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While previous studies have described career outcomes of physician-scientist trainees after graduation, trainee perceptions of research-intensive career pathways remain unclear. This study sought to identify the perceived interests, factors, and challenges associated with academic and research careers among predoctoral MD trainees, MD trainees with research-intense (>50%) career intentions (MD-RI), and MD-PhD trainees.
Methods:
A 70-question survey was administered to 16,418 trainees at 32 academic medical centers from September 2012 to December 2014. MD vs. MD-RI (>50% research intentions) vs. MD-PhD trainee responses were compared by chi-square tests. Multivariate logistic regression analyses were performed to identify variables associated with academic and research career intentions.
Results:
There were 4433 respondents (27% response rate), including 2625 MD (64%), 653 MD-RI (15%), and 856 MD-PhD (21%) trainees. MD-PhDs were most interested in pursuing academia (85.8%), followed by MD-RIs (57.3%) and MDs (31.2%). Translational research was the primary career intention for MD-PhD trainees (42.9%). Clinical duties were the primary career intention for MD-RIs (51.9%) and MDs (84.2%). While 39.8% of MD-PhD respondents identified opportunities for research as the most important career selection factor, only 12.9% of MD-RI and 0.5% of MD respondents shared this perspective. Interest in basic research, translational research, clinical research, education, and the ability to identify a mentor were each independently associated with academic career intentions by multivariate regression.
Conclusions:
Predoctoral MD, MD-RI, and MD-PhD trainees are unique cohorts with different perceptions and interests toward academic and research careers. Understanding these differences may help to guide efforts to mentor the next generation of physician-scientists.
This paper describes an experimental investigation intothe effect of miniature vortex generators (VGs) onthe longitudinal aerodynamic characteristics of ahighly-swept wing with drooped leading edges. Theexperiments were performed in a low-speed windtunnelon a wing of the same delta planform as that used ina previous study. The latter wing was of fixedcamber, while the subject of the present study was awing with three different leading edge droop angles.The maximum reduction in drag due to the VGs wasfound to be about half that for the fixed-camberwing. This is reconciled with the differentbehaviour of the flow on the upper surface for thetwo types of wing. Without control, the drag of thevariable-droop wings is much lower than that of thefixed-camber wing. As a result, with control, thevariable droop wings have lower drag than that ofthe fixed-camber wing. Compared to that of thevariable-droop wings without control, thefixed-camber wing, with control, has lowerlift-dependent drag for lift coefficients between0·4 and 0·7. However, at higher lift coefficients,the reverse applies.
By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged <5 years attending outpatient clinics for diarrhoea were matched by age and sex with controls. Data were collected on family demographics, socioeconomic indicators, and risk behaviour practices. Two rectal swabs and a stool specimen were collected from cases and controls. Samples were cultured for bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus and Cryptosporidium spp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4·9, 95% CI 2·8–8·4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1·7–5·4), and the child being cared for outside home (mOR 2·6, 95% CI 1·3–5·2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6·3, 95% CI 1·2–33·9) for children aged 7–12 months, and pacifier use (mOR 1·9, 95% CI 1·0–3·5) in children aged 0–6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years.
Shigella is an important bacterial cause of infectious diarrhoea globally. The Shigella human challenge model has been used since 1946 for a variety of objectives including understanding disease pathogenesis, human immune responses and allowing for an early assessment of vaccine efficacy. A systematic review of the literature regarding experimental shigellosis in human subjects was conducted. Summative estimates were calculated by strain and dose. While a total of 19 studies evaluating nine strains at doses ranging from 10 to 1 × 1010 colony-forming units were identified, most studies utilized the S. sonnei strain 53G and the S. flexneri strain 2457T. Inoculum solution and pre-inoculation buffering has varied over time although diarrhoea attack rates do not appear to increase above 75–80%, and dysentery rates remain fairly constant, highlighting the need for additional dose-ranging studies. Expansion of the model to include additional strains from different serotypes will elucidate serotype and strain-specific outcome variability.
At the summit of the Antarctic plateau, Dome A offers an intriguing location for future large scale optical astronomical observatories. The Gattini Dome A project was created to measure the optical sky brightness and large area cloud cover of the winter-time sky above this high altitude Antarctic site. The wide field camera and multi-filter system was installed on the PLATO instrument module as part of the Chinese-led traverse to Dome A in January 2008. This automated wide field camera consists of an Apogee U4000 interline CCD coupled to a Nikon fisheye lens enclosed in a heated container with glass window. The system contains a filter mechanism providing a suite of standard astronomical photometric filters (Bessell B, V, R) and a long-pass red filter for the detection and monitoring of airglow emission. The system operated continuously throughout the 2009, and 2011 winter seasons and part-way through the 2010 season, recording long exposure images sequentially for each filter. We have in hand one complete winter-time dataset (2009) returned via a manned traverse. We present here the first measurements of sky brightness in the photometric V band, cloud cover statistics measured so far and an estimate of the extinction.
