Sample records for surgeons fifty years

  1. Fifty years in neonatology. (United States)

    Manley, Brett J; Doyle, Lex W; Davies, Mark W; Davis, Peter G


    Neonatology, the care and study of newborn infants, is a 'young' specialty. Over the last 50 years, there have been many advances in the way that neonatologists care for newborn infants, particularly those born preterm, leading to dramatic improvements in mortality. To illustrate these advances, we describe four eras in neonatology from the point of view of the junior hospital doctor.

  2. PAs: Fifty years young. (United States)

    Mandel, Ellen D; North, Shannon


    The PA profession is 50 years young. Practicing PAs and current students hail from several generational categories ranging from Builders to Generation Z. This article reviews how different generations may have experienced PA program expansion, professional identity, state licensing, and prescription delegation. The authors sampled a cohort of PA program applicants about their views on what evokes optimism and concern for the PA profession. These themes mirror the recently paved professional road, while posing the all-important question: What construction lies on the horizon?

  3. Normalization Fifty Years Beyond

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Tøssebro, Jan; Teittinen, Antti


    toward larger group homes and congregations, inequality across municipalities, marketization, and new public management, but also an increasing emphasis on consumer rights and the use of the personal assistance scheme in services for people with ID. The authors conclude that diverging trends coexist......, with improvements going together with significant setbacks. They explore the trends from a political science perspective and, in particular, note how they relate to recent shifts in public management and changing drivers of change....... test of the reforms is not what happens during reform years, but after the reform energy decreases and political attention fades. Thus, developments after 2000 are of particular interest. The comparative analysis is based on research reviews in the five Nordic countries. The analysis observed a trend...

  4. Lasers: The next fifty years

    NARCIS (Netherlands)

    Kärtner, Franz; Pollnau, Markus; Ueda, Ken-ichi; van Driel, Henry

    This year marks the 50th anniversary of the laser — the first coherent radiation source in the optical domain. This anniversary of this historic development is being celebrated this year through “Laserfest‿ in which the Optical Society is a major partner. The laser enabled a straightforward

  5. Fifty years of polymer science

    NARCIS (Netherlands)

    Prez, Du Filip; Hoogenboom, Richard; Klumperman, Bert; Meier, Michael; Monteiro, Michael; Müller, Alejandro; Vancso, Julius


    The European Polymer Journal (EPJ) has been serving the scientific community for 50 years, which makes it one of the older macromolecular journals with a broad focus. Since its launch 50 years ago, EPJ has provided a distinguished forum for publications in polymer research, including chemistry, phys

  6. Lasers: The next fifty years

    NARCIS (Netherlands)

    Kärtner, Franz; Pollnau, Markus; Ueda, Ken-ichi; Driel, van Henry


    This year marks the 50th anniversary of the laser — the first coherent radiation source in the optical domain. This anniversary of this historic development is being celebrated this year through “Laserfest” in which the Optical Society is a major partner. The laser enabled a straightforward extensio

  7. Vannevar Bush: Fifty Years Later (United States)

    Lagowski, J. J.


    It is ironic that the 50th anniversary year of Vannevar Bush's Report to President Truman entitled "Science the Endless Frontier", which put into motion the eminently successful current system of education of scientists in this country occurs at a time when serious questions are being asked about the usefulness of that very system. Bush viewed his proposal to establish a national research foundation (later to be called the National Science Foundation) as a "social compact." Judgment of scientific merit would be delegated to expert peers in return for scientific progress, which would ultimately benefit the nation in terms of scientific needs--military security, economic productivity, and enhanced quality of life. Bush wanted the funding of basic research intertwined with training, and preferred to use universities for this purpose rather than industrial or national labs. Bush viewed college and university scientists as teachers and investigators. He believed university-based research would uniquely encourage and engage the next generation of scientists as no other institutional arrangement could. Bush did not trust industry's commitment to basic research, an instinct that proved prophetic. The academic reserve of scientists (PhD's in training and postdoctoral students) that existed before World War II, and upon which the United States could draw for its needs, which were primarily associated with defense efforts, was probably one of the defining factors in Bush's suggested strategy. Currently, that reserve of talent has gotten so large that it is the obvious throttle in the pipeline slowing the continued development of the university research enterprise. Since 1977, the rate at which we have trained new scientists exceeds an average of 4% annually. Since 1987, the "science work force"--PhD's--has grown at three times the rate of the general labor supply. Temporary positions for postdoctoral scientists have grown even faster (over 5% per year since 1989). To compound

  8. Fifty years of shear zones (United States)

    Graham, Rodney


    We are here, of course, because 1967 saw the publication of John Ramsay's famous book. Two years later a memorable field trip from Imperial College to the Outer Hebrides saw John on a bleak headland on the coast of North Uist where a relatively undeformed metadolerite within Lewisian (Precambrian) gneisses contained ductile shear zones with metamorphic fabrics in amphibolite facies. One particular outcrop was very special - a shear zone cutting otherwise completely isotropic, undeformed metadolerite, with an incremental foliation starting to develop at 45° to the deformation zone, and increasing in intensity as it approached the shear direction. Here was proof of the process of simple shear under ductile metamorphic conditions - the principles of simple shear outlined in John Ramsay's 1967 book clearly visible in nature, and verified by Ramsay's mathematical proofs in the eventual paper (Ramsay and Graham, 1970). Later work on the Lewisian on the mainland of Scotland, in South Harris, in Africa, and elsewhere applied Ramsay's simple shear principles more liberally, more imprecisely and on larger scale than at Caisteal Odair, but in retrospect it documented what seems now to be the generality of mid and lower crustal deformation. Deep seismic reflection data show us that on passive margins hyper-stretched continental crust (whether or not cloaked by Seaward Dipping Reflectors) seems to have collapsed onto the mantle. Crustal faults mostly sole out at or above the mantle - so the Moho is a detachment- an 'outer marginal detachment', if you like, and, of course, it must be a ductile shear. On non-volcanic margins this shear zone forms the first formed ocean floor before true sea floor spreading gets going to create real oceanic crust. Gianreto Manatschal, Marcel Lemoine and others realised that the serpentinites described in parts of the Alps are exposed remnants of this ductile shear zone. Associated ophicalcite breccias tell of sea floor exposure, while high

  9. Information Systems Curricula: A Fifty Year Journey (United States)

    Longenecker, Herbert E., Jr.; Feinstein, David; Clark, Jon D.


    This article presents the results of research to explore the nature of changes in skills over a fifty year period spanning the life of Information Systems model curricula. Work begun in 1999 was expanded both backwards in time, as well as forwards to 2012 to define skills relevant to Information Systems curricula. The work in 1999 was based on job…

  10. Human space exploration the next fifty years. (United States)

    Williams, David R; Turnock, Matthew


    Preparation for the fiftieth anniversary of human spaceflight in the spring of 2011 provides the space faring nations with an opportunity to reflect on past achievements as well as consider the next fifty years of human spaceflight. The International Space Station is a unique platform for long duration life science research that will play a critical role in preparing for future human space exploration beyond low earth orbit. Some feel the future path back to the Moon and on to Mars may be delayed with the current commitment of the United States to support the development of human-rated commercial spacecraft. Others see this as a unique opportunity to leverage the capability of the private sector in expanding access to space exploration. This article provides an overview of the past achievements in human spaceflight and discusses future missions over the next fifty years and the role space medicine will play in extending the time-distance constant of human space exploration.

  11. Essay: fifty years of condensed matter physics. (United States)

    Cohen, Marvin L


    Since the birth of Physical Review Letters fifty years ago, condensed matter physics has seen considerable growth, and both the journal and the field have flourished during this period. In this essay, I begin with some general comments about condensed matter physics and then give some personal views on the conceptual development of the field and list some highlights. The focus is mostly on theoretical developments.

  12. First Fifty Years of Chemoresistive Gas Sensors

    Directory of Open Access Journals (Sweden)

    Giovanni Neri


    Full Text Available The first fifty years of chemoresistive sensors for gas detection are here reviewed, focusing on the main scientific and technological innovations that have occurred in the field over the course of these years. A look at advances made in fundamental and applied research and leading to the development of actual high performance chemoresistive devices is presented. The approaches devoted to the synthesis of novel semiconducting materials with unprecedented nanostructure and gas-sensing properties have been also presented. Perspectives on new technologies and future applications of chemoresistive gas sensors have also been highlighted.

  13. Fifty Years After, Hidden Children Speak

    Directory of Open Access Journals (Sweden)

    Léa Marcou


    Full Text Available “For fifty years, I have not spoken of my childhood years in France during the second world war. A hidden child, I lived under a false name amongst unknown people, being careful – as I had been taught – not to reveal, by a gesture or by a word, that I was Jewish. I knew I was in danger, still not understanding why and I was constantly afraid. I didn't know whether I would see again one day my parents from whom I had been suddenly taken away. Nonetheless what were my pains compared to those of...

  14. Psychotherapists and the clergy: Fifty years later. (United States)

    Spiegelman, J M


    Jung's two powerful articles on psychotherapy and the clergy, written in 1928 and 1932. are looked at from the vantage point of fifty years later and the author's experience in conducting analysis with many people from both vocations. He notes that relatively few people achieve the kind of integration of the ego that Jung writes about-an essentially religious experience-wherein the center of their existence now gravitates about the Self. Yet Jung's work and views have had a profound effect on spiritually inclined people of all ages. The predictions of Jung's articles, regarding therapy, the dissemination of pyschology to the masses, and other issues are examined.

  15. Cryogenic engineering fifty years of progress

    CERN Document Server

    Reed, Richard


    Cryogenic Engineering: Fifty Years of Progress is a benchmark reference work which chronicles the major developments in the field. Starting with an historical background dating to the 1850s, this book reviews the development of data resources now available for cryogenic fields and properties of materials. The advances in cryogenic fundamentals are covered by reviews of cryogenic principles, cryogenic insulation, low-loss storage systems, modern liquefaction processes, helium cryogenics and low-temperature thermometry. Several well-established applications resulting from cryogenic advances include aerospace cryocoolers and refrigerators, use of LTS and HTS systems in electrical applications, and recent changes in cryopreservation. Extensive references are provided for the readers interested in the details of these cryogenic engineering advances.

  16. [Fifty years of clinical use of warfarin]. (United States)

    Quintero-González, Jesús Alberto


    Warfarin is the most utilized oral anticoagulant for the long term prophylaxes of thrombosis. Its use has been increased as new clinical conditions, capable of leading to thrombosis, have been detected. Due to the special characteristics of warfarin, such as the variability of doses for each individual, the narrow margin between adequate and inadequate doses, interaction with multiple pharmaceutical products, interference of its action by vitamin K present in the diet and the possibility of hemorrhagic complications or thrombotic recurrence, this drug requires a very careful dosage and strict laboratory and clinical monitoring. Despite being in the market for more than de fifty years and its many disadvantages, warfarin has not been substituted for the new oral anticoagulants. In 1999, warfarin was positioned eleventh on the list of the most used medicines in the world.

  17. Fifty years of science, memories, and events

    CERN Multimedia


    In 2004 CERN celebrates its 50th anniversary. More precisely, on Wednesday 29 September 2004, the signature of the convention that established CERN will be 50 years old. During this special year, CERN's public web site will host a celebratory Fiftieth Anniversary web site.

  18. The Road Was Fifty Years Long

    Institute of Scientific and Technical Information of China (English)


    TIBET has always been a place of worldconcern. After the Democratic Reformin 1959, Tibet turned into a socialist societyfrom the former feudal serf system, whichwas an unprecedented historical step. Forforty years since then, the peace anddevelopment of Tibet have received specialattention and concern from the centralgovernment. Du Qiyuan, the president ofTibet Women’s Federation who grew up andhas worked in Tibet for years told me about

  19. Fifty years of allergy: 1965-2015. (United States)

    Campbell, Dianne E; Mehr, Sam


    The last 50 years in allergy could almost be considered the first 50 years. Over this time period, we have witnessed the emergence of allergy as a subspecialty, have seen and continue to observe a tremendous change in prevalence of allergic disease and have gained insight into the mechanisms that underlie allergic predisposition and disease manifestation. We have improved the care of children with many forms of allergic disease and now sit poised to be able to alter the natural history of allergic disease with the use of specific immunotherapy. There is much left to do in the next 50 years including understanding what underlies both the predisposition to atopic disease and its natural resolution and identifying the environmental cofactors involved in the 'allergic epidemic' and therefore targets for effective primary prevention.

  20. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki


    Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

  1. Fifty years ago: the Vaiont night

    Directory of Open Access Journals (Sweden)

    Valerio Spagna


    Full Text Available A geologist at the beginning of his career in the early 1960’s was a teacher of mineralogy and geology at the Agordo “Follador” Mining Institute in the Dolomites area. It was 50 years ago now when he observed the building of the Vaiont dam, and here he tells us of the night of October 9, 1963, when he rushed to the Piave Valley together with the first-aid teams, to confront the remains of Longarone. Did the dam collapse? Everybody thinks so, but the moon was not shining enough to allow an understanding of what had happened. It was only the first faint light of dawn that revealed that the dam was still standing: it was only edged by the water, from the shaping of the tremendous wave that was raised by the Mount Toc landslide when it entered the basin at 100 km/h. The dam edge contributed to the projection of the wave onto the opposite slopes, where once the water mass was released from the narrow Vaiont canyon, it raised solidly into the air, grazing the Casso village and precipitated as a massive block on the Longarone area. Everybody looked upwards with hate and despair, at the residual water streamlets that were overflowing along the concrete wall of the dam. Over the white bare esplanade people appeared extremely small. Pitiful people, gathered around the bodies wrenched from the devastated houses, denuded and buried in the mud.

  2. Atoms for Peace after Fifty Years

    Energy Technology Data Exchange (ETDEWEB)

    Joeck, N; Lehman, R; Vergino, E; Schock, R


    President Eisenhower's hopes for nuclear technology still resonate, but the challenges to fulfilling them are much different today. On December 8, 1953, President Eisenhower, returning from his meeting with the leaders of Britain and France at the Bermuda Summit, flew directly to New York to address the United Nations General Assembly. His presentation, known afterwards as the ''Atoms for Peace'' speech, was bold, broad, and visionary. Eisenhower highlighted dangers associated with the further spread of nuclear weapons and the end of the thermonuclear monopoly, but the president also pointed to opportunities. Earlier that year, Stalin had died and the Korean War armistice was signed. Talks on reunification of Austria were about to begin. The speech sought East-West engagement and outlined a framework for reducing nuclear threats to security while enhancing the civilian benefits of nuclear technology. One specific proposal offered to place surplus military fissile material under the control of an ''international atomic energy agency'' to be used for peaceful purposes, especially economic development. Eisenhower clearly recognized the complex interrelationships between different nuclear technologies and the risks and the benefits that accrue from each. The widespread use of civilian nuclear technology and absence of any use of a nuclear weapon during the next half-century reflects success in his approach. Today, the world faces choices about nuclear technology that have their parallels in the Eisenhower calculus and its legacy. Although his specific fissile material proposal was never implemented, his broader themes gave impetus to agreements such as the nuclear Non-Proliferation Treaty (NPT) and institutions such as the International Atomic Energy Agency (IAEA). The resulting governance process has promoted some and restricted other nuclear technology. Perhaps even more influential was Eisenhower's overarching

  3. Fifty years of Jaynes-Cummings physics (United States)

    Greentree, Andrew D.; Koch, Jens; Larson, Jonas


    electromagnetic modes, arrays of coupled cavities [5-7], and optomechanical systems [8] have further enriched the physics of the Jaynes-Cummings model. From the early interests in masers and the consistent quantum description of radiation and atom-photon interaction, the Jaynes-Cummings model has evolved into a cornerstone of quantum state engineering [9]. The authors of this editorial had not been born when Jaynes and Cummings wrote their remarkable paper. It is, therefore, a special honour for us to be able to draw the reader's attention to the accompanying reminiscence contributed by Frederick Cummings where he gives us a glimpse of the early history of the Jaynes-Cummings model from his perspective [11]. By now, the original 1963 paper by Jaynes and Cummings has gathered numerous citations and, at the time of writing, the number of articles involving Jaynes-Cummings physics is approaching 15 000.1 This special issue does not attempt to review this impressive wealth of research. The interested reader, however, is urged to consult the definitive article by Shore and Knight [10] for a comprehensive review of the first 30 years of Jaynes-Cummings physics. The collection of 26 papers presented in this issue, showcases a snapshot of some of the most recent and continuing research devoted to Jaynes-Cummings physics. We begin our special issue with Professor Cumming's recollections [11]. We then have six papers on quantum information aspects of the Jaynes-Cummings model [12-17]. The next topic includes seven papers on the Dicke and generalized Jaynes-Cummings models [18-24], followed by six papers on circuit QED, which is one of the most important experimental frameworks for Jaynes-Cummings systems [25-30]. Finally, we have six papers on the extension to many cavities, the Jaynes-Cummings-Hubbard model [31-36]. The snapshot of research captured in this special issue illustrates the unifying language provided by the Jaynes-Cummings model, tying together research in a number of

  4. EDITORIAL: Semiconductor lasers: the first fifty years Semiconductor lasers: the first fifty years (United States)

    Calvez, S.; Adams, M. J.


    Anniversaries call for celebrations. Since it is now fifty years since the first semiconductor lasers were reported, it is highly appropriate to celebrate this anniversary with a Special Issue dedicated to the topic. The semiconductor laser now has a major effect on our daily lives since it has been a key enabler in the development of optical fibre communications (and hence the internet and e-mail), optical storage (CDs, DVDs, etc) and barcode scanners. In the early 1960s it was impossible for most people (with the exception of very few visionaries) to foresee any of these future developments, and the first applications identified were for military purposes (range-finders, target markers, etc). Of course, many of the subsequent laser applications were made possible by developments in semiconductor materials, in the associated growth and fabrication technology, and in the increased understanding of the underlying fundamental physics. These developments continue today, so that the subject of semiconductor lasers, although mature, is in good health and continues to grow. Hence, we can be confident that the pervasive influence of semiconductor lasers will continue to develop as optoelectronics technology makes further advances into other sectors such as healthcare, security and a whole host of applications based on the global imperatives to reduce energy consumption, minimise environmental impact and conserve resources. The papers in this Special Issue are intended to tell some of the story of the last fifty years of laser development as well as to provide evidence of the current state of semiconductor laser research. Hence, there are a number of papers where the early developments are recalled by authors who played prominent parts in the story, followed by a selection of papers from authors who are active in today's exciting research. The twenty-fifth anniversary of the semiconductor laser was celebrated by the publication of a number of papers dealing with the early

  5. Fifty years of Cuba's medical diplomacy: from idealism to pragmatism. (United States)

    Feinsilver, Julie M


    Medical diplomacy, the collaboration between countries to simultaneously produce health benefits and improve relations, has been a cornerstone of Cuban foreign policy since the outset of the revolution fifty years ago. It has helped Cuba garner symbolic capital (goodwill, influence, and prestige) well beyond what would have been possible for a small, developing country, and it has contributed to making Cuba a player on the world stage. In recent years, medical diplomacy has been instrumental in providing considerable material capital (aid, credit, and trade), as the oil-for-doctors deals with Venezuela demonstrates. This has helped keep the revolution afloat in trying economic times. What began as the implementation of the one of the core values of the revolution, namely health as a basic human right for all peoples, has continued as both an idealistic and a pragmatic pursuit. This article examines the factors that enabled Cuba to conduct medical diplomacy over the past fifty years, the rationale behind the conduct of this type of soft power politics, the results of that effort, and the mix of idealism and pragmatism that has characterized the experience. Moreover, it presents a typology of medical diplomacy that Cuba has used over the past fifty years.

  6. Women, Fertility and Economics: Fifty Years of Research


    Felipe Del Río; Nelson Alvis; Martha Yánez; Raúl Quejada; Karina Acevedo


    This paper provides a systematic review of the scientific literature on fertility and its relationship with economics. We explore theoretical and empirical frameworks developed in the last fifty years, emphasizing on the classical (Becker, Easterling) and unorthodox approaches (Bongaarts, Iannaccone, Lehrer). This literature review focused on journals of economics, sociology and demography indexed in the Journal Storage database (JSTOR), Elsevier’s research database (ScienceDirect), Elton B. ...

  7. Fifty years of mathematical physics selected works of Ludvig Faddeev

    CERN Document Server

    Niemi, Antti J


    This unique volume summarizes with a historical perspective several of the major scientific achievements of Ludwig Faddeev, with a foreword by Nobel Laureate C N Yang. The volume that spans over fifty years of Faddeev's career begins where he started his own scientific research, in the subject of scattering theory and the three-body problem. It then continues to describe Faddeev's contributions to automorphic functions, followed by an extensive account of his many fundamental contributions to quantum field theory including his original article on ghosts with Popov. Faddeev's contributions to soliton theory and integrable models are then described, followed by a survey of his work on quantum groups. The final scientific section is devoted to Faddeev's contemporary research including articles on his long-term interest in constructing knotted solitons and understanding confinement. The volume concludes with his personal view on science and mathematical physics in particular.

  8. Modigliani's life-cycle theory of savings fifty years later

    Directory of Open Access Journals (Sweden)

    Mauro Baranzini


    Full Text Available In the 1950s, Modigliani proposed a theory of spending in which people make intelligent choices about their spending at each age limited by the resources available over their lives. By using assets and debts, working people can provide for their retirement and tailor their spending to their needs at each age independent of income at each age. The theory predicts that national saving depends on the growth of national income, not its level, and that aggregate wealth depends on the length of retirement. Fifty years later, the life-cycle hypothesis remains an essential part of economists' thinking. Without it, we would have much less to say about the private and public provision of social security, the effects of the stock market on the economy, the effects of demographic change on national saving, the role of saving in economic growth, and the determinants of national wealth.

  9. Fifty Years of Climate Curricular Confusion and Pedagogical Gaps (United States)

    McCaffrey, M. S.; Buhr, S. S.; Niepold, F.


    The processes of weather and climate, including the greenhouse effect and the potential for significant, even catastrophic human impacts on the climate system, were sufficiently understood in 1958 during the International Geophysical Year that the authors of the science education booklet, Planet Earth, The Mystery with 100,000 Clues, published by the U.S. National Academy of Sciences, were confident to predict that continued emissions of carbon dioxide into the atmosphere could, in time, melt icecaps and glaciers and rise sea levels. This important scientific insight was further studied by climatologists, but is largely missing as an integral, important component of science education. Now, fifty years later, with a global population that has doubled, fossil fuel emissions that have tripled, and current energy consumption and emission trajectories that are above the IPCC Business as Usual scenario, leading politicians still doubt that our global economy can impact the climate system. NRC estimates that up to 40 percent of the approximately $10 trillion U.S. economy is affected by weather and climate events annually, making it a crucial if not dominant factor in our economic well-being, particularly for future generations. Despite the long term and short term importance of climate in our lives, society is essentially illiterate about climate science and confused about the connections between energy, economy and climate, as numerous public opinion polls and studies have shown. A key reason is that education programs and pedagogical content knowledge focusing on the basics of climate, including natural variability as well as human induced climate change, are largely missing from K12 and undergraduate education. Climate has fallen through disciplinary cracks, been avoided because of perceived controversy, and neglected because most educators lack training or expertise in the subject matter. With a focus on climate in formal education, this paper will provide an overview

  10. The Proton Synchrotron, going strong at fifty years

    CERN Multimedia

    Django Manglunki

    It was on the evening of 24 November 1959 that an incredulous Hildred Blewett, on detachment to CERN from the Brookhaven laboratory, exclaimed “Yes! We’re through transition!” The first beam of ten billion protons had not only broken through the 5.2 GeV barrier but gone on all the way to 24 GeV, the machine’s top energy at that time.   An operational screenshot from the PS, taken on its 50th anniversary. The three white peaks depict different phases (cycles) of the PS’s operation. In the first and third cycle, the PS is producing a very low-intensity beam for LHC commissioning. In the second cycle, protons are being spilled out for use in the East Area. Fifty years ago the PS, the first strong-focusing proton synchrotron using alternating gradient technology, first began to circulate beams at an unprecedented level of energy. Over the years, a complex of linear and circular accelerators and storage rings grew up around the PS. In the mid-1990s ...

  11. Fifty years of numerical modeling of baroclinic ocean (United States)

    Sarkisyan, A. S.


    This paper presents a brief critical analysis of the main historical stages of numerical modeling for the last fifty years. It was a half a century ago that the numerical simulation of an actual baroclinic ocean was initiated by the author and his students [1, 2]. In meteorology, studies on the numerical modeling of a baroclinic atmosphere existed much earlier [21, 22]. Despite this, a similar move in oceanography was met with strong resistance. At that time, there were many studies on the calculation of the total mass transport. The founders of this field, V.B. Shtokman, H. Sverdrup, and W. Munk, were mistaken in believing that they addressed baroclinic models of the ocean. The author preferred works by V. Ekman [12] and I. Sandström and B. Helland-Hansen [19]. A generalization of recent studies made it possible to come to some conclusions on the need to use the level of the free oceanic surface as a basis rather than the function of total mass transport, on the role of the baroclinic β effect (BARBE), on the joint effect of baroclinicity and bottom relief (JEBAR), etc. The author conditionally divides these fifty years into the following three stages. (1) The first stage was 1961-1969, when the author and his students performed almost exclusively diagnostic and adaptation calculations of climatic characteristics. (2) The second stage began with papers by K. Bryan [23] and his students. This is an important and promising stage involving mainly prognostic studies and four-dimensional analysis. The major advances in modeling at this stage (the Gulf Stream separation point [61], the Kuroshio seasonal evolution [63], the formation of the cold intermediate layer in the Black Sea [80], the subsurface countercurrent in the Caspian Sea [25], the realistic four-dimensional analysis of the Kara Sea [60], etc.) were due to high-resolution and/or data assimilation with an adequate period of integration. (3) The third stage began with the activities of international

  12. Revisiting fifty years of research on pheromone signaling in ciliates. (United States)

    Luporini, Pierangelo; Pedrini, Bill; Alimenti, Claudio; Vallesi, Adriana


    Among protists, pheromones have been identified in a great variety of algal species for their activity in driving gamete-gamete interactions for fertilization. Analogously in ciliates, pheromones have been identified for their activity in inducing the sexual phenomenon of conjugation. Although this identification was pioneered by Kimball more than fifty years ago, an effective isolation and chemical characterization of ciliate pheromones has remained confined to species of Blepharisma, Dileptus and Euplotes. In Euplotes species, in which the molecular structures have been determined, pheromones form species-specific families of structurally homologous helical, cysteine-rich, highly-stable proteins. Being structurally homologous, they can bind cells in competition with one another, raising interesting functional analogies with the families of growth factors and cytokines that regulate cell differentiation and development in higher organisms. In addition to inducing conjugation by binding cells in heterologous fashion, Euplotes pheromones act also as autocrine growth factors by binding to, and promoting the vegetative reproduction of the same cells from which they originate. This autocrine activity is most likely primary, providing a concrete example of how the original function of a molecule can be obscured during evolution by the acquisition of a new one.

  13. DMPD: Fifty years of interferon research: aiming at a moving target. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 16979566 Fifty years of interferon research: aiming at a moving target. Vilcek J. I...mmunity. 2006 Sep;25(3):343-8. (.png) (.svg) (.html) (.csml) Show Fifty years of interferon research: aiming... at a moving target. PubmedID 16979566 Title Fifty years of interferon research: aiming at a moving target.

  14. Fifty Years of Space Weather Forecasting from Boulder (United States)

    Berger, T. E.


    The first official space weather forecast was issued by the Space Disturbances Laboratory in Boulder, Colorado, in 1965, ushering in an era of operational prediction that continues to this day. Today, the National Oceanic and Atmospheric Administration (NOAA) charters the Space Weather Prediction Center (SWPC) as one of the nine National Centers for Environmental Prediction (NCEP) to provide the nation's official watches, warnings, and alerts of space weather phenomena. SWPC is now integral to national and international efforts to predict space weather events, from the common and mild, to the rare and extreme, that can impact critical technological infrastructure. In 2012, the Strategic National Risk Assessment included extreme space weather events as low-to-medium probability phenomena that could, unlike any other meteorogical phenomena, have an impact on the government's ability to function. Recognizing this, the White House chartered the Office of Science and Technology Policy (OSTP) to produce the first comprehensive national strategy for the prediction, mitigation, and response to an extreme space weather event. The implementation of the National Strategy is ongoing with NOAA, its partners, and stakeholders concentrating on the goal of improving our ability to observe, model, and predict the onset and severity of space weather events. In addition, work continues with the research community to improve our understanding of the physical mechanisms - on the Sun, in the heliosphere, and in the Earth's magnetic field and upper atmosphere - of space weather as well as the effects on critical infrastructure such as electrical power transmission systems. In fifty years, people will hopefully look back at the history of operational space weather prediction and credit our efforts today with solidifying the necessary developments in observational systems, full-physics models of the entire Sun-Earth system, and tools for predicting the impacts to infrastructure to protect

  15. [Fifty years of treating stuttering in young children]. (United States)

    Franken, M C


    Developmental stuttering involves a disruption in the smooth connection of sounds or syllables that is characterised by multiple interruptions within a word, such as repetitions of sounds, syllables and parts of words, elongation of words and blockades. During the course of the past fifty years, three phases can be distinguished in the management of developmental stuttering, characterised by a shift in stress from the environmental factors to the role of the organic, i.e. non-psychological, factors. Initially, the parents of toddlers and pre-school children were advised to pay no attention to stuttering behaviour. Then the problem would disappear the quickest of its own accord. After 1985, the stress came to be placed on reducing the level of expectations, for example by speaking to the child more slowly and using shorter and less complex sentences. Another new aspect was that the parents learned to discuss stuttering with the child in a sympathetic and accepting manner. Since 2000, an approach has been introduced in the Netherlands in which parents are taught to respond verbally to both fluent and non-fluent speech. Emphasis is given to rewarding fluent speech, such as in the Australian Lidcombe Program, but the parents are also taught to react to stuttered speech once in a while. At present, early treatment is accepted as a way of preventing chronic stuttering, even if this means that some children will be treated that would have recovered in any case and even though the exact yield is not yet clear. Clinical practice shows that early treatment almost always succeeds in limiting the severity of stuttering to a mild form.

  16. Fifty years of fuzzy logic and its applications

    CERN Document Server

    Rishe, Naphtali; Kandel, Abraham


    This book presents a comprehensive report on the evolution of Fuzzy Logic since its formulation in Lotfi Zadeh’s seminal paper on “fuzzy sets,” published in 1965. In addition, it features a stimulating sampling from the broad field of research and development inspired by Zadeh’s paper. The chapters, written by pioneers and prominent scholars in the field, show how fuzzy sets have been successfully applied to artificial intelligence, control theory, inference, and reasoning. The book also reports on theoretical issues; features recent applications of Fuzzy Logic in the fields of neural networks, clustering, data mining, and software testing; and highlights an important paradigm shift caused by Fuzzy Logic in the area of uncertainty management. Conceived by the editors as an academic celebration of the fifty years’ anniversary of the 1965 paper, this work is a must-have for students and researchers willing to get an inspiring picture of the potentialities, limitations, achievements and accomplishments...

  17. Editorial: “Fifty years Annals of Forest Science”


    Leban, Jean-Michel; Peiffer, Marianne; Bontemps, Jean-Daniel; Dreyer, Erwin


    Annals of Forest Science is publishing a series of review papers to celebrate 50 years of activities as a journal in forest and wood science. The reviews emphasize the extent to which forest and wood sciences changed and developed as a large array of disciplines devoted to complex objects with sometimes many conflicting issues.

  18. Marriage and Fertility in Tianjin, China: Fifty Years of Transition. (United States)

    Pasternak, Burton

    A report of research conducted in Tianjin, People's Republic of China (September 1981-January 1982) describes and analyses changes in family structure, marriage, post-marital residence, and fertility in a neighborhood of factory workers over a 50-year period. Social and economic changes such as delayed marriage, increased access to education, and…

  19. Fifty years of CERN history in the spotlight

    CERN Multimedia


    The programme of events for CERN's Golden Jubilee year was officially unveiled at a press conference on 8 March. The first of these events took place the following day, when the Swiss commemorative postage stamp issued in the Laboratory's honour went on sale in post offices throughout Switzerland.

  20. [Fifty years of mortality or the result of social inequality]. (United States)

    Jimenez Ornelas, R


    An average of 30 years has been added to Mexican life expectancy in the past five decades. Women and men born in 1940 had life expectancies of 41.5 and 39.5 years, respectively, compared to 72.8 and 66.7 in 1990. Mortality declined most sharply between 1940 and 1960, and declined at varying rates in the subsequent decades. In the decade from 1980 to 1990, the mortality decline slowed. The differential in life expectancy between men and women amounted to 6.2 years in 1980 and 6.1 in 1990. The high life expectancy of women means that future advances will be more difficult to achieve. The greater survival of Mexicans over the five decades is due to improvements in living conditions, advances in preventive and curative medicine, and social policy. The slower pace of mortality decline in the past decade may perhaps have been due to deteriorating living conditions, reduced priority accorded to social policies in the areas of health and education, and declining real incomes. Mexican health, education, and other social policies have favored the urban and industrial centers, increasing regional disparities. A comparison of life expectancies in Oaxaca, one of the most impoverished states of Mexico, and Puebla, which has somewhat better conditions, with life expectancies in the wealthy state of Nuevo Leon and the Federal District demonstrates the influence of the level of development on life expectancy. Life expectancy in 1990 in Oaxaca and Puebla was the equivalent of that for all of Mexico ten years earlier. Men in Oaxaca live five years less on average than men in Nuevo Leon. But the gain in life expectancy for males was higher in Oaxaca between 1980 and 1990 than in the other states.

  1. Water chemistry: fifty years of change and progress. (United States)

    Brezonik, Patrick L; Arnold, William A


    Water chemistry evolved from early foundations in several related disciplines. Although it is difficult to associate a precise date to its founding, several events support the argument that the field as we know it today developed in the mid-20th century--at the dawn of the "environmental era"--that is, ∼1960. The field in its modern incarnation thus is about 50 years old. In celebration of this half-centenary, we examine here the origins of water chemistry, how the field has changed over the past 50 years, and the principal driving forces for change, focusing on both the "practice" of water chemistry and ways that teaching the subject has evolved.

  2. Fifty years of wilderness science: An international perspective (United States)

    Steve Carver; Steve McCool; Zdenka Krenova; Mark Fisher; Stephen. Woodley


    The 50th Anniversary of the U.S. Wilderness Act is a cause for celebration, not least of which is the scientific use recognized in Section 4(b) of the act. This year also marks the 20th anniversary of publication of the International Journal of Wilderness (IJW). IJW plays a unique role in wilderness stewardship, science, and advocacy, providing a forum for presentation...

  3. Bibliometric analysis of fifty years of physica status solidi

    Energy Technology Data Exchange (ETDEWEB)

    Marx, Werner [Max Planck Institute for Solid State Research, Stuttgart (Germany); Hoffmann, Dieter [Max Planck Institute for the History of Sciences, Berlin (Germany)


    Bibliometric methods are used to analyze quantitatively the journal physica status solidi (pss) 50 years after its inception. First, the coverage of the journal by the relevant citation indices accessible under the Web of Science (WoS) and the field-specific INSPEC database is examined. The number of papers published per year by the journal as a whole and by the specific pss series is given. The time evolution of the pss output in terms of papers per year is compared with the output evolution of some major competing journals in the field of condensed-matter physics. The top-12 most frequently cited pss papers published within the complete time period 1961-2010 and within the two separate time periods 1974-1989 and 1990-2010 (before and after the German reunification) are listed. The citation time curves (citation history) of the three most frequently cited pss papers are presented. Furthermore, the Journal Impact Factors (JIFs) of the pss journal series (a) and (b) are discussed and their time evolution is shown. Moreover, the distribution of the pss papers over their document types and the authors is given. The countries of authors are ranked for the complete time period 1961-2010 as well as for the time periods 1973-1989 and 1990-2010. The complete ensemble of the citing papers of the pss papers is analyzed and discussed. The journals citing most often the pss papers published in the year 2000 are listed. Finally, the distribution of the pss papers over the various subject areas and classification terms based on the INSPEC database is tabled. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  4. Fifty years of the CERN Proton Synchrotron Volume 2

    CERN Document Server

    Gilardoni, Simone; CERN. Geneva; Burnet, Jean-Paul; Carli, Christian; Chanel, Michel; Garoby, Roland; Giovannozzi, Massimo; Hancock, Steven; Haseroth, Helmut; Hübner, Kurt; Küchler, Detlef; Lewis, Julian; Lombardi, Alessandra; Martini, Michel; Maury, Stephan; Métral, Elias; Möhl, Dieter; Plass, Günther; Rinolfi, Louis; Scrivens, Richard; Steerenberg, Rende; Steinbach, Charles; Vretenar, Maurizio; Zickler, Thomas


    This report sums up in two volumes the first 50 years of operation of the CERN Proton Synchrotron. After an introduction on the genesis of the machine, and a description of its magnet and powering systems, the first volume focuses on some of the many innovations in accelerator physics and instrumentation that it has pioneered, such as transition crossing, RF gymnastics, extractions, phase space tomography, or transverse emittance measurement by wire scanners. The second volume describes the other machines in the PS complex: the proton linear accelerators, the PS Booster, the LEP pre-injector, the heavy-ion linac and accumulator, and the antiproton rings.

  5. Fifty years of the CERN Proton Synchrotron Volume 1

    CERN Document Server

    CERN. Geneva; Carli, Christian; Chanel, Michel; Garoby, Roland; Gilardoni, Simone; Giovannozzi, Massimo; Hancock, Steven; Haseroth, Helmut; Hübner, Kurt; Küchler, Detlef; Lewis, Julian; Lombardi, Alessandra; Manglunki, Django; Martini, Michel; Maury, Stephan; Métral, Elias; Möhl, Dieter; Plass, Günther; Rinolfi, Louis; Scrivens, Richard; Steerenberg, Rende; Steinbach, Charles; Vretenar, Maurizio; Zickler,Thomas


    This report sums up in two volumes the first 50 years of operation of the CERN Proton Synchrotron. After an introduction on the genesis of the machine, and a description of its magnet and powering systems, the first volume focuses on some of the many innovations in accelerator physics and instrumentation that it has pioneered, such as transition crossing, RF gymnastics, extractions, phase space tomography, or transverse emittance measurement by wire scanners. The second volume describes the other machines in the PS complex: the proton linear accelerators, the PS Booster, the LEP pre-injector, the heavy-ion linac and accumulator, and the antiproton rings.

  6. Fifty years of IAA History Symposia (1967-2016) (United States)

    Skoog, A. Ingemar; Hall, R. Cargill


    The International Academy of Astronautics (IAA) Symposia on the History of Rocketry and Astronautics have been held annually at the International Astronautical Congresses since 1967. During these past 50 years nearly 800 papers have been presented and subsequently published in the proceedings. With a 20-year rule imposed for historical presentations, the first 10 symposia concentrated on pre-World War II and early 1950s activities. A surprisingly large number of papers on early, less well-known Soviet-Russian contributions to rocketry and astronautics were presented in the first symposia, despite the ongoing Space Race between the U.S and USSR. Another important element in these symposia involved memoir papers offered by pre- and post-war rocket and astronautics pioneers from many countries, and the participation of many of these pioneers in person. In sum, the history of national space and rocket projects from some 40 countries were presented over the years in IAA History Symposia. These 50 symposia have provided a platform for scholars and professional and non-professional historians to meet and discuss the history of rocketry and astronautics, and to personally interview many space pioneers, most of whom today are deceased. Their personal recollections have since been shared with a large audience. Over time, IAA history papers divided into recognizable periods: ancient times through the 19th century, and the 20th and 21st centuries, which separate among actions and events that took place before 1945, in 1945 to 1957, and after 1957 (which marked the beginning of the space age). Proceedings of the IAA History Symposia have been published in English, ultimately in the History Series of the American Astronautical Society (AAS) and its publishing arm, Univelt Inc., under an agreement secured with the IAA. This paper presents an overview of the IAA History Symposia. It examines the early years of the history committee and its first symposium, the evolution of

  7. [From conventional cytogenetics to microarrays. Fifty years of Philadelphia chromosome]. (United States)

    Hernández, Jesús M; Granada, Isabel; Solé, Francesc


    In 1960 Ph-chromosome was found associated with the presence of chronic myelogenous leukemia. In these 50 years an increasing number of cytogenetic abnormalities have been found associated with hematological malignancies. The presence of these abnormalities is not only important for the diagnosis of the patient, but it also contributes to the prognosis of patients with leukemia or lymphoma. For this reason the WHO classification of hematological disease has included these studies for the correct characterization of leukemias and lymphomas. In addition, the use of FISH and micromatrix methodologies have refined the genetic lesions present in these malignancies. The cytogenetic changes observed also provide further information in relation to the therapy.

  8. The right to health fifty years on: still skeptical? (United States)

    Kirby, M


    The drafting of the Universal Declaration of Human Rights was a crucial step in the recognition of a legal right to health. Although the past 50 years have revealed weaknesses in the Declaration, it has been an important catalyst for social and legal change worldwide and for new thinking about public health. Recently, the struggle against the HIV/AIDS epidemic has taught us that protecting the human rights of those most at risk is, in fact, a most effective means of preventing the spread of HIV. Traditional public health problems, as well as those involving new biotechnologies, must today be addressed with specific attention to human rights.

