Emil Zuckerkandl, M.D. (1849-1910): Bridging Anatomic Study and the Operating Room Table.

In the mid-19th century, the Vienna School of Anatomy was at the epicenter of the rapidly growing field of anatomy. One of the school’s most distinguished professors, Hungarian-born anatomist Emil Zuckerkandl was instrumental in transforming anatomy from a descriptive science to one of practical and clinical value. A prolific researcher interested in nearly all areas of morphology and most famously, the chromaffin system, Zuckerkandl’s discoveries from more than a century ago still provide a foundation for surgeons to this day

Traditional Owners of the Great Barrier Reef: the next generation of Reef 2050 actions

In short, this Report: Confirms that there are two options for progressing the integration of Traditional Owner interests in the Reef 2050 Plan. Option 1 (Business As Usual) represents a continuation of the current approach of Government-based review and refinement of the (now 23) Traditional Owner actions in the Reef 2050 Plan. Option 2 (Towards Genuine Co-governance) represents Government taking a far more negotiated approach at the GBR-wide level (and subsequently down to local scales) that applies the principles of Free Prior and Informed Consent. Based on extensive engagement concerning the aspirations of Traditional Owners and their support organisations across the GBR, the overwhelming stated desire and demand is for genuine partnership in the overarching governance of the Reef and far deeper ownership of, and participation in, its active day to day management (Option 2). There is an unambiguous view that the foundations set in the Reef 2050 Plan (Option 1), while a step in the right direction, simply reflect Traditional Owner aspirations in someone else’s planning. Meanwhile, a consistent message from Traditional Owners, fuelled by their existing and emerging rights in sea country, is that this more passive form of involvement cannot continue into the future; that a genuine form of agreement making and active implementation (from GBR to local scales) must emerge

SOD1 in cerebral spinal fluid as a pharmacodynamic marker for antisense oligonucleotide therapy

Background: Therapies designed to decrease the level of SOD1 are currently in a clinical trial for patients with superoxide dismutase (SOD1)-linked familial amyotrophic lateral sclerosis (ALS). Objective: To determine whether the SOD1 protein in cerebral spinal fluid (CSF) may be a pharmacodynamic marker for antisense oligonucleotide therapy and a disease marker for ALS. Design: Antisense oligonucleotides targeting human SOD1 were administered to rats expressing SOD1G93A. The human SOD1 protein levels were measured in the rats\u27 brain and CSF samples. In human CSF samples, the following proteins were measured: SOD1, tau, phosphorylated tau, VILIP-1, and YKL-40. Participants: Ninety-three participants with ALS, 88 healthy controls, and 89 controls with a neurological disease (55 with dementia of the Alzheimer type, 19 with multiple sclerosis, and 15 with peripheral neuropathy). Results: Antisense oligonucleotide-treated SOD1G93A rats had decreased human SOD1 messenger RNA levels (mean [SD] decrease of 69% [4%]) and decreased protein levels (mean [SD] decrease of 48% [14%]) in the brain. The rats\u27 CSF samples showed a similar decrease in hSOD1 levels (mean [SD] decrease of 42% [14%]). Inhuman CSF samples, the SOD1 levels varied a mean (SD) 7.1% (5.7%) after additional measurements, separated by months, were performed. The CSF SOD1 levels were higher in the participants with ALS (mean [SE] level, 172 [8] ng/mL; P\u3c.05) and the controls with a neurological disease (mean [SE] level, 172 [6] ng/mL; P\u3c.05) than in the healthy controls (mean [SE] level, 134 [4] ng/mL). Elevated CSF SOD1 levels did not correlate with disease characteristics in participants with ALS or controls with dementia of the Alzheimer type, but they did correlate with tau, phosphorylated tau, VILIP-1 and YKL-40 levels in controls with dementia of the Alzheimer type. Conclusions: SOD1 in CSF may be an excellent pharmacodynamic marker for SOD1-lowering therapies because antisense oligonucleotide therapy lowers protein levels in the rat brain and rat CSF samples and because SOD1 levels in CSF samples from humans are stable over time. © 2013 American Medical Association. All rights reserved

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Burnout among surgeons has been attributed to increased workload and decreased autonomy. Although prior studies have examined burnout among transplant surgeons, no studies have evaluated burnout in abdominal transplant surgery fellows. The objective of our study was to identify predictors of burnout and understand its impact on personal and patient care during fellowship. A survey was sent to all abdominal transplant surgery fellows in an American Society of Transplant Surgeons-accredited fellowship. The response rate was 59.2% (n = 77) and 22.7% (n = 17) of fellows met criteria for burnout. Fellows with lower grit scores were more likely to exhibit burnout compared with fellows with higher scores (3.6 vs 4.0, P = .026). Those with burnout were more likely to work \u3e100 hours per week (58.8% vs 27.6%, P = .023), have severe work-related stress (58.8% vs 22.4%, P = .010), consider quitting fellowship (94.1% vs 20.7%, P \u3c .001), or make a medical error (35.3% vs 5.2%, P = .003). This national analysis of abdominal transplant fellows found that burnout rates are relatively low, but few fellows engage in self-care. Personal and program-related factors attribute to burnout and it has unacceptable effects on patient care. Transplant societies and fellowship programs should develop interventions to give fellows tools to prevent and combat burnout

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163973/1/ajt16075_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163973/2/ajt16075.pd