaluate and compare colleague feedback within and across General Practice trainee cohorts. Methods: Colleague feedback, from multisource feedback of Practice Experience Program participants and Australian General Practice Training Registrars, collected between January 2018 and April 2020, was compared to identify similarities and differences. Analyses entailed descriptive statistics, between and within groups rater consistency and agreement measures, principal component analysis, t-tests, analysis of variance, and psychometric network analysis. Results: Colleague ratings of Practice Experience Program participants (overall average 88.58%) were lower than for Registrars (89.08%), although this difference was not significant. ‘Communication with patients’ was rated significantly lower for Practice Experience Program participants (2.13%) while this group was rated significantly better for their ‘Ability to say no’ (1.78%). Psychometric network analyses showed stronger linkages between items making up the behavioural component (compared to the items of the performance and self-management components, as found by principal component analysis) for Practice Experience Program participants as compared to Registrars. Practice Experience Program participants were stronger in clinical knowledge and skills as well as confidentiality, while Registrars were stronger in communicating with patients, managing their own stress, and in their management and leadership skills. Conclusions: The multisource feedback scores of doctors undertaking the Practice Experience Program suggests that, while all mean values are ‘very good’ to ‘excellent’, there are areas for improvement. The linkages between skills suggests that Practice Experience Program doctors’ skills are somewhat isolated and have yet to fully synthesise. We now have a better understanding of how different groups of General Practitioners in training compare with respect to professional and interpersonal skills. Based on the demonstrated differences, the Practice Experience Program might benefit from the addition of educational activities to target the less developed skills

A comparison of patient appraisal of professional skills for GPs in training participating in differing education programs

Background: Medical boards and healthcare providers internationally are coming under increasing pressure to attract international medical graduates (IMGs) and overseas trained doctors (OTDs) to cope with predicted general practice (GP) doctor shortages. Various pathways to registration are made available for this purpose. There is very little understanding of the effects of different training pathways to licensing and registration on the ability of IMGs and OTDs, as well as locally trained doctors, to acquire the desirable professional skills deemed necessary for working effectively in the primary care sector. Methods: Feedback from patients was collected at the end of their scheduled consultation with their doctor using a questionnaire consisting of 13 Likert scale items that asked them to rate their experience of the consultation. Feedback was obtained for doctors going through the Royal Australian College of General Practice (RACGP) Practice Experience Program (PEP) and the Australian General Practice Training Program (AGPT), with the former intended primarily for IMGs and OTDs, and the latter for local medical graduates including from New Zealand. Patient feedback was also obtained for patients visiting already Fellowed and experienced GPs for comparative purposes, resulting in data for three groups of doctors (two trainee, one already Fellowed). Rater consistency and agreement measures, analysis of variance, principal component analysis, t-tests and psychometric network analysis were undertaken between and within groups to identify similarities and differences in patient experience and professionalism of doctors. Results: There was a small but significant difference in average patient raw scores given to PEP and AGPT doctors (90.25, 90.97%), with the highest scores for ‘Respect shown’ (92.24, 93.15%) and the lowest for ‘Reassurance’ 89.38, 89.84%). Male patients gave lower scores (89.56%) than female patients (91.23%) for both groups of doctors. In comparison, patients gave experienced GPs an average 91.38% score, with male patients giving a lower average score than female patients (90.62, 91.93%). Two components were found in the patient data (interpersonal communication, caring/empathy) that account for over 80% of the variance. When patient scores were aggregated by doctor, the average PEP and AGPT doctor scores received were 90.27 and 90.99%, in comparison to the average experienced GP score of 91.43%. Network analysis revealed differences in the connectedness of items between these two groups as well as in comparison with experienced GPs, suggesting that PEP doctors’ skills are less cohesively developed in the areas of listening ability, explaining and providing reassurance. Conclusions: The small but statistically significant differences between doctor groups reported in this preliminary study are supplemented by percentile analysis, network analysis and principal component analysis to identify areas for further exploration and study. There is scope for improving the integration of interpersonal communication skills of GPs in Training with their caring and empathy skills, when compared with experienced GPs as a benchmark. Suggestions are made for enhancing professional skills from a patients’ perspective in future training programs

Killer serials: Did electronic journals really destroy the university press?