  9. Fifty years of fuel quality and vehicle emissions

    Energy Technology Data Exchange (ETDEWEB)

    Rose, K. [CONCAWE, Brussels (Belgium)


    In the late 1970s, with growing emphasis on urban air quality in Europe, CONCAWE embarked on new research related to fuels and vehicles. After only a few years, it became clear that fuel properties and specifications would be increasingly important to the future of the European refining industry, and considerable research was completed in the 1970s to better understand the impact of fuel composition on vehicle performance and emissions. This early work led to the formation of the first Fuels and Emissions Management Group (FEMG) in 1982, almost 20 years after the formation of the CONCAWE Association. Since these early days, FEMG has been responsible for ensuring CONCAWE's strategic outlook on future vehicle and fuel developments, monitoring regulatory and vehicle developments, and overseeing a diverse portfolio of fuel quality and vehicle emissions research. Since the 1980s, tremendous progress has been made in improving European air quality, in part by reducing emissions from road transport and other sectors, and major improvements in European fuel qualities have contributed to these reductions. Nevertheless, many challenges are still ahead, especially further reductions in pollutant emissions from vehicles while also reducing greenhouse gas (GHG) emissions from transport. In the near-term, these GHG reductions will largely come from improvements in engine and vehicle fuel consumption and by blending of GHG-reducing bio-blending components. Dealing with these challenges to fuel quality and performance will require a continuing focus on CONCAWE's founding principles: sound science, cost effectiveness and transparency.

  10. Fifty years of the Korean Society for Parasitology. (United States)

    Cho, Seung-Yull


    In 1959, the Korean Society for Parasitology was founded by clinical scientists, specialists of public health, and 5 core parasitologists with experience in American science and medicine. The Society this year celebrates its 50th anniversary. Due to public health importance at the time of foundation, medical parasitology was the main stream for next 3 decades. Domestic problems of niche parasitic diseases, unlisted in 6 tropical diseases of major importance, had been studied by own efforts. To cope with the demand of parasite control, evaluation system for control activity was built up. Control activity against soil-transmitted nematodes, conducted for almost 3 decades, was evaluated as a success. Evaluation of praziquantel efficacy for clonorchiasis, paragonimiasis, and neurocysticercosis, population dynamics of Ascaris lumbricoides infection in a situation of continuous reinfections, diagnostic modalities of antibody tests combined with brain imaging developed for helminthiasis of the central nervous system and researches on intestinal trematodes were achievements in the first 30 years. During the recent 2 decades, science researches, such as cell and molecular biology of parasites and immunology of parasitic infections have been studied especially on parasitic allergens and proteolytic and anti-oxidant enzymes. Experiences of international cooperation for world health have been accumulated and would be expanded in the future.

  11. [Fifty years of cooperation--FEBS and Polish Biochemical Society]. (United States)

    Barańska, Jolanta


    This year, the Federation of European Biochemical Societies (FEBS) celebrates its 50th anniversary. The Polish Biochemical Society, represented by the Society's President, Kazimierz Zakrzewski, was a founding member of the organization. The text presents a history of collaboration between FEBS and Polish Biochemical Society, the participation of Polish Biochemical Society members in different FEBS activities, as well as the role they played in running the Federation. Author describes FEBS Congresses which taken place in Warsaw, the first 3rd FEBS Meeting in 1966 and then 29th Congress in 2004. The profiles of Jakub Karol Parnas, the founding father of the Polish biochemistry and some crucial Presidents of the Society, are also presented. The text describes Parnas Conferences, organized jointly by Polish and Ukrainian Biochemical Societies from 1996, and growing from 2011 into three-nation event with participation of Ukrainian, Israeli and Polish scientists, largely due to significant help from FEBS. Summarizing the last few years, author judge the cooperation between the Federation and the Polish Biochemical Society as optimal.

  12. Fifty Years of the Spectrum Problem: Survey and New Results

    CERN Document Server

    Durand, Arnaud; Makowsky, Johann; More, Malika


    In 1952, Heinrich Scholz published a question in the Journal of Symbolic Logic asking for a characterization of spectra, i.e., sets of natural numbers that are the cardinalities of finite models of first order sentences. G\\"unter Asser asked whether the complement of a spectrum is always a spectrum. These innocent questions turned out to be seminal for the development of finite model theory and descriptive complexity. In this paper we survey developments over the last 50-odd years pertaining to the spectrum problem. Our presentation follows conceptual developments rather than the chronological order. Originally a number theoretic problem, it has been approached in terms of recursion theory, resource bounded complexity theory, classification by complexity of the defining sentences, and finally in terms of structural graph theory. Although Scholz' question was answered in various ways, Asser's question remains open. One appendix paraphrases the contents of several early and not easily accesible papers by G. Ass...

  13. Changes in sunflower breeding over the last fifty years

    Directory of Open Access Journals (Sweden)

    Vear Felicity


    Full Text Available This article discusses changes in sunflower breeding objectives since the introduction of hybrid varieties 50 years ago. After a reminder of the importance of some early programmes, Canadian in particular, the present situation for each breeding objective is compared with those encountered earlier. Breeding for yield has changed from maximum possible yield under intensive agriculture to yield with resistance to abiotic stresses, moderate droughts and shallow soils in particular, helped by collaboration with agronomists to produce crop models. Breeding for oil has changed from quantity to quality and the value of seed meal is again becoming economically important. Necessary disease resistances vary with agronomic practises and selection pressure on pathogens according to varietal genetics. The possibilities of new types of sunflower are also discussed. Advances in genomics will change breeding procedures, but with rapidly changing molecular techniques, international collaboration is particularly important.

  14. Perspectives on Erving Goffman's "Asylums" fifty years on. (United States)

    Adlam, John; Gill, Irwin; Glackin, Shane N; Kelly, Brendan D; Scanlon, Christopher; Mac Suibhne, Seamus


    Erving Goffman's "Asylums" is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines.

  15. Poly(N-isopropylacrylamide) Phase Diagrams: Fifty Years of Research. (United States)

    Halperin, Avraham; Kröger, Martin; Winnik, Françoise M


    In 1968, Heskins and Guillet published the first systematic study of the phase diagram of poly(N-isopropylacrylamide) (PNIPAM), at the time a "young polymer" first synthesized in 1956. Since then, PNIPAM became the leading member of the growing families of thermoresponsive polymers and of stimuli-responsive, "smart" polymers in general. Its thermal response is unanimously attributed to its phase behavior. Yet, in spite of 50 years of research, a coherent quantitative picture remains elusive. In this Review we survey the reported phase diagrams, discuss the differences and comment on theoretical ideas regarding their possible origins. We aim to alert the PNIPAM community to open questions in this reputably mature domain.

  16. Fifty years of federal radioactive waste management: Policies and practices

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, R.G.


    This report provides a chronological history of policies and practices relating to the management of radioactive waste for which the US Atomic Energy Commission and its successor agencies, the Energy Research and Development Administration and the Department of Energy, have been responsible since the enactment of the Atomic Energy Act in 1946. The defense programs and capabilities that the Commission inherited in 1947 are briefly described. The Commission undertook a dramatic expansion nationwide of its physical facilities and program capabilities over the five years beginning in 1947. While the nuclear defense activities continued to be a major portion of the Atomic Energy Commission`s program, there was added in 1955 the Atoms for Peace program that spawned a multiplicity of peaceful use applications for nuclear energy, e.g., the civilian nuclear power program and its associated nuclear fuel cycle; a variety of industrial applications; and medical research, diagnostic, and therapeutic applications. All of these nuclear programs and activities generated large volumes of radioactive waste that had to be managed in a manner that was safe for the workers, the public, and the environment. The management of these materials, which varied significantly in their physical, chemical, and radiological characteristics, involved to varying degrees the following phases of the waste management system life cycle: waste characterization, storage, treatment, and disposal, with appropriate transportation linkages. One of the benefits of reviewing the history of the waste management program policies and practices if the opportunity it provides for identifying the lessons learned over the years. Examples are summarized at the end of the report and are listed in no particular order of importance.

  17. Chemical Hydrogeology: Fifty Years of Advances, Breakthroughs, and Innovation (United States)

    Brusseau, M. L.


    Chemical hydrogeology focuses on the composition, properties, and biogeochemical processes inherent to water in subsurface environments. Multiple avenues of research coalesced in the 1960's to foment the development of chemical hydrogeology as a distinct field. In the intervening 50 years, chemical hydrogeology principles have been applied to innumerable issues and problems, and concomitantly, the field has continually experienced advances, breakthroughs, and innovations in theory, analysis, and application. An overarching theme to chemical hydrogeology in both theory and application is integration--- integration of disciplines (interdisciplinary, multidisciplinary), integration of approaches (theoretical, experimental, analytical), and integration of scales (spatial, temporal). Chemical hydrogeology has never been more relevant and more challenged as today, as we face critical issues related to for example water scarcity and availability of clean water, impacts of energy development, production and storage, and human interactions with ecosystem services. This presentation will illustrate recent advances in chemical hydrogeology, ranging from application of advanced imaging for characterization of pore-scale multiphase systems to integrated physical and biogeochemical assessments of field-scale contaminant transport.

  18. Fifty Years of Quasars: Physical Insights and Potential for Cosmology

    CERN Document Server

    Sulentic, J W; Dultzin, D; D'Onofrio, M; del Olmo, A


    Last year (2013) was more or less the 50th anniversary of the discovery of quasars. It is an interesting time to review what we know (and don't know) about them both empirically and theoretically. These compact sources involving line emitting plasma show extraordinary luminosities extending to one thousand times that of our Milky Way in emitting volumes of a few solar system diameters (bolometric luminosity log L$_{bol} \\sim $ 44-48 [erg s$^{-1}$]: D=1-3 light months $\\sim$ $10^3$ - $10^4$ gravitational radii). The advent of 8-10 meter class telescopes enables us to study them spectroscopically in ever greater detail. In 2000 we introduced a 4D Eigenvector 1 parameters space involving optical, UV and X-Ray measures designed to serve as a 4D equivalent of the 2D Hertzsprung-Russell diagram so important for depicting the diversity of stellar types and evolutionary states. This diagram has revealed a principal sequence of quasars distinguished by Eddington ratio (proportional to the accretion rate per unit mass)...

  19. Fifty years of progress in speech understanding systems (United States)

    Zue, Victor


    Researchers working on human-machine interfaces realized nearly 50 years ago that automatic speech recognition (ASR) alone is not sufficient; one needs to impart linguistic knowledge to the system such that the signal could ultimately be understood. A speech understanding system combines speech recognition (i.e., the speech to symbols conversion) with natural language processing (i.e., the symbol to meaning transformation) to achieve understanding. Speech understanding research dates back to the DARPA Speech Understanding Project in the early 1970s. However, large-scale efforts only began in earnest in the late 1980s, with government research programs in the U.S. and Europe providing the impetus. This has resulted in many innovations including novel approaches to natural language understanding (NLU) for speech input, and integration techniques for ASR and NLU. In the past decade, speech understanding systems have become major building blocks of conversational interfaces that enable users to access and manage information using spoken dialogue, incorporating language generation, discourse modeling, dialogue management, and speech synthesis. Today, we are at the threshold of developing multimodal interfaces, augmenting sound with sight and touch. This talk will highlight past work and speculate on the future. [Work supported by an industrial consortium of the MIT Oxygen Project.

  20. Marijuana: A Fifty-Year Personal Addiction Medicine Perspective. (United States)

    Smith, David E


    As of September 2015, the cultivation, possession, and/or use of marijuana is illegal under U.S. federal law as a Schedule I narcotic; however, it is legal in four states and Washington, D.C. Forty-six states allow some form of medicinal marijuana or decriminalization. Marijuana has been used medicinally for thousands of years; Marijuana's regulation by law enforcement in the U.S., rather than the medical community, led to an almost complete halt to academic and scientific research after the 1930s. The late 1960s saw an upsurge in recreational marijuana use by middle-class youth, the majority of whom experienced minimal adverse effects aside from arrest and attendant legal complications. Since the mid-1990s, the use of medicinal marijuana for certain conditions has gained increasing acceptance. Stronger strains and formulations of marijuana pose a risk to the developing brains of adolescents. Within the addiction medicine community, there is currently no consensus on marijuana. In the East, the feeling is primarily that marijuana continue to be proscribed. In the West, where clinicians must face the realities of medicalization, decriminalization, and/or legalization, as well as widespread recreational use, there is more of a movement to minimize adverse effects, particularly on youth.

  1. Fifty Years of THERP and Human Reliability Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ronald L. Boring


    In 1962 at a Human Factors Society symposium, Alan Swain presented a paper introducing a Technique for Human Error Rate Prediction (THERP). This was followed in 1963 by a Sandia Laboratories monograph outlining basic human error quantification using THERP and, in 1964, by a special journal edition of Human Factors on quantification of human performance. Throughout the 1960s, Swain and his colleagues focused on collecting human performance data for the Sandia Human Error Rate Bank (SHERB), primarily in connection with supporting the reliability of nuclear weapons assembly in the US. In 1969, Swain met with Jens Rasmussen of Risø National Laboratory and discussed the applicability of THERP to nuclear power applications. By 1975, in WASH-1400, Swain had articulated the use of THERP for nuclear power applications, and the approach was finalized in the watershed publication of the NUREG/CR-1278 in 1983. THERP is now 50 years old, and remains the most well known and most widely used HRA method. In this paper, the author discusses the history of THERP, based on published reports and personal communication and interviews with Swain. The author also outlines the significance of THERP. The foundations of human reliability analysis are found in THERP: human failure events, task analysis, performance shaping factors, human error probabilities, dependence, event trees, recovery, and pre- and post-initiating events were all introduced in THERP. While THERP is not without its detractors, and it is showing signs of its age in the face of newer technological applications, the longevity of THERP is a testament of its tremendous significance. THERP started the field of human reliability analysis. This paper concludes with a discussion of THERP in the context of newer methods, which can be seen as extensions of or departures from Swain’s pioneering work.

  2. Fifty-one Years of Hawaiian Hotspot Debate (United States)

    Hofmann, A. W.; Farnetani, C. G.


    Tuzo Wilson's ground breaking realization that the progressively increasing ages of volcanism along linear chains of Pacific islands are best explained by movement of the Pacific plate over a stationary heat source was followed by Jason Morgan's physically more plausible plume theory. Hawaii, the "mother" of all plumes/hotspots, has become the focus of a continuing burden-of-proof battle about the existence of mantle plumes. The monotonic age progression of this island chain has been amply confirmed, but the hotspot locus is not perfectly fixed, and this has been taken to be a failed test of the plume model. Numerous numerical experiments in bottom-heated settings have demonstrated that plumes are a physically natural mode of convection, but antiplumers focus on the fact that in internally heated media, plumes are unlikely. Early proposals of propagating lithospheric fractures with magma tapped from the underlying asthenosphere have never been sufficiently developed to seriously compete with the convection models. Geochemists eagerly adopted the plume model and developed highly model-dependent criteria for identifying mantle plumes, but these are easily knocked down, because most geochemical tracers carry no information about the specific mantle depth being sampled. Conversely, petrological-geochemical models invoking exclusively asthenospheric magma sources have not explained how, in the absence of a Bunsen burner, high melt production can be localized in one geographic spot for 108 years. Our work has focussed on using dynamic modelling to trace the path of geochemical heterogeneities from the base of the mantle to the volcanoes. We find that large-scale heterogeneities existing in the lower thermal boundary layer are drawn into close proximity in the plume conduit and in the erupting volcanoes. Geochemistry cannot prove mantle plumes, but plumes offer a promising path to understanding the geochemistry of the deep mantle.

  3. Deterrence, denuclearization, and proliferation: Alternative visions of the next fifty years

    Energy Technology Data Exchange (ETDEWEB)

    Lehman, R.F. II


    The great library of Alexandria may have contained fewer volumes than the number which have been written on the subject of nuclear weapons in the Cold War. With the end of the Cold War, a new nuclear library is in the making. Much thought is being given to the next steps in nuclear policy, strategy, forces, arms control, and nonproliferation. For this very distinguished conference, however, I have been asked to look further ahead indeed, forward fifty-years. Prognostication is always a risky business. Detailed predictions beyond the shortest duration are difficult to label as ``scientific`` even in the social sciences. Forecasting ahead fifty years in an age of ever accelerating change would seem to be hopeless. Projecting the future of nuclear weapons, however, may not be as complex as one might think. Detailing the future fifty years from now is not necessary. We want to inform upcoming decisions by examining the possibilities, not write a history in advance of what is to happen. Our look forward con benefit from a brief look back fifty years. In retrospect, those years passed quickly, and with each additional year, analysts make them appear more simple than they seemed at the time. This paper contributes further to this process of oversimplification, as we say, ``for heuristic purposes.`` When in doubt, I have erred on the side of being provocative.

  4. Domain analysis of computational science - Fifty years of a scientific computing group

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, M.


    I employed bibliometric- and historical-methods to study the domain of the Scientific Computing group at Brookhaven National Laboratory (BNL) for an extended period of fifty years, from 1958 to 2007. I noted and confirmed the growing emergence of interdisciplinarity within the group. I also identified a strong, consistent mathematics and physics orientation within it.

  5. Fifty years of continuous improvement: (What has DOE done for analytical chemistry?)

    Energy Technology Data Exchange (ETDEWEB)

    Shults, W.D.


    Over the past fifty years, analytical scientist within the DOE complex have had a tremendous impact on the field of analytical chemistry. This paper suggests six ``high impact`` research/development areas that either originated within or were brought to maturity within the DOE laboratories. ``High impact`` means they lead to new subdisciplines or to new ways of doing business.

  6. Darrell Huff and Fifty Years of How to Lie with Statistics


    Steele, J. Michael


    Over the last fifty years, How to Lie with Statistics has sold more copies than any other statistical text. This note explores the factors that contributed to its success and provides biographical sketches of its creators: author Darrell Huff and illustrator Irving Geis.

  7. Fifty Years Later: Comments on the Further Development of a Science of Verbal Behavior (United States)

    Leigland, Sam


    Fifty years after the publication of Skinner's "Verbal Behavior", some possibilities for the future of Skinner's "science of verbal behavior" are considered. Specifically, certain areas of development or advancement are examined which might be of special importance to the expansion and influence of the functional analysis of verbal behavior.…

  8. Fifty Ninth Annual Report: United States Department of Labor. Fiscal Year 1971. (United States)

    Department of Labor, Washington, DC.

    This fifty-ninth annual report of the United States Department of Labor for the fiscal year 1971 contains a 6-page report by the Secretary of Labor, 11 separate Federal Department reports, and a variety of appended tables covering such areas as enrollments and funding for various government programs. Detailing the initiation or improvement of a…

  9. Fifty years of entomological publications in the Revista de Biología Tropical. (United States)

    Hanson, Paul


    Over its fifty year history nearly twenty percent of the papers published in the Revista de Biología Tropical have been about insects and arachnids. In the 1950's papers on arthropods of medical importance were dominant, in the 1960's there was a poliferation of papers on bees, and in more recent years the subjects have become increasingly diverse. In terms of nationality of contributing authors, the journal appears to have become increasingly international in later years.

  10. [Fifty years ago, the double helix gave birth to molecular biology]. (United States)

    Lunardi, J


    Fifty years ago, a paper signed by two young scientists, James Watson and Francis Crick, and reporting a model for DNA based on a double helix structure was published in the scientific review Nature in date of april 25, 1953. Although this model of striking simplicity and rare elegance was actually worked out in a few months by the two men, it was the result of quite 100 years of research aimed at the definition of the structure of the genetic material present in living organisms. The double helix was the outcome of a multidisciplinary approach initiated in the mid 19th century by the genetic laws of Gregor Mendel and the discovery of the chemical nature of the desoxyribonucleic acid by Johann Friedrich Miesher. The discovery of the DNA structure had been at the origin of major scientific progress regarding mechanisms that rule the replication and the expression of the genetic information. Theses researches have given birth to a new scientific field, molecular biology, which everyone will see very soon is actually part in a quasi symbiotic manner of all other biological fields dealing with life. The spectacular development of molecular biology during the last fifty years was in great part possible thanks to a concomitant enormous development of the different methods of investigation of the biological molecules and structure. The present rising of biotechnology applications is the direct consequence of the tremendous amount of fundamental knowledge gained during the last few decennia. They open very important and attractive perspectives both on medical or on socio-economic point of views. There is no doubt that the next fifty years will be as fruitful as the last ones.

  11. CASTLE BRAVO: Fifty Years of Legend and Lore. A Guide to Off-Site Radiation Exposures (United States)


    Commander, TG7.1), Bob Campbell (TG7.1 J-6), Carl Lyon (TG7.1 J-3), Garry Higgins (TG7.1 TU-12), and Roger Ray (TG7.1 J-3). Hal Plank (TG7.1 TU-1...scrupulously clear to other laboratory staff members ( Campbell 1985). January 2013 CASTLE BRAVO: Fifty Years of Legend and Lore Introduction 3 Soon...regular mess line for meals and had the same ration as the crew. The meat course was the least popular. The majority of the party asked for more soup

  12. Learning from the Past: A Fifty-year Perspective on Pakistan's Development


    Pervez Hasan


    In some ways, Pakistan’s economic growth since 1947 has been remarkable. The country’s economic viability was considered, in some quarters,1 in serious doubt at its emergence, but it has managed, despite a quadrupling of the population, to bring about significant improvement in the average living standards. Per capita GNP growth, on average around 2 percent per annum over a long stretch of nearly fifty years, has been the best among countries of the subcontinent. This growth has meant an incr...

  13. The continuous time random walk, still trendy: fifty-year history, state of art and outlook (United States)

    Kutner, Ryszard; Masoliver, Jaume


    In this article we demonstrate the very inspiring role of the continuous-time random walk (CTRW) formalism, the numerous modifications permitted by its flexibility, its various applications, and the promising perspectives in the various fields of knowledge. A short review of significant achievements and possibilities is given. However, this review is still far from completeness. We focused on a pivotal role of CTRWs mainly in anomalous stochastic processes discovered in physics and beyond. This article plays the role of an extended announcement of the Eur. Phys. J. B Special Issue [">] containing articles which show incredible possibilities of the CTRWs. Contribution to the Topical Issue "Continuous Time Random Walk Still Trendy: Fifty-year History, Current State and Outlook", edited by Ryszard Kutner and Jaume Masoliver.

  14. Fifty Years Remembered: The First 50 Years of the Tulsa District, U.S. Army Corps of Engineers (United States)


    District Engineer! Col. Frank Patete Project Manager! Beverly Leland Author! Ann Patton Managing Editor! Larry Silvey Production Manager! Michael Shelton...youngsters and fishermen, Pat Mayse raft riders, Keystone Triathe/on swimmers , Broken Bow hikers, and Keystone campers. SECTION 1: FIFTY YEARS OF...representative of construction contractor Hensel Phelps sign the contract for repairs to begin. REBUILDING TINKER’S 3001 It was the largest and most

  15. Fifty Years of Progress, 1937-1987 [Lawrence Berkeley Laboratory (LBL, LBNL) (United States)

    Budinger, T. F. (ed.)


    This booklet was prepared for the 50th anniversary of medical and biological research at the Donner Laboratory and the Lawrence Berkeley Laboratory of the University of California. The intent is to present historical facts and to highlight important facets of fifty years of accomplishments in medical and biological sciences. A list of selected scientific publications from 1937 to 1960 is included to demonstrate the character and lasting importance of early pioneering work. The organizational concept is to show the research themes starting with the history, then discoveries of medically important radionuclides, then the use of accelerated charged particles in therapy, next human physiology studies then sequentially studies of biology from tissues to macromolecules; and finally studies of the genetic code.

  16. Advances in Cotton Breeding for Resistance to Fusarium and Verticillium Wilt in the Last Fifty Years in China

    Institute of Scientific and Technical Information of China (English)

    JIAN Gui-liang; MA Cun; ZHENG Chuan-lin; ZOU Ya-fei


    This review summarizes the main advances in cotton breeding for resistance to fusarium andverticillium wilt in the last fifty years in China. The topics discussed include main achievements, experiences,problems and countermeasures for solving.

  17. FOREWORD: Fifty years of atomic time-keeping: 1955 to 2005 (United States)

    Quinn, Terry


    The year 2005 is the centenary of Einstein's four famous papers that were published in 1905. This anniversary is being widely celebrated all over the world and, indeed, 2005 has been dubbed World Year of Physics. The year 2005, however, also marks the fiftieth anniversary of the first operation of Essen and Parry's caesium beam atomic frequency standard at the NPL in May 1955. While Einstein's papers signalled a revolution in physics and in our understanding of the natural world, the first atomic clock signalled a revolution in time-keeping that has become, among other things, one of the most powerful tools in pushing back the frontiers of Einstein's theories of special and general relativity. The atomic clock has also had consequences for navigation comparable to those brought about by Harrison's mechanical clocks almost exactly two hundred years before. Harrison's H3 was completed in 1757 and H4 in 1759. The atomic clock, and the creation of an atomic time scale that quickly followed, led ten years later to the adoption of an atomic definition for the SI second in Resolution 1 of the 13th General Conference on Weights and Measures, 1967/68. This marked the end of time-keeping based on the movements of the heavenly bodies that had beaten the rhythm of the days and the seasons since the dawn of human civilization. Fifty years on is a good occasion to look back, to look forward and at the same time to examine where we are today, in terms of measuring time. While we still arrange for our atomic clocks to show noon when the sun is overhead on the Greenwich meridian, everything else has changed in the fifty years since 1955. In this special issue of Metrologia the reader will find articles on the development of the atomic clock, its theory and practice, how the first atomic time scale was devised and formally introduced and how we maintain atomic time today, as well as articles looking forward to even more accurate clocks and time scales. Included also are articles on

  18. Fifty years of co-evolution and beyond: integrating co-evolution from molecules to species. (United States)

    Carmona, Diego; Fitzpatrick, Connor R; Johnson, Marc T J


    Fifty years after Ehrlich and Raven's seminal paper, the idea of co-evolution continues to grow as a key concept in our understanding of organic evolution. This concept has not only provided a compelling synthesis between evolutionary biology and community ecology, but has also inspired research that extends beyond its original scope. In this article, we identify unresolved questions about the co-evolutionary process and advocate for the integration of co-evolutionary research from molecular to interspecific interactions. We address two basic questions: (i) What is co-evolution and how common is it? (ii) What is the unit of co-evolution? Both questions aim to explore the heart of the co-evolutionary process. Despite the claim that co-evolution is ubiquitous, we argue that there is in fact little evidence to support the view that reciprocal natural selection and coadaptation are common in nature. We also challenge the traditional view that co-evolution only occurs between traits of interacting species. Co-evolution has the potential to explain evolutionary processes and patterns that result from intra- and intermolecular biochemical interactions within cells, intergenomic interactions (e.g. nuclear-cytoplasmic) within species, as well as intergenomic interactions mediated by phenotypic traits between species. Research that bridges across these levels of organization will help to advance our understanding of the importance of the co-evolutionary processes in shaping the diversity of life on Earth. © 2015 John Wiley & Sons Ltd.

  19. From pharmaceutical standardizing to clinical research: 20 years of experience with fifty-millesimal potencies

    Directory of Open Access Journals (Sweden)

    Wania Papile Galhardi


    Full Text Available Background: 20 years ago we began to standardize the procedures of preparation and use of fifty-millesimal dilutions (LM or Q according to indications in the 6th edition of Hahnemann’s Organon. Aim: to describe the main stages in standardization as well as our teaching and research experience on Organon 6th edition. Results: with the use of standardized LM dilutions we observed a lower incidence of homeopathic aggravation than with our earlier experience with non standardized preparations. Organon.modus, a clinical-pharmaceutical protocol derived from the standardization was adequate for the teaching of homeopathy at Faculty of Medicine of Jundiai (São Paulo, the first Brazilian medical school with a graduate course on homeopathy. A randomized double-blind trial comparing individualized homeopathic medicines prescribed in LM dilutions and fluoxetine showed the former not be inferior to the latter in the treatment of moderate-to-severe depression. Conclusion: protocol Organon.modus showed to be adequate to graduate-level teaching of homeopathy and efficient in a controlled clinical trials, favoring its use as common denominator between the art of healing and medical science.

  20. Fifty years of the integrated control concept: moving the model and implementation forward in Arizona. (United States)

    Naranjo, Steven E; Ellsworth, Peter C


    Fifty years ago, Stern, Smith, van den Bosch and Hagen outlined a simple but sophisticated idea of pest control predicated on the complementary action of chemical and biological control. This integrated control concept has since been a driving force and conceptual foundation for all integrated pest management (IPM) programs. The four basic elements include thresholds for determining the need for control, sampling to determine critical densities, understanding and conserving the biological control capacity in the system and the use of selective insecticides or selective application methods, when needed, to augment biological control. Here we detail the development, evolution, validation and implementation of an integrated control (IC) program for whitefly, Bemisia tabaci (Genn.), in the Arizona cotton system that provides a rare example of the vision of Stern and his colleagues. Economic thresholds derived from research-based economic injury levels were developed and integrated with rapid and accurate sampling plans into validated decision tools widely adopted by consultants and growers. Extensive research that measured the interplay among pest population dynamics, biological control by indigenous natural enemies and selective insecticides using community ordination methods, predator:prey ratios, predator exclusion and demography validated the critical complementary roles played by chemical and biological control. The term 'bioresidual' was coined to describe the extended environmental resistance from biological control and other forces possible when selective insecticides are deployed. The tangible benefits have been a 70% reduction in foliar insecticides, a >$200 million saving in control costs and yield, along with enhanced utilization of ecosystem services over the last 14 years.

  1. Emerging frontiers of pharmacy education in Saudi Arabia: The metamorphosis in the last fifty years (United States)

    Asiri, Yousif A.


    The trends in the quality of biomedical education in pharmacy schools have witnessed significant changes in the 21st century. With the advent of continuous revision and standardization processes of medical curricula throughout the world, the focus has been on imparting quality education. This pedagogic paradigm has shifted to pharmacy schools. In Saudi Arabia, the concept of “medical and pharmacy education” is relatively new as mainstream pharmacy curriculum and universities were established only half a century ago. This period has seen major changes in the dimension of “pharmacy education” to keep pace with the education systems in the United States and Europe. As our knowledge and perceptions about pharmaceuticals change with time, this motivates educators to search for better teaching alternatives to the ever increasing number of enthusiastic and budding pharmacists. Recently, the academic system in Saudi Arabian Pharmacy has adopted a more clinically-oriented Pharm. D. curriculum. This paper deals with the major changes from the inception of a small pharmacy faculty in 1959, the College of Pharmacy at the King Saud University, Riyadh, to the model of progress and a prototype of pharmacy colleges in Saudi Arabia. The fifty year chronological array can be regarded as an epitome of progress in pharmacy education in Saudi Arabia from its traditional curriculum to the modern day Pharm. D. curriculum with a high population growth and expanding health care sector, the demand for qualified pharmacists is growing and is projected to grow considerably in the future. The number of pharmacy graduates is increasing each year by many folds and to meet the needs the system lays stress upon a constant revising and updating of the current curriculum from a global perspective. PMID:23960737

  2. Reflections on fifty years of publications on the history of general biology and special embryology. (United States)

    Oppenheimer, J M


    The publications of fifty years (1925-1974) of the histroy of biology and embryology are surveyed. In America, the earliest background for work during this period was provided by the collectors, mainly physicians, of books into extensive private libraries. The collectors, for instance Osler, Cushing, and Fulton in this country and Geoffrey Keynes abroad, became expert technical bibliographers during the early part of the half-century under consideration. High standards for medical, thus biological history, insofar as these fields overlap, were also set earlier by Sudhoff's Institut für Geschichte der Medizin in Leipzig, and American historical studies benefited when Sigerist came from Leipzig to Baltimore in the early 1930's. Textbooks of medical history are omitted from discussion here, but a number of more or less general histories of biology published within the specified period are briefly evaluated. The discussion next turns to histories of embryology, general and special. Recent monographs on the classical embryologists, Wolff and von Baer, are enumerated, as are a number of biographies and autobiographies of important embryologists published here or abroad during our half-century. Then general histories of embryology are discussed, and finally some specialized ones. Needham, Roger, and Adelmann are singled out as the most important contributors to the history of embryology, in the West, during the period covered. Few of the contributors to the history of biology and medicine during the years of 1925 through 1974 were trained as historians while students. It is concluded that the History of Science Society has performed an important contribution in professionalizing the history of biology and embryology, but it is pointed out that a great new challenge faces it in the necessity to counteract anti-historical and anti-intellectual moods and movements of today.

  3. Through the Looking Glass: Adult Education through the Lens of the Australian Journal of Adult Learning over Fifty Years (United States)

    Harris, Roger; Morrison, Anne


    In this paper we review fifty years of articles published in Australian Journal of Adult Learning in its various iterations. We examine the different roles of the journal: to illuminate the history and trends of adult education authors; to be the flagship of the adult education profession in Australia; to reflect on significant national events;…

  4. A Fifty-Year Love Affair with Organic Chemistry (by William S. Johnson) (United States)

    Kauffman, Reviewed By George B.; Kauffman, Laurie M.


    This latest volume is the 20th in Jeff Seeman's projected 22-volume series of autobiographies of 20th-century organic chemists that began publication in 1990 (Kauffman, G. B. J. Chem. Educ. 1991, 68, A21). Unfortunately, Johnson did not live to see this volume in print. Ted Bartlett and Ray Conrow reviewed the final manuscript, galleys, and page proofs; and Ted Bartlett, Paul Bartlett, John D. Roberts, and Gilbert Stork contributed an epilogue that complements Johnson's own words, adds a warm, personal final touch that he was unable to provide, and incorporates his final research into the volume. Born in New Rochelle, New York, on February 24, 1913, William Summer Johnson attended Amherst College with the aid of a scholarship and various odd jobs such as tending furnace, washing dishes, and playing saxophone in dance bands (he seriously considered becoming a professional musician). Here he became enamored with organic chemistry, which he taught as an instructor for a year after his graduation magna cum laude in 1936. He then worked with a fellowship under Louis Fieser, who sparked his interest in steroids, at Harvard University, from which he received his M.A. (1938) and Ph.D. (1940) degrees. In 1940 Johnson joined the faculty at the University of Wisconsin, where he rose through the ranks, eventually becoming Homer Adkins Professor of Chemistry (1954-60). He began the total synthesis of steroids, the main subject of his life's work, "which soon proved to be the hottest synthetic target of the time". In 1960 he accepted an invitation to become head of and to upgrade the Stanford University Chemistry Department. With faculty recruiting as his primary concern, he was able to add Carl Djerassi, Paul J. Flory, Harden M. McConnell, Henry Taube, and Eugene E. van Tamelen to the department, resulting in its spectacular rise from 15th to 5th place in the nation. He remained at Stanford for the rest of his career, serving as department head for nine years. He died at the

  5. Trends in scientific publications of Indian spine surgeons over 14 years (2000–2013

    Directory of Open Access Journals (Sweden)

    Rishi Mugesh Kanna


    Conclusion: The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.

  6. Twelve years of scientific production on Medline by Latin American spine surgeons.

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    Full Text Available BACKGROUND: Despite the small contribution of LA in the Science Citation Index (SCI, a growing contribution by LA research to international literature has been observed in recent years. STUDY DESIGN: Systematic review. PURPOSE: To evaluate the scientific contribution of Latin American (LA Spine Surgeons in the last decade. METHODS: A literature search of publications by LA spinal surgeons on topics concerning the spine or spinal cord was performed using an online database; The results were limited to articles published from January 2000 to December 2011. The quality of the publication was evaluated with the journal impact factor (IF, Oxford classification and number of citations. RESULTS: This study comprised 320 articles published in the Medline database by LA spine surgeons from 2000 to 2011. In recent years, there has been an increase in the number of publications by LA spine surgeons. It was observed that 38.4% of LA papers were published in LA journals. 46.6% of the articles were published in journals with an IF lower than 1, and there was no statistically significant difference in the number of articles published in journals with a higher IF during the period. Linear-by-linear association analysis demonstrated an improvement in the level of evidence provided by LA articles published in recent years. CONCLUSIONS: This study showed a growth in the number of publications in last 12 years by LA spinal surgeons. It is necessary to discuss a way to increase quantity and quality of scientific publications, mainly through a better education in research.

  7. Fifty years of tobacco carcinogenesis research: from mechanisms to early detection and prevention of lung cancer. (United States)

    Hecht, Stephen S; Szabo, Eva


    The recognition of the link between cigarette smoking and lung cancer in the 1964 Surgeon General's Report initiated definitive and comprehensive research on the identification of carcinogens in tobacco products and the relevant mechanisms of carcinogenesis. The resultant comprehensive data clearly illustrate established pathways of cancer induction involving carcinogen exposure, metabolic activation, DNA adduct formation, and consequent mutation of critical genes along with the exacerbating influences of inflammation, cocarcinogenesis, and tumor promotion. This mechanistic understanding has provided a framework for the regulation of tobacco products and for the development of relevant tobacco carcinogen and toxicant biomarkers that can be applied in cancer prevention. Simultaneously, the recognition of the link between smoking and lung cancer paved the way for two additional critical approaches to cancer prevention that are discussed here: detection of lung cancer at an early, curable stage, and chemoprevention of lung cancer. Recent successes in more precisely identifying at-risk populations and in decreasing lung cancer mortality with helical computed tomography screening are notable, and progress in chemoprevention continues, although challenges with respect to bringing these approaches to the general population exist. Collectively, research performed since the 1964 Report demonstrates unequivocally that the majority of deaths from lung cancer are preventable.

  8. Fifty Years of "Comparative Education Review" Bibliographies: Reflections on the Field (United States)

    Raby, Rosalind Latiner


    For the past three years, the "Comparative Education Review" ("CER") has published annual bibliographic essays reflecting the changes in the field over the previous year. This year, to mark the 50th anniversary of the Comparative and International Education Society (CIES), the author analyzed "CER" bibliographies since 1959, in addition to…

  9. Fifty years of language maintenance and language dominance in bilingual Hispanic immigrants. (United States)

    Bahrick, H P; Hall, L K; Goggin, J P; Bahrick, L E; Berger, S A


    Spanish language tests of 801 Cuban and Mexican immigrants showed no evidence of language loss during 50 years of U.S. residence; a few years after immigration, their English vocabulary approximated that of English monolinguals. The critical-age hypothesis was not supported for the acquisition of English vocabulary when English schooling and language usage were controlled by multiple regression. Most Ss continued to speak about as much Spanish as English; but read, wrote, and heard (on television and radio) far more English than Spanish. Under these conditions, Ss maintained Spanish dominance on tests of vocabulary recognition, lexical decision, and oral comprehension. Dominance was task specific and shifted to English on a category generation task about 12 years after immigration. No evidence of bilingual language interference was found; this is attributed to the strong Spanish foundation of the participants.

  10. Fifty-Year Flood-Inundation Maps for Santa Rosa de Aguan, Honduras (United States)

    Mastin, Mark C.; Olsen, T.D.


    After the devastating floods caused by Hurricane Mitch in 1998, maps of the areas and depths of the 50-year-flood inundation at 15 municipalities in Honduras were prepared as a tool for agencies involved in reconstruction and planning. This report, which is one in a series of 15, presents maps of areas in the coastal municipality of Santa Rosa de Aguan that are prone to oceanic storm-surge flooding and wave action. The 50-year flood on the Rio Aguan (4,270 cubic meters per second), would inundate most of the area surveyed for this municipality and beyond. Therefore a detailed numerical hydraulic model was not developed for this municipality as it was for the others. The 50-year storm surge would likely produce higher water levels than the 50-year flood on the river during normal astronomical tides. The elevation of the 50-year storm surge was estimated to be 4.35 meters above normal sea level, based on hurricane probabilities and published storm-surge elevations associated with various hurricane categories. Flood-inundation maps, including areas of wave-action hazard and a color-shaded elevation map, were created from the available data and the estimated 50-year storm tide. Geographic Information System (GIS) coverages of the hazard areas are available on a computer in the municipality of Santa Rosa de Aguan as part of the Municipal GIS project and on the Internet at the Flood Hazard Mapping Data Web page ( These coverages allow users to view the maps in much more detail than is possible using the maps in this report.

  11. Surgeons and surgery from ancient Persia (5,000 years of surgical history). (United States)

    Zargaran, Arman; Fazelzadeh, Afsoon; Mohagheghzadeh, Abdolali


    The development of surgery is indebted to scientists and surgeons from various civilizations throughout history. The present study considers surgery in the ancient Persian civilization. It highlights aspects of the subject, such as findings of the first trephinated skulls in Iran; surgeons' social class (kareto baēšaza in the Avestan language-dating back 3,000 years); surgical operations such as cesarean section and procedures to treat breast cancer; and the use of anesthetic compounds and surgical practice in the military. It is hoped that this catalogue of historical evidence of surgical practice in ancient Persian civilization will contribute to the history of surgery, as an important field in medical science.

  12. Fifty-year follow-up and Strampelli anterior chamber intraocular lens. (United States)

    Oakley, Carmen L; Nigro, Matthew A; Vote, Brendan J


    The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era. The Strampelli anterior chamber intraocular lens was created in 1953, and was primarily used to treat myopia and aphakia. Due to the positioning of the lens, it was associated with a number of complications, and was later modified to decrease the rate of significant complications, including endothelial cell loss. This paper describes a 62-year-old man, who has had a Strampelli intraocular lens (IOL) in situ for 52 years, with relatively few complications. The case provides a framework for reflection on the significant advances in the development of IOLs since the Strampelli era.