Despite the absence of artificial light pollution at Antarctic plateau sites such as Dome A, other factors such as airglow, aurorae and extended periods of twilight have the potential to adversely affect optical observations. We present a statistical analysis of the airglow and aurorae at Dome A using spectroscopic data from Nigel, an optical/near-IR spectrometer operating in the 300–850 nm range. The median auroral contribution to the B, V and R photometric bands is found to be 22.9, 23.4 and 23.0 mag arcsec−2 respectively. We are also able to quantify the amount of annual dark time available as a function of wavelength; on average twilight ends when the Sun reaches a zenith distance of 102.6°.
Experts have proposed removing obsessive–compulsive disorder (OCD) from the anxiety disorders section and grouping it with putatively related conditions in DSM-5. The current study uses co-morbidity and familiality data to inform these issues.
Method
Case family data from the OCD Collaborative Genetics Study (382 OCD-affected probands and 974 of their first-degree relatives) were compared with control family data from the Johns Hopkins OCD Family Study (73 non-OCD-affected probands and 233 of their first-degree relatives).
Results
Anxiety disorders (especially agoraphobia and generalized anxiety disorder), cluster C personality disorders (especially obsessive–compulsive and avoidant), tic disorders, somatoform disorders (hypochondriasis and body dysmorphic disorder), grooming disorders (especially trichotillomania and pathological skin picking) and mood disorders (especially unipolar depressive disorders) were more common in case than control probands; however, the prevalences of eating disorders (anorexia and bulimia nervosa), other impulse-control disorders (pathological gambling, pyromania, kleptomania) and substance dependence (alcohol or drug) did not differ between the groups. The same general pattern was evident in relatives of case versus control probands. Results in relatives did not differ markedly when adjusted for demographic variables and proband diagnosis of the same disorder, though the strength of associations was lower when adjusted for OCD in relatives. Nevertheless, several anxiety, depressive and putative OCD-related conditions remained significantly more common in case than control relatives when adjusting for all of these variables simultaneously.
Conclusions
On the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV.
PLATO is a 6 tonne completely self-contained robotic observatory that provides its own heat, electricity, and satellite communications. It was deployed to Dome A in Antarctica in January 2008 by the Chinese expedition team, and is now in its second year of operation. PLATO is operating four 14.5cm optical telescopes with 1k × 1k CCDs, a wide-field sky camera with a 2k × 2k CCD and Sloan g, r, i filters, a fibre-fed spectrograph to measure the UV to near-IR sky spectrum, a 0.2m terahertz telescope, two sonic radars giving 1m resolution data on the boundary layer to a height of 180m, a 15m tower, meteorological sensors, and 8 web cameras. Beginning in 2010/11 PLATO will be upgraded to support a Multi Aperture Scintillation Sensor and three AST3 0.5m schmidt telescopes, with 10k × 10 CCDs and 100TB/annum data requirements.
The Protocol on Environmental Protection to the Antarctic Treaty requires that past and present work sites be cleaned up unless removal would result in greater adverse environmental impact than leaving the contaminant in its existing location. In the early 1990s Australia began the documentation of contaminated sites associated with its research stations, which resulted in an extensive record of contamination at abandoned stations and waste-disposal sites. Currently the technical capability to remediate these sites does not exist because of environmental challenges that are unique to the cold regions. Investigations indicate that clean-up operations in the past have proceeded without adequate precautions and without effective monitoring. To address these problems, three research priorities have been identified to assist meeting international and national obligations to clean up these sites. They are: understanding contaminant mobilisation processes; development of ecological risk assessment for use in monitoring and setting priorities; and development of clean-up and remediation procedures. This study provides sufficient information to guide the completion of a clean-up at Casey Station and to indicate how other similar sites should be managed. The next stage is to develop the theory into an operational plan to include detailed protocols for clean-up, monitoring, site remediation, and management of the waste stream from site to final repository. To achieve this, the Australian Antarctic Division has established a contaminated sites taskforce to facilitate the transition from research and development of techniques to implementation of suitable clean-up options.
Obsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.
Method
Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.
Results
Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.
Conclusions
OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.