Given the rapidly changing economics of scholarly communication in the digital age, the importance of accurate, specific data on the resource flows within this realm has become increasingly important. Both the producers and the collectors of scholarly information require accurate information in order to nimbly navigate their changing roles in advancing the progress of knowledge. Two key actors in this area are university presses and academic libraries, which both hold keystone roles in scholarly communications, as disseminators and conservators of scholarship, respectively. This paper describes an exploratory study examining one contentious aspect of the relationship between these two actors: trends in purchases of university press books by academic libraries. It does so in order to provide an empirical basis for evaluating frequent claims by publishers that declines in libraries' monographic purchasing over the past three decades can be held primarily responsible for the declining economic fortunes of university presses over the same period. The results of this analysis indicate that this relationship is not clear‐cut, for at least two reasons: first, to the extent that purchasing reductions have occurred, they have occurred much more recently than prior accounts have suggested, and second, purchasing trends vary significantly between different libraries and between different sizes of university press.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106969/1/14505001080_ftp.pd

Interaction of Host Cellular Proteins with Components of the Hepatitis Delta Virus

The hepatitis delta virus (HDV) is the smallest known RNA pathogen capable of propagation in the human host and causes substantial global morbidity and mortality. Due to its small size and limited protein coding capacity, HDV is exquisitely reliant upon host cellular proteins to facilitate its transcription and replication. Remarkably, HDV does not encode an RNA-dependent RNA polymerase which is traditionally required to catalyze RNA-templated RNA synthesis. Furthermore, HDV lacks enzymes responsible for post-transcriptional and -translational modification, processes which are integral to the HDV life cycle. This review summarizes the known HDV-interacting proteins and discusses their significance in HDV biology

Paraneoplastic Acral Vascular Syndrome

Introduction Cases of rheumatologic phenomena coinciding with malignancy have been well-documented in the medical literature. These syndromes may be associated with common autoimmune markers, potentially masking the underlying diagnosis of malignancy. The association between malignancy and its coinciding rheumatologic manifestations is poorly understood. These paraneoplastic symptoms are more prevalent in high-stage adenocarcinomas of the lung, breast, and ovary. Possible mechanisms may include cytokine derangements, blood hyperviscosity, and circulatory disruption. While some evidence suggests that control of the primary tumor alleviates its associated paraneoplastic symptoms, other proposed therapies include heparin, prednisone, aspirin, and vasodilatory agents. Efficacy is limited due to association of these syndromes with high-grade malignancy. We describe the case of a patient presenting with para neoplastic acral vascular syndrome (PAVS) in association with primary ovarian carcimona.1.2 Case The patient is a 57-year-old female with a history ofHashimoto\u27s thyroiditis and migraines, who presents with an ulcerating rash of the fingertips and a tender discoloration of the plantar aspect of both feet. The rash began four weeks prior to presentation as a purple discoloration of the fingertips, progressing to a desquamating, palmar rash with distal phalangeal ulceration and necrosis of the fingertips. Almost simultaneously, the patient experienced purple discoloration of the soles of her feet bilaterally and described a sensation of standing on marbles. She denies similar episodes in the past as well as sick contacts. She reports experiencing excessive stress in preparing for her daughter\u27s wedding, exposure to a new type of dryer sheet, and a recent manicure/pedicure. The patient was recently treated with two medrol dose packs, minocydine, nitroglycerin paste (which had to be discontinued due to hypotension), and aspirin. Following treatment, the patient had no relief of symptoms

Perceptions of cancer of unknown primary site: A national survey of Australian medical oncologists