  13. Fifty years of oil exploration in Nigeria: the paradox of plenty ...

    African Journals Online (AJOL)

    Yet over many years, it has been observed that nations rich in oil, gas, or mineral ... with rich endowments of natural resources [oil as in the case of Nigeria] often ... like this had given rise to other contemporary oil nations overtaking Nigeria.

  14. Visualizing DNA domains and sequences by microscopy: a fifty-year history of molecular cytogenetics.

    NARCIS (Netherlands)

    Jong, de J.H.S.G.M.


    This short review presents a historical perspective of chromosome research during the last 50 years. It shows how molecular knowledge and technology of DNA entered cytogenetics step by step making it now daily practice in almost every modem chromosome lab. A crucial milestone in these decades has be

  15. Fifty-Year Trends in the Chemical Industry: What Do They Mean for Chemical Education? (United States)

    Tolman, Chadwick A.; Parshall, George W.


    Describes major changes that have occurred in the chemical industry over the last 50 years including trends in the development of products and processes, changes in chemical manufacturing, the globalization of business, and modifications of research laboratory practices. Discusses implications for chemistry education and predictions for future…

  16. Trends in scientific publications of Indian spine surgeons over 14 years (2000-2013). (United States)

    Kanna, Rishi Mugesh; Falavigna, Asdrubal; da Silva, Pedro Guarise; Quadros, Francine Wurzius; Merlin, Luiz Henrique; Radaelli, Lucas; Guyot, Juan Pablo; Dozza, Diego; Riew, Daniel K; Martins, Délio; Yoshiharu, Kawaguchi; Rajasekaran, S


    The number and quality of scientific publications reflects the standards of scientific research in a country. However, the contribution of Indian spine surgeons toward global publications is unknown. The goal is to study the publications of Indian spine surgeons between 2000 and 2013. A literature search of the publications by Indian spine surgeons was performed using MEDLINE. The search terms used were India and several spine-related terminologies. The main information of the selected papers including the year of publication, scientific journal, type of pathology studied, Neurosurgical or Orthopedic Department where the study was done, type of study, and the type of article was analyzed. A total of 4459 articles were identified using MEDLINE and after exclusion, 507 articles were analyzed. A growth of 440% in the number of publications was observed in the period between 2009 and 2013, during which 60.15% of the articles were published. Clinical studies (n = 492; 97.04) were the most common types of articles, followed by experimental studies and other types. The Neurosurgery department published the majority of the articles (58.2%). The three most common pathologies studied were spinal tumors (17.35%), surgical technique (15.4%), and spinal infection (15.2%). The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.

  17. Fifty-odd years of inter-group contact: from hypothesis to integrated theory. (United States)

    Hewstone, Miles; Swart, Hermann


    We review 50-odd years of research on Allport's (1954)'contact hypothesis', to assess progress, problems, and prospects. We chart the progress that has been made in understanding two distinct forms of contact: direct and indirect. We highlight the progress made in understanding the effects of each type of contact, as well as both moderating and mediating factors, and emphasize the multiple impacts of direct contact, especially. We then consider some of the main critiques of inter-group contact, focusing on empirical issues and whether contact impedes social change, and provide a research agenda for the coming years. We conclude that this body of work no longer merits the modest title of 'hypothesis', but fully deserves acknowledgement as an integrated and influential theory.

  18. Fifty years with the Hamilton scales for anxiety and depression. A tribute to Max Hamilton

    DEFF Research Database (Denmark)

    Bech, P


    From the moment Max Hamilton started his psychiatric education, he considered psychometrics to be a scientific discipline on a par with biochemistry or pharmacology in clinical research. His clinimetric skills were in operation in the 1950s when randomised clinical trials were established...... as the method for the evaluation of the clinical effects of psychotropic drugs. Inspired by Eysenck, Hamilton took the long route around factor analysis in order to qualify his scales for anxiety (HAM-A) and depression (HAM-D) as scientific tools. From the moment when, 50 years ago, Hamilton published his first...... placebo-controlled trial with an experimental anti-anxiety drug, he realized the dialectic problem in using the total score on HAM-A as a sufficient statistic for the measurement of outcome. This dialectic problem has been investigated for more than 50 years with different types of factor analyses without...

  19. A new experimental proposal for {sup 235}U PFNS to answer a fifty years old question

    Energy Technology Data Exchange (ETDEWEB)

    Kornilov, N.; Massey, T.; Grimes, S.; Voinov, A. [Dept. of Physics and Astronomy, Ohio Univ., Athens, OH 45701 (United States)


    The Prompt Fission Neutron Spectrum (PFNS) from {sup 235}U(n,f) is very important for various nuclear applications. It has been investigated in different experiments. In spite of {approx}50 years of experimental efforts, a continuing conflict exists at thermal neutron energy. Microscopic experimental PFNS cannot describe macroscopic data. In this report we discuss the current status of this problem and suggest a new experiment, which could possibly resolve this problem. (authors)

  20. Fifty years of studying the Medvezhiy Glacier (West Pamirs) by the Institute of Geography, RAS


    G. B. Osipova


    Overview of researches conducted over 50 years (1963–2012) by Institute of Geography RAS on the surging glacier Medvezhiy, the West Pamirs is given. Ground investigations (changes of its surface altitude, ice movement velocity, ablation, ice thickness, temperature and others) made after surge 1963 allowed finding the basic features of this glacier regime and calculating the mass balance of its surging part for the whole cycle from the recovery phase up to a surge. Using the results a quality ...

  1. The 1953 Stanley L. Miller Experiment: Fifty Years of Prebiotic Organic Chemistry (United States)

    Lazcano, Antonio; Bada, Jeffrey L.


    The field of prebiotic chemistry effectively began with a publication in Science 50 years ago by Stanley L. Miller on the spark discharge synthesis of amino acids and other compounds using a mixture of reduced gases that were thought to represent the components of the atmosphere on the primitive Earth. On the anniversary of this landmark publication, we provide here an accounting of the events leading to the publication of the paper. We also discuss the historical aspects that lead up to the landmark Miller experiment.

  2. Fifty Years of Sino-Norwegian Cooperation——An Interview with Norwegian Ambassador

    Institute of Scientific and Technical Information of China (English)



    Geographical distance has not hindered friendly relations, ongoing for more than two centuries, between China and Norway. Norway recognized the People's Republic of China on January 7, 1950 and diplomatic relations were established on October 5, 1954. In 1955, the two countries began to exchange ambassadors. Since then their political, economic and cultural cooperation has steadily advanced. The year 2004 marks the 50th anniversary of establishment of Sino-Norwegian diplomatic relations. In honor of the occasion, China Today spoke with Norwegian Ambassador Tor Chr. Hildan on bilateral trade and economic cooperation.

  3. A Fifty-Year Sustainability Assessment of Italian Agro-Forest Districts

    Directory of Open Access Journals (Sweden)

    Fabio Recanatesi


    Full Text Available As cropland management and land use shifted towards more intensive practices, global land degradation increased drastically. Understanding relationships between ecological and socioeconomic drivers of soil and landscape degradation within these landscapes in economically dynamic contexts such as the Mediterranean region, requires multi-target and multi-scalar approaches covering long-term periods. This study provides an original approach for identifying desertification risk drivers and sustainable land management strategies within Italian agro-forest districts. An Environmental Sensitivity Area (ESA approach, based on four thematic indicators (climate, soil, vegetation and land-use and a composite index of desertification risk (ESAI, was used to evaluate changes in soil vulnerability and landscape degradation between the years 1960 and 2010. A multivariate model was developed to identify the most relevant drivers causing changes in land susceptibility at the district scale. Larger districts, and those with a higher proportion of their total surface area classified as agro-forest, had a significantly lower increase in land susceptibility to degradation during the 50 years when compared with the remaining districts. We conclude that preserving economic viability and ecological connectivity of traditional, extensive agricultural systems is a key measure to mitigate the desertification risk in the Mediterranean region.

  4. Fifty years of studying the Medvezhiy Glacier (West Pamirs by the Institute of Geography, RAS

    Directory of Open Access Journals (Sweden)

    G. B. Osipova


    Full Text Available Overview of researches conducted over 50 years (1963–2012 by Institute of Geography RAS on the surging glacier Medvezhiy, the West Pamirs is given. Ground investigations (changes of its surface altitude, ice movement velocity, ablation, ice thickness, temperature and others made after surge 1963 allowed finding the basic features of this glacier regime and calculating the mass balance of its surging part for the whole cycle from the recovery phase up to a surge. Using the results a quality model for prediction of rapid motions of surging glaciers had been developed. Forecast of the next surge of the Medvezhiy Glacier made for 1973 on the basis of this model had been justified. As a result of the aerial and topographic monitoring (1989–1991 the glacier surge was quantitatively followed for the first time over its whole cycle, i.e. from a surge up to a next stage of its recovery. Results of our researches allowed formulating the foundations of the space monitoring of surging glaciers. In 2001 and 2011 surges of the glacier were detected and traced using the satellite imagery (MIR, ISS. In total for 50 years, five surges of this glacier and two full cycles of its life were investigated by various methods in different details.

  5. Fifty Years of Clinical Application of Newcastle Disease Virus: Time to Celebrate!

    Directory of Open Access Journals (Sweden)

    Volker Schirrmacher


    Full Text Available This review provides an overview of 50 years of basic and clinical research on an oncolytic avian virus, Newcastle Disease Virus (NDV, which has particular anti-neoplastic and immune stimulatory properties. Of special interest is the fact that this biological agent induces immunogenic cell death and systemic anti-tumor immunity. Furthermore, localized oncolytic virotherapy with NDV was shown to overcome systemic tumor resistance to immune checkpoint blockade immunotherapy. Clinical experience attests to low side effects and a high safety profile. This is due among others to the strong virus-induced type I interferon response. Other viral characteristics are lack of interaction with host cell DNA, lack of genetic recombination and independence of virus replication from cell proliferation. In this millennium, new recombinant strains of viruses are being produced with improved therapeutic properties. Clinical applications include single case observations, case series studies and Phase I to III studies.

  6. [Fifty years of psychiatry at the interface between psyche and soma: a SWOT analysis]. (United States)

    van Houdenhove, B; Luyten, P


    During the past 50 years the border area between psychiatry and somatic medicine has undergone remarkable changes. Theories have become better-founded, both psychologically and neurobiologically, research has become more sophisticated, and liaison-psychiatrists and health psychiatrist/behavioural medicine psychologists have played an increasingly active role in this domain. At the beginning of the 21st century modern psychosomatic medicine is facing new challenges; these include how to create a workable diagnostic classification system, how to instruct and educate both health professionals and lay-persons to an adequate level, how to utilize innovative research paradigms without having recourse to reductionism and how to implement in medical practice treatments that are geared to the needs of the individual patient.

  7. Invertebrate learning and memory: Fifty years of olfactory conditioning of the proboscis extension response in honeybees. (United States)

    Giurfa, Martin; Sandoz, Jean-Christophe


    The honeybee Apis mellifera has emerged as a robust and influential model for the study of classical conditioning, thanks to the existence of a powerful Pavlovian conditioning protocol, the olfactory conditioning of the proboscis extension response (PER). In 2011, the olfactory PER conditioning protocol celebrates 50 years since it was first introduced by Kimihisa Takeda in 1961. Here, we review its origins, developments, and perspectives in order to define future research avenues and necessary methodological and conceptual evolutions. We show that olfactory PER conditioning has become a versatile tool for the study of questions in extremely diverse fields in addition to the study of learning and memory and that it has allowed behavioral characterizations, not only of honeybees, but also of other insect species, for which the protocol was adapted. We celebrate, therefore, Takeda's original work and prompt colleagues to conceive and establish further robust behavioral tools for an accurate characterization of insect learning and memory at multiple levels of analysis.

  8. World meat consumption patterns: An overview of the last fifty years (1961-2011). (United States)

    Sans, P; Combris, P


    Driven by economic development and urbanisation, protein consumption has surged worldwide over the last 50years, rising from 61g per person per day in 1961 to 80g per person per day in 2011 [Corrected]. This contribution analyses the apparent convergence of dietary models worldwide with respect to the proportion of ABP and especially meat in intake. By using FAO data for 183 countries over the period 1961-2011, the authors show the connection between annual per capita GDP and the level of ABP (R2=0.62) and meat consumption (R2=0.62). They emphasise the surge in ABP intake in emerging countries (China, Brazil) which has partly replaced plant protein. However, for similar degrees of economic development, the composition of ABPs and the position of meat within this category vary significantly among countries, suggesting that historical, geographical, cultural and religious factors may be involved.

  9. Cognitive function fifty-six years after surgical treatment of temporal lobe epilepsy: A case study

    Directory of Open Access Journals (Sweden)

    Sarah Jane Banks


    Our investigation at 56 postoperative years focused on cognitive skills, with some emphasis on learning and memory; a clinical examination was also performed, and the anatomical extent of the resection was determined on 3-Tesla magnetic resonance imaging. Four age- and IQ-appropriate women were tested as healthy control subjects. The patient showed material-specific impairments in language and verbal memory compared with the control subjects and also compared with her own earlier performance, but her performance on other cognitive tasks did not differ from that of the control subjects. Thus, her specific deficits had worsened over time, and she was also impaired compared with healthy individuals of her age, but her deficits remained confined to the verbal sphere, consistent with her temporal lobe seizure focus and surgery.

  10. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning. (United States)

    van Ginneken, Bram


    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant technology for tackling CAD in the lungs, generally producing better results than do classical rule-based approaches, and how the field is now rapidly changing: in the last few years, we have seen how even better results can be obtained with deep learning. The key differences among rule-based processing, machine learning, and deep learning are summarized and illustrated for various applications of CAD in the chest.

  11. Legend and legacy: Fifty years of defense production at the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Gerber, M.S.


    Today, the Hanford Site is engaged in the largest waste cleanup effort ever undertaken in human history. That in itself makes the endeavor historic and unique. The Hanford Site has been designated the ``flagship`` of Department of Energy (DOE) waste remediation endeavors. And, just as the wartime Hanford Project remains unmatched in history, no counterpart exists for the current waste cleanup enterprise. This report provides a summary of the extensive historical record, however, which does give a partial road map. The science of environmental monitoring pioneered at the Hanford Site, and records of this type are the most complete of any in the world, from private companies or public agencies, for the early years of Site operations. The Hanford Site was unique for establishing a detailed, scientific, and multi-faceted environmental monitoring program.

  12. Fifty years of immunisation in Australia (1964-2014): the increasing opportunity to prevent diseases. (United States)

    Royle, Jenny; Lambert, Stephen B


    Medicine has seen dramatic changes in the last 50 years, and vaccinology is no different. Australia has made a significant contribution to world knowledge on vaccine-preventable diseases. Certain deadly diseases have disappeared or become rare in Australia following successful introduction of vaccines. As diseases become rarer, public knowledge about the diseases and their serious consequences has decreased, and concerns about potential vaccine side effects have increased. To maintain confidence in immunisations, sharing of detailed information about the vaccines and the diseases we are trying to prevent is integral to the continued success of our public health programme. Modern quality immunisation programmes need to communicate complex information to immunisation providers and also to the general community. Improving immunisation coverage rates and eliminating the gap in coverage and timeliness between Aboriginal and Torres Strait Islander peoples and non-Indigenous people has become a high priority.

  13. Hydro-Quebec and Quebec society: fifty years of shared history

    Energy Technology Data Exchange (ETDEWEB)

    Linteau, P. A. [Quebec Univ., Montreal, PQ (Canada)


    An historical overview of Hydro-Quebec, the giant electric utility, and its influence on Quebec society was provided on the occasion of the Corporation`s fiftieth anniversary. Its role in Quebec`s economic nationalism, especially since the 1960s, and its role and achievements in research through IREQ, the Quebec electricity research institute, were explained. The challenges facing the Corporation in the years to come in terms of meeting growing demands for power, in meeting expectations in terms of their role as the engine of Quebec`s economic well-being, environmental concerns, and no less importantly, dealing with native peoples` opposition to further development of lands they claim as their own, were briefly discussed. 6 refs., photos.

  14. One hundred and fifty years of sprint and distance running - Past trends and future prospects. (United States)

    Weiss, Martin; Newman, Alexandra; Whitmore, Ceri; Weiss, Stephan


    Sprint and distance running have experienced remarkable performance improvements over the past century. Attempts to forecast running performances share an almost similarly long history but have relied so far on relatively short data series. Here, we compile a comprehensive set of season-best performances for eight Olympically contested running events. With this data set, we conduct (1) an exponential time series analysis and (2) a power-law experience curve analysis to quantify the rate of past performance improvements and to forecast future performances until the year 2100. We find that the sprint and distance running performances of women and men improve exponentially with time and converge at yearly rates of 4% ± 3% and 2% ± 2%, respectively, towards their asymptotic limits. Running performances can also be modelled with the experience curve approach, yielding learning rates of 3% ± 1% and 6% ± 2% for the women's and men's events, respectively. Long-term trends suggest that: (1) women will continue to run 10-20% slower than men, (2) 9.50 s over 100 m dash may only be broken at the end of this century and (3) several middle- and long-distance records may be broken within the next two to three decades. The prospects of witnessing a sub-2 hour marathon before 2100 remain inconclusive. Our results should be interpreted cautiously as forecasting human behaviour is intrinsically uncertain. The future season-best sprint and distance running performances will continue to scatter around the trends identified here and may yield unexpected improvements of standing world records.

  15. Fifty years dynamics of Russian forests: Impacts on the earth system (United States)

    Shvidenko, Anatoly; Schepaschenko, Dmitry; Kraxner, Florian


    The paper presents a succinct history of Russian forests during the time period of 1960-2010 and reanalysis of their impacts on global carbon and nitrogen cycles. We present dynamics of land cover change (including major categories of forest land) and biometric characteristics of forests (species composition, age structure, growing stock volume etc.) based on reconciling all relevant information (data of forest and land inventories, official forest management statistics, multi-sensor remote sensing products, data of forest pathological monitoring etc.). Completeness and reliability of background information was different during the period of the study. Forest inventory data and official statistics were partially modified based on relevant auxiliary information and used for 1960-2000. The analysis for 2001-2010 was provided with a crucial use of multi-sensor remote sensing data. For this last period a hybrid forest mask was developed at resolution of 230m by integration of 8 remote sensing products and using geographical weighted regression and data of crowdsourcing. During the considered 50 years forested areas of Russia substantially increased by middle of 1990s and slightly declined (at about 5%) after. Indicators needed for assessment of carbon and nitrogen cycles of forest ecosystems were defined for the entire period (aggregated estimates by decades for 1960-2000 and yearly for 2001-2010) based on unified methodology with some peculiarities following from availability of information. Major results were obtained by landscape-ecosystem method that uses as comprehensive as possible empirical and semi-empirical information on ecosystems and landscapes in form of an Integrated Land Information System and complimentary combines pool- and flux-based methods. We discuss and quantify major drivers of forest cover change (socio-economic, environmental and climatic) including forest management (harvest, reforestation and afforestation), impacts of seasonal weather on

  16. Impacts of Climatic Change on River Runoff in Northern Xinjiang of China over Last Fifty Years

    Institute of Scientific and Technical Information of China (English)

    YANG Yuhui; CHEN Yaning; LI Weihong; WANG Minzhong; SUN Guili


    The characteristics of climatic change and river runoff, as well as the response of river runoff to climatic change in the northern Xinjiang are analyzed on the basis of the hydrological and meteorological data over the last 50 years by the methods of Mann-Kendall nonparametric test and the nonlinear regression model. The results show that: 1) The temperature and the precipitation increased significantly in the whole northern Xinjiang, but the precipitation displayed no obvious change, or even a decreasing trend in the northern mountainous area of the northern Xinjiang. 2) River runoff varied in different regions in the northern Xinjiang. It significantly increased in the northern slope of the Tianshan Mountains and the north of the northern Xinjiang (p=0.05), while slightly increased in the west of the northern Xinjiang. 3) North Atlantic Oscillation (NAO) affects river runoff by influencing temperature and precipita-tion. The NAO and precipitation had apparent significant correlations with the river runoff, but the temperature did not in the northern Xinjiang. Since the mid-1990s river runoff increase was mainly caused by the increasing temperature in the northern slope of the Tianshan Mountains and the north of the northern Xinjiang. Increased precipitation resulted in increased river runoff in the west of the northern Xinjiang.

  17. The Sertoli cell: one hundred fifty years of beauty and plasticity. (United States)

    França, L R; Hess, R A; Dufour, J M; Hofmann, M C; Griswold, M D


    It has been one and a half centuries since Enrico Sertoli published the seminal discovery of the testicular 'nurse cell', not only a key cell in the testis, but indeed one of the most amazing cells in the vertebrate body. In this review, we begin by examining the three phases of morphological research that have occurred in the study of Sertoli cells, because microscopic anatomy was essentially the only scientific discipline available for about the first 75 years after the discovery. Biochemistry and molecular biology then changed all of biological sciences, including our understanding of the functions of Sertoli cells. Immunology and stem cell biology were not even topics of science in 1865, but they have now become major issues in our appreciation of Sertoli cell's role in spermatogenesis. We end with the universal importance and plasticity of function by comparing Sertoli cells in fish, amphibians, and mammals. In these various classes of vertebrates, Sertoli cells have quite different modes of proliferation and epithelial maintenance, cystic vs. tubular formation, yet accomplish essentially the same function but in strikingly different ways.

  18. Fifty years of hypersonics: where we've been, where we're going

    Energy Technology Data Exchange (ETDEWEB)

    Bertin, J.J.; Cummings, R.M. [United States Air Force Academy, CO (United States). Department of Aeronautics


    Hypersonic flight has been with us since 22 September 1963, when Robert M. White flew the North American X-15 at 4520 mph at an altitude of 354,200 ft - a Mach number of 6.7. This remarkable achievement was accomplished over six decades due to intensive research and development by a large number of scientists and engineers. In spite of that momentous achievement, designers have found the hypersonic environment to be harsh and non-forgiving. New programs since the 1960s have often uncovered the unknown unknowns, usually the hard way - early flights of new systems have often revealed problems of which the designers are unaware. Such problems include: the ineffectiveness of the body flap for the Space Shuttle Orbiter, the viscous/inviscid interactions produced by the umbilical fairings that damaged the conical section tile protection system of the Gemini Capsule, and the shock/shock interaction that damaged the X-15A-2 when it carried the hypersonic ramjet experiment. In order to continue to make advances in hypersonic flight a sustained and visionary effort is essential to generate required knowledge and technology. In order to better prepare for future developments in hypersonic flight, this article reviews the advances made within the past 50 years and then looks into the future, not just for new technological developments, but for new ways of thinking about the unknown challenges that lie ahead. (author)

  19. Fifty years of research in Balkan endemic nephropathy: where are we now?

    Energy Technology Data Exchange (ETDEWEB)

    Stefanovic, V.; Polenakovic, M. [Faculty of Medicine, Nish (Serbia)


    Despite broad investigations into the possible role of genetic factors, environmental agents and immune mechanisms, the etiology of Balkan endemic nephropathy (BEN) is only partially understood. An increased incidence of upper urothelial cancer in patients with BEN and in populations from endemic settlements has been demonstrated. Genetic studies have landed support for genetic predisposition to BEN. The similarity of the morphological and clinical pattern of BEN and Chinese herbs nephropathy has raised the possibility of a common etiologic agent, aristolochic acid (AA), described in 1969 by Ivic and confirmed by a recent study of AA-DNA adducts. Ochratoxin A (OTA) is studied extensively as the etiologic agent of BEN. Weathering of low-rank coals nearby the endemic villages produces water-soluble polycyclic aromatic hydrocarbons and aromatic amines, similar to metabolic products of acetaminophen, which has a causal relationship with analgesic nephropathy. AA is confirmed as the etiologic agent of BEN; however, it may not be the sole risk factor. More research is needed on the patterns of BEN over time and between different endemic places. Therefore, it is important to test etiological hypotheses in different endemic foci, preferably as a multicentric research. An international approach to solving the etiology of BEN is needed in the coming years. The geographic correlation and presence of AA-DNA adducts in both BEN and associated urothelial cancer support the hypothesis that these diseases share a common etiology.

  20. Fifty years of research on serotypes and mating types in Dileptus anser: A review. (United States)

    Uspenskaya, Zoya I; Yudin, Alexander L


    The ciliate Dileptus anser is increasingly used as a laboratory model not only in protozoological research sensu stricto, but also in general biology. However, genetic studies of this ciliate have never been carried out, and this species is new to the comparative genetics of ciliates. This review describes the genetic experiments conducted at the Institute of Cytology of the Russian Academy of Sciences for the last 50 years. Two characters that are classical for the genetics of ciliates, serotypes and mating types were selected for analysis. The results presented do not fit into conventional genetic schemes and may have epigenetic nature. Features of this model that were revealed earlier (the simplest possible system of multiple mating types, full serial dominance of the alleles in the mat locus, the excretion of pheromones, etc.) are promising with regard to interesting comparisons of breeding systems in ciliates. The results obtained in studies of mating pheromones in D. anser have demonstrated that this model is a perspective one for further exploration of intercellular recognition in lower eukaryotes and of other related issues. Copyright © 2015 Elsevier GmbH. All rights reserved.

  1. Fifty-year trends in a box turtle population in Maryland (United States)

    Hall, R.J.; Henry, P.F.P.; Bunck, C.M.


    A survey conducted in 1995 investigated long term declines reported in a population of box turtles Terrapene Carolina monitored each decade since 1945 in bottomland hardwood forest at the Patuxent Wildlife Research Center, Maryland. Methods duplicated past surveys in most respects, but were supplemented by radiotelemetry and a survey of dominant vegetation. Seventy different turtles were found on the 11.8 ha study area, a decline of >75% since peak populations were recorded in 1955. Searchers were less efficient in 1995 than in 1945-1975 for a variety of possible reasons. Among turtles recorded, approximately equal numbers persisted from each of the past five decades, with some individuals surviving >70 years. A sex ratio strongly favoring males was first recorded in 1975 and continued in 1995, but juveniles and subadults were found in greater proportion in 1995 than in any other survey. Six of nine radio-marked turtles left the bottomland study area and migrated to the adjoining bluffs to hibernate, suggesting more extensive movements and perhaps less stable home ranges than formerly thought. Age structure of trees indicated a gradual change to more shade-tolerant species. Examination of rates of change from survey data suggested that major losses probably resulted from changes in hydrology that exacerbated flooding in 1972, with recovery only beginning in 1995 and perhaps limited both by repeated flood events and successional changes in the forest. Slow recovery from losses may indicate that populations of the species would respond poorly to exploitation.

  2. Fifty years of population growth and absorption of labor in Brazil: from 1950 to 2000. (United States)

    Paiva, P D


    For a long time, the Brazilian population has grown at a relatively high rate, and only recently has the process of demographic transition intensified in the country. While the associated decline in fertility could result in a future decline in the size of the working-age population, it could also lead to an increase in female participation in the labor market. Brazil's economy is performing well, with gross domestic product (GDP) growing at an average annual rate of 7.1% during 1947-80. Marked growth in industrial employment opportunities has accompanied this growth in GDP. The size of the informal sector, however, has not decreased in similar proportion, while the 1981-83 economic crisis caused urban employment levels to drop, especially in industry and construction. Moreover, the level of rural-urban migration has increased and the agricultural employment index has fallen. The author evaluates past growth trends of the Economically Active Population (EAP) and of employment in Brazil, and assesses the potential growth of the labor force until the year 2000.

  3. Homo cyborg: fifty years old Homo Ciborg: Cincuenta años después

    Directory of Open Access Journals (Sweden)

    Chris Hables Gray


    Full Text Available While the term “cyborg” is only 50 years old, the process that has produced cyborgization is much older: the evolution of the human. Humans have evolved to modify ourselves and our environment, especially through evolving culture and the technologies it creates. Culture is part of nature. Today’s mundane i-cyborgs, military drones, intimate human-machine merging and genetic engineering are a result of this; which in turn produce feelings of uncanniness, hubris, and fear. Contemporary politics must take this complex dynamic into account if we are to secure a sustainable, survivable, future for ourselves and our descendents. Social experiments such as Burning Man are a prefiguration of the kinds of (self conscious techno-social creativity needed.Mientras la terminología “ciborg” tiene apenas 50 años, son mucho más antiguos los procesos de “ciborgización”: la evolución humana. Los humanos evolucionaron para modificar su entorno y a sí mismos, especialmente a través de la cultura y las tecnologías. La cultura es parte de la naturaleza. De ella resultan los i-ciborgs mundanos de la actualidad,  los aviones militares no tripulados, la fusión íntima humano-máquina y la ingeniería genética: lo que a su vez produce sensaciones de inquietud, arrogancia y miedo. La política contemporánea debe de considerar si estamos asegurando un futuro sostenible y vivible para nuestros descendientes. Algunos experimentos sociales como el Burning Man son una prefiguración de esta necesidad creativa por la concienciación tecno-social.

  4. Comparing Socialist and Post-Socialist Television Culture. Fifty Years of Television in Croatia

    Directory of Open Access Journals (Sweden)

    Zrinjka Peruško


    Full Text Available This article builds a theoretical model for comparative analysis of media culture based on the notion of genre, and applies it to a comparative analysis of television as a cultural form in socialist and post-socialist Croatia. The paper explores how the shares and generic composition of program modes of information, entertainment and fiction change in time, and how the contribution of different genres to program flow and modes varies with the changes of political, economic and technological context. Longitudinal trends in television flows are comparatively evaluated in relation to trends in genre developments in Europe and their relationship to the changes in the cultural role of television. The results show a decrease in the information and an increase in the fiction mode between socialism and democracy, with some similarities of the Croatian and western television culture in relation to genre and mode composition and flow, albeit with a belated introduction of neo television genres. Notwithstanding the limited freedom of expression and ideological content, which necessarily influenced socialist media culture, television as a cultural form in Croatia developed in concert with the global program flows. The article is based on original content analysis of television schedules where the unit of analysis is a televisions program listing. The analogue television universe is represented by longitudinal data for 1959, 1969, 1979, 1989, 1999, and 2009. The stratified systematic sample (N=3934 for each chosen year consists of two constructed weeks from a universe of all listed programs broadcast on all free to air television channels with a national reach license.

  5. Fifty years of cytogenetics: a parallel view of the evolution of cytogenetics and genotoxicology. (United States)

    Garcia-Sagredo, J M


    A parallelism exists between human cytogenetics and cytogenetic toxicology. The breakthroughs, mostly coming from and used in clinical genetics, are widely used in genetic toxicology. The birth of human cytogenetics occurred in 1956 when it was published that the diploid number of chromosomes in humans is 46. The first stage in chromosome-induced mutagenesis began in 1938 when Sax published the effects of X-rays on the chromosomes of Drosophila. In 1959, the cytogenetic anomalies for Down, Klinefelter, and Turner syndromes were described, and parallelly in 1960, the first publication on chromosomal aberrations in man caused by ionizing radiation appeared. The cytogenetic analysis of chromosomal aberrations in cell cultures is considered one of the primary methods to evaluate induced mutagenesis. At the end of the 1960s, banding techniques allowed chromosomes to be individually identified, in parallel, the sister chromatid exchange analysis technology was described. Another milestone in the history of induced mutagenesis was the discovery that mutagenic agents were able to alter chromosomal division and segregation in gonads inducing meiotic nondisjunction. Here we review new approaches and applications such as biological dosimetry, translocation scoring using FISH, and micronucleus test. Chromosomal aberrations and micronucleus test are now effective cytogenetic biomarkers of early effect used as cancer predictors. Human cytogenetics has proven to be effective over its 50-year lifespan and, although each new technique that has appeared seemed to announce its end, the fact is that the current state of cytogenetics is in reality a collection of techniques that, while common, are cheap, fast, and wide-ranging. Therefore, in genotoxicology, they continue to be useful to identify mutagenic agents as well as to evaluate and analyze exposed populations.

  6. Maternal health in fifty years of Tanzania independence: Challenges and opportunities of reducing maternal mortality. (United States)

    Shija, Angela E; Msovela, Judith; Mboera, Leonard E G


    High rate of maternal death is one of the major public health concerns in Tanzania. Most of maternal deaths are caused by factors attributed to pregnancy, childbirth and poor quality of health services. More than 80% of maternal deaths can be prevented if pregnant women access essential maternity care and assured of skilled attendance at childbirth as well as emergency obstetric care. The objective of this review was to analyse maternal mortality situation in Tanzania during the past 50 years and to identify efforts, challenges and opportunities of reducing it. This paper was written through desk review of key policy documents, technical reports, publications and available internet-based literature. From 1961 to 1990 maternal mortality ratio in Tanzania had been on a downward trend from 453 to 200 per 100,000 live births. However, from 1990's there been an increasing trend to 578 per 100,000 live births. Current statistics indicate that maternal mortality ratio has dropped slightly in 2010 to 454 per 100,000 live births. Despite a high coverage (96%) in pregnant women who attend at least one antenatal clinic, only half of the women (51%) have access to skilled delivery. Coverage of emergence obstetric services is 64.5% and utilization of modern family planning method is 27%. Only about 13% of home deliveries access post natal check-up. Despite a number of efforts maternal mortality is still unacceptably high. Some of the efforts done to reduce maternal mortality in Tanzania included the following initiatives: reproductive and child survival; increased skilled delivery; maternal death audit; coordination and integration of different programs including maternal and child health services, family planning, malaria interventions, expanded program on immunization and adolescent health and nutrition programmes. These initiatives are however challenged by inadequate access to maternal health care services. In order to considerably reduce maternal deaths some of recommended

  7. Fifty Years of Botanical Gardens in China%中国植物园五十年

    Institute of Scientific and Technical Information of China (English)



    概述了中国140多个植物园过去50年发展的历史过程、分布和特征,以及植物园在研究、保护、展示和利用生物多样性等方面的功能.评述了中国植物园早期在经济作物烟草、药用植物薯蓣和野生果树资源研究中对社会和经济发展的贡献,以及近年来在种子科学、物种保护、经济植物引种驯化和育种等方面的理论和应用研究成果.介绍了中国植物园活植物收集的现状.其中木兰科、姜科、苏铁类、药用植物、猕猴桃属和杜鹃属等收集圃的建设已属世界领先.介绍了植物园科普和旅游的发展和中国植物园特有的盆景艺术园和硅化木收集园.%The development, distribution and features of one hundred and forty botanical gardens (BGs) in China are reported and their functions on research, conservation, display and utilization of biodiversity are summarized in this paper. The contributions to the social and economic development in the early stage of Chinese BGs with the researches of economic plant (tobacco), medicinal plant (yam) and wild fruit tree resources are evaluated. The theoretical and applied achievements in recent years in seed science, plant conservation, economic plant introduction, acclimatization and breeding are also described. A general scope of living plant collections in Chinese BGs is presented and the outstanding ones, including Magnoliaceae, Zingiberaceae, Cycadaceae, medicinal plants, Actinidia and Rhododendron are particularly mentioned. With special reference to Chinese penjing art garden and silicified wood garden, the development of scientific popularization and tourism in BGs is reviewed.

  8. Magnetite Biomineralization: Fifty years of progress, from beach-combing to the SQUID microscope (United States)

    Kirschvink, J. L.; Dixson, A. D.; Raub, T.


    Magnetite biomineralization was first discovered 50 years ago as a hardening agent in the teeth of the Polyplacophoran molluscs (chitons) by the late Prof. Heinz A. Lowenstam of Caltech, when he noticed unusual erosional effects produced by their grazing in the intertidal zones of Palau (Lowenstam, 1962). Since then, biogenic magnetite has been detected in a broad range of organisms, including magnetotactic bacteria, protists, insects, fish, amphibians, reptiles, birds, and mammals including humans. In many species, the role of ferromagnetic material as a neurophysiological transducer is demonstrated clearly through the effects of pulse-remagnetization on behavior. A brief (1 uS), properly configured magnetic discharge from a rectified LC circuit, tailored to exceed the coercivity of the magnetite, will often abolish a magnetic behavioral response, or in some cases make the organism go the wrong way. This is a unique ferromagnetic effect. The genes controlling magnetite biomineralization are well characterized in several species of bacteria, and the ability of some of these bacterial genes to initiate magnetite precipitation in mammalian cell lines argues for a common descent, probably via a magnetotactic mitochondrial ancestor. Previous studies in fish reported the presence of single-domain magnetite crystals in cells near projections of the trigeminal nerve, co-located in the olfactory epithelium. Although the cells are rare, the recent development of a spinning magnetic field technique allows easy identification and isolation of these cells for individual study (Eder et al., 2012). The cells are surprisingly magnetic, with moments hundreds of times larger than typical magnetotactic bacteria. Subsequent efforts to identify the anatomical seat of magnetoreceptors have focused on the same locations in new organisms, excluding other areas. Using SQUID moment magnetometry and SQUID scanning microscopy, we report here the unexpected presence of biogenic magnetite in

  9. The big and little of fifty years of Moessbauer spectroscopy at Argonne.

    Energy Technology Data Exchange (ETDEWEB)

    Westfall, C.


    Using radioactive materials obtained by chance, a turntable employing gears from Heidelberg's mechanical toy shops, and other minimal equipment available in post World War II Germany, in 1959 Rudolf Moessbauer confirmed his suspicion that his graduate research had yielded ground-breaking results. He published his conclusion: an atomic nucleus in a crystal undergoes negligible recoil when it emits a low energy gamma ray and provides the entire energy to the gamma ray. In the beginning Moessbauer's news might have been dismissed. As Argonne nuclear physicist Gilbert Perlow noted: ''Everybody knew that nuclei were supposed to recoil when emitting gamma rays--people made those measurements every day''. If any such effect existed, why had no one noticed it before? The notion that some nuclei would not recoil was ''completely crazy'', in the words of the eminent University of Illinois condensed matter physicist Frederich Seitz. Intrigued, however, nuclear physicists as well as condensed matter (or solid state) physicists in various locations--but particularly at the Atomic Energy Research Establishment at Harwell in Britain and at Argonne and Los Alamos in the U.S.--found themselves pondering the Moessbauer spectra with its nuclear and solid state properties starting in late 1959. After an exciting year during which Moessbauer's ideas were confirmed and extended, the physics community concluded that Moessbauer was right. Moessbauer won the Nobel Prize for his work in 1961. In the 1960s and 1970s Argonne physicists produced an increasingly clear picture of the properties of matter using the spectroscopy ushered in by Moessbauer. The scale of this traditional Moessbauer spectroscopy, which required a radioactive source and other simple equipment, began quite modestly by Argonne standards. For example Argonne hosted traditional Moessbauer spectroscopy research using mostly existing equipment in the early days and

  10. A critical appraisal of the first-year experience of 5 pediatric orthopaedic surgeons. (United States)

    Fletcher, Nicholas D; Larson, Annalise N; Glotzbecker, Michael P; Shore, Benjamin J; Hydorn, Christopher R


    The transition into practice following a fellowship in pediatric orthopaedics is challenging. This study seeks to describe the first-year experiences of 5 pediatric orthopaedists. An Institutional Review Board-approved retrospective review was conducted of 5 pediatric orthopaedic surgeons' first year in practice. All were fellowship trained and practiced at private or academic subspecialty groups. Clinical volume, payor mix, surgical cases, as well as complications were evaluated. A total of 1172 surgical procedures were available for review. Surgeons performed an average of 234 cases with a mean case load of 19.5 procedures per month. Fracture care and surgical management of infection represented the largest number of procedures. 42.3% of patients were covered by government insurance or were uninsured. Surgeons saw an average of 30.5 new patients per week in clinic. Of these, 10.7% of patients were scheduled for an elective surgical case. A sample of clinical practice revealed that 41.3% of patients were covered by government or no insurance. 17.8% of surgical patients sustained a complication with the majority being minor or expected. 18.8% of complications were major and required repeat operation. Complications peaked in the fourth month of practice. Although clinical and surgical volumes can vary during the first year of practice, fracture care and surgical management of infection represent the majority of operative cases. A large portion of surgical volume results from emergent care, whereas elective cases are more elusive with only 1 in 10 elective patients resulting in surgical treatment. Despite a significant number of untoward events related to surgery, major surgical complications are uncommon in the first year of practice. The majority of surgical cases in the first year of practice are due to trauma and infection. A high volume of patients must be seen to establish a practice, particularly given the high rate of Medicaid patients. These figures provide

  11. Normalization Fifty Years Beyond

    DEFF Research Database (Denmark)

    Bonfils, Inge Storgaard; Tøssebro, Jan; Teittinen, Antti


    The authors discuss recent developments in services for people with intellectual disabilities (ID) in the Nordic countries. They note that all of the countries saw important reforms during the 1990s, regarding both deinstitutionalization and decentralization. However, they posit that the litmus t...

  12. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

    Directory of Open Access Journals (Sweden)

    Diego Pozza


    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

  13. Fifty years later: Emerging functions of IgE antibodies in host defense, immune regulation, and allergic diseases. (United States)

    Oettgen, Hans C


    Fifty years ago, after a long search, IgE emerged as the circulating factor responsible for triggering allergic reactions. Its extremely low concentration in plasma created significant hurdles for scientists working to reveal its identity. We now know that IgE levels are invariably increased in patients affected by atopic conditions and that IgE provides the critical link between the antigen recognition role of the adaptive immune system and the effector functions of mast cells and basophils at mucosal and cutaneous sites of environmental exposure. This review discusses the established mechanisms of action of IgE in pathologic immediate hypersensitivity, as well as its multifaceted roles in protective immunity, control of mast cell homeostasis, and its more recently revealed immunomodulatory functions.