By
Ian Snape, Contaminants Geochemist Working for the Australian Antarctic Division in Tasmania,
Larry Acomb, Geosphere Inc., 3055 Seawind Drive, Anchorage AK 99516, USA,
David L. Barnes, Dept. of Civil and Environmental Engineering, University of Alaska Fairbanks, PO Box 755900, Fairbanks AK 99775, USA,
Steve Bainbridge, Contaminated Sites Program, Division of Spill Prevention and Response, Department of Environmental Conservation, 610 University Avenue, Fairbanks AK 99709–3643, USA,
Robert Eno, Department of Sustainable Development, Government of Nunavut, PO Box 1000, Stn 1195, Iqaluit NU X0A 0H0, Canada,
Dennis M. Filler, Dept. of Civil and Environmental Engineering, University of Alaska Fairbanks, PO Box 755900, Fairbanks AK 99775, USA,
Natalie Plato, Department of Sustainable Development, Government of Nunavut, PO Box 1000, Stn 1195, Iqaluit NU X0A 0H0, Canada,
John S. Poland, Analytical Services Unit, Queens University, Kingston ON K7L 3N6, Canada,
Tania C. Raymond, Environmental Protection and Change Program, Australian Antarctic Division, Channel Highway, Kingston, Tasmania 7050, Australia,
John L. Rayner, Environmental Protection and Change Program, Australian Antarctic Division, Channel Highway, Kingston, Tasmania 7050, Australia,
Martin J. Riddle, Environmental Protection and Change Program, Australian Antarctic Division, Channel Highway, Kingston, Tasmania 7050, Australia,
Anne G. Rike, Dept. of Environmental Technology, Norwegian Geotechnical Institute, PO Box 3930, Ullevaal Stadion, N-0806 Oslo, Norway,
Allison Rutter, Analytical Services Unit, Queens University, Kingston ON K7L 3N6, Canada,
Alexis N. Schafer, University of Saskatchewan, 51 Campus Drive, Saskatoon, Canada S7N 5A8,
Steven D. Siciliano, University of Saskatchewan, 51 Campus Drive, Saskatoon SK S7N 5A8, Canada,
James L. Walworth, Dept. of Soil Water and Environmental Science, University of Arizona, 429 Shantz Bldg. #38, Tucson AZ 85721, USA
Oil and fuel spills are among the most extensive and environmentally damaging pollution problems in cold regions and are recognized as potential threats to human and ecosystem health. It is generally thought that spills are more damaging in cold regions, and that ecosystem recovery is slower than in warmer climates (AMAP 1998; Det Norske Veritas 2003). Slow natural attenuation rates mean that petroleum concentrations remain high for many years, and site managers are therefore often forced to select among a range of more active remediation options, each of which involves a trade-off between cost and treatment time (Figure 11). The acceptable treatment timeline is usually dictated by financial circumstance, perceived risks, regulatory pressure, or transfer of land ownership.
In situations where remediation and site closure are not urgent, natural attenuation is often considered an option. However, for many cold region sites, contaminants rapidly migrate off-site (Gore et al. 1999; Snape et al. 2006a). In seasonally frozen ground, especially in wetlands, a pulse of contamination is often released with each summer thaw (AMAP 1998; Snape et al. 2002). In these circumstances natural attenuation is likely not a satisfactory option. Simply excavating contaminants and removing them for off-site treatment may not be viable either, because the costs are often prohibitive and the environmental consequences of bulk extraction can equal or exceed the damage caused by the initial spill (Filler et al. 2006; Riser-Roberts 1998).
Understanding the epidemiology of current health threats to deployed U.S. troops is important for medical assessment and planning. As part of a 2004 study among U.S. military personnel deployed to Al Asad Air Base, in the western Anbar Province of Iraq, over 500 subjects were enrolled, provided a blood specimen, and completed a questionnaire regarding history of febrile illness during this deployment (average ∼4 months in country). This mid-deployment serum was compared to pre-deployment samples (collected ∼3 months prior to deployment) and evaluated for seroconversion to a select panel of regional arboviral pathogens. At least one episode of febrile illness was reported in 84/504 (17%) of the troops surveyed. Seroconversion was documented in nine (2%) of deployed forces tested, with no association to febrile illness. Self-reported febrile illness was uncommon although often debilitating, and the risk of illness due to arbovirus infections was relatively low.
The Gimbal Top distribution system for blast furnaces was introducedin October 2006. With this solution any burden profile can begenerated by directing the feed material to any point on the furnacestock line. This is made possible by innovative design features whichallow the chute angle and position to be continuously adjustedduring material discharging. The described Gimbal Top Distributor isfit for the high-temperature and high-pressure environment of ironmakingplants.
In 2004, the Commonwealth of Pennsylvania mandated hospitals to report healthcare-associated infections (HAIs). The increased workload led our Infection Control staff to collaborate with Atlas, a group of chart abstractors.