Introduction: Despite being the 6th cause of cancer death in Australia, cancer of unknown primary (CUP) site remains poorly understood. Aims: To describe practices relating to the diagnosis, investigation, classification, communication and management of CUP amongst medical oncologists. Methods: We invited all members of the Medical Oncology Group of Australia to participate in a national, anonymous online survey about CUP. The survey collected data regarding diagnosis acceptance, diagnostic tests, treatment protocols and communication practices around the diagnosis of CUP. Results: 302 oncologists were invited and 86 (28%) completed the survey. Eighty respondents (93%) were directly involved in the assessment of patients with CUP. Eighty-five (99%) respondents were prepared to make a diagnosis of CUP if, after appropriate diagnostic tests, the primary location could not be ascertained. 83% would assign a primary site to obtain Pharmaceutical Benefits Schedule (PBS) funding of medical therapy. 62% did not have a specific treatment protocol designed for CUP. The majority of oncologists used serum tumour markers and CT scans in the initial work-up, whilst 43% indicated they would use a PET scan in the majority of cases. The majority would arrange mammography in female patients. Thematic analysis of responses to openended questions about how CUP is described identified little consistency in the language being used. Conclusion: The approach to diagnosis, investigation and management of CUP by medical oncologists in Australia is variable. Many preferred to estimate the primary site and treat accordingly. PBS restrictions may encourage the practice of ‘best guessing’

A comprehensive bioinformatic analysis of hepatitis D virus full-length genomes

In association with hepatitis B virus (HBV), hepatitis delta virus (HDV) is a subviral agent that may promote severe acute and chronic forms of liver disease. Based on the percentage of nucleotide identity of the genome, HDV was initially classified into three genotypes. However, since 2006, the original classification has been further expanded into eight clades/genotypes. The intergenotype divergence may be as high as 35%-40% over the entire RNA genome, whereas sequence heterogeneity among the isolates of a given genotype is <20%; furthermore, HDV recombinants have been clearly demonstrated. The genetic diversity of HDV is related to the geographic origin of the isolates. This study shows the first comprehensive bioinformatic analysis of the complete available set of HDV sequences, using both nucleotide and protein phylogenies (based on an evolutionary model selection, gamma distribution estimation, tree inference and phylogenetic distance estimation), protein composition analysis and comparison (based on the presence of invariant residues, molecular signatures, amino acid frequencies and mono- and di-amino acid compositional distances), as well as amino acid changes in sequence evolution. Taking into account the congruent and consistent results of both nucleotide and amino acid analyses of GenBank available sequences (recorded as of January, 2017), we propose that the eight hepatitis D virus genotypes may be grouped into three large genogroups fully supported by their shared characteristics.Fil: Delfino, Cecilia María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Cerrudo, Carolina Susana. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Ingeniería Genética y Biología Molecular y Celular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Biglione, Mirna Marcela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Oubiña, Jose Raul. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas en Retrovirus y Sida. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas en Retrovirus y Sida; ArgentinaFil: Ghiringhelli, Pablo Daniel. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Ingeniería Genética y Biología Molecular y Celular; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mathet, Veronica Lidia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; Argentin

A phase II study of mitomycin C, cisplatin and continuous infusion 5-fluorouracil (MCF) in the treatment of patients with carcinoma of unknown primary site

Carcinoma of unknown primary site remains a common clinical diagnosis, accounting for between 5 and 10% of all cancer patients. Numerous combination chemotherapy regimens have been used in the management of carcinoma of unknown primary site, resulting in response rates of 0–48%. We present the results of a single centre phase II study of the use of the combination of mitomycin C (7 mg m−2 on day 1 of cycles 1, 3 and 5) cisplatin (60 mg m−2 on day 1) and continuous infusion 5-fluorouracil (300 mg m−2 daily), MCF, delivered as a 21-day cycle, in patients with carcinoma of unknown primary site. Thirty-one patients with a diagnosis of carcinoma of unknown primary site were treated in Aberdeen Royal Infirmary between 1997 and 2001 with MCF. In total, 136 cycles of MCF were delivered (median of 5 cycles per patient). Toxicity was acceptable, with 19% grade 3 or 4 neutropenia, 16% grade 3 or 4 thrombocytopenia and 13% grade 3 or 4 nausea and vomiting. No cases of neutropenic sepsis were seen and there were no treatment-related deaths, however, six patients developed thrombotic complications. The overall response rate was 27% (CR 3%; PR 23%). Median time to progression was 3.4 months (95% CI 1.1–5.6 months) and median overall survival was 7.7 months (95% CI 5.7–9.8 months). Survival at 1 year was 28%, and at 2 years, 10%. MCF is a tolerable regimen with comparable toxicity, response rates and survival data to most platinum-based combination chemotherapy regimens in use for this devastating disease