  14. Editing and publishing activities of the Korean Physical Society during the first fifty years since its inauguration in 1952

    Directory of Open Access Journals (Sweden)

    Yoon Suk Koh


    Full Text Available This is a historical review concerning the development of the editing and publishing activities of the Korean Physical Society, unique in its kind in South Korea, during its first fifty years since inauguration. It was founded in 1952, in the midst of the Korean War, and issued its first publication only in 1961. Despite such a late start, the society made great efforts to boost its activities thereafter, developing five different periodicals, including two Science Citation Index-listed journals, established by 2002. It can be seen as a remarkable success story of the Korean physics community, having overcome many hardships, which included the meager human and material resources that it started with and also the social unrest and destruction owing to the Korean War and its aftermath. The development and progress of the Korean Physical Society during this period, with a main focus on its editing and publishing practices, are briefly described.

  15. Changes in Oxidative Stress and Inflammatory Biomarkers in Fragile Adults over Fifty Years of Age and in Elderly People Exclusively Fed Enteral Nutrition

    National Research Council Canada - National Science Library

    Mesa, Maria D; Olza, Josune; Gonzalez-Anton, Carolina; Aguilera, Concepcion M; Moreno-Torres, Rosario; Jimenez, Africa; Perez de la Cruz, Antonio; Ruperez, Azahara I; Gil, Angel


    ...) affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects...

  16. The Birmingham hip resurfacing prosthesis: an independent single surgeon's experience at 7-year follow-up. (United States)

    Madhu, Tiruveedhula S; Akula, Mahesh R; Raman, Raghu N; Sharma, Hemant K; Johnson, Verne G


    An independent single surgeon's 7-year experience with Birmingham hip resurfacing is presented. The study also involved investigation of the significance of pedestal sign in patients requiring revision. A consecutive 117 hips in 101 patients (59 male and 42 female patients) operated on by the senior author (VGJ) were assessed at a mean follow-up of 7 years (range, 5-9.4 years). Mean age at surgery was 54 years (range, 20-74 years). Seventy-three hips had a preoperative diagnosis of primary osteoarthritis, and secondary osteoarthritis was seen in 44 hips. Failure was defined as revision for any reason. Revision of the femoral component alone was undertaken in 8 hips (6.8%): 5 within first year for periprosthetic fracture neck of femur and in 3 hips after 5 years of follow-up. In 2 patients who were known to have osteonecrosis of the femoral head preoperatively, the femoral component progressively collapsed into varus after 5 years of follow-up. Pedestal sign was the earliest radiologic sign noted in these 2 patients and progressed rapidly within 1 year on serial radiographs well before the onset of clinical symptoms. Kaplan-Meier survival with revision as end point at 7 years was 91.5% (95% confidence interval, 97.6%-85.4%). Copyright © 2011 Elsevier Inc. All rights reserved.

  17. The relentless past: The effect of chronic sexual abuse in childhood on fifty years of adolescent and adult development. (United States)

    Colarusso, Calvin A


    Four sisters, now in their late fifties and early sixties, were sexually abused during childhood over a four-year span by the same priest. Until recently they told no one about their experience and never received any psychological diagnostic evaluations or treatment. The author conducted detailed psychiatric evaluations of each of the four women while serving as the plaintiffs' expert witness during their lawsuits against the Catholic Church. The suits have been settled, and the women have given written permission to tell their stories. This unique clinical material provides a rare opportunity to describe and understand the ongoing, pervasive effects of untreated, chronic childhood sexual abuse on developmental processes over half a century. In each instance the women were describing the details of the abuse and the effects on their development for the first time. The severity of the pathology and the intense shame and anxiety associated with discussing their experiences after so many years raises questions about the choice of treatment and technique, particularly in regard to transference and countertransference issues.

  18. Reconstructing and analyzing China's fifty-nine year (1951–2009 drought history using hydrological model simulation

    Directory of Open Access Journals (Sweden)

    Z. Y. Wu


    Full Text Available The recent fifty-nine year (1951–2009 drought history of China is reconstructed using daily soil moisture values generated by the Variable Infiltration Capacity (VIC land surface macroscale hydrology model. VIC is applied over a grid of 10 458 points with a spatial resolution of 30 km × 30 km, and is driven by observed daily maximum and minimum air temperature and precipitation from 624 long-term meteorological stations. The VIC soil moisture is used to calculate the Soil Moisture Anomaly Percentage Index (SMAPI, which can be used as a measure of the severity of agricultural drought on a global basis. We develop a SMAPI-based drought identification procedure for practical uses in the identification of both grid point and regional drought events. As the result, a total of 325 regional drought events varying in time and strength are identified from China's nine drought study regions. These drought events can thus be assessed quantitatively at different spatial and temporal scales. The result shows that the severe drought events of 1978, 2000 and 2006 are well reconstructed, indicating SMAPI is capable of indentifying the onset of a drought event, its progressing, as well as its ending. Spatial and temporal variations of droughts on China's nine drought study regions are studied. Our result shows that on average, up to 30% of the total area of China is prone to drought. Regionally, an upward trend in drought-affected areas has been detected in three regions Inner Mongolia, Northeast and North during the recent fifty-nine years. However, the decadal variability of droughts has been week in the rest five regions South, Southwest, East, Northwest, and Tibet. Xinjiang has even been wetting steadily since the 1950s. Two regional dry centers are discovered in China as the result of a combined analysis on the occurrence of drought events from both grid points and drought study regions. The first center is located in the area partially covered by two

  19. Florence Richardson Wyckoff (1905-1997), Fifty Years of Grassroots Social ActivismVolume III: Watsonville Years 1960-1985



    Florence Wyckoff's three-volume oral history documents her remarkable, lifelong work as a social activist, during which she has become nationally recognized as an advocate of migrant families and children. From the depression years through the 1970s, she pursued grassroots, democratic, community-building efforts in the service of improving public health standards and providing health care, education, and housing for migrant families. Major legislative milestones in her career of advocacy were...

  20. A leadership development program for surgeons: First-year participant evaluation. (United States)

    Pradarelli, Jason C; Jaffe, Gregory A; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B


    In a dynamic health care system, strong leadership has never been more important for surgeons. Little is known about how to design and conduct effectively a leadership program specifically for surgeons. We sought to evaluate critically a Leadership Development Program for practicing surgeons by exploring how the program's strengths and weaknesses affected the surgeons' development as physician-leaders. At a large academic institution, we conducted semistructured interviews with 21 surgical faculty members who applied voluntarily, were selected, and completed a newly created Leadership Development Program in December 2012. Interview transcripts underwent qualitative descriptive analysis with thematic coding based on grounded theory. Themes were extracted regarding surgeons' evaluations of the program on their development as physician-leaders. After completing the program, surgeons reported personal improvements in the following 4 areas: self-empowerment to lead, self-awareness, team-building skills, and knowledge in business and leadership. Surgeons felt "more confident about stepping up as a leader" and more aware of "how others view me and my interactions." They described a stronger grasp on "giving feedback" as well as a better understanding of "business/organizational issues." Overall, surgeon-participants reported positive impacts of the program on their day-to-day work activities and general career perspective as well as on their long-term career development plans. Surgeons also recommended areas where the program could potentially be improved. These interviews detailed self-reported improvements in leadership knowledge and capabilities for practicing surgeons who completed a Leadership Development Program. A curriculum designed specifically for surgeons may enable future programs to equip surgeons better for important leadership roles in a complex health care environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Thirty-five-year results after Charnley total hip arthroplasty in patients less than fifty years old. A concise follow-up of previous reports. (United States)

    Warth, Lucian C; Callaghan, John J; Liu, Steve S; Klaassen, Alison L; Goetz, Devon D; Johnston, Richard C


    We report the updated results for a previously described cohort of patients who were less than fifty years old at the time of the index Charnley total hip arthroplasty with cement. The original cohort consisted of ninety-three consecutive hips in sixty-nine patients. The patients were followed for a minimum of thirty-five years after surgery or until death. At the latest follow-up evaluation, there were forty-one total hip replacements (44%) in thirty-two living patients. Thirty-four (37%) of the ninety-three total hip replacements in the original cohort had been revised or removed. Twenty acetabular (22%) and seven femoral (8%) components had been revised for aseptic loosening. Since the twenty-five-year follow-up, the average six-minute-walk distance decreased from 395 m to 171 m, and this decrease correlated with increasing comorbidity. This study demonstrates the durability of cemented total hip replacements in a young patient population. Although 63% (fifty-nine) of the ninety-three original hip replacements were functioning at the latest follow-up or at the time of death, a significant decrease in activity level was seen over time (p < 0.001). Of the forty-one original implants in the patients who were alive at the time of the thirty-five-year follow-up, only 46% (nineteen) were retained. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  2. Genetic diversity of rice cultivars (Oryza sativa L.) in China and the temporal trends in recent fifty years

    Institute of Scientific and Technical Information of China (English)


    To understand geographical distribution of the genetic diversity of rice cultivars (Oryza sativa L.) and its trends in recent fifty years in China, 453 accessions were analyzed by 36 microsatellites loci and 42 phenotypic traits. Results revealed that the genetic diversity by SSRs is highly consistent with that by phenotypic traits and the genetic diversity of indica cultivars was higher than that of japonica cultivars; the genetic diversity of cultivars declined from 1950s to 1980s and then increased greatly; among the six rice ecological zones (REZs), genetic diversity of REZⅡ was the highest and those of REZⅤ and REZⅥ were the lowest at both DNA and phenotypic level. Jiangsu and Jiangxi provinces in the middle and lower reaches of Yangtze River and Sichuan province in southwest of China were the areas with the highest genetic diversity. Breeders in REZⅤ which is an important japonica rice area but with very low genetic diversity should explore more gene resources to widen the genetic backgrounds of cultivars.

  3. Fifty Years of Magnetic Fusion Research (1958–2008: Brief Historical Overview and Discussion of Future Trends

    Directory of Open Access Journals (Sweden)

    Laila A. El-Guebaly


    Full Text Available Fifty years ago, the secrecy surrounding magnetically controlled thermonuclear fusion had been lifted allowing researchers to freely share technical results and discuss the challenges of harnessing fusion power. There were only four magnetic confinement fusion concepts pursued internationally: tokamak, stellarator, pinch, and mirror. Since the early 1970s, numerous fusion designs have been developed for the four original and three new approaches: spherical torus, field-reversed configuration, and spheromak. At present, the tokamak is regarded worldwide as the most viable candidate to demonstrate fusion energy generation. Numerous power plant studies (>50, extensive R&D programs, more than 100 operating experiments, and an impressive international collaboration led to the current wealth of fusion information and understanding. As a result, fusion promises to be a major part of the energy mix in the 21st century. The fusion roadmaps developed to date take different approaches, depending on the anticipated power plant concept and the degree of extrapolation beyond ITER. Several Demos with differing approaches will be built in the US, EU, Japan, China, Russia, Korea, India, and other countries to cover the wide range of near-term and advanced fusion systems.

  4. From conditioning to learning communities: implications of fifty years of research in e-learning interaction design

    Directory of Open Access Journals (Sweden)

    Andrew Ravenscroft


    Full Text Available This paper will consider e-learning in terms of the underlying learning processes and interactions that are stimulated, supported or favoured by new media and the contexts or communities in which it is used. We will review and critique a selection of research and development from the past fifty years that has linked pedagogical and learning theory to the design of innovative e-learning systems and activities, and discuss their implications. It will include approaches that are, essentially, behaviourist (Skinner and Gagné, cognitivist (Pask, Piaget and Papert, situated (Lave, Wenger and Seely-Brown, socioconstructivist (Vygotsky, socio-cultural (Nardi and Engestrom and community-based (Wenger and Preece. Emerging from this review is the argument that effective elearning usually requires, or involves, high-quality educational discourse, that leads to, at the least, improved knowledge, and at the best, conceptual development and improved understanding. To achieve this I argue that we need to adopt a more holistic approach to design that synthesizes features of the included approaches, leading to a framework that emphasizes the relationships between cognitive changes, dialogue processes and the communities, or contexts for e-learning.

  5. Fifty Years of Pulsar Candidate Selection: From simple filters to a new principled real-time classification approach

    CERN Document Server

    Lyon, R J; Cooper, S; Brooke, J M; Knowles, J D


    Improving survey specifications are causing an exponential rise in pulsar candidate numbers and data volumes. We study the candidate filters used to mitigate these problems during the past fifty years. We find that some existing methods such as applying constraints on the total number of candidates collected per observation, may have detrimental effects on the success of pulsar searches. Those methods immune to such effects are found to be ill-equipped to deal with the problems associated with increasing data volumes and candidate numbers, motivating the development of new approaches. We therefore present a new method designed for on-line operation. It selects promising candidates using a purpose-built tree-based machine learning classifier, the Gaussian Hellinger Very Fast Decision Tree (GH-VFDT), and a new set of features for describing candidates. The features have been chosen so as to i) maximise the separation between candidates arising from noise and those of probable astrophysical origin, and ii) be as...

  6. Fifty Years of Pulsar Candidate Selection: From simple filters to a new principled real-time classification approach (United States)

    Lyon, R. J.; Stappers, B. W.; Cooper, S.; Brooke, J. M.; Knowles, J. D.


    Improving survey specifications are causing an exponential rise in pulsar candidate numbers and data volumes. We study the candidate filters used to mitigate these problems during the past fifty years. We find that some existing methods such as applying constraints on the total number of candidates collected per observation, may have detrimental effects on the success of pulsar searches. Those methods immune to such effects are found to be ill-equipped to deal with the problems associated with increasing data volumes and candidate numbers, motivating the development of new approaches. We therefore present a new method designed for on-line operation. It selects promising candidates using a purpose-built tree-based machine learning classifier, the Gaussian Hellinger Very Fast Decision Tree (GH-VFDT), and a new set of features for describing candidates. The features have been chosen so as to i) maximise the separation between candidates arising from noise and those of probable astrophysical origin, and ii) be as survey-independent as possible. Using these features our new approach can process millions of candidates in seconds (˜1 million every 15 seconds), with high levels of pulsar recall (90%+). This technique is therefore applicable to the large volumes of data expected to be produced by the Square Kilometre Array (SKA). Use of this approach has assisted in the discovery of 20 new pulsars in data obtained during the LOFAR Tied-Array All-Sky Survey (LOTAAS).

  7. 50 años de música electroacústica en Chile Electroacustic Music in Chile: Fifty years

    Directory of Open Access Journals (Sweden)

    Federico Schumacher Ratt


    Full Text Available Cincuenta años han pasado desde que León Schidlowsky compusiera Nacimiento, la primera obra electroacústica chilena. Cincuenta años de una historia a menudo desconocida, compuesta de algunos éxitos resonantes, de desarrollos a veces truncos y de silencios bastante expresivos. La música electroacústica en Chile ha tenido un desarrollo pendular: de momentos de gran pasión e interés ha pasado al desconocimiento casi absoluto, y viceversa. A pesar de ya medio siglo de historia en el país -y algo más en el mundo- pareciera que los alcances y posibilidades de la música electroacústica, o más bien del concepto que en ella subyace (la tecnología aplicada a la música, en este caso más precisamente, la informática musical, no son en nuestro medio aún lo suficientemente bien analizados, comprendidos y proyectados en cuanto a la producción musical actual y futura. En este artículo, intentamos aproximarnos a las posibilidades y exigencias que ofrece actualmente esta disciplina desde el punto de vista del análisis, de la composición y de la interpretación musical. Como ubicación, se revisará algo de nuestra historia poniendo el acento en los extremos, en sus inicios y en los años que nos son más próximosFifty years ago, León Schidlowsky wrote Nacimiento (Birth, the first electroacustic work in composed Chile. Fifty years have elapsed of a history which very frequently has been forgotten. It is mude up of resounding achievements, periods of development, sometimes interrupted, and very meaningful gaps. Like a pendulum, electroacustic music in Chile has swung from periods of great passion and interest to other periods when has been practically ignored, and viceversa. In spite of almost half a century of history in Chile and a slightly longer period in the world, it would seem that the extent and possibilities of electroacustic music or better, the concept underlying this music -a technology applied to music, or more precisely to

  8. The cost of postgraduate medical education and continuing medical education: re-examining the status fifty years back. (United States)

    Walsh, Kieran


    The subject of the cost and value of medical education is becoming increasingly important. However, this subject is not a new one. Fifty years ago, Mr. DH Patey, Dr. OF Davies, and Dr. John Ellis published a report on the state of postgraduate medical education in the UK. The report was wide-ranging, but it made a considerable mention of cost. In this short article, I have presented the documentary research that I conducted on their report. I have analyzed it from a positivist perspective and have concentrated on the subject of cost, as it appears in their report. The authors describe reforms within postgraduate medical education; however, they are clear from the start that the issue of cost can often be a barrier to such reforms. They state the need for basic facilities for medical education, but then outline the financial barriers to their development. The authors then discuss the costs of library services for education. They state that the "annual spending on libraries varies considerably throughout the country." The authors also describe the educational experiences of newly graduated doctors. According to them, the main problem is that these doctors do not have time to attend formal educational events, and that this will not be possible until there is "a more graduated approach to responsible clinical work," something which is not possible without financial investment. While concluding their report, the authors state that the limited money invested in postgraduate medical education and continuing medical education has been well spent, and that this has had a dual effect on improving medical education as well as the standards of medical care.

  9. Journal of the College of Physicians and Surgeons of Pakistan: Five Years Bibliometric Analysis. (United States)

    Saeed Ullah, Saeed; Jan, Saeed Ullah; Jan, Tahir; Ahmad, Hafiz Nafees; Jan, Muhammad Yahya; Rauf, Muhammad Abdur


    To conduct the bibliometric analysis of the Journal of the College of Physicians and Surgeons Pakistan (JCPSP) from 2012 to 2014. The prime objectives of this report were to determine the number and percentage of articles by year, authorship pattern, gender and geographical affiliation, ranking by subject and citation analysis. A data collection instrument was developed as bibliometric form. The data was analysed using the Microsoft Excel spread sheet. Editorials and letters to editors were excluded. There were 1106 total research documents, including 721 original articles and 385 case reports. A rapid increase in number of articles per year was noticed, more original papers than case reports. Majority of the authors were male. The contribution of Balochistan and Khyber Pakhtunkhwa was less than the other provinces. JCPSP was the most cited document in the reference list of the research documents. The scholars of Khyber Pakhtunkhwa and Balochistan and female researchers should give more attention in writing quality articles eligible for consideration at this Journal. It is also suggested that writers should be compelled to address such fields of medical sciences as neurology, nephrology, anatomy and pharmacology, while writing original articles and case reports.

  10. Long-term results of a modified Spitzy shelf operation for residual hip dysplasia and subluxation. A fifty year follow-up study of fifty six children and young adults. (United States)

    Holm, Anne Guro Vreim; Reikerås, Olav; Terjesen, Terje


    The purposes of this study were to establish long-term outcome of the Spitzy shelf-operation and evaluate whether the procedure would delay osteoarthritis. During 1954-1976, 56 patients (70 hips) underwent Spitzy shelf operation at a mean age of 11.9 years (5 to 22). Indications included residual hip dysplasia or subluxation with Centre-Edge angle shelf operation. Survival was assessed by Cox regression. Univariable Cox regression was performed separately for each variable. Potential predictors (p-value shelf procedure was 39.9 years (21 to 53). Survival fell from 83 % 30 years post-operatively, to 22 % at 50 years. Fifty-three hips (76 %) had undergone total hip replacement at mean age of 49.4 years (33 to 64). Seventeen hips had not received total hip replacement, mean survival 47.9 years (39 to 53). The study showed that Spitzy shelf-operation had satisfactory long-term outcome with hip-survival in almost 90 % at patient age 40 years. The results indicate that Spitzy shelf-operation postpone total hip replacement. We consider Spitzy shelf-operation a good alternative in patients above 8 years. In younger children the procedure is not recommended due to increased frequency of graft resorption.

  11. An Ode to Stuart Hall's "The Supply of Demand": The Case of Post-Secondary Education in Ontario Fifty Years Later (United States)

    FitzGerald Murphy, Maggie


    Despite the fact that over fifty years have passed since its publication, Stuart Hall's article "The Supply of Demand" (1960), is remarkably relevant today. The central message that society must not be blinded by "prosperity" such that it no longer envisions and demands a better world is especially pertinent in light of the…

  12. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study


    Petr Sedlak; Jana Pařízková; Robert Daniš; Hana Dvořáková; Jana Vignerová


    Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the ach...

  13. Fifty-year old and still ticking.... an interview with Emile Zuckerkandl on the 50th anniversary of the molecular clock. Interview by Giacomo Bernardi. (United States)

    Zuckerkandl, Emile


    In 1962, a young post-doctoral fellow and a prominent Nobel Prize winner, Emile Zuckerkandl and Linus Pauling, published a seminal paper that described the relationship between the average number of aminoacid replacements and divergence time, known as the molecular clock (Zuckerkandl and Pauling 1962). Fifty years after the original publication, I was fortunate enough to interview Emile Zuckerkandl. We shared thoughts on his life and the historical events that led to the discovery of the molecular clock.

  14. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study (United States)

    Sedlak, Petr; Pařízková, Jana; Daniš, Robert; Dvořáková, Hana; Vignerová, Jana


    Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life. PMID:26380296

  15. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study. (United States)

    Sedlak, Petr; Pařízková, Jana; Daniš, Robert; Dvořáková, Hana; Vignerová, Jana


    Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n = 3678) height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life.

  16. Secular Changes of Adiposity and Motor Development in Czech Preschool Children: Lifestyle Changes in Fifty-Five Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    Petr Sedlak


    Full Text Available Secular trends of adiposity and motor development in preschool children since the fifties of the last century up to the beginning of this millennium were analyzed so as to reveal possible changes due to continuously differentiating lifestyle. In preschool children (n=3678 height, weight, skinfold thickness over triceps, subscapular, and suprailiac were measured by Harpenden caliper in 1957, 1977, 1980, 1985, 1990, and 2012. Simultaneously, motor performance was tested by evaluating the achievements in broad jump and throwing a ball, as a marker of adaptation to changing level of physical activity, free games, and exercise. Along the period of five decades the values of skinfold thickness increased significantly until 2012, mainly on the trunk. Simultaneously, the level of motor performance significantly decreased. Modifications of the way of life during the mentioned five decades characterized by sedentarism and inadequate food intake as related to energy output influenced negatively both adiposity and motor performance already in preschool children. Mostly increased deposition of fat on the trunk which is considered as a marker of possible development of metabolic syndrome was apparent already in preschool age, indicating the importance of early intervention concerning also physical activity and availability for exercise since early life.

  17. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

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    Ahmet Barış Durukan


    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  18. Recovery dynamics and invasibility of herbaceous plant communities after exposure to fifty-year climate extremes in different seasons

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    F. E. Dreesen


    Full Text Available Disturbance events such as climatic extremes may enhance the invasibility of plant communities, through the creation of gaps and the associated local increase in available resources. In this study, experimental herbaceous communities consisting of three species were subjected to 50 yr extreme drought and/or heat events, in spring, summer or autumn. In the year of the induced extremes, species mortality and end-of-season biomass were examined. In two subsequent years without further disturbances, establishment of new species was recorded. The drought and drought + heat extremes in summer and autumn induced greater plant mortality compared with the heat extremes in those seasons and compared with all extremes applied in spring, in all three originally planted species. Recovery in terms of biomass towards the end of the growing season, however, was species-specific. The dominant species, the nitrogen fixer Trifolium repens, recovered poorly from the drought and drought + heat extremes which governed the community response. Community biomass, which was heavily affected by the drought and especially by the drought + heat events in summer and autumn, reached control values already one year later. Invasibility was increased in the communities that underwent the drought + heat extremes in the first year following the extreme events, but no longer in the second year. During the two years of invasion, the community composition changed, but independently of the type and impact of the extreme event. In short, the extreme climate events greatly affected the survival and productivity of the species, modified the species composition and dominance patterns, and increased the invasibility of our plant communities. However, none of these community properties seemed to be affected in the long term, as the induced responses faded out after one or two years.

  19. 成批烧伤救治50年%Experiences in rescue and treatment of mass burn casualties in fifty years

    Institute of Scientific and Technical Information of China (English)



    The article reviewed the history and the main experiences of rescue of mass burn casualties and their treatment during the past fifty years in China. Some issues including medical support for mass burn casually and treatment regime in future, such as the prevention of burn calamities, further elevation of the eure rate and lowering in the rate of disability, further development in network of burn care and preliminary scheme of rescue of mass burn casualties and their treatment, accelerating the development and study on the substitutes of allo-skin graft were discussed.

  20. The Meta-Analysis of Clinical Judgment Project: Fifty-Six Years of Accumulated Research on Clinical Versus Statistical Prediction (United States)

    Aegisdottir, Stefania; White, Michael J.; Spengler, Paul M.; Maugherman, Alan S.; Anderson, Linda A.; Cook, Robert S.; Nichols, Cassandra N.; Lampropoulos, Georgios K.; Walker, Blain S.; Cohen, Genna; Rush, Jeffrey D.


    Clinical predictions made by mental health practitioners are compared with those using statistical approaches. Sixty-seven studies were identified from a comprehensive search of 56 years of research; 92 effect sizes were derived from these studies. The overall effect of clinical versus statistical prediction showed a somewhat greater accuracy for…

  1. Oak Ridge National Laboratory [ORNL] Review, Vol. 25, Nos. 3 and 4, 1992 [The First Fifty Years (United States)

    Krause, C.(ed.)


    In observation of the 50th anniversary of Oak Ridge National Laboratory, this special double issue of the Review contains a history of the Laboratory, complete with photographs, drawings, and short accompanying articles. Table of contents include: Wartime Laboratory; High-flux Years; Accelerating Projects; Olympian Feats; Balancing Act; Responding to Social Needs; Energy Technologies; Diversity and Sharing; Global Outreach; Epilogue

  2. Fifty years of Brazilian Dental Materials Group: scientific contributions of dental materials field evaluated by systematic review


    Wellington Luiz de Oliveira ROSA; Tiago Machado SILVA; Lima, Giana da Silveira; SILVA, Adriana Fernandes; Piva,Evandro


    ABSTRACT Objective A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. Material and Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma) statement. Searches were performed until December 2014 in six databases: MedLine (PubMed), Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI -...

  3. Lauriston S. Taylor lecture: fifty years of scientific research: the importance of scholarship and the influence of politics and controversy. (United States)

    Brent, Robert L


    Over the past 50 years our laboratory has performed and published many studies in the fields of teratology, radiation biology and radiation embryology. The early work took place when I was a research employee at the University of Rochester Manhattan Project in 1944 and where I had my introduction to embryology and genetics. Over the years our lab has provided consultations dealing with the risks of various environmental toxicant exposures during pregnancy. With the advent of the Internet, consulting has become more rapid and efficient. In the past year our pregnancy Web site of the Health Physics Society received approximately 154,000 hits, of which over a thousand contacts were still quite anxious after reading the Web site answers and requested a personal consultation. From this extensive experience we have learned that many physicians and other counselors are not prepared to counsel patients concerning radiation risks. Approximately 8% of the patient contacts who have consulted a professional have been provided with inaccurate information that would have resulted in an unnecessary interruption of a wanted pregnancy. There are five areas of radiation embryology that are considered to be controversial. 1) Can the fetus be harmed by ionizing radiation if the fetus is not directly exposed? 2) Is the production of mental retardation from radiation during pregnancy a threshold phenomenon? 3) Does fractionation and protraction of radiation decrease the magnitude of the reproductive and developmental risks? 4) Is there a period during pregnancy when radiation will result in an increased mortality but not an increase in malformations? 5) How sensitive is the fetus to the oncogenic effects of radiation? We utilize the scientific information obtained from studies in these five areas to counsel patients concerning pregnancy radiation risks. The willingness and persistence of scientists to debate the controversial aspects of this research and apply the best available

  4. A vision for the second fifty years of nuclear energy. Vision and strategies; Wizja drugiego piecdziesieciolecia energetyki jadrowej

    Energy Technology Data Exchange (ETDEWEB)

    Hori, M. [International Nuclear Societies Council (Poland)] [and others


    The paper is the Polish issue of the report worked out by International Nuclear Societies Council published in 1996. The report contains the experts opinion on development of nuclear energy and applications of radiation techniques and sources worldwide during the next 50 years. The worldwide energy demand prognosis as well as needs of different branches of industry, agriculture, medicine, etc. have been taken into account. The broad spectrum of aspects (safety assurance, economy, environmental impacts) connected with nuclear technology utilization has been also discussed. Transl., 24 refs, 6 figs, 6 tabs.

  5. Suicides in Serbia at the beginning of the 21st century and trends in the past fifty years

    Directory of Open Access Journals (Sweden)

    Penev Goran


    Full Text Available In 2006 in Serbia, 1444 persons committed suicide (19.5 per 100.000 population. Compared to the early 50s of the 20th century, the number of suicides has nearly doubled, but there has been a moderate decrease in the last 15 years. Similar, but somewhat more moderate tendencies are noted in the change of the value of the suicide rates. The lowest suicide rates were recorded during the 1950s, around 12 per 100.000, and the highest in the last decade of the 20th century when the rate reached 20 suicides per 100.000 inhabitants. The highest suicide rate is among the elderly, and there is also a noticeable tendency of increase in the share of the elderly in the total number of suicides, which is primarily the consequence of intense demographic aging. With youth, the last thirty years note a decline of both the number of suicides and the value of the suicide rates. The number of young people aged 15-24 who have committed suicide in 2006 is less than half of the number from 1971 (decreased from 150 to 66, and the values of suicide rates are also significantly low (decreased from 11.5 to 6.9 per 100.000. Despite certain changes in the values of age-specific suicide rates achieved in the last 50 years, their age patterns of suicide mortality can be characterized as stable. Men are dominant among persons who have committed suicide, with double the number of women, and the highest recorded value of the suicide rate of women never surpassed the value of the lowest suicide rate in men. In terms of marital status, the total rate of suicides is highest with widowers then divorced persons, married persons, and lowest rates are with celibates. In all four groups, suicide rates are at least 3 times higher for men. There is also a clear connection between the level of education and suicide rates for both sexes, with the suicide rate decreasing with higher educational level. In terms of total suicide rate, Serbia is currently in the top half of the European list of

  6. Extended radical mastectomy versus simple mastectomy followed by radiotherapy in primary breast cancer. A fifty-year follow-up to the Copenhagen Breast Cancer randomised study

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Helge; Kaae, Sigvard (Radium Center, Finsen Inst., Copenhagen (Denmark)); Jensen, Maj-Britt; Mouridsen, Henning T. (DBCG Registry, Copenhagen (Denmark))


    From November 1951 to December 1957, 666 consecutive patients with untreated primary breast cancer admitted to the Radium Center in Copenhagen were randomised before their operability was evaluated into two groups, simple mastectomy with postoperative radiotherapy or extended radical mastectomy. Following physical examination 241 of the patients were excluded, primarily due to tumours deemed inoperable due to clinical criteria (n =107) and due to poor general condition (n =69). Twenty-five years results of disease-free free survival and fifty years results of survival are presented, showing no difference between the two groups. Patients with clinical stage I did significantly better than patients with stage II-III tumours. Patients with grade I tumours had a better survival than patients with grade II-III. The breast cancer associated mortality was lower in premenopausal patients compared to postmenopausal patients. An excess mortality due to breast cancer was evident up to 20-25 years following the primary diagnosis

  7. Extended radical mastectomy versus simple mastectomy followed by radiotherapy in primary breast cancer. A fifty-year follow-up to the Copenhagen Breast Cancer randomised study. (United States)

    Johansen, Helge; Kaae, Sigvard; Jensen, Maj-Britt; Mouridsen, Henning T


    From November 1951 to December 1957, 666 consecutive patients with untreated primary breast cancer admitted to the Radium Center in Copenhagen were randomised before their operability was evaluated into two groups, simple mastectomy with postoperative radiotherapy or extended radical mastectomy. Following physical examination 241 of the patients were excluded, primarily due to tumours deemed inoperable due to clinical criteria (n =107) and due to poor general condition (n =69). Twenty-five years results of disease-free free survival and fifty years results of survival are presented, showing no difference between the two groups. Patients with clinical stage I did significantly better than patients with stage II-III tumours. Patients with grade I tumours had a better survival than patients with grade II-III. The breast cancer associated mortality was lower in premenopausal patients compared to postmenopausal patients. An excess mortality due to breast cancer was evident up to 20-25 years following the primary diagnosis.

  8. Birmingham Hip Resurfacing: A Single Surgeon Series Reported at a Minimum of 10 Years Follow-Up. (United States)

    Mehra, Akshay; Berryman, Fiona; Matharu, Gulraj S; Pynsent, Paul B; Isbister, Eric S


    We report outcomes on 120 Birmingham Hip Resurfacings (BHRs) (mean age 50 years) at a minimum of ten-years follow-up. Cases were performed by one surgeon and included his learning curve. Six hips were revised, with no revisions for infection, dislocation, or adverse reaction to metal debris. Ten-year survival was 94.2% (95% confidence interval (CI) 88.8%-98.7%) for all revisions and 96.1% (95% CI 91.5%-99.8%) for revisions for aseptic loosening. Gender (P = 0.463) and head size (P = 0.114) did not affect revision risk. Mean post-operative Harris hip score was 84.0. Contrary to previous independent reports, good outcomes into the second decade were achieved with the BHR in both men and women. Longer term follow-up will confirm whether these promising outcomes in women continue.

  9. Fifty years of Weibel-Palade bodies: the discovery and early history of an enigmatic organelle of endothelial cells. (United States)

    Weibel, E R


    In 1962, a rod-shaped cytoplasmic organelle of endothelial cells, later called the Weibel-Palade body, was serendipitously discovered by electron microscopy. It contains a set of parallel tubules and is wrapped in a membrane. Subsequent studies in the following decades established the unique localization of this organelle in endothelial cells of all vertebrates studied, meaning that it could serve as a marker of endothelial cells in tissue cultures. However, these studies did not reveal its functional significance, except for an indication that it could be related to an undefined thromboplastic substance. Twenty years after its discovery as a structural entity, it was shown by others that it houses von Willebrand factor and is thus clearly related to the coagulation system. In this review, I provide a personal historical account of the discovery and the subsequent limited work that I carried out on the organelle, putting it in the perspective of the current state of knowledge after half a century of research by many scientists.

  10. Fifty years of Brazilian Dental Materials Group: scientific contributions of dental materials field evaluated by systematic review

    Directory of Open Access Journals (Sweden)

    Wellington Luiz de Oliveira ROSA

    Full Text Available ABSTRACT Objective A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. Material and Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma statement. Searches were performed until December 2014 in six databases: MedLine (PubMed, Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI - Instituto Nacional de Propriedade Industrial was screened in order to get an overview of Brazilian technological development in the dental materials field. Two reviewers independently analyzed the documents. Only studies and patents related to dental materials were included in this review. Data regarding the material category, dental specialty, number of documents and patents, filiation countries, and the number of citations were tabulated and analyzed in Microsoft Office Excel (Microsoft Corporation, Redmond, Washington, United States. Results A total of 115,806 studies and 53 patents were related to dental materials and were included in this review. Brazil had 8% affiliation in studies related to dental materials, and the majority of the papers published were related to dental implants (1,137 papers, synthetic resins (681 papers, dental cements (440 papers, dental alloys (392 papers and dental adhesives (361 papers. The Brazilian technological development with patented dental materials was smaller than the scientific production. The most patented type of material was dental alloys (11 patents, followed by dental implants (8 patents and composite resins (7 patents. Conclusions Dental materials science has had a substantial number of records, demonstrating an important presence in scientific and technological development of dentistry. In addition, it is important to approximate the relationship between academia and industry to expand the technological development

  11. Fifty years of Brazilian Dental Materials Group: scientific contributions of dental materials field evaluated by systematic review (United States)

    ROSA, Wellington Luiz de Oliveira; SILVA, Tiago Machado; LIMA, Giana da Silveira; SILVA, Adriana Fernandes; PIVA, Evandro


    ABSTRACT Objective A systematic review was conducted to analyze Brazilian scientific and technological production related to the dental materials field over the past 50 years. Material and Methods This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (Prisma) statement. Searches were performed until December 2014 in six databases: MedLine (PubMed), Scopus, LILACS, IBECS, BBO, and the Cochrane Library. Additionally, the Brazilian patent database (INPI - Instituto Nacional de Propriedade Industrial) was screened in order to get an overview of Brazilian technological development in the dental materials field. Two reviewers independently analyzed the documents. Only studies and patents related to dental materials were included in this review. Data regarding the material category, dental specialty, number of documents and patents, filiation countries, and the number of citations were tabulated and analyzed in Microsoft Office Excel (Microsoft Corporation, Redmond, Washington, United States). Results A total of 115,806 studies and 53 patents were related to dental materials and were included in this review. Brazil had 8% affiliation in studies related to dental materials, and the majority of the papers published were related to dental implants (1,137 papers), synthetic resins (681 papers), dental cements (440 papers), dental alloys (392 papers) and dental adhesives (361 papers). The Brazilian technological development with patented dental materials was smaller than the scientific production. The most patented type of material was dental alloys (11 patents), followed by dental implants (8 patents) and composite resins (7 patents). Conclusions Dental materials science has had a substantial number of records, demonstrating an important presence in scientific and technological development of dentistry. In addition, it is important to approximate the relationship between academia and industry to expand the technological development in

  12. Changes in Oxidative Stress and Inflammatory Biomarkers in Fragile Adults over Fifty Years of Age and in Elderly People Exclusively Fed Enteral Nutrition

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    Maria D. Mesa


    Full Text Available We aim to evaluate whether exclusive feeding of an enteral formula enriched with n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFA affects oxidative stress and the antioxidant defence system and may improve the levels of some relevant inflammatory, and cardiovascular biomarkers in frail adults over fifty years of age and in elderly subjects. Fifty-five patients were divided into two groups and were exclusively fed a newly designed normoproteic and isocaloric enteral formula enriched with eicosapentaenoic (98 mg/d and docosahexaenoic acids (46 mg/d (n=26 or a reference enteral diet (n=29. Oxidative, inflammatory and cardiovascular risk biomarkers and red blood cell fatty acid profiles were determined at the beginning and after 90 and 180 days of feeding. The n-3 LC-PUFA percentage tended to be higher (P=0.053 in the experimental group than in the reference group. Administration of the n-3 LC-PUFA diet did not increase oxidative stress or modify plasma antioxidant capacity but decreased antioxidant enzymatic activities. MMP-9 plasma concentration decreased with both formulae, whereas tPAI-1 tended to decrease (P=0.116 with the administration of the experimental formula. In conclusion, administration of the new n-3 LC-PUFA-enriched product for 6 months did not negatively alter the oxidative status and improved some cardiovascular risk biomarkers.

  13. Endoscopic Treatment of Vesicoureteral Reflux in Children with Dextranomer/Hyaluronic Acid—A Single Surgeon's 6-Year Experience

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    Hou-Chuan Chen


    Full Text Available Endoscopic treatment for vesicoureteral reflux (VUR has become an established alternative to long-term antibiotic prophylaxis and ureteral reimplantation. We present the outcome of endoscopic treatment with dextranomer/hyaluronic acid copolymer (Deflux for VUR in children by a single surgeon at our institute from October 2003 to October 2009. We reviewed the cases of 150 patients (total 239 ureters, 56 girls (37% and 94 boys (63%, with a mean age of 2.2 years and a median followup of 2.5 years (range 3–68 months. Among the 239 ureters treated, 67.4% (161/239 were cured with a single injection, and a second and third injection raised the cure rate to 86.6% (207/239 and 88.3% (211/239, respectively. None had postoperative ureteral obstruction.

  14. Fifty Years of Matter Waves (United States)

    Medicus, Heinrich A.


    Discusses the origin of de Broglie's concept and its influences on his contemporaries, notably on Einstein, Schrodinger, Elsasser, Davisson, and Thomson. Indicates that the theory served not only as the starting point of quantum mechanics, but also opened new experimental possibilities. Historical inaccuracies are corrected with new material…

  15. A ten years follow-up of the results of surgery for Dupuytren's disease. A study of fifty-eight cases. (United States)

    Norotte, G; Apoil, A; Travers, V


    Fifty-eight patients (52 males and 6 females) operated on for Dupuytren contracture were examined by the same author with a more than ten year follow-up. At time of surgery the average was 55 years old. 69 hands (169 fingers) rated 4.33 according to the simplified Tubiana's score were treated by the same operative procedure: Mac Indoe's incision, digital Z plasty (if needed), subtotal fasciectomy and physiotherapy beginning 8 days postoperatively. At long term, recurrence appears for 49 hands (71%) one every two in the two first postoperative years, one out of five after five years. 24 of them were graded stage I. The recurrence appeared 14 times associated with an extension of the disease and the earlier, the higher was the initial stage. Some factors seem to be of a bad prognosis regarding recurrence: age (93% of recurrence under 50 years old) Ledderhose or Lapeyronie (100%) other associated diseases (Alcoholism, diabetes mellitus, epilepsy) and severe preoperative stage. Subjective results are good: 45 patients are satisfied and only 3 underwent a second operation.