Objective.
The objective of this study was to assess our first year of experience with mandatory reporting of HAIs—specifically, to assess Atlas' contribution to surveillance.
Design.
Cases were selected if they had 1 or more of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes designated by Pennsylvania as a possible HAI. After training by the Infection Control staff, Atlas applied National Nosocomial Infection Surveillance (NNIS) system case definitions for catheter-associated urinary tract infections (UTIs) and surgical site infections (SSIs), and they applied NNIS chest imaging criteria to eliminate cases that were not ventilator-associated pneumonia (VAP). To assess Atlas' performance, Infection Control staff conducted a parallel review.
Results.
For discharges from the hospital during the fourth quarter of 2004, a total of 410 UTIs, 59 SSIs, and 56 VAPs were identified on the basis of state-designated ICD-9-CM codes; review by Atlas/Infection Control determined that 15%, 15%, and 16% of cases met case definitions, respectively. Of cases reviewed by both Infection Control and Atlas, 87% of the assessments made by Atlas were correct for UTI, and 96% were correct for SSI. For VAP, Infection Control concluded that 39% of cases could be ruled out on the basis of chest imaging criteria; Atlas correctly dismissed these 12 cases but incorrectly dismissed an additional 6 (error, 19%). Surveillance was not timely: 1-2 months elapsed between the time of HAI onset and the earliest case review.
Conclusions.
With ongoing training by Infection Control, Atlas successfully demonstrated a role in retrospective HAI surveillance. However, despite a major effort to comply with mandates, time lags and other design limitations rendered the data of low utility for Infection Control. States that are planning HAI-reporting programs should standardize an efficient surveillance methodology that yields data capable of guiding interventions to prevent HAI.
Ninety-seven isolates of Shigella flexneri from children seeking medical care from three sites in Egypt were characterized. Overall, 46·4% of children (median age 17 months) were febrile or reported blood in their stools, 25·8% were dehydrated and 16·5% were admitted to hospital. Serotypes 2a (37·1%), 1b (18·6%), 1c (17·5%), and 6 (15·5%) comprised over 88·7% of the total isolates. We observed marked resistance to ampicillin (87·6%), tetracycline (84·5%) and trimethoprim–sulfamethoxazole (63·9%). Pulsed-field electrophoresis grouped the majority of isolates within a serotype together, separately from isolates of an alternative serotype. The set gene was present in all serogroup 2a isolates, however, the sen gene was detected in every isolate. Our results show S. flexneri 1c has emerged as a dominant S. flexneri serotype in Egypt. Development and application of a Shigella vaccine should consider the diversity of Shigella serotypes within a geographical region prior to administration.
A field experiment investigating the effect of oil contamination on benthic microbial communities was conducted near Casey Station, East Antarctica. Defaunated sediment was treated with a mixture of Special Antarctic Blend diesel and lubricating oil and deployed in three different bays for eleven weeks. A molecular fingerprinting technique, denaturing gradient gel electrophoresis (DGGE), was used to investigate the microbial community structure. The variation between replicate samples within treatment groups indicates that the benthic microbial populations are very diverse and evenly distributed. Comparisons to determine the significance of both deployment location and hydrocarbon treatment showed that the greatest effect was from a combination of location and treatment. Detailed analysis suggests that subtle differences may be obscured by variability introduced by PCR and gel stages in DGGE, undermining this experimental approach. It is concluded that both location and hydrocarbon contamination influenced the development of the microbial communities but that the effect of hydrocarbon treatment varied with location. This has important implications for the design of future experiments on the effect of hydrocarbons on benthic communities, especially if it is intended to generalize the conclusions drawn from site specific studies.
The ways by which contaminants in freezing ground disperse and interact with associated ecosystems is a new and challenging field of applied research that is crucial to effective assessment, monitoring, and remediation in cold regions. Three key issues have been identified as needing urgent research and development. The first concerns the development and application of meaningful environmental guidelines for cold regions. This usually means that contaminants in freezing ground per se need to be considered in their broadest context by also addressing associated ecosystems, such as the receiving marine environment. The second issue concerns developing best practice for bioremediation of seasonally frozen soils. Of particular concern are the risks, benefits, and costs of using so-called bioproducts, which may not offer substantial improvements over biostimulation of indigenous cold-adapted organisms. The third issue concerns the need for assessment and monitoring protocols and cost-effective analytical tools. In this respect the potential use of field portable instruments deserves careful consideration and on-site testing. Taken together, development of these issues during the coming years will be crucial if the science behind managing contaminants in freezing ground is to catch up with the knowledge that underpins the remediation industry elsewhere.