  16. [The competent surgeon. Bridging the gap between undergraduate final year and postgraduate surgery training]. (United States)

    Kadmon, M; Ganschow, P; Gillen, S; Hofmann, H S; Braune, N; Johannink, J; Kühn, P; Buhr, H J; Berberat, P O


    Competency-based frameworks rely on relevant professional competency rather than formal regulations. The transitional phase between final year undergraduate and common trunk postgraduate medical training is characterized by an increase of professional responsibility whereby previously acquired knowledge, skills and abilities have to be merged and applied to patients. Undergraduate and postgraduate training programs should ensure a successive transfer of responsibility for medical practice to final year students and young residents depending on individual competence. The concept of entrustable professional activities (EPA) represents a curricular concept based on concrete medical tasks which may be assigned to the responsibility of the trainee.

  17. Who wants to be a surgeon? A study of 300 first year medical students

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    Ellis Harold


    Full Text Available Abstract Background While medicine in general is becoming more female-dominated, women are still under-represented in surgery. Opinion is divided as to whether this is due to lifestyle considerations, disinterest or perceived discrimination. It is not clear at what stage these careers decisions are made. Methods 300 first year medical students at Guy's King's and St Thomas' School of Medicine (GKT were asked their view on possible career choices at this stage. Results While men represented only 38% of the student population, they represented over two-thirds of the students wishing to pursue a career in surgery. Women still opt for general practice and paediatrics. Conclusion Surgery is a disproportionately unpopular career choice of the female first-year medical students of GKT compared to the male students. It appears that the choice is freely made and, at this stage at least, does not represent concerns about compatibility with lifestyle.

  18. 郭沫若文学研究五十年%Retrospect on Studies of Guo Mo-ruo' Writings in the Past Fifty Years

    Institute of Scientific and Technical Information of China (English)



    郭沫若文学研究是中国现代文学研究的一个重要组成部分。新中国成立后的50年间,它应合着中国现代文学学科的发展节拍而发展。三次研究高潮取得了堪称辉煌的学术成就,演化了一个逐步摆脱政治化规约的建构学术品格的历史。%Studies of Guo Mo-Ruo' writings form essential parts in academic studies of modern Chinese literature. Since the foundation of New China in 1949, researches in both fields have been developing with almost the same speed. In the past fifty years, there have been three high tides in the studies of Guo Mo-ruo''s writings, which gained brilliant academic achievements. It is also a history of constructing high academic quality and style by gradually shaking off the bonds of political interference.

  19. [Fifty years of research on tuberculosis. Lessons I have learnt during 50 years and topics to be investigated in the future]. (United States)

    Shimao, T


    I have engaged in the research on tuberculosis for 50 years, and lessons I have learnt during this period could be summarized in the following ten topics. First is great research achievements by our predecessors on the establishment of so-called primary infection theory on the pathogenesis of TB, planning of TB control principles based on the theory and development of new technologies used for TB control, such as mass miniature X-ray examination and BCG vaccination in 1920s and 1930s. TB control law was enforced in 1951, and the modern TB programme was initiated. Second, the field is a treasure house of interesting data. Several interesting data on TB soon after the World War II in Tokyo and a rural area were collected and analyzed from the mass health examination. Third, looking at the increase of tuberculin positivity with age, it was found that the tuberculin negativity decreased as the exponential function of age, and the current concept of the annual risk of TB infection was already developed in late 1940s. It was 18.1% in male and 11.6% in female in Tokyo in late 1940s. Based on this concept, age specific TB mortality was analyzed by the type of TB, and the rates of miliary TB and TB meningitis were similar to the rate of newly infected to the total population, while the rate of all forms could be divided into early and late death as shown in Fig. 1. Fourth, I suffered from TB by myself from 1951 to 1953, receiving first thoracoplasty in two stages under local anaesthesia, then right upper lobectomy and segmentectomy of superior segment of right lower lobe. From this experience, I learnt a lot about the psychology and suffering of TB patients. Fifth, the importance of recognition of real magnitude of the problem in such a disease as TB in which many TB cases did not aware of their disease. The answer to this was the first TB prevalence survey in 1953 using stratified random sampling method, and based on the results of the survey, the mass health examination

  20. Impact of Surgeon Experience During Carotid Endarterectomy Operation and Effects on Perioperative Outcomes

    Directory of Open Access Journals (Sweden)

    Volkan Yüksel

    Full Text Available Abstract Objective: We evaluated the effect of surgeon experience on complication and mortality rates of carotid endarterectomy operation. Methods: Fifty-nine consecutive patients who underwent carotid endarterectomy between January 2013 and February 2016 were divided into two groups. Patients who had been operated by surgeons performing carotid endarterectomy for more than 10 years were allocated to group 1 (experienced surgeons; n=34. Group 2 (younger surgeons; n=25 consisted of patients operated by surgeons independently performing carotid endarterectomy for less than 2 years. Both groups were compared in respect of operative results and postoperative complications. Results: No intergroup difference was found for laterality of the lesion or concomitant coronary artery disease. In group 1, signs of local nerve damage (n=2; 5.9% were detected, whereas in group 2 no evidence of local nerve damage was observed. Surgeons in group 1 used local and general anesthesia in 3 (8.8% and 31 (91.2% patients, respectively, while surgeons in group 2 preferred to use local and general anesthesia in 1 (4% and 24 (96% patients, respectively. Postoperative stroke was observed in group 1 (n=2; 5.9% and group 2 (n=2; 5.8%. Conclusion: Younger surgeons perform carotid endarterectomy with similar techniques and have similar results compared to experienced surgeons. Younger surgeons rarely prefer using shunt during carotid endarterectomy. The experience and the skills gained by these surgeons during their training, under the supervision of experienced surgeons, will enable them to perform successful carotid endarterectomy operations independently after completion of their training period.

  1. Mentoring surgeons. (United States)

    Toledo-Pereyra, Luis H


    From time immemorial mentoring has been the angular stone sustaining the building of medical and surgical education. Good teachers are not necessarily good mentors, and good mentors are not always good teachers. A combination of both is very plausible and should be encouraged. Today, the qualities of a good mentor, in our case the surgeon-mentor, should include respect, time, commitment, trust, determination, encouragement, patience, and opportunity for independence. The mentee would need to respond to similar virtues of trust, encouragement, and respect. The reciprocal consideration of equally divided roles would be clearly desirable. Recognizing the importance of a good mentor and making this role the priority of medical schools would enhance our ability to form better professionals. It would certainly promote professionalism, better patient care, and research.

  2. [International Relationship of Japanese General Thoracic Surgeons]. (United States)

    Okumura, Meinoshin


    Japanese thoracic surgeons have created personal relationship with European and North American surgeons. During the last 10 years, official relation between Japanese Association for Chest Surgery(JACS) and European Society of Thoracic Surgeons (ESTS) has been established besides personal interaction, and communication among the thoracic surgeons in Asia was prompted through Asia Thoracoscopic Surgery Education Program( ATEP). International relationship through academic associations is expected to contribute to encouraging general thoracic surgeons.

  3. Leo Doyle, master surgeon. (United States)

    Vellar, I


    On 3 March 1953 Leo Doyle died at the Mercy Hospital, Melbourne. The day before he died Leo Doyle had been operating at the Mercy Hospital when he took ill. Doyle's final illness was almost certainly the result of the severe aortic stenosis that had been developing over some years. His death at the relatively young age of 61 ended the career of a man described by Sir Gordon Gordon Taylor as the greatest technical surgeon that he had ever seen. In all likelihood Australian surgery will never see the likes of Doyle, a virtuoso surgeon, again. And yet to many of the surgeons who were Doyle's contemporaries and to those who followed him he remained somewhat of an enigma. Perhaps in some way the description of the great French surgeon Baron Dupuytren may also be applicable to Leo Doyle: known to all, loved by many, understood by few. By all accounts Leo Doyle's surgical repertoire knew no bounds. He operated with equal facility on the central nervous system, the head and neck, in the thorax, abdomen and pelvis and he was more than competent in gynaecology, urology and orthopaedics. In the latter part of his career he became, par excellence, a cancer surgeon. He was, arguably, Australia's first surgical oncologist. No procedure was deemed too complicated or demanding. Like some other superb technicians his judgement at times did not match his technical ability. Doyle was one of the first surgeons in Australia to perform hindquarter amputation and he helped to pioneer the operations of total gastrectomy and oesophagogastrectomy. An avid reader of the surgical literature, he possessed an enormous library which was matched by an equally large collection of surgical instruments. Unlike Devine he published relatively little. He was not a good clinical teacher, preferring to teach by example in the operating theatre. Although interested in music and the visual arts, surgery was his life.

  4. Quality of Life of Indian Pediatric Surgeons: Results of a Survey (of Indian Association of Pediatric Surgeons Members) (United States)

    Zameer, M. M.; Rao, Sanjay; Vinay, C.; D’Cruz, Ashley


    Introduction: Much is debated on the quality of life of pediatric surgeons practicing in India, all based on anecdotal and personal experiences. There is no systematic study on this. This study addresses this and attempts to glean a clearer picture of the life as a pediatric surgeon in India. Methodology: This questionnaire-based study was administered via an online survey to all Indian Association of Pediatric Surgeons members. The responses were anonymous and investigators blinded. Data were collated and analyzed using STAT11.1. Results: A total of 173 pediatric surgeons responded. Eighty-six percent were men. About 73.7% of the surgeons were between 31 and 50 years of age. Almost 63.4% practiced in urban areas, whereas 36% in other smaller towns. About 0.6% reported that their practice was rural. Almost 26.4% were in private/solo practices, whereas 53.4% were in institution-based practice. Almost 80% felt that they were adequately trained while starting their practice. About 78% are professionally satisfied with their work. Only 44.5% of surgeons felt that they were compensated adequately financially. Reading was the favorite pass time. Almost 40% of the surgeons felt that they were either overweight or obese. About 41% of the surgeons exercise more than 3 times a week. Only 11.4% smoke, whereas 36% drink. Fifty-three percent of surgeons felt that their personal savings were adequate. Seventy-six percent use Facebook. Sixty-eight percent were satisfied with their quality of life. Age was significantly associated with professional satisfaction, financial satisfaction, and quality of life and all improve as one's age progresses. None were affected with one's gender, type of practice, and the place of practice. Age, weight, exercise, and one's savings significantly affected ones quality of life. Conclusion: This is the first study which objectively highlights that most surgeons are happy professionally and financially in due course of time and demolishes the common

  5. Isolated keratinized gingiva incision in alveolar cleft bone grafts improves qualitative outcomes: a single surgeon's 23 year experience. (United States)

    López-Cedrún, Jose L; Gonzalez-Landa, Gonzalo; Figueroa, Alvaro


    Few publications have described the flap design of the secondary cleft alveoloplasty. In this article we describe a modified technique of the classical flap design with the purpose of minimizing injury to the dental papillae and periodontium of the involved dentition. We report our long-term experience, specifically with regards to oronasal fistulae recurrence, wound healing and graft exposure and loss. All the patients were operated on using the same technique by a single surgeon. A total of 148 clefts have been operated with this approach, involving 117 patients with complete cleft lip and palate with a follow-up between 12 and 240 months. The most important finding in this study is the excellent wound healing observed in almost all patients. Only three patients (2%) suffered a dehiscence with oronasal fistulae recurrence and bone loss. Another patient lost the graft without fistula recurrence. Minor dehiscence with partial bone loss occurred in 4 patients (2.7%). These patients did not need surgical closure and only superficial exposed bone particles were lost without compromising the clinical outcome. Our modification presents a flap design that is easy to elevate and mobilize, without disturbing the buccal sulcus or the gingival inter-dental papillae. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. [The robotic surgeon training]. (United States)

    Crestani, Alessandro; Rossanese, Marta; Abbinante, Maria; Calandriello, Mattia; Kungulli, Afrovita; Giannarini, Gianluca; Ficarra, Vincenzo


    The widespread robotic surgery in the world highlighted the relevance of the training programs for young urologists and residents. In the last years, urologic societies and some independent robotic surgeons strongly worked to standardize some general and specific training modules. Theoretical and practical sections of robotic training programs have been recently specified. The role of simulators, dry and wet laboratories, bedside assistance, and modular (step-by-step) training at console represent the most relevant elements of robotic surgeon training. Ideally, these didactic tools should be available in modern training centers. The development of structured robotic training programs should be considered as one of the priorities that the urologic community must take into account in the near future.

  7. A Simple Algorithm for Immediate Postmastectomy Reconstruction of the Small Breast—A Single Surgeon's 10-Year Experience (United States)

    Kitcat, Magelia; Molina, Alexandra; Meldon, Charlotte; Darhouse, Nagham; Clibbon, Jon; Malata, Charles M.


    Introduction: Immediate small breast reconstruction poses challenges including limited potential donor site tissues, a thinner skin envelope, and limited implant choice. Few patients are suitable for autologous reconstruction while contralateral symmetrization surgery that often offsets the problem of obvious asymmetry in thin and small-breasted patients is often unavailable, too expensive, or declined by the patient. Methods: We reviewed 42 consecutive patients with mastectomy weights of 350 g or less (the lowest quartile of all reconstructions). Indications for the mastectomy, body mass index, bra cup size, comorbidity, reconstruction type, and complications were recorded. Results: A total of 59 immediate reconstructions, including 25 latissimus dorsi flaps, 23 implant-only reconstructions, 9 abdominal flaps, and 2 gluteal flaps, were performed in 42 patients. Of the 42 mastectomies, 4 were prophylactic. Forty-three percent of patients had immediate contralateral balancing surgery. The average mastectomy weight was 231 g (range, 74-350 g). Seven percent of implant-based reconstructions developed capsular contracture requiring further surgery. One free transverse rectus abdominus myocutaneous flap failed because of fulminant methicillin resistant staphylococcus aureus septicaemia. Discussion and Conclusion: Balancing contralateral surgery is key in achieving excellent symmetry in reconstruction small-breasted patients. However, many patients wish to avoid contralateral surgery, thus restricting a surgeon's reconstructive options. Autologous flaps, traditionally, had not been considered in thinner women because of inadequacy of donor site tissue, but in fact, often, as with larger-breasted patients, produce superior cosmetic results. We propose a simple algorithm for the reconstruction of small-breasted women (without resorting to super-complex microsurgery), which is designed to tailor the choice of reconstructive technique to the requirements of the individual

  8. Fifty not out (United States)


    What have the DESY laboratory in Germany, Richard Feynman's visionary lecture on nanotechnology, the discovery of the Aharonov-Bohm effect and the "two cultures" debate got in common? The answer is that they are all half a century old this year. The DESY lab was officially launched on 18 December 1959 and is marking its 50th anniversary with a series of events that included the official opening of the PETRA III synchrotron last month. Initially a particle-physics lab pure and simple, DESY is now changing its focus to accelerator science and is set to open its massive new 1bn European X-ray Free Electron Laser in 2014 (p12).

  9. DMT at fifty. (United States)

    Szára, Stephen


    The steps taken for the discovery of the hallucinogenic effects of N.N-Dimethyl-tryptamine (DMT) is described. DMT had a difficult first 50 years in medical research primarily for legal reasons as it was classified as one of the "drugs of abuse" by authorities in the USA and by the World Health Organization. It has not proved to be a "schizotoxin" as it was first suspected, but the book is not closed on its potential role in some other, high level function as an endogenous neuromodulator. Further clinical work may even substantiate its usefulness in therapeutic application, such as an adjunct to psychotherapy, perhaps not by itself, but in a modified form, or in combination with other substances.


    Directory of Open Access Journals (Sweden)

    Jacek Starzyk


    Full Text Available Issuing medical statements is important in the professional activity of doctors. A medical statement of the surgeon Jan Kłossowicz from 1811 is presented in the paper. In this statement, the clinical image of scurvy was presented. This disease has been known since the 13th century. It was found in the 16th century that lemon juice prevents and treats this disease. In 1928, the ascorbic acid active substance was isolated. The description of scurvy drawn by the surgeon Jan Kłossowicz was compared with the descriptions of this disease in medical textbooks from the early second half of the 19th century and the end of the 20th century. It was found that within the timespan of nearly 200 years the way in which the medical image of this disease is presented has not changed significantly. It was stressed that the medical statements concerning the state of health which were issued by doctors in previous centuries are a valuable source of information on the symptomatology of diseases.

  11. Hydrology and Ecology of the Colorado River Delta in the Face of Changing Climate and Land Use Practices: the Next Fifty Years (United States)

    Nagler, P. L.; Glenn, E. P.


    The Lower Colorado River Delta in the U.S. and Mexico is an internationally important aquatic biome, supporting fresh water and estuarine wetlands and a riparian corridor rich in avian and other wildlife. These rich ecosystems could be severely harmed by invasive species interacting with projected climate change and land use practices over the next 50 years. It is critical to measure land cover and monitor ecosystem and land use changes because these ecosystems are supported by fresh and brackish water flows originating from flood control releases and agricultural return flows in the U.S. and Mexico. Most climate models project a drying trend in the Colorado River watershed due to global warming, decreasing the frequency of flood releases to the Delta. Total basin water storage in the reservoir system is expected to be reduced by 32-40 percent, and flow volume is expected to meet demands in only 59-75 percent of years in 50 years. The frequency of spills (years in which water is released from the reservoirs to the Delta) will decrease under a global warming scenario. However, the Pacific Decadal Oscillation and ENSO events will continue to introduce variability into river flows, and there will still be years in which water is spilled to the Delta. Agricultural return flows will decrease as more water is diverted from agriculture to metropolitan use in both countries. The salinity of the ground water in Mexico, which currently supports cottonwood and willow trees in the riparian corridor, is increasing at a rate of about 20 ppm per year, and in 50 years it might be too saline for cottonwoods and willows. The riparian zone may become dominated by saltcedar and other salt-tolerant shrubs, degrading the habitat for birds and other wildlife. As flows to the Delta diminish, monitoring and active restoration projects to maintain trees and wetlands will be needed to preserve habitat value.

  12. Parity non-conservation in beta-decay of nuclei: revisiting experiment and theory fifty years after. IV. Parity breaking models

    CERN Document Server

    Georgiev, Mladen


    This part offers a survey of models proposed to cope with the symmetry-breaking challenge. Among them are the two-component neutrinos, the neutrino twins, the universal Fermi interaction, etc. Moreover, the broken discrete symmetries in physics are very much on the agenda and may occupy considerable time for LHC experiments next year aimed at revealing the symmetry-breaking mechanisms.

  13. Use of porous tantalum components in Paprosky two and three acetabular revision. A minimum five-year follow-up of fifty one hips. (United States)

    Flecher, Xavier; Appy, Benjamin; Parratte, Sébastien; Ollivier, Matthieu; Argenson, Jean-Noel


    Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. The objective of this study was to analyse the outcome and survivorship of acetabular revision hip arthroplasty using tantalum components for loosening associated with bone loss at a minimum of five-year follow-up. We retrospectively reviewed 51 consecutive patients (51 hips) who had an acetabular revision using porous tantalum components at a minimum follow-up of five years. The mean age was 64 years (range, 31-87). There were 27 males and 24 females, 47 right hips and four left hips. Twenty-five (49 %) included a femoral revision. According to Paprosky's classification 18 hips were classified type 2A, 11 type 2B, ten type 2C, seven type 3A and five type 3B. No bone grafting was performed. Sixteen hips (31.3 %) required the use of additional tantalum-made augments stabilized by screws and cement at the cup-augment interface. At a mean followup of 6.8 years (range, 5.1-10 years), the Harris hip score improved from 44 pre- operatively (range, 23-72) to 84 post-operatively (range, 33-98). The mean post-operative hip centre position in relation to the teardrop was 29 mm (range, 20-43 mm) horizontally and 21 mm (range, 8-36 mm) vertically. The mean acetabular inclination was 42° (range, 17-60°). Six hips (11.7 %) required a re-operation without component revision (two for chronic instability, one ossification removal, one haematoma, one deep infection and one periprosthetic femoral fracture). One patient required a cup re-revision for septic loosening. No aseptic loosening occurred. At last followup the radiological analysis showed one evolutive osteolysis and one screw breakage. The global survivorship was 92.3 % at 64 months. If only aseptic loosening was defined as the end-point the survivorship was 100 % at 64 months. When

  14. 中国虫生真菌应用50年简史%Fifty years of application of entomogenous fungi in China

    Institute of Scientific and Technical Information of China (English)



    In China, there is a long history over 2300 years of entomogenous fungi used as medicines,but their use against insect pests did not start until mid 1950′s.In 1970,the central government held a workshop to encourage the use of Beauveria bassiana against pine caterpillars,making the year a milestone in Chinese history of microbial pest control.Since then, quite a few fungi have been tried for control of over 60 forest and crop pests.In the past decades,low tech production has been being improved towards commercial production with higher techniques.Until 2006,5 products of fungal insecticides have been registered.Meanwhile,large scale application techniques have been being improved with molecular ecological approach towards a rational application strategy.

  15. The Relationship of Anterior Cruciate Ligament Lesions and Osteochondral Lesions with Meniscal Tears in Patients Younger than Fifty Years of Age

    Directory of Open Access Journals (Sweden)

    Samed Ordu


    Full Text Available Aim: The purpose of this study was to determine the incidence of anterior cruciate ligament (ACL lesions and osteochondral lesions according to type and localization of the meniscal tear and age, gender in patients who have been arthroscopicaly treated, besides, to make the coexisting lesions more predictable in these patients. Methods: We retrospectively investigated 352 patients under 50 years of age who underwent surgery for a meniscal tear between 2008 and 2012. We scanned the surgical operation notes, preoperative questionnaires and the magnetic resonance imaging findings. We recorded patients who had ACL lesions, such as elongation, partial rupture and total rupture. Osteochondral lesions were classified according to the Outerbridge classification from grade 1 to grade 4. Results: Chondral lesions were present in 77.4% of patients with degenerative meniscal tears and in 63% of patients with radial meniscal tears. One the other hand, osteochondral lesions were observed in only 33.9% of patients with other types of meniscal tears. 46.6% of ACL lesions accompanied by meniscal tears with longitudinal pattern, such as longitudinal tears, bucket handle tears and root tears. For the other types of meniscal tears, this percentage was 20.7. When we excluded degenerative type meniscal tears, the mean age of the patients with radial tears was 40.86±9.03 years and the mean age of the patients with other types of tear was 35.44±9.44 years. The difference was statistically significant. Conclusion: We found close relationship between osteoarthritic chondral lesions and radial tears in the root of the posterior horn of the medial meniscus. On the other side, longitudinal tears were related with ACL lesions. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 177-80

  16. Fifty-year follow-up of mortality among a cohort of iron-ore miners in Sweden, with specific reference to myocardial infarction mortality. (United States)

    Björ, B; Burström, L; Jonsson, H; Nathanaelsson, L; Damber, L; Nilsson, T


    This study investigates both general mortality and mortality from myocardial infarction among men employed in iron-ore mines in Sweden. The mortality of employees (surface and underground workers) at the iron-ore mines in Malmberget and Kiruna, Sweden was investigated. The study cohort comprised men who had been employed for at least 1 year between 1923 and 1996. The causes of death were obtained from the national cause of death register from 1952 to 2001. Indirect standardised mortality ratios (SMR) were calculated for four main causes. Mortality specifically from myocardial infarction was also analysed. 4504 deaths in the cohort gave an SMR for total mortality of 1.05 (95% CI 1.02 to 1.09). Mortality was significantly higher for lung cancer (SMR 1.73, 95% CI 1.52 to 1.97). There was an increased risk of injuries and poisonings (SMR 1.34, 95% CI 1.24 to 1.46) and respiratory diseases (SMR 1.14, 95% CI 1.00 to 1.28). There were 1477 cases of myocardial infarction, resulting in an SMR of 1.12 (95% CI 1.07 to 1.18). SMR was higher (1.35, 95% CI 1.22 to 1.50) for men aged 60 years of age (1.06, 95% CI 1.00 to 1.13). Mortality from myocardial infarction was higher than expected. There was also an increased risk of death from injuries and poisonings, lung cancer and respiratory diseases, as well as higher general mortality. Our findings support the results of previous studies that there is an association between working in the mining industry and adverse health outcomes.

  17. Fifty years of changes in reef flat habitats of the Grand Récif of Toliara (SW Madagascar) and the impact of gleaning (United States)

    Andréfouët, S.; Guillaume, M. M. M.; Delval, A.; Rasoamanendrika, F. M. A.; Blanchot, J.; Bruggemann, J. H.


    The Grand Récif of Toliara (GRT) in Madagascar is a large (33 km2) barrier reef system of the SW Indian Ocean that had been well investigated in the 1960s and early 1970s. A massive degradation of the reef has been reported since at least the early 1980s, just a few years after research activities ceased in the area. Examination of historical aerial photographs and modern high-resolution remote sensing images confirms a continuous loss of coral habitat on GRT outer reef flats between 1962 and 2011, with an average loss of 65 % and a range of 37-79 % loss during this 50-year period. The usual suspects of coral community declines (cyclones, bleaching and sedimentation) may have contributed to the demise of the GRT. However, an independent study (Salimo 1997) suggests that the chronic pressure of fisherman gleaning on reef flats with destructive tools is the main driver of the observed changes. Salimo's reported level of frequentation (6.8 fishermen per day and per km-2) and rates of destruction per fisherman (7.7 m2 of coral habitat h-1) yield a cumulated overall loss in agreement with the image-based rates of habitat loss. The GRT is unlikely to recover because this chronic stress is unlikely to decrease in the near future. Indeed, the GRT daily provides subsistence fishery resources for local Vezo people and to agriculturalist or pastoralist ethnic groups who have turned to exploiting coastal resources due to increasing aridity and dwindling agricultural and livestock production.

  18. The 1.3-m Robotically Controlled Telescope (RCT) at Kitt Peak - A Fifty year old dream Realized: Telescope Characteristics, Current Research and Education Progr (United States)

    Guinan, Edward; Gelderman, Richard; Strolger, Louis-Gregory; Carini, Michael T.; McGruder, Charles, III; Campbell, Rachel; Walter, Donald K.; Davis, Donald R.; Tedesco, Edward F.; Engle, Scott G.


    The 1.3 m Robotically Controlled Telescope (RCT) on Kitt Peak has a rich history, including its role as a prototype for remotely controlled telescopes during the 1960s. As such, the RCT could be considered one of the first - Telescopes from Afar. The telescope, originally called the Remotely Controlled Telescope, has been renamed the Robotically Controlled Telescope to reflect the change in operational control and mode of use. The RCT was a conceptual precursor of today's robotic telescopes, but the actual operation of a remotely controlled telescope was technologically premature for its time, and was subsequently manually operated primarily to conduct optical and infrared observations as well being used as a test bed for new spectroscopic and photometric instruments. In 1995 budget constraints forced the closing of the telescope as part of the Kitt Peak National Observatory (KPNO), following nearly 30 years of distinguished service to KPNO. A request for proposals to operate this telescope was issued to the science community. The RCT consortium, lead by Western Kentucky University, was the successful proposer for operation of the telescope. After several difficult years of retrofitting, refurbishing, and automating the telecope and observatory dome, the telescope has returned to routine science operations in November 2009. The RCT has operated smoothly since that time, with no major interruptions. Observations of objects of interest to the consortium partners (including: comets & asteroids, variable & binary stars, exoplanets, supernovae, quasars & blazars) are being routinely obtained and evaluated. One of the distinguishing features of the RCT is that it is an autonomous observatory designed to handle diverse optical imaging and photometry programs. These include being able to automatically deal with a wide range of observing parameters such as -integration time, sky conditions, repetitions, return visits, filters, air mass, non-sidereal objects, transients etc

  19. Fifty years after the Nuremberg Nazi Doctors' Trial: reviewing how the laws of the Third Reich applied to individuals with oral clefts. (United States)

    Wyszynski, D F


    The Nazi Doctors' Trial, held in the city of Nuremberg 50 years ago, is a landmark in the history of medicine and science. For the first time, the horrors inflicted by a group of German scientists on innocent victims became widely known. Most of the defendants received sentences that ranged from relatively short imprisonment to death. The Trial also provided elements to develop standards for permissible medical experimentation, known as the Nuremberg Code. The atrocities judged in the Nazi Doctors' Trial, however, were not isolated. They were part of an overall eugenic system that encouraged euthanasia, compulsory sterilization, and selective marriages based on "genetic health" and "racial hygiene." Individuals with oral clefts were considered subject to these laws and suffered their consequences. This paper describes the main features of the Trial, reviews the state of knowledge on oral clefts in the 1930s and 1940s, presents how the laws of the Third Reich impacted the lives of individuals with oral clefts, and speculates on the implications of past and present eugenic policies in the future of humankind.

  20. Long-term trends in sodium and chloride in the Mohawk River, New York: the effect of fifty years of road-salt application. (United States)

    Godwin, K S; Hafner, S D; Buff, M F


    Ecological studies have demonstrated the adverse effects of road-salt, primarily NaCl, on water quality, flora, and fauna. In this study, we quantified changes in ionic composition and solute flux of water draining the Mohawk River Basin (9103 km(2)) in New York State, from 1952 to 1998. Using various statistical, graphical, and modeling techniques, we showed that concentrations ofNa+ and Cl- have increased by 130 and 243%, respectively, while other constituents have decreased or remained constant. The use of de-icing salt on roads within the watershed, which we estimate at 39 kg km(-2) day(-1), appears to be the primary mechanism responsible for reported increases, accounting for the increase in NaCl export from 16 to 46 kg km(-2) day(-1) over the 47-year period.Moreover, despite population decline within this rural upstate watershed, increased environmental stewardship, and The Clean Water Act, concentrations of Na+ and Cl- still increased during the 1990s.

  1. Adolescent Self-Organization and Adult Smoking and Drinking over Fifty Years of Follow-Up: The British 1946 Birth Cohort. (United States)

    Nishida, Atsushi; Cadar, Dorina; Xu, Man K; Croudace, Timothy; Jones, Peter B; Kuh, Diana; Richards, Marcus


    Variations in markers of adolescent self-organization predict a range of economic and health-related outcomes in general population studies. Using a population-based birth cohort study we investigated associations between adolescent self-organization and two common factors over adulthood influencing health, smoking and alcohol consumption. The MRC National Survey of Health and Development (the British 1946 birth cohort) was used to test associations between a dimensional measure of adolescent self-organization derived from teacher ratings, and summary longitudinal measures of smoking and alcohol consumption over the ensuing five decades. Multinomial regression models were adjusted for sex, adolescent emotional and conduct problems, occupational social class of origin, childhood cognition, educational attainment and adult occupational social class. With all covariates adjusted, higher adolescent self-organization was associated with fewer smoking pack years, although not with quitting; there was no association with alcohol consumption across adulthood (none or heavy compared with light to moderate). Adolescent self-organization appears to be protective against smoking, but not against heavy alcohol consumption. Interpretation of this differential effect should be embedded in an understanding of the social and sociodemographic context in which these health behaviours occur over time.

  2. [Effects of fire recurrence on fire behaviour in cork oak woodlands (Quercus suber L.) and Mediterranean shrublands over the last fifty years]. (United States)

    Schaffhauser, Alice; Pimont, François; Curt, Thomas; Cassagne, Nathalie; Dupuy, Jean-Luc; Tatoni, Thierry


    Past fire recurrence impacts the vegetation structure, and it is consequently hypothesized to alter its future fire behaviour. We examined the fire behaviour in shrubland-forest mosaics of southeastern France, which were organized along a range of fire frequency (0 to 3-4 fires along the past 50 years) and had different time intervals between fires. The mosaic was dominated by Quercus suber L. and Erica-Cistus shrubland communities. We described the vegetation structure through measurements of tree height, base of tree crown or shrub layer, mean diameter, cover, plant water content and bulk density. We used the physical model Firetec to simulate the fire behaviour. Fire intensity, fire spread, plant water content and biomass loss varied significantly according to fire recurrence and vegetation structure, mainly linked to the time since the last fire, then the number of fires. These results confirm that past fire recurrence affects future fire behaviour, with multi-layered vegetation (particularly high shrublands) producing more intense fires, contrary to submature Quercus woodlands that have not burnt since 1959 and that are unlikely to reburn. Further simulations, with more vegetation scenes according to shrub and canopy covers, will complete this study in order to discuss the fire propagation risk in heterogeneous vegetation, particularly in the Mediterranean area, with a view to a local management of these ecosystems.

  3. An exponential growth of computational phantom research in radiation protection, imaging, and radiotherapy: a review of the fifty-year history. (United States)

    Xu, X George


    Radiation dose calculation using models of the human anatomy has been a subject of great interest to radiation protection, medical imaging, and radiotherapy. However, early pioneers of this field did not foresee the exponential growth of research activity as observed today. This review article walks the reader through the history of the research and development in this field of study which started some 50 years ago. This review identifies a clear progression of computational phantom complexity which can be denoted by three distinct generations. The first generation of stylized phantoms, representing a grouping of less than dozen models, was initially developed in the 1960s at Oak Ridge National Laboratory to calculate internal doses from nuclear medicine procedures. Despite their anatomical simplicity, these computational phantoms were the best tools available at the time for internal/external dosimetry, image evaluation, and treatment dose evaluations. A second generation of a large number of voxelized phantoms arose rapidly in the late 1980s as a result of the increased availability of tomographic medical imaging and computers. Surprisingly, the last decade saw the emergence of the third generation of phantoms which are based on advanced geometries called boundary representation (BREP) in the form of Non-Uniform Rational B-Splines (NURBS) or polygonal meshes. This new class of phantoms now consists of over 287 models including those used for non-ionizing radiation applications. This review article aims to provide the reader with a general understanding of how the field of computational phantoms came about and the technical challenges it faced at different times. This goal is achieved by defining basic geometry modeling techniques and by analyzing selected phantoms in terms of geometrical features and dosimetric problems to be solved. The rich historical information is summarized in four tables that are aided by highlights in the text on how some of the most

  4. Fifty Years in the Technology of Acoustic Emission(1961--2011)%声发射技术五十年(1961-2011)

    Institute of Scientific and Technical Information of China (English)

    Allen T Green; 张磊


    This paper has a description of some of the Acoustic Emission projects that I have been involved with during the past 50 years. While my career in AE started with determining the residual strength of a glass and epoxy composite cylindrical pressure vessel it quickly expanded into many different materials, products and structures. In this paper I present information on efforts in; non-metallic and metallic pressure vessels; factors effecting AE; identification of modes of deformation; noise rejection methods; leak detection in Above Ground Storage Tanks; combining AE with UT; Acousto-Ultrasonic examination of wood particle boards; in-flight monitoring of Aircraft structure; and determination of water stress in grape plants and others.%文章对过去50年笔者所涉及的一些声发射项目做了回顾。笔者的声发射生涯是从检验玻璃环氧树脂圆柱形压力容器的剩余强度开始的,然后很快地延伸到了其它的很多材料、制品和结构中去。笔者在文中会介绍尽量多的信息,诸如:非金属和金属压力容器、影响声发射的因素、变型模式的识别、降噪技术、地上储罐泄漏探测、结合AE与UT、木材颗粒板的声-超声检验、飞行中飞机结构的监测以及葡萄科植物的缺水探测等。

  5. Hand dominance in orthopaedic surgeons.

    LENUS (Irish Health Repository)

    Lui, Darren F


    Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

  6. [Mercury and copper accumulation during last fifty years and their potential ecological risk assessment in sediment of mangrove wetland of Shenzhen, China]. (United States)

    Li, Rui-Li; Chai, Min-Wei; Qiu, Guo-Yu; He, Bei


    The processes of sediment transport and deposition can record some relative anthropogenic information in gulf region. Chronological analysis of the sediment core collected from mangrove wetland in Shenzhen Bay showed that the sedimentation rate was about 1.38 cm x a(-1). Soil buck density, pH, electrical conductivity (EC) and total organic carbon (TOC) changed in range of 0.36-0.71 g x cm(-3), 6-7, 2.93 x 10(3) -4.97 x 10(3) microS x cm(-1), and 1.5% - 3.8%, respectively. With the increase of soil depth, the soil buck density and EC increased gradually. However, the TOC decreased, with no significant change of pH. Contents of Hg and Cu in the whole depth of core ranged between 92-196 ng x g(-1) and 29-83 microg x g(-1), respectively. And both of them in sediment increased firstly and then decreased with the increasing soil depth. At 14 cm depth, contents of Hg and Cu reached up to the highest levels. Correspondingly, the ecological risk of Hg and Cu changed similarly with the contents of Hg and Cu. At 14 cm depth, the ecological risk indexes of Hg and Cu were at the highest levels of 39.10 and 13.85, respectively. The potential ecological risks of both Hg and Cu in sediments were mild. The rapid economical development of Hong Kong in 1960-1985 and Shenzhen in 1985-2000 contributed much to the Hg and Cu accumulation in mangrove wetland of Shenzhen Bay, China. Since the year of 2000, the reduction in contents of Hg and Cu has been expected as a consequence of the adoption of contamination control policies, improving the environment for growth of mangrove. In conclusion, the variations of core sediment heavy metal contents and its ecological risk assessment along the vertical profile reveal the interaction processes and extent of anthropogenic influences from the areas around the Shenzhen Bay and the catchments.

  7. Influence of cardiac surgeon report cards on patient referral by cardiologists in new york state after 20 years of public reporting

    NARCIS (Netherlands)

    Brown, D.L.; Epstein, A.M.; Schneider, E.C.


    Background- Report cards of risk-adjusted mortality rates of individual cardiac surgeons have been publicly available in New York State since 1991. A survey of New York cardiologists in 1996 found that these report cards had little effect on their referral recommendations to cardiac surgeons. It is

  8. Radiological imaging of congenital hand anomalies - a 6-year single-centre experience and what the hand surgeons want to know

    Energy Technology Data Exchange (ETDEWEB)

    Gerety, E.L.; Hopper, M.A. [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Grant, I. [Cambridge University Hospitals NHS Foundation Trust, Department of Plastic Surgery, Cambridge (United Kingdom)


    Congenital hand anomalies present a rare but important physical and emotional challenge for children and parents. Radiological imaging is important for accurate diagnosis, to aid decision making and to monitor changes in the growing hand. The goal of any treatment is to help the child achieve his/her maximum potential, to provide a useful hand with attention to cosmesis. We investigated the range of congenital hand anomalies imaged in a tertiary referral centre. We examined the timing of imaging and the key clinical questions. The radiology imaging system was searched retrospectively for radiographs of congenital hand anomalies over a 6-year period. The images were reviewed and patient demographics, diagnosis and other imaging recorded. Over 6 years, 85 patients had imaging. Twenty-three patients had bilateral problems and 11 had recognised syndromes. The most common abnormalities imaged were duplicated thumbs (28 %), followed by syndactyly (18 %). Children were first imaged as early as 1 day old, with the median age of initial imaging 12 months. Thumb duplication and syndactyly are the most common conditions for which radiographs are requested at our hospital, although overall syndactyly is considered the most common congenital hand anomaly. For a variety of reasons, children are often imaged very early, before review by the Specialist in Children's Hand Surgery (despite surgery being unlikely before 1 year of age.) We discuss the classification systems and specific issues that hand surgeons want to know from the radiologists. (orig.)

  9. Chemists in Rijeka Together for Fifty Years

    Directory of Open Access Journals (Sweden)

    Milin, C.


    Full Text Available Whatever part of the World you come from, when you come to Rijeka you came to the heart of Europe. Rijeka is waiting for you with the scent of its sea and the hospitality of its people. Rijeka is a town of unusual, turbulent and intersected history. At the end of the IX Century the area of Rijeka was one of the most powerful industrial zones in Europe. Prof. Eugen Cerkovnikov, Ph. D., a much-respected chemist, first Head of the Department for Chemistry and Biochemistry on the then newly established Medical School in Rijeka, launched the initiative to form a branch-office of the Croatian Chemist Society in Rijeka. On 18 January, 1958 in the Big Classroom of the Medical School in Rijeka the Founding Assembly was held, and many respected scientists of that period were present.In 1960, the Rijeka branch-office of the Croatian Chemist Society merged with the Society of Chemists and Technologists and in 1973 the Biochemists section joined. In the five decades of its existence, the love towards chemistry, biochemistry, molecular biology, technology and chemical engineering, the love towards the basis of natural sciences and the wish to educate new, progressive generations formed the mission of the Society. The Society does not want to be closed in a guild organisation; its aim is to open its doors towards all those striving to progress.Former presidents of the Society were: Eugen Cerkovnikov (1958-1974, Marijan Kolombo (1974-1980, Josip Šilipeter (1980-1984, Marinko Oršia (1984-1996 i Nikola Bla?evia (1996-; and each one of them marked his era. Transitional circumstances have shut down forever many, until recently, extremely powerful industries in Rijeka. Today, Rijeka is searching for new paths, and we believe that our Society will continue to work on and give its contribution to this search.

  10. Fifty Years of Discoveries in Nuclear Structure (United States)

    Hamilton, J. H.; Ramayya, A. V.

    The complementary nature of the Vanderbilt experimental work and the theoretical work of the Frankfurt group on the rotation-vibration model, the generalized collective model, shape coexistence and cluster radioactivity is described. Recent discoveries in neutron-rich nuclei γ-vibrational bands compared with RVM and GCM are presented. Ultimate examples of cluster radioactivity in cold binary and ternary fission are discussed. Finally, we present evidence for the evolution from axial symmetry in 101Y to maximum triaxialilty in 113Rh and for chiral doublet bands in neutron-rich triaxial even-even nuclei between A=106 - 112.

  11. Military Aptitude Testing: The Past Fifty Years (United States)


    Enhanced Computer-Administered Testing ECFA Examen Calificacion de Feurzas Armadas EST Enlistment Screening Test ETP Enlistment Testing Program GAO...qualification standards and in part on the needs of the Service. Qualification standards are more complex than just mental standards; they also include medical...and moral standards. Mental standards include educational level as well as aptitude test scores. The military testing program (MTP) began with the

  12. Fifty years of the renormalization group

    CERN Document Server

    Shirkov, D V


    Renormalization was the breakthrough that made quantum field theory respectable in the late 1940s. Since then, renormalization procedures, particularly the renormalization group method, have remained a touchstone for new theoretical developments. This work relates the history of the renormalization group. (17 refs).

  13. Thurstones's Discriminal Processes Fifty Years Later (United States)

    Luce, R. Duncan


    Thurstone's landmark papers on psychophysics, published in the twenties, are discussed in this presidential address to the Psychometric Society. The development of psychophysics from Thurstone to the present is presented in some detail. (JKS)

  14. Energy Resources and the Next Fifty Years (United States)

    Landon, S. M.


    At this time, approximately 85 percent of the energy needs of the United States are supplied by fossil fuels. Crude oil currently supports transportation, generally as gasoline or jet fuel. The United States is importing roughly 60 percent of the crude oil we are now using and our domestic refining capacity is declining. Coal is providing more than 56 percent of the nation's electricity, although the use of natural gas as a fuel for electricity generation has been increasing. Natural gas, with today's technology, is considered a cleaner fuel as we continue to move toward decarbonization. The next logical phase in this historical progress will probably be the transition to pure hydrogen as an energy source, chiefly as a fuel for fuel cells. The initial source of hydrogen will probably be natural gas, given the existing infrastructure for natural gas, its cost, and its availability. Demand for natural gas is expected to peak in approximately 2050. But in the transition to an affordable, efficient, reliable, market-driven, carbon-free energy economy, substantial demand will still exist for coal and crude oil, even as these energy fuels are phased out. A massive requirement will exist for natural gas as the transition fuel since renewables will probably continue to supply only about 10 percent of our nation's electricity demand. The implied demand for coal and oil in the U. S. and the World can readily be met with existing known or probable resources; the challenge will be in assuring supplies that are secure, priced reasonably, and made ever cleaner. The implied demand for natural gas, however, exceeds the currently estimated resource base both in the U. S. and globally. For example, the currently estimated remaining resource of natural gas in the U. S. is about 2,000 TCF. The implied demand for natural gas in a methane economy, during the transition to a non-fossil source of hydrogen, is on the order of 3,000 to 4,000 TCF, half again to twice currently estimated volumes, assuming likely population growth, average economic growth of 3 percent annually, average energy efficiency of 2 percent annually, and a contribution of natural gas of more than 50 percent of total energy used. Potential additions to the resource base are from such sources as basin-centered formations, coalbed methane, sub-volcanic reservoirs, methane hydrates, among others; but many of these sources are not well understood and the practicality and cost of their availability are not known.

  15. Fifty Years of Scholarship in Media Ethics (United States)

    Christians, Clifford G.


    Describes changing attitudes toward the role of mass media ethics, as reflected in the literature. Available from: Journal of Communication, The Annenberg School of Communications, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, $15.00 yr; $4.00 sc. (KS)

  16. Medical sociology: a personal fifty year perspective. (United States)

    Straus, R


    This paper reviews the author's experience in becoming a medical sociologist before the field had become formalized. The contributions to medical sociology of sociologist Selden D. Bacon and physician and medical educator William R. Willard are described. The relationship of medical sociology to medical behavioral science, as experienced at the University of Kentucky, is discussed. Finally, the thesis of the author's 1957 paper on the nature and status of medical sociology is re-examined.

  17. The Fifty Year Rehabilitation of the Egg

    Directory of Open Access Journals (Sweden)

    Donald J. McNamara


    Full Text Available The 1968 American Heart Association announced a dietary recommendation that all individuals consume less than 300 mg of dietary cholesterol per day and no more than three whole eggs per week. This recommendation has not only significantly impacted the dietary patterns of the population, but also resulted in the public limiting a highly nutritious and affordable source of high quality nutrients, including choline which was limited in the diets of most individuals. The egg industry addressed the egg issue with research documenting the minimal effect of egg intake on plasma lipoprotein levels, as well as research verifying the importance of egg nutrients in a variety of issues related to health promotion. In 2015 dietary cholesterol and egg restrictions have been dropped by most health promotion agencies worldwide and recommended to be dropped from the 2015 Dietary Guidelines for Americans.

  18. Local Control, Toxicity, and Cosmesis in Women >70 Years Enrolled in the American Society of Breast Surgeons Accelerated Partial Breast Irradiation Registry Trial

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Atif J., E-mail: [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Vicini, Frank A.; Beitsch, Peter [American Society of Breast Surgeons, Columbia, MD (United States); Goyal, Sharad [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); Kuerer, Henry M.; Keisch, Martin; Quiet, Coral; Zannis, Victor; Keleher, Angela; Snyder, Howard; Gittleman, Mark; Whitworth, Pat; Fine, Richard [American Society of Breast Surgeons, Columbia, MD (United States); Lyden, Maureen [BioStat International, Inc., Tampa, FL (United States); Haffty, Bruce G. [Robert Wood Johnson University Hospital, Cancer Institute of New Jersey, New Brunswick, NJ (United States); American Society of Breast Surgeons, Columbia, MD (United States)


    Purpose: The American Society of Breast Surgeons enrolled women in a registry trial to prospectively study patients treated with the MammoSite Radiation Therapy System breast brachytherapy device. The present report examined the outcomes in women aged >70 years enrolled in the trial. Methods and Materials: A total of 1,449 primary early stage breast cancers were treated in 1,440 women. Of these, 537 occurred in women >70 years old. Fisher's exact test was performed to correlate age ({<=}70 vs. >70 years) with toxicity and with cosmesis. The association of age with local recurrence (LR) failure times was investigated by fitting a parametric model. Results: Older women were less likely to develop telangiectasias than younger women (7.9% vs. 12.4%, p = 0.0083). The incidence of other toxicities was similar. Cosmesis was good or excellent in 92% of the women >70 years old. No significant difference was found in LR as a function of age. The 5-year actuarial LR rate with invasive disease for the older vs. younger population was 2.79% and 2.92%, respectively (p = 0.5780). In women >70 years with hormone-sensitive tumors {<=}2 cm who received hormonal therapy (n = 195), the 5-year actuarial rate of LR, overall survival, disease-free survival, and cause-specific survival was 2.06%, 89.3%, 87%, and 97.5%, respectively. These outcomes were similar in women who did not receive hormonal therapy. Women with small, estrogen receptor-negative disease had worse LR, overall survival, and disease-free survival compared with receptor-positive patients. Conclusions: Accelerated partial breast irradiation with the MammoSite radiation therapy system resulted in low toxicity and produced similar cosmesis and local control at 5 years in women >70 years compared with younger women. This treatment should be considered as an alternative to omitting adjuvant radiotherapy for older women with small-volume, early-stage breast cancer.

  19. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU Lu; WANG Yiran


    Military surgeons are a special group of doctors. They are both medical workers and soldiers.Their mission is to serve the wounded on the battlefield.And there is no doubt that military surgeons will save our comrades in the army. However,should a military surgeon save the wounded enemy? It is indeed a dilemma.Some may save the wounded enemy because military surgeons are doctors after all and they can't possibly abandon anybody to his fate,but some refuse to do so because military surgeons are soldiers.Therefore,some situations on the battlefield are discussed and advice is suggested for military surgeons,with heartfelt anticipation for there being less casualties on the battlefield as well as alleviating human suffering caused by war.

  20. Military Surgeon and Humanity

    Institute of Scientific and Technical Information of China (English)

    LU; Lu; WANG; Yiran


    Military surgeons are a special group of doctors.They are both medical workers and soldiers.Their mission is to serve the wounded on the battlefield.And there is no doubt that military surgeons will save our comrades in the army.However,should a military surgeon save the wounded enemy?It is indeed a dilemma.Some may save the wounded enemy because military surgeons are doctors after all and they can’t possibly abandon anybody to his fate,but some refuse to do so because military surgeons are soldiers.Therefore,some situations on the battlefield are discussed and advice is suggested for military surgeons,with heartfelt anticipation for there being less casualties on the battlefield as well as alleviating human suffering caused by war.

  1. Society of Gynecologic Surgeons (United States)

    Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ... Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ...

  2. Find a Surgeon (United States)

    ... skin, muscle, bone and cartilage finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ... skin, muscle, bone and cartilage finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function. As ...

  3. Surgeon compensation and motivation. (United States)

    Leitch, K K; Walker, P M


    Financial incentives are the only form of compensation that will motivate surgeons at an academic health sciences center to perform the tasks outlined in the hospital's mission statement. A questionnaire divided into 5 sections: demographics, compensation, time allocation, benefits and incentives, and motivational factors. The Department of Surgery, The Toronto Hospital, Toronto, Ontario. All academic surgeons (N=64) practicing at The Toronto Hospital in July 1997. Of the 64 eligible mailed surveys, there were responses for 59. Of these 59 surgeons, 48 (81%) receive compensation through a fee-for-service method. However, only 32 (54%) of the surgeons prefer the fee-for-service method, while 18 (31%) prefer salary and 9 (15%) prefer an alternative system. On average, these academic surgeons spend 44% of their time teaching or performing research, for which they receive 14% of their total income. Of the motivational factors assessed, financial bonuses are a positive motivational factor for all "surgeon tasks." In addition, task-specific motivational factors were established for research, teaching, and operating, including research facilities, mentorship and prestige, and interesting case types, respectively. Surgeons are not appropriately renumerated for time spent on academic activities, and many would prefer an alternative form of compensation to the fee-for-service method. Knowledge that surgeons are receptive to tasks supporting the hospital's mission statement leads us to conclude that appropriate motivation can shape the activity of academic surgeons. Financial rewards ranked the highest as a motivational factor for all surgeon tasks; however, task-specific motivational factors were identified. Overall, multiple factors, specifically targeted to the individual, will serve to motivate. Thus, compensation packages based on individual preferences and personal motivational factors will be the most successful.

  4. Surgeons' perceptions on industry relations: A survey of 822 surgeons. (United States)

    Altieri, Maria S; Yang, Jie; Wang, Lily; Yin, Donglei; Talamini, Mark; Pryor, Aurora D


    The relationships between industry and medical professionals are controversial. The purpose of our study was to evaluate surgeons' current opinions regarding the industry-surgery partnership, in addition to self-reported industry ties. After institutional review board approval, a survey was sent via RedCap to 3,782 surgeons across the United States. Univariate and multivariable regression analyses were performed to evaluate the responses. The response rate was 23%. From the 822 responders, 226 (27%) reported at least one current relationship with industry, while 297 (36.1%) had at least one such relationship within the past 3 years. There was no difference between general surgery versus other surgical specialties (P = .5). Among the general surgery subspecialties, respondents in minimally invasive surgery/foregut had greater ties to industry compared to other subspecialties (P = .001). In addition, midcareer surgeons, male sex, and being on a reviewer/editorial board were associated with having industry ties (P industry are important for innovation. Our study showed that relationships between surgeons and industry are common, because more than a quarter of our responders reported at least one current relationship. Industry relations are perceived as necessary for operative innovation. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Burnout and career satisfaction among American surgeons. (United States)

    Shanafelt, Tait D; Balch, Charles M; Bechamps, Gerald J; Russell, Thomas; Dyrbye, Lotte; Satele, Daniel; Collicott, Paul; Novotny, Paul J; Sloan, Jeff; Freischlag, Julie A


    To determine the incidence of burnout among American surgeons and evaluate personal and professional characteristics associated with surgeon burnout. : Burnout is a syndrome of emotional exhaustion and depersonalization that leads to decreased effectiveness at work. A limited amount of information exists about the relationship between specific demographic and practice characteristics with burnout among American surgeons. Members of the American College of Surgeons (ACS) were sent an anonymous, cross-sectional survey in June 2008. The survey evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments. Of the approximately 24,922 surgeons sampled, 7905 (32%) returned surveys. Responders had been in practice 18 years, worked 60 hours per week, and were on call 2 nights/wk (median values). Overall, 40% of responding surgeons were burned out, 30% screened positive for symptoms of depression, and 28% had a mental QOL score >1/2 standard deviation below the population norm. Factors independently associated with burnout included younger age, having children, area of specialization, number of nights on call per week, hours worked per week, and having compensation determined entirely based on billing. Only 36% of surgeons felt their work schedule left enough time for personal/family life and only 51% would recommend their children pursue a career as a physician/surgeon. Burnout is common among American surgeons and is the single greatest predictor of surgeons' satisfaction with career and specialty choice. Additional research is needed to identify individual, organizational, and societal interventions that preserve and promote the mental health of American surgeons.

  6. Civil Surgeon Info (United States)

    Department of Homeland Security — USCIS designates certain doctors (also known as civil surgeons) to perform the medical exam required for most Green Card applicants. This data set represents the...

  7. Searching for Surgeons (United States)

    ... Clinical Scholars in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon Specific Registry NSQIP Annual ... Southern Territories Gabon Gambia Gaza Strip Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey ...

  8. Wilfred Trotter: surgeon, philosopher. (United States)

    Rosen, Irving B


    There is no significant biography that records the accomplishments of Sir Wilfred Trotter, who was a general surgeon in its pure sense at a time when surgical specialization was in its infancy. Trotter was born in the 1870s in England. Despite being bedridden during his childhood with a musculoskeletal condition he was able to study medicine at London University, and eventually became Professor and Chair of Surgery at the University College Hospital, a position he held until his death in November 1939. He made many contributions to surgical care, particularly in the field of oncology. He attended to many famous people, including King George V and Sigmund Freud and was greatly honoured in his own milieu. He was named honorary surgeon and Sargent Surgeon to the king. In addition, he was a thoughtful individual who addressed problems in human behaviour, contradicting the stereotype of the contemporary surgeon.

  9. Society of Thoracic Surgeons (United States)

    ... Care for You How to Use Apps and Social Media for Your Practice Why Participation in the STS ... STS_CTsurgery Surgeons Residents & Students Allied ... Hotel Discount for STS Members Copyright © 2016 The Society ...

  10. William Cheselden: anatomist, surgeon, and medical illustrator. (United States)

    Sanders, M A


    William Cheselden was Great Britain's foremost surgeon/scientist in the first half of the 18th century. Cheselden directly challenged the Company of Barber-Surgeons' exclusive right to control dissection in London by being the first to conduct a regular series of anatomy lectures and demonstrations outside of the Company's Hall. He incorporated his lecture syllabus into a handbook of anatomy, The Anatomy of the Humane Body, which was used by students for nearly 100 years. Cheselden also wrote the text and drew the illustrations for a majestic atlas of comparative osteology, the Osteographia, or the Anatomy of the Bones. Cheselden used his superior knowledge of anatomy to reduce the morbidity and mortality associated with perineal lithotomy, one of the few operations possible in his era. Sagacious and pragmatic, Cheselden recognized that the enlightened practice of surgery beginning to take root in 18th-century London could flourish only under an autonomous body of surgeons. Cheselden used his personal funds and political skills to urge Parliament to pass legislation for the dissolution of the combined Company of Barber-Surgeons and the establishment of separate and distinct Surgeons' and Barbers' Companies. After disjoinder of the two groups on May 2, 1745, Cheselden served as one of the Wardens of the new Company of Surgeons--a predecessor of the Royal College of Surgeons of England. In 1746, Cheselden, who helped design the first Surgeons' Hall, served as the Company's Master.

  11. Comparison of patient and surgeon expectations of total hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Claire Jourdan

    Full Text Available OBJECTIVES: Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement. METHODS: 132 adults (mean age 62.8+/-13.7 years, 52% men on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100. Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences. RESULTS: Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100. Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons. CONCLUSION: Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.

  12. [General surgeons and varicose vein surgery]. (United States)

    Morales-Cuenca, Germán; Moreno-Egea, Alfredo; Aguayo-Albasini, Jose Luis


    Chronic venous insufficiency is a highly prevalent condition, with significant health and economic repercussions. Although important therapeutic developments have been introduced in recent years, the majority are dealt with by general surgeons in national health hospitals. These surgeons do not have the required and continuous training, and continue to perform classic surgery techniques. Also, their presence at scientific, organisational meetings and training is almost nil. We present an update on developments in phlebology, and tapping into the preliminary results of a national survey, we reflect on the current status of phlebology and beyond for those general surgeons who should have a role in this field.

  13. Practice patterns in the perioperative treatment of patients undergoing septorhinoplasty: a survey of facial plastic surgeons. (United States)

    Shadfar, Scott; Deal, Allison M; Jarchow, Andrea M; Yang, Hojin; Shockley, William W


    IMPORTANCE The common practices used in the perioperative care of patients undergoing septorhinoplasty are diverse and controversial. A consensus statement on the preferred clinical pathway in the perioperative treatment of patients undergoing septorhinoplasty has yet to be approached formally. OBJECTIVES To investigate the perioperative treatment of patients undergoing septorhinoplasty and to identify common practice patterns based on the preferences of leading facial plastic surgeons. DESIGN, SETTING, AND PARTICIPANTS We distributed an online survey to members of the American Academy of Facial Plastic and Reconstructive Surgery. Specifically, fellowship directors and academic contact members were anonymously polled and stratified by the number of septorhinoplasties performed annually. MAIN OUTCOME AND MEASURE A cohesive clinical guide to perioperative treatment after rhinoplasty. RESULTS Of the 92 members surveyed, 67 (73%) successfully completed the survey. The distribution of respondents included 43 academicians (64%) and 24 physicians in private practice (36%). Twenty-eight surgeons (42%) performed fewer than 50 rhinoplasties a year and 39 (58%), more than 50, representing 3510 to 4549 septorhinoplasties in total among respondents. Forty-four surgeons (66%) refrained from using any packing, and 41 (61%) used intranasal splints, with polymeric silicone splints the most popular of these (n = 24 [59%]). Sixty-six surgeons (99%) used external nasal splints, including 49 (74%) who used a thermoplastic splint and 49 (74%) who left the external nasal splint in place for 7 days or longer. The most common postoperative interventions to reduce edema and ecchymosis were elevation of the head of bed by 62 (93%), ice packs by 50 (75%), and Arnica montana by 33 (49%). Only 12 surgeons (18%) used postoperative corticosteroids to reduce edema. Fifty-six respondents (84%) prohibited participation in contact sports until at least 6 weeks after surgery. CONCLUSIONS AND

  14. Impacts of Climate Change on Water Resources in Shaanxi Province During Past Fifty Years Based on Regression Models%基于评估模型的陕西省水资源气候影响分析

    Institute of Scientific and Technical Information of China (English)

    程肖侠; 孙娴; 方建刚; 毛明策; 梁奇琛


    利用陕西省1961—2009年96个观测站的年降水、气温资料以及1997—2006年水利部公布的水资源资料,基于线性拟合、水资源丰枯评价指标、变差系数及产水模数等方法和指标,对陕西省近50 a来的水资源状况进行了气候影响分析。结果表明,基于降水、气温的水资源评估模型能够对陕西省水资源状况进行评估,且评估效果好于只考虑降水的评估模型。近50 a来陕西省气候趋于暖干,年平均气温自20世纪90年代升高,1996年前后发生突变;年降水自20世纪80年代中后期减少,1988年前后发生突变。受气温升高,降水减少影响,近50 a来陕西省水资源量呈减少趋势,1991年前后发生突变,水资源量显著减少。20世纪90年代之前,陕西省水资源量正常偏多,之后水资源正常偏枯,且年际变化显著,年水资源量不稳定。陕西省属于旱年缺水类型,天然供水量的减少增加了水资源利用率,水资源供需压力增大。%Employing the annual mean precipitation and temperature data from 96 meteorological stations in Shaanxi Province during the period from 1961 to 2009,and the water resource data published by Chinese Ministry of Water Resources from 1997 to 2006,the impacts of climate change on water resources of Shaanxi Province were analyzed by linear regression,water resource evaluation index,variation coefficient,and water mode.The results show that,the water resource assessment model based on both precipitation and temperature data was more reasonable in evaluation than the one merely based on precipitation data.The climate had become warmer and drier in the past fifty years,the annual mean temperature increases substantially around 1996 and the annual precipitation decreases sharply around 1988.With the declining precipitation and increasing temperature,the water resources had gradually reduced in the past 50 years,and worsened around 1991.The water resources were more than enough

  15. Opportunities in Total Knee Arthroplasty: Worldwide Surgeons' Perspective. (United States)

    Dunbar, Michael; Newman, Jared M; Khlopas, Anton; Chughtai, Morad; Martinez, Nick; Bhowmik-Stoker, Manoshi; Mont, Michael A


    This study surveyed a group of US and international orthopaedic surgeons to prioritize areas of improvement in primary total knee arthroplasty (TKA). Specifically, we assessed surgeon responses regarding the top five areas of TKA needing improvement; which were stratified by: a) US surgeons, b) international surgeons, c) US surgeons' implant-brand-loyalty, and d) surgeons' years of experience and case volume. Four hundred and eighteen surgeons who were board-certified, in practice for at least two years, spent 60% of their time in clinical practice, and performed a minimum of 25 lower extremity joint arthroplasties per year were surveyed. They chose the top five areas (among 17) needing improvement for TKA. Results were stratified by surgeons' location (US and international), implant-brand-loyalty, years of experience, and case volume. Functional outcomes was the top identified area for improvement (US 63% and international 71%), followed by brand loyalty (Company I 68%, other brand 59%, and multi-brand/no loyalty 66%), years of experience (early-career 64%, mid-career 63%, and late-career 75%) and case volume (low-volume 69%, mid-volume 60%, and high-volume 71%). Following this was costs for US surgeons (47%) and implant survivorship for international surgeons (57%). While costs were the next highest area for specific Company-loyal surgeons (57%), implant survivorship was the next highest area for the other two cohorts. Implant survivorship was the second most important area of improvement regardless of years of experience and for low- and mid-volume surgeons. Surgeons identified functional outcomes as the most important area needing improvement. Cost of implants was more important for American as compared to international surgeons.

  16. Magnification for the dermatologic surgeon. (United States)

    Chodkiewicz, Hubert M; Joseph, Aaron K


    Ergonomic practice increases the productivity, quality, and longevity of the dermatologic surgeon. When used properly, magnification devices can be ergonomic and beneficial additions to the dermatologic surgeon's practice. Herein, we review the available magnification options for the dermatologic surgeon and evaluate the options based on cost, design, and functional advantages and disadvantages. Magnification for the dermatologic surgeon may be a useful tool for a healthier, more efficient, and higher-quality practice.

  17. An Analysis of Future Publications, Career Choices, and Practice Characteristics of Research Presenters at an American College of Surgeons State Conference: A 15-Year Review. (United States)

    Ahmad, Humera F; Jarman, Benjamin T; Kallies, Kara J; Shapiro, Stephen B

    The Accreditation Council for Graduate Medical Education requires scholarly activity within general surgery residency programs. The association between in-training research presentations and postgraduation publications is unknown. We hypothesized that surgical trainee presentations at an American College of Surgeons (ACS) state chapter meeting resulted in peer-reviewed publications and future scholarly activity. The ACS Wisconsin state chapter meeting agendas from 2000 to 2014 were reviewed to identify all trainees who delivered podium presentations. A literature search was completed for subsequent publications. Program coordinators were queried and an electronic search was performed to determine practice location and type for each residency graduate. Wisconsin state chapter ACS meeting. General surgery residents, fellows, and medical students in Wisconsin. There were 288 podium presentations by trainees (76% residents, 20% medical students, and 4% fellows). Presentations were clinical (79.5%) and basic science (20.5%). There were 204 unique presenters; 25% presented at subsequent meetings. Of these unique presenters, 46% published their research and 31% published additional research after residency. Among presenters who completed residency or fellowship (N = 119), 34% practiced in a university setting, and 61% practiced in a community setting; 31% practiced in Wisconsin. When comparing clinical vs basic science presenters, there was no difference in fellowship completion (37% vs 44%; p = 0.190) or practice type (38% vs 46% in a university setting; p = 0.397). Repeat presenters were more likely to pursue a fellowship vs those presenting once (76% vs 37%; p = 0.001). Research presentations by surgical trainees at an ACS state chapter meeting frequently led to peer-reviewed publications. Presenters were likely to pursue research opportunities after residency. Repeat presenters were more likely to pursue a fellowship. ACS Wisconsin chapter meetings provide an

  18. Chinese medicine and the surgeon. (United States)

    Leung, Ping-Chung; Biji, Sreedhar; Yeung, Chung-Kwong


    The surgeon aims at a direct, complete removal of the pathology. In spite of the modern advancements of imaging facilities and precision instrumentations, unsatisfactory results and recurrences are not uncommon. This paper provides a general review of the four specific areas in surgery that would benefit from Chinese medicine. Extensive searches were made on four surgical areas based on available English language journals, viz. low-back pain, chronic ulcers, renal calculus, and enuresis in children, in the past 10 years. The quoted communications are mainly related to clinical evidences, while a smaller number of crucial laboratory reports are also included. Low-back pain, a most frequent orthopaedic problem, would benefit from acupuncture treatment. Chronic leg ulcers could achieve better results of healing using herbal supplements. Problems of renal stones, besides the conventional methods of removal, could be further supplemented with herbal drinks that aim at prevention of recurrences. Enuresis in children, an untreatable common condition, may respond well to acupuncture. Surgeons should keep an open mind. In case of difficulties, they could seriously consider options of traditional treatment.

  19. Surgeon unemployment: would practice sharing be a viable solution? (United States)

    Wakeam, Elliot; Feinberg, Stan


    Surgeon unemployment has become a crisis within Canadian surgery in recent years. Without dedicated governmental workforce planning, ensuring that new residency graduates can find employment will require new models of employment. Practice sharing, whereby a new graduate and a senior surgeon partner to divide their practices, allows the senior surgeon to wind down and the newer surgeon to ramp up. Importantly, this arrangement builds in formal mentoring, which is so important in the early years of starting a surgical practice. Practice sharing may be a solution for the workforce issues currently afflicting new surgical graduates across Canada.

  20. [The surgeon at retirement]. (United States)

    Fernández del Castillo-Sánchez, Carlos


    Our vocation has called us to become physicians and we have learned and practiced surgery as part of our medical training and knowledge. Surgery is an art expressed during each intervention carried out with effectiveness and devotion; enjoying the pleasure to perform it without hurry, with harmony, fluency and cleanness. Therefore, medicine and surgery belong to the same vocation being at service of people with the clear mission to heal patients and if we favor it, this activity will get our attention firmly and forever. A physician is a sensitive person that understands the sadness and happiness consequence of his actions at the office, operating room, research and relationships with colleagues. This provides him a pleasant experience of practicing medicine and especially surgery. Medical and surgical professions produce an irresistible attraction and they are very rewarding experiences; however, as time goes by there are effects over physician's health. Surgeons will switch from an active professional role into a passive agent and will need to assess himself and answer if he is still in optimal conditions to practice medicine. Therefore, every surgeon must be prepared to grow old from the start and preserve his Faith once retirement has been accepted as the next step in his career.

  1. Two surgeons and the ECG-a double blind study

    Institute of Scientific and Technical Information of China (English)

    Ulf Martin Schilling


    Objective: To assess the capability of operating abdominal and orthopaedic surgeons to analyze a set of standardized ECG. Methods: Twenty operating abdominal and orthopaedic surgeons at a university hospital were included. Each participant analyzed a set of five standardized ECG with an answering scheme for eight different items, giving a maximum score of 40. The answers were matched according to specialty and experience of the doctors of less than 5 years, between 5 and 10 years or more than 10 years. The reference standard was set by two independent consultants in cardiology. Results: The mean overall score was 25.25 (63.13%±4.78%) varying between 38 (95%) and 20(50%). Abdominal surgeons performed a mean score of 27.625 (69.06%±9.53%), and orthopaedic surgeons 23.67 points (59.17%±3.69%). The difference between the performance of abdominal and orthopaedic surgeons was not significant (P=0.09). 20/20 surgeons identified ST-elevation and no surgeon accepted the ECG showing acute ST-elevation myocardial infarction as normal. Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

  2. Herniation of the cervical disk in plastic surgeons. (United States)

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen; Chen, Tim-Mo


    Herniations of the cervical disk in plastic surgeons are far more common in practice than the paucity of reported cases would indicate. A likely explanation may be the peculiar, nonergonomic positions that plastic surgeons must hold during surgery while wearing a headlight and loupes. From January 2003 to December 2006, at Tri-Service General Hospital, Taiwan, 4 plastic surgeons experienced herniations of the cervical disk. Magnetic resonance imaging study indicated there was disk herniation or bulging with spinal cord impingement. Two plastic surgeons received cervical diskectomy, corpectomy with strut reconstruction using titanium cages. These 2 surgeons were symptom-free 2 years after their operations. The other 2 plastic surgeons were under conservative physical therapy with persistent symptoms. The clinical evidence indicated that cervical disk herniation is an occupational hazard in plastic surgeons. To prevent prolonged hyperflexion and twisting of the neck, we proposed wearing a cervical brace during surgery for the plastic surgeons at Tri-Service-General Hospital since January 2008. No more plastic surgeons have experienced herniation of the cervical disk since then. The results indicated that wearing a cervical brace may be an effective measure to protect plastic surgeons from cervical disk disease.

  3. The Dangers of Gathering Data: Surgeon-Specific Outcomes Revisited (United States)

    Ferraris, Victor A.; Ferraris, Suellen P.; Wehner, Paulette S.; Setser, Edward R.


    The accuracy of risk adjustment is important in developing surgeon profiles. As surgeon profiles are obtained from observational, nonrandomized data, we hypothesized that selection bias exists in how patients are matched with surgeons and that this bias might influence surgeon profiles. We used the Society of Thoracic Surgeons risk model to calculate observed to expected (O/E) mortality ratios for each of six cardiac surgeons at a single institution. Propensity scores evaluated selection bias that might influence development of risk-adjusted mortality profiles. Six surgeons (four high and two low O/E ratios) performed 2298 coronary artery bypass grafting (CABG) operations over 4 years. Multivariate predictors of operative mortality included preoperative shock, advanced age, and renal dysfunction, but not the surgeon performing CABG. When patients were stratified into quartiles based on the propensity score for operative death, 83% of operative deaths (50 of 60) were in the highest risk quartile. There were significant differences in the number of high-risk patients operated upon by each surgeon. One surgeon had significantly more patients in the highest risk quartile and two surgeons had significantly less patients in the highest risk quartile (p < 0.05 by chi-square). Our results show that high-risk patients are preferentially shunted to certain surgeons, and away from others, for unexplained (and unmeasured) reasons. Subtle unmeasured factors undoubtedly influence how cardiac surgery patients are matched with surgeons. Problems may arise when applying national database benchmarks to local situations because of this unmeasured selection bias. PMID:23204823

  4. The vascular surgeon-scientist: a 15-year report of the Society for Vascular Surgery Foundation/National Heart, Lung, and Blood Institute-mentored Career Development Award Program. (United States)

    Kibbe, Melina R; Dardik, Alan; Velazquez, Omaida C; Conte, Michael S


    The Society for Vascular Surgery (SVS) Foundation partnered with the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) in 1999 to initiate a competitive career development program that provides a financial supplement to surgeon-scientists receiving NIH K08 or K23 career development awards. Because the program has been in existence for 15 years, a review of the program's success has been performed. Between 1999 and 2013, 41 faculty members applied to the SVS Foundation program, and 29 from 21 different institutions were selected as awardees, resulting in a 71% success rate. Three women (10%) were among the 29 awardees. Nine awardees (31%) were supported by prior NIH F32 or T32 training grants. Awardees received their K award at an average of 3.5 years from the start of their faculty position, at the average age of 39.8 years. Thirteen awardees (45%) have subsequently received NIH R01 awards and five (17%) have received Veterans Affairs Merit Awards. Awardees received their first R01 at an average of 5.8 years after the start of their K award at the average age of 45.2 years. The SVS Foundation committed $9,350,000 to the Career Development Award Program. Awardees subsequently secured $45,108,174 in NIH and Veterans Affairs funds, resulting in a 4.8-fold financial return on investment for the SVS Foundation program. Overall, 23 awardees (79%) were promoted from assistant to associate professor in an average of 5.9 years, and 10 (34%) were promoted from associate professor to professor in an average of 5.2 years. Six awardees (21%) hold endowed professorships and four (14%) have secured tenure. Many of the awardees hold positions of leadership, including 12 (41%) as division chief and two (7%) as vice chair within a department of surgery. Eight (28%) awardees have served as president of a regional or national society. Lastly, 47 postdoctoral trainees have been mentored by recipients of the SVS Foundation Career Development

  5. Emergency surgeon-performed hepatobiliary ultrasonography. (United States)

    Kell, M R; Aherne, N J; Coffey, C; Power, C P; Kirwan, W O; Redmond, H P


    Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  6. Emergency surgeon-performed hepatobiliary ultrasonography.

    LENUS (Irish Health Repository)

    Kell, M R


    BACKGROUND: Acute hepatobiliary pathology is a common general surgical emergency referral. Diagnosis requires imaging of the biliary tree by ultrasonography. The accuracy and impact of surgeon-performed ultrasonography (SUS) on the diagnosis of emergent hepatobiliary pathology was examined. METHODS: A prospective study, over a 6-month period, enrolled all patients with symptoms or signs of acute hepatobiliary pathology. Patients provided informed consent and underwent both SUS and standard radiology-performed ultrasonography (RUS). SUS was performed using a 2-5-MHz broadband portable ultrasound probe by two surgeons trained in ultrasonography, and RUS using a 2-5-MHz fixed unit. SUS results were correlated with those of RUS and pathological diagnoses. RESULTS: Fifty-three consecutive patients underwent 106 ultrasonographic investigations. SUS agreed with RUS in 50 (94.3 per cent) of 53 patients. SUS accurately detected cholelithiasis in all but two cases and no patient was inaccurately diagnosed as having cholelithiasis at SUS (95.2 per cent sensitivity and 100 per cent specificity). As an overall complementary diagnostic tool SUS provided the correct diagnosis in 96.2 per cent of patients. Time to scan was significantly shorter following SUS (3.1 versus 12.0 h, P < 0.05). CONCLUSION: SUS provides a rapid and accurate diagnosis of emergency hepatobiliary pathology and may contribute to the emergency management of hepatobiliary disease.

  7. Maximizing efficiency on trauma surgeon rounds. (United States)

    Ramaniuk, Aliaksandr; Dickson, Barbara J; Mahoney, Sean; O'Mara, Michael S


    Rounding by trauma surgeons is a complex multidisciplinary team-based process in the inpatient setting. Implementation of lean methodology aims to increase understanding of the value stream and eliminate nonvalue-added (NVA) components. We hypothesized that analysis of trauma rounds with education and intervention would improve surgeon efficacy. Level 1 trauma center with 4300 admissions per year. Average non-intensive care unit census was 55. Five full-time attending trauma surgeons were evaluated. Value-added (VA) and NVA components of rounding were identified. The components of each patient interaction during daily rounds were documented. Summary data were presented to the surgeons. An action plan of improvement was provided at group and individual interventions. Change plans were presented to the multidisciplinary team. Data were recollected 6 mo after intervention. The percent of interactions with NVA components decreased (16.0% to 10.7%, P = 0.0001). There was no change between the two periods in time of evaluation of individual patients (4.0 and 3.5 min, P = 0.43). Overall time to complete rounds did not change. There was a reduction in the number of interactions containing NVA components (odds ratio = 2.5). The trauma surgeons were able to reduce the NVA components of rounds. We did not see a decrease in rounding time or individual patient time. This implies that surgeons were able to reinvest freed time into patient care, or that the NVA components were somehow not increasing process time. Direct intervention for isolated improvements can be effective in the rounding process, and efforts should be focused upon improving the value of time spent rather than reducing time invested. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Do Orthopaedic Surgeons Acknowledge Uncertainty? (United States)

    Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert


    Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

  9. American Society of Plastic Surgeons (United States)

    ... know the risks and trust a board-certified plastic surgeon to perform your cosmetic or reconstructive surgery. ASPS member surgeons have the training and experience that ... 1300 Chain Bridge Road McLean, VA 22101 (703) 790-5454 Timothy Germain ...

  10. How many orthopedic surgeons does it take to write a research article? 50 years of authorship proliferation in and internationalization of the orthopedic surgery literature. (United States)

    Rahman, Luthfur; Muirhead-Allwood, Sarah K


    Publications are considered to indicate academic achievement and can lead to various rewards, including job opportunities and research funding. Recent years have seen a rising trend in the number of articles published, multiple authorship, and internationalization of the biomedical literature. The goal of this study was to analyze the trends in authorship over the past 50 years to determine whether the orthopedic literature parallels trends seen in other areas of the biomedical literature. We performed an observational study with analysis of the number of authors and geographic origin of articles published in the Journal of Bone and Joint Surgery British Volume (JBJS) and Clinical Orthopaedics and Related Research (CORR). We analyzed 2776 articles (CORR, n=1809; JBJS, n=967) published between 1958 and 2008 at 10-year intervals. There has been a significant increase in the mean number of authors per article from 1.638 to 4.08 (P<.0001) and 1.633 to 4.540 (P<.0001) for CORR and JBJS, respectively between 1958 and 2008. There has been a significant increase in the international contribution to both journals (P<.0001). The number of countries contributing to articles increased from 5 to 39 and from 17 to 33 for CORR and JBJS, respectively. These findings are similar to other areas of the biomedical literature. The reasons for this proliferation are multifactorial, including multicenter trials and inappropriate authorship. Guidelines for authorship and preparation of manuscripts from the International Committee of Medical Journal Editors or from individual journals are widely available, and every effort should be made to adhere to them to prevent inappropriate authorship proliferation in the future.

  11. Cost and logistics of implementing a tissue-based American College of Surgeons/Association of Program Directors in Surgery surgical skills curriculum for general surgery residents of all clinical years. (United States)

    Henry, Brandon; Clark, Philip; Sudan, Ranjan


    The cost and logistics of deploying the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) National Technical Skills Curriculum across all training years are not known. This information is essential for residency programs choosing to adopt similar curricula. A task force evaluated the authors' institution's existing simulation curriculum and enhanced it by implementing the ACS/APDS modules. A 35-module curriculum was administered to 35 general surgery residents across all 5 clinical years. The costs and logistics were noted, and resident satisfaction was assessed. The annual operational cost was $110,300 ($3,150 per resident). Cost per module, per resident was $940 for the cadaveric module compared with $220 and $240 for dry simulation and animal tissue-based modules, respectively. Resident satisfaction improved from 2.45 to 4.78 on a 5-point, Likert-type scale after implementing the ACS/APDS modules. The ACS/APDS skills curriculum was implemented successfully across all clinical years. Cadaveric modules were the most expensive. Animal and dry simulation modules were equivalent in cost. The addition of tissue-based modules was associated with high satisfaction. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. [Louis Ombrédanne (1871-1956) pediatric and plastic surgeon]. (United States)

    Glicenstein, J


    One of the fathers of pediatric surgery in France, Louis Ombrédanne (1871-1956) was a great plastic surgeon. During his residency he was initiated to plastic surgery by Charles Nélaton (1851-1911). Both wrote two books: "La rhinoplastie" and "Les autoplasties", taking stock of these techniques in the early 20th century. In 1906, he was the first to describe the pectoral muscle flap for immediate breast reconstruction after mastectomy. He used this flap in conjunction with an axillo thoracic flap. From 1908 to 1941, Louis Ombrédanne practised pediatric surgery, most of which was devoted in reconstruction of congenital and acquire anomalies. From 1924 to 1941, he was Professor of pediatric surgery at the hospital Enfants-Malades in Paris. In 1907, Louis Ombrédanne created a prototype of an ether inhaler as a safe anesthetic device. The device was successfully used for fifty years in Europe.

  13. The nature of surgeon human capital depreciation. (United States)

    Hockenberry, Jason M; Helmchen, Lorens A


    To test how practice interruptions affect worker productivity, we estimate how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). Examining 188 surgeons who performed 56,315 CABG surgeries in Pennsylvania between 2006 and 2010, we find that a surgeon's additional day away from the operating room raised patients' inpatient mortality by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points. Among emergent patients treated by high-volume providers, where temporal distance is most plausibly exogenous, an additional day away raised mortality risk by 0.398 percentage points (11.4% relative effect) but reduced cost by up to 1.4 percentage points. This is consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications. Our estimates imply additional intraprocedural treatment intensity has a cost per life-year preserved of $7871-18,500, well within conventional cost-effectiveness cutoffs.

  14. Effect of surgeon experience on femoral component size selection during total knee arthroplasty. (United States)

    Nandi, Sumon; Bono, James V; Froimson, Mark; Jones, Morgan; Bershadsky, Boris


    Femoral component size selection during total knee arthroplasty should not vary from surgeon to surgeon for patients with the same bone size. This study explored if systematic variations in femoral component size selection exist. Thirteen surgeons' choices of femoral component size (Duracon, n = 1388; Triathlon, n = 740) were analyzed using a generalized linear model with femoral component size as the dependent variable and surgeon identification, years in practice, and adult reconstruction fellowship training as the independent variables. The model adjusted for differences in bone size. It was found that more experienced surgeons implant larger femoral components. New instruments and training protocols may be necessary to adjust for surgeon experience.

  15. What Is a Foot and Ankle Surgeon? (United States)

    ... Foot & Ankle Surgeon? A A A | Print | Share What is a Foot & Ankle Surgeon? Foot and ankle ... of conditions that affect people of every age. What education has a foot and ankle surgeon received? ...

  16. What Is a Pediatric Heart Surgeon? (United States)

    ... Text Size Email Print Share What is a Pediatric Heart Surgeon? Page Content Article Body If your ... require heart surgery. What Kind of Training Do Pediatric Heart Surgeons Have? Pediatric heart surgeons are medical ...

  17. [Surgeons in Krakow between WWI and WWII]. (United States)

    Wysocki, A; Dolecki, M


    During the war time when Polish borders had not been established yet, apart from having two surgical departments Jagiellonian University, Krakow had surgical departments in the Bonifratow, Izraelicki and Military Hospitals. More surgical departments were opened up in later years in pubic Health System Hospitals, among them were Narutowicz at near Pradnicka street and Sisters of Mercy at Lea street. Other well-known Krakow surgeons operated in smaller, private surgeries, such as: Dom Zdrowia (House of Health) or Zwiazkowy (Union) Clinic. At that time only 30 Surgeons worked in Kraków. They were outstanding specialists with a broad practice. Among them were Maksymilian Rutkowski, Jan Glatzel, Stanislaw Nowicki, Michal Hladij. Gradually, younger surgeons started to join them. they were: Jan Kowalczyk, Jerzy Jasienski, Stanislaw Kania, Wladyslaw Laszczak, Jozef Bugusz, Jozef Gasinski. Many of them who worked in the surgical hospitals in Krakow, left the city after obtaining a professorship (like Kornel Michejda, professor at the University of Wilno) or became heads of wards, like Zygmunt Drobniewicz, Alfons Mackowski and Tadeusz Guschlbauer. All of these surgeons were highly respected by the medical community as well as by the general public in their respective town and surrounding areas. A large income allowed that best of them to fund and supply their own wards. Occasionally, however, among the less successful surgeons, an uncompromising competition for patients developed. These events were disapproved and condemned by the medical establishment. Many surgeons led an active life outside of their profession. A surgeon with an exceptionally colorful personality was Jan Glatzel: witty, highly intelligent, a connoisseur of fine art, book lover with an active social life. Maksymilian Rutkowski was active in charitable organizations, helping to support Bratnia Pomoc Medykow. Michal Hladij, president of KS Cracovia, vice president of Krakowski Klub Automobilowy rendered his

  18. Smartphones and the plastic surgeon. (United States)

    Al-Hadithy, Nada; Ghosh, Sudip


    Surgical trainees are facing limited training opportunities since the introduction of the European Working Time Directive. Smartphone sales are increasing and have usurped computer sales for the first time. In this context, smartphones are an important portable reference and educational tool, already in the possession of the majority of surgeons in training. Technology in the palm of our hands has led to a revolution of accessible information for the plastic surgery trainee and surgeon. This article reviews the uses of smartphones and applications for plastic surgeons in education, telemedicine and global health. A comprehensive guide to existing and upcoming learning materials and clinical tools for the plastic surgeon is included. E-books, podcasts, educational videos, guidelines, work-based assessment tools and online logbooks are presented. In the limited resource setting of modern clinical practice, savvy plastic surgeons can select technological tools to democratise access to education and best clinical care. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. 亚裔美国史学五十年:反思与展望%Fifty Years of Asian- American Historiography: Reflecting on the Past and Looking into the Future

    Institute of Scientific and Technical Information of China (English)



    This essay aims to examine the merits and problems of Asian -American historiography in the past 50 years. In the early days, a major problem in the field was an ideology -guided, monistic approach to academic research. By only focusing on racial discrimination and by deterring others from exploring Asian immigration history from different or additional perspectives, this approach dominated the field for nearly three decades at the cost of a fuller and more balanced picture of historical events. In recent years, however, there have emerged some new trends challenging the dogmatic approach to Asian - American studies. By examining the relationships between whites, blacks, and Asians as a triangulated relationship instead of a binary one, scholars writing since the mid - 1990s have refuted the traditional "black and white" theory on race relations in America. Meanwhile, those who explore Asian - American history from a transnational perspective have argued, persuasively, that Asian immigrants had dual nationalism and dual- cultural identities. In particular, they have discovered that Japanese immigration and Japanese expansionism were closely intertwined. Behind the decision to relocate the Japanese during World War II, "military necessity" did exist, ese new trends indicate that Asian- American historiography is headed toward maturity.%回顾和检讨亚裔美国史学在过去半个世纪里所走过的道路可以发现,早期亚裔美国史学中一个最突出的问题是以意识形态为主导的一元论历史观。在近30年的时间里,学者大都仅仅从“种族歧视”这一个角度去诠释历史事件,反对从其他视野去观察亚洲移民的经历。不过,最近15年来,这个领域中出现了冲破一元论历史观束缚的趋势。新一代学者提出了白人、黑人和亚裔之间三角形关系的论点,从而否定了“有色对白种”的双重种族关系理论模式。从“跨国主义”的视野观察

  20. 15th Chapter of Surgeons Lecture: Surgeon of the new millennium--surgeon, scientist and scholar. (United States)

    Tan, S K


    The surgeon of the new millennium has come a long way from his humble beginnings in the Middle Ages as the lowly barber-surgeon. The skills and techniques developed by outstanding surgeons like Astley Cooper of the 19th century have withstood the test of time and have been refined by subsequent generations of surgical masters. The scientific basis of modern surgery was put on a firm footing in the early 19th century through the discovery of anaesthesia and microorganisms as a cause of many diseases and surgical complications. The 20th century brought about rapid progress in medicine, information technology (IT) and the life sciences, and closed with a big bang with the completion of the sequencing of the human genome. For the surgeon of the 21st century to remain relevant, he must embrace the concept of the Total Surgeon. Not doing so will render him irrelevant in the course of time, for having good surgical technique alone is insufficient. He must also lead in scientific endeavours to push the frontiers of the life sciences in attempts to solve the insoluble, and be scholarly in thought, attitude and behaviour. In other words, he must be a Surgeon-Scientist-Scholar.

  1. 近50年来祁连山及河西走廊极端气温的季节变化特征%Seasonal Characteristics of Extreme Temperature Changes in Qilian Mountains and Hexi Corridor During Last Fifty Years

    Institute of Scientific and Technical Information of China (English)



    Based on daily temperature data of 18 meteorological stations in Qilian Mountains and Hexi Corri- dor from 1960 to 2009, the seasonal characteristics of extreme temperature change were analyzed by methods of linear trend, Morlet wavelet and Mann-Kendall. The results indicate that extreme high temperature days in each season are on the rise significantly, especially increased with larger scales after the middle of 1980s. But that is contrary to extreme low temperature days, which decreased with larger scales after the middle of 1980s in spring and summer, and decreased after the middle and later of 1960s in autumn and winter. The changing scale of extreme temperature days is the largest in winter, and the changes of them are before ten years in win- ter than in other seasons, which indicated that the significant change of extreme temperature days took place in winter firstly. The cycle changes of extreme temperature days in different seasons are different, but they are grouped in 6-10 a, 12-16 a and 18-22 a. The major cycle of extreme high temperature days in spring, summer, autumn and winter are changing respectivelywith 8 a, 14 a, 16 a and 16 a, and that of extreme low temperature days are changing respectively with 14 a, 16 a, 14 a and 6 a. The mutation of extreme high temperature days in spring, summer, autumn and winter increased in 2002, 1997, 1994, 1986, respectively, but that of extreme low temperature days decreased in 2002, 1997, 1987, 1986, respectively. Except autumn, the abrupt changes of ex- treme high temperature days and extreme low temperature days in other seasons are coincident. The response to global warming of extreme temperature days is earlier in autumn and winter than that in spring and summer. The change of extreme temperature days will bring some effect to the Qilian Mountains and Hexi Corridor. The increase of extreme high temperature days will add pressure of preventing fire for forest and grasslands in Qilian Mountains. The decrease of

  2. The Progresses of Seaport City Studies in the Last Fifty Years%20世纪60年代以来海港城市研究进展

    Institute of Scientific and Technical Information of China (English)

    王海壮; 栾维新


    As a special urban type,seaport cities have aroused wide concern from academic communities at home and abroad since the 1960s.Nowadays,there are plenty of academic outputs in this field,which are classi-fied into several research topics such as port-city relationship,port development and evolution,integrated plan-ning of port and city,and spatial structure of port cities.Although several scholars reviewed some subjects in this field recently,there is not a complete literature review of seaport city studies.This paper collected academic works related in recent more than 50 years,sorted them out in term of study topics firstly,and then summed up,analyzed and compared these subjects to show the research context and to find study shortages and future direc-tions in this field.After reviewing,we can draw the following conclusions.Firstly,the attention to seaport cities is increasing worldwide,but it lacks coherence at home.Secondly,research perspective has transferred from port-city evolution to port-city relationship,but the latter is relatively confined at home.Thirdly,the study meth-od has changed from qualitative to quantitative analysis,but still lacks interdisciplinary approach.Fourthly,spa-tial analysis is an essential method all the time,and scale and indicators shall be supplemented in the future study.Finally,there are many studies in this field that focus on evolution process and status of seaport cities,but there are relatively few studies on theories and their applications to newly built seaport cities.%作为一种特殊的城市类型,海港城市自20世纪60年代开始就受到国内外学术界的广泛关注,如今已有较为丰富的学术产出,可大体划归为港城关系、港口地域演化、港城一体规划和港城空间结构等研究主题,尽管前人曾对某一方面的研究进展作过评述性的工作,但仍缺乏比较系统全面的海港城市研究综述。本文搜集半个多世纪的国内外相关文献,根据研究主

  3. Fifty challenging problems in probability with solutions

    CERN Document Server

    Mosteller, Frederick


    Can you solve the problem of ""The Unfair Subway""? Marvin gets off work at random times between 3 and 5 p.m. His mother lives uptown, his girlfriend downtown. He takes the first subway that comes in either direction and eats dinner with the one he is delivered to. His mother complains that he never comes to see her, but he says she has a 50-50 chance. He has had dinner with her twice in the last 20 working days. Explain. Marvin's adventures in probability are one of the fifty intriguing puzzles that illustrate both elementary ad advanced aspects of probability, each problem designed to chall

  4. Caution: Alcohol Advertising and the Surgeon General's Alcohol Warnings May Have Adverse Effects on Young Adults. (United States)

    Blood, Deborah J.; Snyder, Leslie B.

    A study investigated the effects of the newly introduced Surgeon General's alcohol warnings and advertisements on college students. One hundred fifty-nine undergraduates in communication sciences at the University of Connecticut viewed slides of alcohol products, with or without advertisements and warnings. Following the viewings, subjects filled…

  5. [The first woman surgeons in the Netherlands]. (United States)

    Mulder, M; De Jong, E


    This article describes the position of woman surgeons in the Netherlands. In 1913 the first woman, Heleen Robert, was accepted as member of the Dutch Society of Surgery. Three others, Jeanne Knoop, Frieda van Hasselt and Rosalie Wijnberg, followed during the next ten years. The nomination of Rosalie Wijnberg caused a turbulent discussion as she was working as a gynaecologist and not as a surgeon. One can wonder about this argument as other members were gynaecologists too. It seems that the male attitudes towards women were changing as more women entered the male dominated field. Nevertheless, from 1931 on, the year in which the registration of specialists was created, a number of women succeeded in obtaining a registration in surgery. Four of them were interviewed: dr. D.A.E. Norel, A.G. Wiersum-de Kwaadsteniet, J. Leeksma-Lievense and A.A. Fierstra. The general opinion still is that surgery is not a female profession. At the moment there are some twenty women working as general surgeon compared to a seven hundred men.

  6. The surgeon and the child. (United States)

    Klein, Michael D


    For many reasons pediatric surgeons have been asked to do all general and thoracic procedures in children. The profession has responded by training more, but the core of special cases requiring pediatric surgical expertise has not changed, and there is concern that the many surgeons now in training will not each do enough cases to attain and maintain operative expertise. This presentation examines the psychological, educational, and surgical literature on the development of expertise, especially operative expertise. From this I conclude that individual surgeon volume when gained in deliberate practice with a coach and with effort is essential, and that several technologies hold promise for allowing deliberate practice in simulation environments. I propose that in order to avoid a decline in pediatric surgical operative expertise we must reorganize pediatric surgical training and practice to align with Optimal Resources for Children's Surgery and the evolution of training in general surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Fifty years of fiscal planning and implementation in the Netherlands

    NARCIS (Netherlands)

    Beetsma, R.; Giuliodori, M.; Walschot, M.; Wierts, P.


    Using real-time data from the annual budget over the period 1958-2009, we explore the planning and realization of fiscal policy in the Netherlands. Our key findings are the following. First, planned surpluses are on average unbiased, although they are overoptimistic during the first half of the samp

  8. The lure of local SETI: Fifty years of field experiments (United States)

    Ailleris, Philippe


    With the commemoration in October 2007 of the Sputnik launch, space exploration celebrated its 50th anniversary. Despite impressive technological and scientific achievements the fascination for space has weakened during the last decades. One contributing factor has been the gradual disappearance of mankind's hope of discovering extraterrestrial life within its close neighbourhood. In striking contrast and since the middle of the 20th century, a non-negligible proportion of the population have already concluded that intelligent beings from other worlds do exist and visit Earth through space vehicles popularly called Unidentified Flying Objects (UFOs). In light of the continuous public interest for the UFO enigma symbolized by the recent widely diffused media announcements on the release of French and English governmental files; and considering the approach of broadening the strategies of the "Active SETI" approach and the existence of a rich multi-disciplinary UFO documentation of potential interest for SETI; this paper describes some past scientific attempts to demonstrate the physical reality of the phenomena and potentially the presence on Earth of probes of extraterrestrial origin. Details of the different instrumented field studies deployed by scientists and organizations during the period 1950-1990 in the USA, Canada and Europe are provided. In conclusion it will be argued that while continuing the current radio/optical SETI searches, there is the necessity to maintain sustaining attention to the topic of anomalous aerospace phenomena and to develop new rigorous research approaches.

  9. Fifty-one years of Los Alamos Spacecraft

    Energy Technology Data Exchange (ETDEWEB)

    Fenimore, Edward E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    From 1963 to 2014, the Los Alamos National Laboratory was involved in at least 233 spacecraft. There are probably only one or two institutions in the world that have been involved in so many spacecraft. Los Alamos space exploration started with the Vela satellites for nuclear test detection, but soon expanded to ionospheric research (mostly barium releases), radioisotope thermoelectric generators, solar physics, solar wind, magnetospheres, astrophysics, national security, planetary physics, earth resources, radio propagation in the ionosphere, and cubesats. Here, we present a list of the spacecraft, their purpose, and their launch dates for use during RocketFest

  10. 50 (Fifty) Years of Research on Man in Flight (United States)


    authorized a Vito Commander position in March 1972. Colonel Dt-)pelt was appointed the first Vice Commander of the Laboratory. Colonel D oppelt wa-is...Clauser, 7184, 1972) " Development of the Systems Analysis Integrated Network ot Tasks ( SAINT ). First man system model for predicting nuclear S V effects

  11. Fifty Years of IMF Variation: The Intermediate-Mass Stars

    CERN Document Server

    Scalo, J


    I track the history of star count estimates of the Milky Way field star and open cluster IMFs, concentrating on the neglected mass range from 1 to 15 M${_\\odot}$. The prevalent belief in a universal IMF appears to be without basis for this mass range. Two recent estimates of the field star IMF using different methods and samples give values of the average logarithmic slope $\\Gamma$ between -1.7 and -2.1 in the mass range 1.1 to 4 M${_\\odot}$. Two older estimates between 2 and 15 M${_\\odot}$ disagree severely; the field IMF in this range is essentially unknown from star counts. Variations in $\\Gamma$ among open cluster IMFs in this mass range have not decreased despite numerous detailed studies, even for studies using homogeneous data and reduction procedures and including only clusters with a significant mass range. These cluster variations \\textit{might} be due to the combined effects of sampling, systematic errors, stellar evolution uncertainties, dynamical evolution, and unresolved binaries. If so, then th...

  12. Fifty years later: A neurodynamic explanation of Fitts' law. (United States)

    Beamish, Dan; Bhatti, Shabana Ali; MacKenzie, I Scott; Wu, Jianhong


    An intrinsic property of human motor behaviour is a trade-off between speed and accuracy. This is classically described by Fitts' law, a model derived by assuming the human body has a limited capacity to transmit information in organizing motor behaviour. Here, we propose an alternative foundation, based on the neurodynamics of the motor circuit, wherein Fitts' law is an approximation to a more general relationship. In this formulation, widely observed inconsistencies with experimental data are a consequence of psychomotor delay. The methodology developed additionally provides a method to estimate the delay within the motor circuit from the speed-accuracy trade-off alone.

  13. The Laser: fifty years already; Le Laser: deja cinquante ans

    Energy Technology Data Exchange (ETDEWEB)

    Pocholle, J.P. [Thales Research and Technology, 91 - Palaiseau (France)


    The fiftieth anniversary celebration has this characteristic which it makes it possible to carry a retrospective glance on the evolution of a subject. From this point of view, the LASER, as a scientific concept or a technological tool, does not escape the rule. This article recalls the historical contributions leading to the first demonstration of the laser effect by Theodore Maiman in 1960, starting from a theoretical concept established by Albert Einstein in 1917. This demonstration naturally opened a strong activity in the laboratories. It resulted in the creation of instruments which took part in the enrichment of knowledge in the fields of physics, chemistry and the biomedical one. In our daily life, the communications, the information storage, the imagery, lighting and the industrial tools profited from the properties of the coherent or quasi-coherent emission of the light. Each one of these applications to follow-up its own evolutions which we will also try to describe in this article. (author)

  14. Fifty years of crop protection, 1950-2000

    NARCIS (Netherlands)

    Zadoks, J.C.


    We detected the presence of fructosamine in human and bovine semen. In seminal plasma of healthy normozoospermic men (N = 17) fructosamine was found in 53% of the cases (fru+). In fru+ semen samples the concentration of fructosamine was (mean ± S.E.M., N = 9) 0.45 ± 0.09 mmol/L and varied from 0.15

  15. Ion Channels, from Fantasy to Fact in Fifty Years1 (United States)

    Jordan, Peter C.

    Biologists have long recognized that the transport of ions and of neutral species across cell membranes is central to physiological function. Cells rely on their biomembranes, which separate the cytoplasm from the extracellular medium, to maintain the two electrolytes at very different composition. Specialized molecules, essentially biological nanodevices, have evolved to selectively control the movement of all the major physiological species. As should be clear, there have to be at least two distinct modes of transport. To maintain the disequilibrium, there must be molecular assemblies that drive ions and other permeable species against their electrochemical potential gradients. Such devices require energy input, typically coupling a vectorial pump with a chemical reaction, the dephosphorylation of ATP (adenosine triphosphate). These enzymes (biochemical catalysts) control highly concerted, and relatively slow, process, with turnovers of ≫ 100 s¡ 1.

  16. Recent nonmetropolitan population change in fifty-year perspective. (United States)

    Johnson, K M; Purdy, R L


    Post-1970 nonmetropolitan population shifts are examined by dividing nonmetropolitan counties into ten cohorts based on the duration and direction of consistent population change since 1920. Analysis indicates that the post-1970 gains reported by Beale are pervasive in nonmetropolitan America, occurring even in a majority of the counties that lost population consistently from 1920 to 1970. Growth was greatest in countries adjacent to metropolitan areas but was more than urban spillover effect. In a clear break with traditional patterns, net inmigration contributed significantly to overall population gain and was particularly strong among countries without an urban center. The rate of natural increase continued to slow in the post-1970 period, with natural decrease becoming common among countries with protracted histories of population decline.

  17. Beyond the Ionosphere: Fifty Years of Satellite Communication (United States)

    Butrica, Andrew J. (Editor)


    The three overlapping stages of satellite communications development outlined provide the three-part framework for the organization of the papers contained in this book. Part 1, 'Passive Origins,' treats the first stage of satellite communications development, extending from the 1940s into the early 1960s, when passive artificial and natural satellites funded by the military and private enterprise established the field. Part 2, 'Creating the Global, Regional, and National Systems,' addresses events that constituted the second stage of development. Early in this stage, which stretched from the 1960s into the 1970s, satellite systems began to make their appearance in the United States, while domestic and international efforts sought to bring order to this new but chaotic, field in the form of Comsat and Intelsat. Part 3, 'The Unfolding of the World System,' explores the development of satellite communications in the remainder of the world, with a strong emphasis on Asia.

  18. Hashing in computer science fifty years of slicing and dicing

    CERN Document Server

    Konheim, Alan G


    Written by one of the developers of the technology, Hashing is both a historical document on the development of hashing and an analysis of the applications of hashing in a society increasingly concerned with security. The material in this book is based on courses taught by the author, and key points are reinforced in sample problems and an accompanying instructor s manual. Graduate students and researchers in mathematics, cryptography, and security will benefit from this overview of hashing and the complicated mathematics that it requires

  19. Fifty years of nuclear fission: Nuclear data and measurements series

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, J.E.


    This report is the written version of a colloquium first presented at Argonne National Laboratory in January 1989. The paper begins with an historical preamble about the events leading to the discovery of nuclear fission. This leads naturally to an account of early results and understanding of the fission phenomena. Some of the key concepts in the development of fission theory are then discussed. The main theme of this discussion is the topography of the fission barrier, in which the interplay of the liquid-drop model and nucleon shell effects lead to a wide range of fascinating phenomena encompassing metastable isomers, intermediate-structure effects in fission cross-sections, and large changes in fission product properties. It is shown how study of these changing effects and theoretical calculations of the potential energy of the deformed nucleus have led to broad qualitative understanding of the nature of the fission process. 54 refs., 35 figs.

  20. Fifty years of oxacalix[3]arenes: A review

    Directory of Open Access Journals (Sweden)

    Kevin Cottet


    Full Text Available Hexahomotrioxacalix[3]arenes, commonly called oxacalix[3]arenes, were first reported in 1962. Since then, their chemistry has been expanded to include numerous derivatives and complexes. This review describes the syntheses of the parent compounds, their derivatives, and their complexation behaviour towards cations. Extraction data are presented, as are crystal structures of the macrocycles and their complexes with guest species. Applications in fields as diverse as ion selective electrode modifiers, fluorescence sensors, fullerene separations and biomimetic chemistry are described.

  1. Fifty years of illumination about the natural levels of adaptation

    DEFF Research Database (Denmark)

    Boomsma, Jacobus Jan


    A visionary Darwinian ahead of his time, George C. Williams developed in his 1966 book Adaptation and Natural Selection the essentials of a unifying theory of adaptation that remains robust today and has inspired immense progress in understanding how natural selection works....

  2. Fifty years of CFD for room air distribution

    DEFF Research Database (Denmark)

    Nielsen, Peter Vilhelm


    , and to addressing situations with more steady-state solutions. The article finishes with a number of different case studies such as design of air supply openings, smoke management in buildings, cross-infection risks from the exhalation of particles and calculation of people moving in a room. The use of benchmark...

  3. Fifty-year study of the Peierls-Nabarro stress

    CSIR Research Space (South Africa)

    Nabarro, FRN


    Full Text Available The origin of the Peierls model and its relation to that of Frenkel and Kontorova are described. Within this model there are three essentially different formulae for the stress required to move a dislocation rigidly through a perfect lattice...

  4. Fifty years of Szigeti's dielectric theory – A review

    Indian Academy of Sciences (India)

    D B Sirdeshmukh; L Sirdeshmukh; K G Subhadra


    During the period 1949–1961 Szigeti published four seminal papers on the dielectric behaviour of crystals. Szigeti's theory is applicable to isotropic and anisotropic, ionic and covalent crystals with different structures. Szigeti's theory connects dielectric, spectroscopic and elastic properties. An important outcome of Szigeti's theory is the concept of the effective ionic charge (). It is pointed out that correlates with a number of physical properties and is a measure of ionicity of the interatomic bond. Since Szigeti's work, several theoretical models have been proposed to account for the fact that < 1. These models provide an insight into the complex polarization mechanisms in solids. This review summarizes Szigeti's work and the work that followed; the implications and applications of Szigeti's theory are discussed. Some new results are also included.

  5. Fifty years of fiscal planning and implementation in the Netherlands

    NARCIS (Netherlands)

    Beetsma, R.; Giuliodori, M.; Walschot, M.; Wierts, P.


    Using real-time data from the annual budgets over the period 1958-2009, we explore budgetary planning and implementation in the Netherlands. Three fiscal policy regimes are distinguished. Our key findings are the following. First, plans are on average unbiased, although they are overoptimistic durin

  6. Fifty years of fiscal planning and implementation in the Netherlands

    NARCIS (Netherlands)

    Beetsma, R.; Giuliodori, M.; Walschot, M.; Wierts, P.


    Using real-time data from the annual budgets over the period 1958-2009, we explore budgetary planning and implementation in the Netherlands. Three fiscal policy regimes are distinguished. Our key findings are the following. First, plans are on average unbiased, although they are overoptimistic durin

  7. [The surgeons civil responsibility insurance]. (United States)

    Santovito, D


    After a short research in the field national insurances, the author analyses the professional physician insurance policy; the ambiguity and difficulty of contracts concerning the professional health activity of surgeon, whether as state employee or as independent professional are pointed put. With the introduction of the ministerial decree dated January 29,1992, the new labour agreement, the privacy law, the evolution of ''informed consent'', the esthetic injury concept, the safety regulations law and the administrative liability, surgeons must pay attention to draw up an insurance policy suitable to their profession.

  8. The Journal of The Experimental Analysis of Behavior at Fifty (United States)

    Laties, Victor G


    The Journal of the Experimental Analysis of Behavior was founded in 1958 by a group of male psychologists, mainly from the northeastern USA and connected with either Harvard or Columbia. Fifty years later about 20% of both editors and authors reside outside this country and almost the same proportion is made up of women. Other changes in the journal include having its own website for more than a decade and now publishing online as well as on paper. A recent connection with PubMed Central of the National Library of Medicine has made possible the completely free electronic presentation of the entire archive of about 3,800 articles. PMID:18338677

  9. [The educational program for modern military surgeons]. (United States)

    Willy, C; Gutcke, A; Klein, B; Rauhut, F; Friemert, B; Kollig, E W; Weller, N; Lieber, A


    Casualties in military conflict produce patterns of injuries that are not seen in routine surgical practice at home. In an era of increasing surgical sub-specialization the deployed surgeon needs to acquire and maintain a wide range of skills from a variety of surgical specialties. Improvised explosive devices (IEDs) have become the modus operandi for terrorists and in the current global security situation these tactics can be equally employed against civilian targets. Therefore, knowledge and training in the management of these injuries are relevant to both military and civilian surgeons. To create this kind of military surgeon the so-called "DUO-plus" model for the training of surgical officers (specialization general surgery plus a second specialization either in visceral surgery or orthopedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery and emergency gynecology, are integrated into this concept and will be taught in courses. Log books will be kept in accordance with the training curricula. On successful completion of the program medical officers will be officially appointed as Medical Officer "Einsatzchirurg" by their commanding officers for a maximum of 5 years and it will be necessary to renew it after this period. These refresher programs will require participation in visiting physicians programs in the complementary surgical disciplines in order to retain the essential specific skills.

  10. Surgeon-related factors and outcome in rectal cancer. (United States)

    Porter, G A; Soskolne, C L; Yakimets, W W; Newman, S C


    OBJECTIVE: To determine whether surgical subspecialty training in colorectal surgery or frequency of rectal cancer resection by the surgeon are independent prognostic factors for local recurrence (LR) and survival. SUMMARY BACKGROUND DATA: Variation in patient outcome in rectal cancer has been shown among centers and among individual surgeons. However, the prognostic importance of surgeon-related factors is largely unknown. METHODS: All patients undergoing potentially curative low anterior resection or abdominoperineal resection for primary adenocarcinoma of the rectum between 1983 and 1990 at the five Edmonton general hospitals were reviewed in a historic-prospective study design. Preoperative, intraoperative, pathologic, adjuvant therapy, and outcome variables were obtained. Outcomes of interest included LR and disease-specific survival (DSS). To determine survival rates and to control both confounding and interaction, multivariate analysis was performed using Cox proportional hazards regression. RESULTS: The study included 683 patients involving 52 surgeons, with > 5-year follow-up obtained on 663 (97%) patients. There were five colorectal-trained surgeons who performed 109 (16%) of the operations. Independent of surgeon training, 323 operations (47%) were done by surgeons performing < 21 rectal cancer resections over the study period. Multivariate analysis showed that the risk of LR was increased in patients of both noncolorectal trained surgeons (hazard ratio (HR) = 2.5, p = 0.001) and those of surgeons performing < 21 resections (HR = 1.8, p < 0.001). Stage (p < 0.001), use of adjuvant therapy (p = 0.002), rectal perforation or tumor spill (p < 0.001), and vascular/neural invasion (p = 0.002) also were significant prognostic factors for LR. Similarly, decreased disease-specific survival was found to be independently associated with noncolorectal-trained surgeons (HR = 1.5, p = 0.03) and surgeons performing < 21 resections (HR = 1.4, p = 0.005). Stage (p < 0

  11. Paying surgeons less has cost more. (United States)

    Bernstein, Joseph; Derman, Peter


    The Balanced Budget Act of 1997 mandated reductions in physician reimbursement. This reduction in payments could be envisioned to limit expenditures on 2 counts: first, individual fees would be lower, producing inherent savings. Furthermore, reducing fees should depress the incentive to work, thereby generating additional savings from reduced output. A rival point of view holds that lower fees might paradoxically lead to greater spending because surgeons compensate for per-case reductions by performing more cases. If this income-targeting hypothesis is correct, lower per-case fees leads to increased volume. Increased work output has particularly sizable economic effects in fields like orthopedic surgery because the total cost of orthopedic interventions is usually many times larger than the physician's fee (largely owing to the cost of implants). As such, increases in work volume more than negate the potential savings from lower surgeon's fees.This phenomenon was studied in the context of total knee arthroplasty. In the decade spanning 1996 to 2005, inflation-adjusted physician reimbursement decreased by approximately 5% per year, leading to a cumulative drop in reimbursement from $2847 to $1685. Nonetheless, because the number of procedures performed increased from 253,841 to 498,169 and because payments to hospitals far exceeded payments to surgeons, total expenditures for total knee arthroplasty increased dramatically: more than $7.1 billion additional was spent on hospital payments. Continuing to pay surgeons less is apt to continue to cost more. Counter to intuition, the best strategy for controlling overall spending might be higher, not lower, surgical fees.

  12. A language for effective communication between surgeons and radiographers in trauma theatre. (United States)

    Chaganti, S; Kumar, D; Patil, S; Alderman, P


    The advent of the image intensifier has revolutionised trauma surgery since its development in 1955. The manufacturers have given names to various movements of the machine in the operating manual but it has not been popular among orthopaedic surgeons or radiographers. Lack of knowledge of names of various movements and ambiguity in command often leads to confusion between the surgeon and the radiographer regarding which way to move the image intensifier. A questionnaire-based study was conducted to assess the efficacy of communication between orthopaedic surgeons and radiographers while using the image intensifier intra-operatively. Diagrams depicting the movements of the image intensifier were used in the questionnaire. Fifty questionnaires were given to orthopaedic surgeons and 50 to radiographers to name the various movements. Ninety questionnaires were returned, 45 from surgeons and 45 from radiographers. Five questionnaires from surgeons and five from radiographers were returned blank. Of those responding, 97% could name the vertical movement, 68% the horizontal movement, 12% the swivel and 29% the angulation movement. None could name the orbital movement. Even though orthopaedic surgeons do not operate the image intensifier themselves, knowledge of the movements of the image intensifier and their names can improve the efficacy of communication between surgeons and radiographers. A common language and precision in command can avoid confusion and has the potential to improve theatre time utilisation. The nomenclature of various movements of the image intensifier has been described and possible precise commands for various movements have been postulated.

  13. Kant and the cosmetic surgeon. (United States)

    Carey, J S


    Philosophers know that modern philosophy owes a great debt to the intellectual contributions of the 18th century philosopher Immanuel Kant. This essay attempts to show how cosmetic surgeons, and all surgeons at that, could learn much from his work. Not only did Kant write about the structure of human reasoning and how it relates to appearances but he also wrote about the nature of duties and other obligations. His work has strongly influenced medical ethics. In a more particular way, Kant wrote the most important work on aesthetics. His theory still influences how philosophers understand the meaning of the beautiful and how it pertains to the human figure. This essay presents an exercise in trying to apply Kantian philosophy to aesthetic plastic surgery. Its intention is to show cosmetic surgeons some of the implicit and explicit philosophical principles and potential arguments undergirding their potential surgical evaluations. It is meant to challenge the surgeon to reconsider how decisions are made using philosophical reasoning instead of some of the more usual justifications based on psychology or sociology.

  14. Fifty shades of exploitation: Fan labor and Fifty Shades of Grey

    Directory of Open Access Journals (Sweden)

    Bethan Jones


    Full Text Available This exploration of the debates that have taken place in fandom over the ethics of pulling fan fiction and publishing it as original work draws on the notion of the fannish gift economy, which postulates that gifts such as fan fiction and fan art have value in the fannish community because they are designed to create and cement its social structure. Tension exists between fans who subscribe to the notion of a fannish gift economy and those who exploit fandom by using it to sell their pulled-to-publish works. An examination of E. L. James's 2012 Fifty Shades trilogy (comprising the books Fifty Shades of Grey, Fifty Shades Darker, and Fifty Shades Freed, which began as Twilight fan fiction, in addition to Twilight fan art sold through sites such as Redbubble and Etsy, demonstrates a tension between the two modes of fan expression: sale of artworks appears to be an acceptable practice in fandom, but the commercial sale of fan fic, even when marketed as original fiction, is widely contested.

  15. Smartphone apps for orthopaedic surgeons. (United States)

    Franko, Orrin I


    The use of smartphones and their associated applications (apps) provides new opportunities for physicians, and specifically orthopaedic surgeons, to integrate technology into clinical practice. The purpose of this study was twofold: to review all apps specifically created for orthopaedic surgeons and to survey orthopaedic residents and surgeons in the United States to characterize the need for novel apps. The five most popular smartphone app stores were searched for orthopaedic-related apps: Blackberry, iPhone, Android, Palm, and Windows. An Internet survey was sent to ACGME-accredited orthopaedic surgery departments to assess the level of smartphone use, app use, and desire for orthopaedic-related apps. The database search revealed that iPhone and Android platforms had apps specifically created for orthopaedic surgery with a total of 61 and 13 apps, respectively. Among the apps reviewed, only one had greater than 100 reviews (mean, 27), and the majority of apps had very few reviews, including AAOS Now and AO Surgery Reference, apps published by the American Academy of Orthopaedic Surgeons and AO Foundation, respectively. The national survey revealed that 84% of respondents (n = 476) have a smartphone, the majority (55%) have an iPhone, and that 53% of people with smartphones already use apps in clinical practice. Ninety-six percent of respondents who use apps reported they would like more orthopaedic apps and would pay an average of nearly $30 for useful apps. The four most requested categories of apps were textbook/reference, techniques/guides, OITE/board review, and billing/coding. The use of smartphones and apps is prevalent among orthopaedic care providers in academic centers. However, few highly ranked apps specifically related to orthopaedic surgery are available, and the types of apps available do not appear to be the categories most desired by residents and surgeons.

  16. Association Between Surgeon Scorecard Use and Operating Room Costs. (United States)

    Zygourakis, Corinna C; Valencia, Victoria; Moriates, Christopher; Boscardin, Christy K; Catschegn, Sereina; Rajkomar, Alvin; Bozic, Kevin J; Soo Hoo, Kent; Goldberg, Andrew N; Pitts, Lawrence; Lawton, Michael T; Dudley, R Adams; Gonzales, Ralph


    ) in 2014 to $765 (IQR, $233-$1719) (17 227 cases) in 2015. This decrease represents a total savings of $836 147 in the intervention group during the 1-year study. After controlling for surgeon, department, patient demographics, and clinical indicators in a mixed-effects model, there was a 9.95% (95% CI, 3.55%-15.93%; P = .003) surgical supply cost decrease in the intervention group over 1 year. Patient outcomes were equivalent or improved after the intervention, and surgeons who received scorecards reported higher levels of cost awareness on the health care value survey compared with controls. Cost feedback to surgeons, combined with a small departmental financial incentive, was associated with significantly reduced surgical supply costs, without negatively affecting patient outcomes.

  17. Postcardiotomy centrifugal assist: a single surgeon's experience. (United States)

    Curtis, Jack J; McKenney-Knox, Charlotte A; Wagner-Mann, Colette C


    Because of the infrequent application of cardiac assist devices for postcardiotomy heart failure, most published reports include the results of learning curves from multiple surgeons. Between October 1986 and June 2001, a single surgeon used 35 Sarns Centrifugal Pumps as ventricular assist devices in 21 patients with severe hemodynamic compromise after open heart surgery (0.88% incidence). Patients' ages ranged from 39 to 77 (mean, 59.6 years). Three patients required right ventricular assist devices, 4 left ventricular assist devices, and 14 had biventricular assist devices. For all, the indication for application was inability to wean from cardiopulmonary bypass despite multiple inotropes and intraaortic balloon pumping. All were expected to be intraoperative deaths without further mechanical assistance. Patients were assisted from 2 to 434 h (median, 48 h). Fifteen patients (71.4%) were weaned from device(s), and 11 patients (52.4%) were hospital survivors. Actuarial survival in those dismissed from the hospital was 78% at 5 years and 39% at 10 years. Patients facing certain demise after cardiac surgery can be salvaged with temporary centrifugal mechanical assist. Results are competitive with that achieved with more sophisticated devices. Hospital survivors enjoy reasonable longevity.

  18. Non-technical skills of surgical trainees and experienced surgeons. (United States)

    Gostlow, H; Marlow, N; Thomas, M J W; Hewett, P J; Kiermeier, A; Babidge, W; Altree, M; Pena, G; Maddern, G


    In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. Surgical trainees and experienced surgeons undertook a simulated scenario designed to challenge their non-technical skills. Scenarios were video recorded and participants were assessed using the Non-Technical Skills for Surgeons (NOTSS) scoring system. Participants were divided into subgroups according to years of experience and their NOTSS scores were compared. For most NOTSS elements, mean scores increased initially, peaking around the time of Fellowship, before decreasing roughly linearly over time. There was a significant downward trend in score with increasing years since being awarded Fellowship for six of the 12 NOTSS elements: considering options (score -0·015 units per year), implementing and reviewing decisions (-0·020 per year), establishing a shared understanding (-0·014 per year), setting and maintaining standards (-0·024 per year), supporting others (-0·031 per year) and coping with pressure (-0·015 per year). The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience. © 2017 BJS Society Ltd Published by John Wiley & Sons Ltd.

  19. Temporal geomapping of pediatric surgeons in the United States. (United States)

    Snyder, Charles L


    Several studies have addressed the issue of manpower needs in pediatric surgery. The number of training programs has multiplied dramatically over the past decade. The distribution of surgeons is more significant than the absolute change in numbers--are major metropolitan areas seeing a more dramatic increase than less populated areas? To evaluate the geographic and demographic changes associated with this increase, we used choropleth and geomapping techniques to evaluate the change in number and distribution of American Pediatric Surgical Association (APSA) members (and by proxy, pediatric surgeons) in the United States over the past decade. Data regarding membership were obtained from APSA. In 1996, management companies changed, and accurate data for initial year of membership were only available after 1996. Online sources ( and were used for data analysis. There was a 175% increase in the number of APSA members over the past decade. The geographic distribution parallels the state population to some extent but is uneven. The number of APSA members by state over time is displayed in color density maps. Predictions of prior manpower studies were generally accurate. The number of pediatric surgeons in the United States has rapidly increased in the past decade, with no sign of diminution in this trend. Increases in the number of surgeons correlates with state population, indicating a tendency for surgeons to reside in more densely populated areas, as expected. Areas with a disproportionately high or low number of surgeons can be identified via choropleth mapping.

  20. Depth Perception of Surgeons in Minimally Invasive Surgery. (United States)

    Bogdanova, Rositsa; Boulanger, Pierre; Zheng, Bin


    Minimally invasive surgery (MIS) poses visual challenges to the surgeons. In MIS, binocular disparity is not freely available for surgeons, who are required to mentally rebuild the 3-dimensional (3D) patient anatomy from a limited number of monoscopic visual cues. The insufficient depth cues from the MIS environment could cause surgeons to misjudge spatial depth, which could lead to performance errors thus jeopardizing patient safety. In this article, we will first discuss the natural human depth perception by exploring the main depth cues available for surgeons in open procedures. Subsequently, we will reveal what depth cues are lost in MIS and how surgeons compensate for the incomplete depth presentation. Next, we will further expand our knowledge by exploring some of the available solutions for improving depth presentation to surgeons. Here we will review the innovative approaches (multiple 2D camera assembly, shadow introduction) and devices (3D monitors, head-mounted devices, and auto-stereoscopic monitors) for 3D image presentation from the past few years.

  1. A change in opinion on surgeon's performance indicators. (United States)

    Maytham, Gary; Kessaris, Nicos


    Individual performance indicators for cardiac surgeons in the UK were published in 2004. A comprehensive update published in 2009 reported statistically significant decreases in mortality rates suggesting that the publication of this data may have contributed to this improvement in outcomes. In view of this, the authors present an assessment of the attitudes of cardiac surgeons to individual performance tables, having performed this by sending questionnaires exploring the surgeon's views on performance tables to UK cardiac surgeons in 2005 and 2009. The responses demonstrated that whilst the majority of cardiac surgeons (68.8%) were initially opposed to performance tables, the number welcoming their introduction increased significantly (22.9-48.5%) over the four-year period. The attitude of the consultants towards the possible effect of this data on the management of high-risk patients also changed, with fewer consultants believing they would (P=0.0001) or may (P=0.023) avoid these patients. The observed change in attitude of cardiac surgeons may be due to acclimatization to an established system of audit, improved mortality rates, a desire for more transparency following the Bristol Enquiry, or improved risk stratification. These findings may be of benefit to those tasked with initiating these indicators elsewhere.

  2. Sir Charles Ballance: pioneer British neurological surgeon. (United States)

    Stone, J L


    nerve regeneration and nerve grafting, and after many years of devoted research, he devised successful operations for facial nerve paralysis. For this and early vascular work, he is often credited as the first English surgeon to reintroduce classical Hunterian methods of experiment into surgery. He was honored as the founder and President of The Society of British Neurological Surgeons in 1926. Perhaps best known as a general and aural surgeon, Ballance was second only to Horsley in reputation as a pioneer British neurological surgeon. Described as a painstakingly slow but delicate and meticulous operator, Ballance made a contribution to neurosurgery and temporal bone surgery that was immense.



    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan


    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  4. 21 CFR 878.4460 - Surgeon's glove. (United States)


    ... DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4460 Surgeon's glove. (a) Identification. A surgeon's glove is a device made of natural or synthetic rubber intended to be worn by... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgeon's glove. 878.4460 Section 878.4460...

  5. Surgeons' non-technical skills. (United States)

    Yule, Steven; Paterson-Brown, Simon


    The importance of non-technical skills to surgical performance is gaining wide acceptance. This article discusses the core cognitive and social skills categories thought to underpin medical knowledge and surgical expertise, and describes the rise of non-technical skill models of assessment in surgery. Behavior rating systems such as NOTSS (Non-Technical Skills for Surgeons) have been developed to support education and assessment in this regard. We now understand more about these critical skills and how they impact surgery. The challenge in the future is to incorporate them into undergraduate teaching, postgraduate training, workplace assessment, and perhaps even selection.

  6. A snapshot survey of perceptions of healthcare professionals on ageing surgeons. (United States)

    Rajaratnam, Vaikunthan; Kumar, Chandra M; Roy Chowdhury, Anupama; Su, Chang


    The aim of this research was to understand healthcare professionals' perception of the continued practice of ageing surgeons in Singapore. A quantitative method was chosen for this research to determine healthcare professionals' perception of the practice of ageing surgeons. Ethical approval was obtained from the local ethical review board. A cross-sectional method using a population survey was performed among healthcare professionals in two tertiary institutions and the study was confined to stakeholders in practices of ageing surgeons. The population sampled was limited to nurses in the theatre, anaesthetists, surgeons and geriatricians (physicians). An online questionnaire was designed for the survey that took into consideration the various conceptual frameworks of ageing surgeons' practice that was obtained from a literature review. There were 104 respondents of a population of 350 sampled (theatre nurses, anaesthetists, physicians and surgeons) giving a respondent rate of 30%. The mean age of the participants was 39.7; 72% were doctors (surgeons 34%, physicians 20% and anaesthetists 18%) and 28% nurses. Only 35% agreed with the statement that older surgeons face deterioration in cognitive faculties and 29% remained neutral. A similar trend was seen with the perception that older surgeons face a decline in memory. However, 44% agreed with the statement that older surgeons face a decline in visuospatial ability and another 40% agreed that they had a decline in psychomotor skills and reaction time. Fifty per cent agreed with the statement that they face deterioration in physical abilities. Sixty-three per cent did not think that older surgeons face a decline in reasoning and judgement. Forty-eight per cent believed that older surgeons' vast fund of knowledge and experience could compensate for physical and cognitive changes. Only 13% agreed with the statement that older surgeons have higher surgical mortality. Forty-five per cent agreed that the retirement age

  7. Does Surgeon Sex Matter?: Practice Patterns and Outcomes of Female and Male Surgeons. (United States)

    Sharoky, Catherine E; Sellers, Morgan M; Keele, Luke J; Wirtalla, Christopher J; Karakousis, Giorgos C; Morris, Jon B; Kelz, Rachel R


    We sought to compare postoperative outcomes of female surgeons (FS) and male surgeons (MS) within general surgery. FS in the workforce are increasing in number. Female physicians provide exceptional care in other specialties. Differences in surgical outcomes of FS and MS have not been examined. We linked the AMA Physician Masterfile to discharge claims from New York, Florida, and Pennsylvania (2012 to 2013) to examine practice patterns and to compare surgical outcomes of FS and MS. We paired FS and MS operating at the same hospital using cardinality matching with refined balance and compared inpatient mortality, any postoperative complication, and prolonged length of stay (pLOS) in FS and MS. Overall practice patterns differed between the 663 FS and 3219 MS. We identified 2462 surgeons (19% FS, 81% MS) at 429 hospitals who met inclusion criteria for outcomes analysis. FS were younger (mean age ± SD FS: 48.5 ± 8.4 years, MS: 54.3 ± 9.4y; P best fit for them regardless of sex.

  8. Burnout syndrome in oral and maxillofacial surgeons: a critical analysis. (United States)

    Porto, G G; Carneiro, S C; Vasconcelos, B C; Nascimento, M M; Leal, J L F


    The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. [Hospitals and surgeons: Madrid 1940]. (United States)

    de Quevedo, Francisco Vázquez


    The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.

  10. Projections of Demand for Cardiovascular Surgery and Supply of Surgeons. (United States)

    Lee, Jung Jeung; Park, Nam Hee; Lee, Kun Sei; Chee, Hyun Keun; Sim, Sung Bo; Kim, Myo Jeong; Choi, Ji Suk; Kim, Myunghwa; Park, Choon Seon


    While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors

  11. The Glass Houses of Attending Surgeons: An Assessment of Unprofessional Behavior on Facebook Among Practicing Surgeons. (United States)

    Langenfeld, Sean J; Sudbeck, Craig; Luers, Thomas; Adamson, Peter; Cook, Gates; Schenarts, Paul J


    Our recent publication demonstrated that unprofessional behavior on Facebook is common among surgical residents. In the formulation of standards and curricula to address this issue, it is important that surgical faculty lead by example. Our current study refocuses on the Facebook profiles of faculty surgeons involved in the education of general surgery residents. The American College of Surgeons (ACS) web site was used to identify general surgery residencies located in the Midwest. Departmental web sites were then searched to identify teaching faculty for the general surgery residency. Facebook was then searched to determine which faculty had profiles available for viewing by the general public. Profiles were then placed in 1 of the 3 following categories: professional, potentially unprofessional, or clearly unprofessional. A chi-square test was used to determine significance. In all, 57 residency programs were identified on the ACS web site, 100% of which provided an institutional web site listing the surgical faculty. A total of 758 general surgery faculty were identified (133 women and 625 men), of which 195 (25.7%) had identifiable Facebook accounts. In all, 165 faculty (84.6%) had no unprofessional content, 20 (10.3%) had potentially unprofessional content, and 10 (5.1%) had clearly unprofessional content. Inter-rater reliability was good (88.9% agreement, κ = 0.784). Clearly unprofessional behavior was found only in male surgeons. For male surgeons, clearly unprofessional behavior was more common among those in practice for less than 5 years (p = 0.031). Alcohol and politics were the most commonly found variables in the potentially unprofessional group. Inappropriate language and sexually suggestive material were the most commonly found variables in the clearly unprofessional group. Unprofessional behavior on Facebook is less common among surgical faculty compared with surgical residents. However, the rates remain unacceptably high, especially among men and

  12. Nuclear histochemistry: Its history in fifty volumes

    Directory of Open Access Journals (Sweden)

    M.G. Manfredi Romanini


    Full Text Available The fiftieth anniversary of the double helix was marked two years ago. The elucidation of the structure of DNA by Watson and Crick can rightfully be considered to be "the" milestone in modern biology because it has conditioned the explosive growth in our understanding of the molecular mechanisms regulating the structural and functional organization of single cells and multicellular organisms....

  13. Robotics and the pediatric surgeon. (United States)

    Lorincz, Attila; Langenburg, Scott; Klein, Michael D


    Surgical robots are enabling devices for minimally invasive (laparoscopic) surgery (MIS). They use a computer to enhance a surgeon's skills as hand movements are transmitted to robotic arms. The computer filters tremor, which becomes important at high magnifications of 10 to 15 times available in MIS. It also provides motion scaling so that large hand movements are converted to very small movements of the robotic arm. The robotic arms also have wrists that make suturing and knot tying far more accurate and efficient. Surgical robots are currently used clinically for procedures such as MIS Nissen fundoplication, cholecystectomy, and splenectomy. Laboratory experience indicates that they may provide advantages for newborn procedures such as portoenterostomy for biliary atresia and repair of esophageal atresia and tracheoesophageal fistula. They have a potential for making possible MIS procedures, which can only be done open now, and for introducing entirely new procedures as well as for the performance of procedures by operators distant from the patient.

  14. 55岁以下成年移位股骨颈骨折内固定术后失败的研究分析%Failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old

    Institute of Scientific and Technical Information of China (English)

    俞银贤; 马金忠; 朱力波; 陆海明; 桑伟林


    目的:回顾性研究年龄55岁以下成年患者移位股骨颈骨折内固定治疗失败病例以提高对其治疗的重视.方法:2007年1月至2010年6月治疗55岁以下移位股骨颈骨折内固定术后失败患者18例,男13例,女5例;年龄27~55岁,平均(48.0±6.0)岁;空心钉治疗17例,髓内钉治疗1例.入院时诊断为股骨头坏死16例,骨不连合并股骨头坏死2例.结果:18例患者内固定术后至手术失败时间8~32个月,平均23个月.复位内固定术后Garden指数不佳;入院时髋关节Harris评分33~80分,平均(56.0±12.5)分.8例股骨头坏死病例和2例骨不连合并股骨头坏死病例接受了全髋关节置换术,5例股骨头坏死病例接受了表面髋关节置换术,3例虽然影像学有股骨头坏死征象但临床症状不明显,接受了保守治疗.所有行髋关节表面置换和全髋关节置换的病例术后随访12~53个月,平均34个月,术后Harris评分(94.0±3.0)分(89~96分).结论:股骨头坏死是55岁以下成年移位股骨颈骨折闭合复位内固定术后常见并发症,必须提高对青壮年股骨颈骨折闭合复位内固定治疗的重视.%Objective:To investigate the failure of internal fixation on displaced femoral neck fractures in adults under fifty-five years old retrospectively inorder to pay more attention to the treatment of these fractures. Methods: From Junary 2007 to June 2010,18 failed cases of internal fixation on displaced femoral neck fractures in adults under fifty-five years old were treated,there were 13 males and 5 females with an average age of (48.0±6.0) years old ranging from 27 to 55. Among them, 17 patients were treated with cannulated screws and ) patient was treated with intramedullaiy nail; 16 patients were diagnosed as osteonecrosis and 2 patients as osteonecrosis associated with nonunion. Results:The average time from internal fixation to failure was 23 months (ranged, 8 to 32 months). The quality of fracture reduction in

  15. Partial denture-- an ENT surgeon's nightmare. (United States)

    Venugopal, M; Sagesh, M


    Foreign body oesophagus is one among the common otorhinolaryngology emergencies that we come across. Artificial partial denture impaction in the oesophagus is often an ENT surgeon's nightmare. This study was done in the department of otorhinolaryngology, Government Medical College Kozhikode for a period of 2 years. All patients presented with history of accidental swallowing of partial denture followed by dysphagia. Radiological evaluation was done and subsequently oesophagoscopy and removal of the denture was done. In failed cases exploration and removal of foreign body was required. Complications were found in partial denture with metal wire clasps. It is better to avoid using malfitting dentures with small base, those with metal wire clasps and be cautious of using dentures in alcoholics and unconscious patients.

  16. The advent of the restorative plastic surgeon. (United States)

    Carty, Matthew J; Pribaz, Julian J; Talbot, Simon G; Caterson, Edward J; Pomahac, Bohdan


    Plastic surgery is presently typified by the existence of discrete clinical identities, namely that of the cosmetic plastic surgeon and the reconstructive plastic surgeon. The emergence of vascularized composite allotransplantation has been accompanied by the development of a third distinct clinical identity, that of the restorative plastic surgeon. The authors describe the core competencies that characterize this new identity, and discuss the implications of the advent of this new professional paradigm.

  17. American Society of Colon and Rectal Surgeons (United States)

    ... Assessment and Safety Committee Initiatives Past Presidents Healthcare Economics Committee 2017 Tripartite Meeting Search form Search Login Join Now Find a Surgeon ASCRS Patients Members Physicians Latest ...

  18. Assessment and remedial clinical education of surgeons in California. (United States)

    Cosman, Bard C; Alverson, Aaron D; Boal, Peter A; Owens, Erik L; Norcross, William A


    Assessment and remedial clinical education of practicing surgeons is feasible and possibly beneficial. Retrospective series. Urban academic medical center. Licensed surgeons. Structured assessment and remedial clinical education based on resident-education models. Assessment and clinical education results. Forty-seven general, general/vascular, and colorectal surgeons were assessed by the University of California, San Diego, Physician Assessment and Clinical Education program in 2000 to 2010. Forty-six (98%) were male (mean [SD] age, 54 [11] years; range, 34-80 years). Thirty-three (70%) came from state medical board actions: 25 from California's disciplinary division, 2 from California's licensing division, 3 from other state boards, and 3 self-referred during other state board actions. Fourteen (30%) came from health care organizations: 8 from California hospitals, 3 from hospitals in other states, 2 self-referred during hospital proceedings, and 1 self-referred during a medical group investigation. Twenty-three (49%) underwent a 2-day assessment only, including a 1-hour mock oral board examination: 8 "passed" with no recommendations; 6, with minor recommendations; 6 had major recommendations; and 3 "failed." Twenty-four surgeons (51%) also completed 26 five-day clinical education programs, with 20 "passes," 1 minor recommendation, 3 major recommendations, and 2 "fails." A program of assessment and remedial clinical education of surgeons designed to meet the needs of one medical board is being used by nongovernmental organizations as well, and it seems to meet the needs of some individual surgeons. This type of program may play a role in the profession's self-regulation.

  19. Current Use of Methylprednisolone for Acute Spinal Cord Injury by Spine Surgeons of Thailand

    Directory of Open Access Journals (Sweden)

    Sirichai Wilartratsami


    Full Text Available Objective: To determine current decision making in methylprednisolone succinate (MPS administration for acute spinal cord injury (ASCI treatment in Thailand. Methods: A questionnaire was sent to all orthopedic surgeons who attended the annual meeting of the Spine Society of Thailand 2016. The questionnaire had 3 parts of questions including demographic data, opinions in MPS use in general ASCI patients and patients who meet the exclusion criteria in NASCIS III study. Results: Fifty five respondents completed the survey (overall response rate was 27.1 % and there was 78.18% prescribe MPS to ASCI patients. Among them, 40 % prescribe according to NASCIS II and 55.6% NASCIS III. The main reasons for MPS administration are practice standard (38.6%, effectiveness (31.8% and liability issue (22.7%. In patients who met the exclusion criteria of NASCIS III, most respondents do not prescribe any steroids in patients who had age below 14 years old (42.2%, pregnancy (77.8%, severe underlying disease (72.7%, body weight more than 109 kg (40.9%, gunshot injury (59.1% and previous spinal cord injury (46.5%. Interestingly, there were 93.2% prescribed MPS to patients who sustained ACSI more than 8 hours. Conclusion: Because the institutional standard supported MPS use, most participants prescribed MPS in ASCI despite current clinical data from recent studies. Most participants who did not use MPS in patients had exclusion criteria of NASCIS III.

  20. [Michel Latarjet (1913-1999), surgeon explorer!]. (United States)

    Awada, T; Liverneaux, P


    In 1954, Michel Latarjet, anatomist and surgeon of Lyon, developed an original surgical technique to treat the unstable shoulder . This technique since kept his name: "Latarjet". He was a character in 1000 facets: highly skilled anatomist, skillful surgeon, talented sportsman, accomplished musician, big traveler, and many others... An eclectic life, symbol of an abundant XXth century.

  1. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad


    that the risk was equal to traditional laparoscopy (3%). The fraction of surgeons willing to learn SILS and NOTES was 44.6% and 32.7%, respectively. The desire to learn was higher among less experienced and surgically active surgeons. Of the responders, 68.8% considered SILS and 43.2% considered NOTES would...

  2. The "Journal of the Experimental Analysis of Behavior" at Zero, Fifty, and One Hundred (United States)

    Catania, A. Charles


    The experimental content areas represented in "JEAB" in its first volume (1958) and fifty 50 years later in Volume 87 are in many ways similar with regard to research on schedules of reinforcement, research with human subjects, and several other topics. Experimental analysis has not been displaced by quantitative analysis. Much less research on…

  3. Women's Heart Disease: Cindy Parsons and Follow the Fifty (United States)

    ... this page please turn JavaScript on. Feature: Women's Heart Disease Cindy Parsons and Follow the Fifty Past Issues / ... Program, knowing that her personal risk factors for heart disease, including family history, were high. She watched her ...

  4. Transformationer i mediekulturen - Fifty Shades som fanfænomen


    Matthiasen, Anja Falkner; Barding, Antonia; Eliasen, Kristina Maria Danielsen


    This project examines the Fifty Shades phenomenon where fan cultures and community building surrounding this particular universe are a few of the keywords to understanding this said phenomenon. Through Henry Jenkins’ transmedia storytelling and worldbuilding theory and Donald Horton & Richard Wohl’s theory on parasocial interactions as well as John B. Thompson’s non-reciprocal relation theory it can be concluded that the fans are what’s keeping the Fifty Shades universe alive and still rapidl...

  5. Oncological screening for Bilateral Breast Reduction: a survey of practice variations in UK Breast and Plastics surgeons 2009. (United States)

    Hennedige, Anusha A; Kong, Tze Yean; Gandhi, Ashu


    Bilateral Breast Reduction (BBR) is a common procedure performed by Breast and Plastic surgeons in the UK. No consensus exists regarding preoperative screening for malignancy or for selective criteria for such screening. Preoperative BBR screening practices among UK Breast and Plastic surgeons are unknown. Ascertain the preoperative and postoperative BBR screening practices of UK Breast and Plastic surgeons. A questionnaire was posted to all 434 Breast and 335 Plastic surgeons in the UK. All results were analysed with relevant statistical methods. 64% of Breast surgeons and 72% of Plastic surgeons responded. 40% of Breast surgeons and 91% of Plastic surgeons perform BBR. Routine radiological screening: 92% Breast 41% Plastic (p Plastic. Routine histology for BBR specimens: 96% Breast 90% Plastic. Selective screening of patients aged 30-40 years old: Breast 38% Plastic 10%. Selective screening of patients aged 40-50: Breast 78%, Plastic 53%. Selective screening of patients with strong family history of breast cancer: Breast 72%, Plastic 91%. Selective screening of patients with previous breast cancer: Breast 77%, Plastic 93%. There are significant differences in practice between UK Breast surgeons and Plastic surgeons in preoperative oncological screening for BBR. The large discrepancy in preoperative radiological screening, reflects a ubiquitous pro-screening ideology among Breast surgeons not prevalent among Plastic surgeons. These results will provoke debate towards the direction of consensus to ultimately reflect best practice. Copyright © 2010. Published by Elsevier Ltd.

  6. Work-related musculoskeletal disorders among dental surgeons: A pilot study

    Directory of Open Access Journals (Sweden)

    Abdul Rahim Shaik


    Full Text Available Aim: To describe the work-related musculoskeletal disorders among on-job dental surgeons. Objectives: To identify the musculoskeletal disorders in terms of perception of pain and stiffness experienced by the dental surgeons due to the rigors of dental work, to determine the prevailing working environment with particular reference to dental work station in relation to musculoskeletal disorders, and to find the association between pain and stiffness experienced by the dental surgeons and the selected socio-demographic variables. Materials and Methods: The study was conducted on 30 graduated dental surgeons having a work experience of 1 year or more, post graduates and faculty members of various specialties at Yenepoya Dental College Hospital, Mangalore. The subjects were selected randomly from the hospital and they were given closed-ended questionnaire to find out perception of pain and stiffness experienced in the past 6 months. The observation of the working environment was done by walk-through observational survey. Results: The study showed that 6.6% dental surgeons always experienced shoulder pain, while 83.3% dental surgeons sometimes experienced back pain and 70% sometimes experienced neck pain. Majority of the dental surgeons (73.3% experienced stiffness in the back and 23.3% experienced severe pain in their neck. It was observed that the number of patients attended per day by the dental surgeons had a significant association (P = 0.024 with the pain they experienced in their hip/thigh region. The frequency of pain experienced by the dental surgeons in the hip/thigh and knee joints also showed a significant association (P = 0.037 with the height of the dental surgeons. Conclusion: The study revealed that various socio-demographic variables contributed to the musculoskeletal disorders experienced by the dental surgeons. However, the number of patients attended per day by the dental surgeons vis-à-vis pain experienced in the back, wrist, and

  7. Gender differences in the professional and private lives of plastic surgeons. (United States)

    Halperin, Terri J; Werler, Martha M; Mulliken, John B


    There are over 700 female members in the American Society of Plastic Surgeons. The purpose of this study was to assess possible differences between female and male plastic surgeons with respect to their practice characteristics, duration of practice, and some aspects of their private lives. We designed a 41 question survey to compare the practice features and personal demographics of female and male members of the American Society of Plastic Surgeons. A total of 1498 questionnaires were sent via e-mail to all female members (n = 687) and a random cohort of male members (n = 811). The respondents were age stratified by decade and their responses were compared by gender using chi tests. The overall response rate was 36.3%: 337 females (49%) and 207 males (25.5%) (P plastic surgeons were more than twice as likely as female plastic surgeons to earn an income greater than $400,000 per year (P plastic surgeons are significantly more likely to be unmarried, to postpone having children or be childless, as compared to their male counterparts. Furthermore, female plastic surgeons have a lower income than their male colleagues despite similar hours and practice profile. Nevertheless, female plastic surgeons appear to have similar career satisfaction and are no more likely to retire earlier or more frequently than male plastic surgeons.

  8. Bilateral Breast Reconstruction with Abdominal Free Flaps: A Single Centre, Single Surgeon Retrospective Review of 55 Consecutive Patients

    Directory of Open Access Journals (Sweden)

    Peter McAllister


    Full Text Available Breast reconstruction using free tissue transfer is an increasingly utilised oncoplastic procedure. The aim was to review all bilateral breast reconstructions using abdominal free flaps by a single surgeon over an 11-year period (2003–2014. A retrospective review was performed on all patients who underwent bilateral breast reconstruction using abdominal free flaps between 2003 and 2014 by the senior author (DAM. Data analysed included patient demographics, indication for reconstruction, surgical details, and complications. Fifty-five female patients (mean 48.6 years [24–71 years] had bilateral breast reconstruction. The majority (41, 74.5% underwent immediate reconstruction and DIEP flaps were utilised on 41 (74.5% occasions. Major surgical complications occurred in 6 (10.9% patients, all of which were postoperative vascular compromise of the flap. Failure to salvage the reconstruction occurred on 3 (5.5% occasions resulting in a total flap failure rate of 2.7%. Obesity (>30 kg/m2 and age > 60 years were shown to have a statistically increased risk of developing postoperative complications (P60 years were associated with higher complication rates.

  9. The surgeon and human immunodeficiency virus. (United States)

    Mielke, Jens; Kalangu, Kazadi K N


    The moral dilemmas faced by surgeons worldwide who treat patients infected with the human immunodeficiency virus (HIV) can be viewed against the background of experience in sub-Saharan countries, where the community prevalence is in excess of 25% (90% of hospital inpatients). When seeking consent for an HIV test before surgery, frank communication regarding the surgeons' perspective of risks to themselves and the patient is helpful. When consent for a test must be obtained from a substitute decision-maker, the surgeon should consider if the patient would want the decision-maker to know the result. Understanding the natural history of HIV in the surgical setting can help deal with the uncertainties encountered and should be a research priority for developing countries. International professional organizations are useful platforms for the exchange of ideas when surgeons encounter uncertainty by increasing access to journals and creating opportunities for discussion. Although supervisory bodies in some parts of the world prevent HIV-infected surgeons from putting patients at risk by offering surgery, the withdrawal of their services in developing countries can cause more harm than good. Surgeons in that position may be entitled to offer surgery but only with full disclosure of the risk of HIV infection to the patient. The decision-making process known as "accountability for reasonableness" allows surgeons to determine fairness, legitimacy, and acceptability when making resource allocation decisions involving patients with HIV.

  10. The Future of Plastic Surgery: Surgeon's Perspective. (United States)

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih


    Since the days of Sushruta, innovation has shaped the history of plastic surgery. Plastic surgeons have always been known as innovators or close followers of innovations. With this descriptive international survey study, the authors aimed to evaluate the future of plastic surgeons by analyzing how plastic surgery and plastic surgeons will be affected by new trends in medicine. Aesthetic surgery is the main subclass of plastic surgery thought to be the one that will change the most in the future. Stem cell therapy is considered by plastic surgeons to be the most likely "game changer." Along with changes in surgery, plastic surgeons also expect changes in plastic surgery education. The most approved assumption for the future of plastic surgery is, "The number of cosmetic nonsurgical procedures will increase in the future." If surgeons want to have better outcomes in their practice, they must at least be open minded for innovations if they do not become innovators themselves. Besides the individual effort of each surgeon, international and local plastic surgery associations should develop new strategies to adopt these innovations in surgical practice and education.

  11. Leadership theory: implications for developing dental surgeons in primary care? (United States)

    Willcocks, S


    The development of leadership in healthcare has been seen as important in recent years, particularly at the clinical level. There have been various specific initiatives focusing on the development of leadership for doctors, nurses and other health care professions: for example, a leadership competency framework for doctors, the LEO programme and the RCN clinical leadership programme for nurses. The NHS has set up a Leadership Council to coordinate further developments. However, there has not been the same focus in dentistry, although the recent review of NHS dental services (Steele review) has proposed a need for leadership initiatives in NHS dentistry as a medium-term action. Central to this will be a need to focus on the leadership role for dental surgeons. Leadership is all the more important in dentistry, given the change of government and the policy of retrenchment, major public sector reform, the emergence of new organisations such as new commissioning consortia, possible changes to the dental contract, new ways of working, and changes to the profession such as the requirements for the revalidation of dental surgeons. The question is: which leadership theory or approach is best for dental surgeons working in primary care? This paper builds on earlier work exploring this question in relation to doctors generally, and GPs, in particular, and planned work on nurses. It will seek to address this question in relation to dental surgeons working in primary care.

  12. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

    Dalager, Tina; Søgaard, Karen; Bech, Katrine Tholstrup

    Background: A large proportion of surgeons performing minimally invasive surgery (MIS) experience musculoskeletal pain in the upper body possibly due to awkward and long-term static positions. This can be detrimental for workability and health. The objective of the present review is to sum up...... in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...

  13. Online reviews of orthopedic surgeons: an emerging trend. (United States)

    Frost, Chelsea; Mesfin, Addisu


    Various websites are dedicated to rating physicians. The goals of this study were to: (1) evaluate the prevalence of orthopedic surgeon ratings on physician rating websites in the United States and (2) evaluate factors that may affect ratings, such as sex, practice sector (academic or private), years of practice, and geographic location. A total of 557 orthopedic surgeons selected from the 30 most populated US cities were enrolled. The study period was June 1 to July 31, 2013. Practice type (academic vs private), sex, geographic location, and years since completion of training were evaluated. For each orthopedic surgeon, numeric ratings from 7 physician rating websites were collected. The ratings were standardized on a scale of 0 to 100. Written reviews were also collected and categorized as positive or negative. Of the 557 orthopedic surgeons, 525 (94.3%) were rated at least once on 1 of the physician rating websites. The average rating was 71.4. The study included 39 female physicians (7.4%) and 486 male physicians (92.6%). There were 204 (38.9%) physicians in academic practice and 321 (61.1%) in private practice. The greatest number of physicians, 281 (50.4%), practiced in the South and Southeast, whereas 276 (49.6%) practiced in the West, Midwest, and Northeast. Those in academic practice had significantly higher ratings (74.4 vs 71.1; P<.007). No significant difference based on sex (72.5 male physicians vs 70.2 female physicians; P=.17) or geographic location (P=.11) were noted. Most comments (64.6%) were positive or extremely positive. Physicians who were in practice for 6 to 10 years had significantly higher ratings (76.9, P<.01) than those in practice for 0 to 5 years (70.5) or for 21 or more years (70.7).

  14. Surgeon-patient communication during awake procedures. (United States)

    Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander


    Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Sir Donald Ross, pioneer aortic valve surgeon. (United States)

    Wheatley, David


    Tribute to Sir Donald Ross by David Wheatley, as read by Robert Kleinloog, President, Society of Cardiothoracic Surgeons of South Africa at the Annual Congress of the South African Heart Association 19 October 2014.

  16. Society of American Gastrointestinal and Endoscopic Surgeons (United States)

    ... The Research Foundation of the American Society of Colon and Rectal Surgeons (ASCRS) and the Society of American ... W. OIympic Blvd Suite 600 Los Angeles, CA 90064 USA Tel: (310) 437- ...

  17. Social Media as a Platform for Surgical Learning: Use and Engagement Patterns Among Robotic Surgeons. (United States)

    Myers, Christopher G; Kudsi, Omar Yusef; Ghaferi, Amir A


    : In response to technological advances and growing dispersion of surgical practice around the globe, social media platforms have emerged in recent years as channels for surgeons to share experiences, ask questions, and learn from one another. To better understand surgeons' engagement with these platforms, we analyzed data from a closed-membership Facebook group for robotic surgeons. Our analysis revealed that surgeons posted more frequently on midweek days, and further that text posts received significantly more comments, and significantly fewer "likes," than posts containing links, photos, or videos. We discuss the implications of these use and engagement patterns for the viability of social media platforms as tools for surgeons to learn vicariously from their peers' experiences and expertise.

  18. Dual antiplatelet therapy use by Canadian cardiac surgeons. (United States)

    Yanagawa, Bobby; Ruel, Marc; Bonneau, Christopher; Lee, Myunghyun M; Chung, Jennifer; Al Shouli, Sadek; Fagan, Andrew; Al Khalifa, Abdulwahab; White, Christopher W; Yamashita, Michael H; Currie, Maria E; Teoh, Hwee; Mewhort, Holly E M; Verma, Subodh


    Dual antiplatelet therapy is the cornerstone treatment for patients with acute coronary syndrome. Recent Canadian Guidelines recommend the use of dual antiplatelet therapy for 1 year after coronary artery bypass grafting in patients with acute coronary syndrome, but considerable variability remains. We performed a survey of 75 Canadian cardiac surgeons to assess the use of dual antiplatelet therapy. Whereas 58.6% of respondents indicated that the benefits of dual antiplatelet therapy were seen irrespective of how patients were managed after acute coronary syndrome, 36.2% believed that the benefits of dual antiplatelet therapy were limited to those treated medically or percutaneously. In regard to the timing of dual antiplatelet therapy administration, 57% of respondents indicated that dual antiplatelet therapy should be given upstream in the emergency department, whereas 36.2% responded that dual antiplatelet therapy should be given only once the coronary anatomy has been defined. The majority surveyed (81%) weighed bleeding risk as being more important than ischemic risk reduction. In stable patients after acute coronary syndrome, the majority of surgeons would wait approximately 4 days after the last dose of P2Y12 antagonist before coronary artery bypass grafting. Only 44.6% indicated that they routinely use dual antiplatelet therapy postrevascularization in the setting of acute coronary syndrome. Rather, most surgeons use dual antiplatelet therapy for select patients, such as those with a stented vessel without a bypass graft, endarterectomy, or off-pump coronary artery bypass grafting. Cardiac surgeons exhibit variation in their attitudes and practice patterns toward dual antiplatelet therapy after coronary artery bypass grafting, and in approximately half of cases, their practice does not adhere to current guideline recommendations. New trials focusing on coronary artery bypass grafting cases in their primary analysis and educational initiatives for surgeons

  19. Canadian cardiac surgeons' perspectives on biomedical innovation. (United States)

    Snyman, Gretchen; Tucker, Joseph E L; Cimini, Massimo; Narine, Kishan; Fedak, Paul W M


    Barriers to successful innovation can be identified and potentially addressed by exploring the perspectives of key stakeholders in the innovation process. Cardiac surgeons in Canada were surveyed for personal perspectives on biomedical innovation. Quantitative data was obtained by questionnaire and qualitative data via interviews with selected survey participants. Surgeons were asked to self-identify into 1 of 3 categories: "innovator," "early adopter," or "late adopter," and data were compared between groups. Most surgeons viewed innovation favourably and this effect was consistent irrespective of perceived level of innovativeness. Key barriers to the innovation pathway were identified: (1) support from colleagues and institutions; (2) Canada's health system; (3) sufficient investment capital; and (4) the culture of innovation within the local environment. Knowledge of the innovation process was perceived differently based on self-reported innovativeness. The majority of surgeons did not perceive themselves as having the necessary knowledge and skills to effectively translate innovative ideas to clinical practice. In general, responses indicate support for implementation of leadership and training programs focusing on the innovation process in an effort to prepare surgeons and enhance their ability to successfully innovate and translate new therapies. The perspectives of cardiac surgeons provide an intriguing portal into the challenges and opportunities for healthcare innovation in Canada. Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  20. Occupational Hazards Among Dental Surgeons In Karachi. (United States)

    Baig, Nabeel Naeem; Aleem, Sajid Atif


    To determine the frequency of different occupational hazards among dental surgeons in Karachi. Cross-sectional survey. Amulticenter study conducted at Ameen Diabetic and Dental Hospital, Dental OPD, Karachi Medical and Dental College, and Abbasi Shaheed Hospital, Karachi, from February to March 2014. Dentists, practicing in different areas of Karachi, were given a self-administered questionnaire. It comprised of a form containing information about the socio-demographic profile of dentists and questionnaires regarding occupational hazards experienced in practice. Atotal of 130 dentists, involved in clinical practice, were randomly selected. There were 45 (35%) males and 85 (65%) females. The average age was 39 ±5.76 years. Out of 130 dentists, 93.8% (122/130) had occupational hazard during practice. Cervical back pain was observed in 81.96% dentists followed by knee / elbow joint pain in 53.27%, eye infection in 44.615%, impaired hearing in 40.98%, psychological stress in 41.80% and material allergy was 12.29%. Various spinal and joint pains, eye infections, impaired hearing, stress and material allergy represented occupational hazard to 93.8% of the surveyed dentists.

  1. Assessment of patient factors, surgeons, and surgeon teams in immediate implant-based breast reconstruction outcomes. (United States)

    Gfrerer, Lisa; Mattos, David; Mastroianni, Melissa; Weng, Qing Y; Ricci, Joseph A; Heath, Martha P; Lin, Alex; Specht, Michelle C; Haynes, Alex B; Austen, William G; Liao, Eric C


    Outcome studies of immediate implant-based breast reconstruction have focused largely on patient factors, whereas the relative impact of the surgeon as a contributing variable is not known. As the procedure requires collaboration of both a surgical oncologist and a plastic surgeon, the effect of the surgeon team interaction can have a significant impact on outcome. This study examines outcomes in implant-based breast reconstruction and the association with patient characteristics, surgeon, and surgeon team familiarity. A retrospective review of 3142 consecutive implant-based breast reconstruction mastectomy procedures at one institution was performed. Infection and skin necrosis rates were measured. Predictors of outcomes were identified by unadjusted logistic regression followed by multivariate logistic regression. Surgeon teams were grouped according to number of cases performed together. Patient characteristics remain the most important predictors for outcomes in implant-based breast reconstruction, with odds ratios above those of surgeon variables. The authors observed significant differences in the rate of skin necrosis between surgical oncologists with an approximately two-fold difference between surgeons with the highest and lowest rates. Surgeon teams that worked together on fewer than 150 procedures had higher rates of infection. Patient characteristics are the most important predictors for surgical outcomes in implant-based breast reconstruction, but surgeons and surgeon teams are also important variables. High-volume surgeon teams achieve lower rates of infection. This study highlights the need to examine modifiable risk factors associated with optimum implant-based breast reconstruction outcomes, which include patient and provider characteristics and the surgical team treating the patient. Risk, III.

  2. Preventing infection in general surgery: improvements through education of surgeons by surgeons.

    LENUS (Irish Health Repository)

    McHugh, S M


    Surgical patients are at particular risk of healthcare-associated infection (HCAI) due to the presence of a surgical site leading to surgical site infection (SSI), and because of the need for intravascular access resulting in catheter-related bloodstream infection (CRBSI). A two-year initiative commenced with an initial audit of surgical practice; this was used to inform the development of a targeted educational initiative by surgeons specifically for surgical trainees. Parameters assessed during the initial audit and a further audit after the educational initiative were related to intra- and postoperative aspects of the prevention of SSIs, as well as care of peripheral venous catheters (PVCs) in surgical patients. The proportion of prophylactic antibiotics administered prior to incision across 360 operations increased from 30.0% to 59.1% (P<0.001). Surgical site dressings were observed in 234 patients, and a significant decrease was found in the percentage of dressings that were tampered with during the initial 48h after surgery (16.5% vs 6.2%, P=0.030). In total, 574 PVCs were assessed over the two-year period. Improvements were found in the proportion of unnecessary PVCs in situ (37.9% vs 24.4%, P<0.001), PVCs in situ for >72h (10.6% vs 3.1%, P<0.001) and PVCs covered with clean and intact dressings (87.3% vs 97.6%, P<0.001). Significant improvements in surgical practice were established for the prevention of SSI and CRBSI through a focused educational programme developed by and for surgeons. Potentially, other specific measures may also be warranted to achieve further improvements in infection prevention in surgical practice.

  3. Knowledge, attitudes, and practice patterns in surgical management of bicuspid aortopathy: a survey of 100 cardiac surgeons. (United States)

    Verma, Subodh; Yanagawa, Bobby; Kalra, Sameer; Ruel, Marc; Peterson, Mark D; Yamashita, Michael H; Fagan, Andrew; Currie, Maria E; White, Christopher W; Wai Sang, Stephane Leung; Rosu, Cristian; Singh, Steve; Mewhort, Holly; Gupta, Nandini; Fedak, Paul W M


    Clinical practice guidelines have been established for surgical management of the aorta in bicuspid aortic valve disease. We hypothesized that surgeons' knowledge of and attitudes toward bicuspid aortic valve aortopathy influence their surgical approaches. We surveyed cardiac surgeons to probe the knowledge of, attitudes toward, and surgical management of bicuspid aortopathy. A total of 100 Canadian adult cardiac surgeons participated. Fifty-two percent of surgeons believed that the mechanism underlying aortic dilation in those with bicuspid aortic valve was due to an inherent genetic abnormality of the aorta, whereas only 2% believed that altered valve-related processes were involved in this process. Only a minority (15%) believed that bicuspid valve leaflet fusion type is associated with a unique pattern of aortic dilatation aortic phenotype. Sixty-five percent of surgeons recommended echocardiographic screening of first-degree relatives of patients with bicuspid aortic valve. Most surgeons (61%) elected to replace the aorta when the diameter is 45 mm or greater at the time of valve surgery. Fifty-five percent of surgeons surveyed suggested that in the absence of concomitant valvular disease, they would recommend ascending aortic replacement at a threshold of 50 mm or greater. Approximately one third of surgeons suggested that they would elect to replace a mildly dilated ascending aorta (40 mm) at the time of valve surgery. The most common surgical approach (61%) for combined valve and aortic surgery was aortic valve replacement and supracoronary replacement of the ascending aorta, and only a minority suggested the use of deep hypothermic circulatory arrest and open distal anastomosis. More aggressive approaches were favored with greater surgeon experience, and when circulatory arrest was chosen, the majority (68%) suggested they would use antegrade cerebral perfusion. In the setting of aortic insufficiency and a dilated aorta, 42% of surgeons suggested that they

  4. Sexist Attitudes Among Emerging Adult Women Readers of Fifty Shades Fiction. (United States)

    Altenburger, Lauren E; Carotta, Christin L; Bonomi, Amy E; Snyder, Anastasia


    Stereotypical sexist representations of men and women in popular culture reinforce rigid views of masculinity (e.g., males as being strong, in control, masterful, and aggressive) and femininity (e.g., women as being fragile and weak, unassertive, peaceful, irrational, and driven by emotions). The present study examined associations between the fictional series Fifty Shades-one popular culture mechanism that includes pervasive traditional gender role representations-and underlying sexist beliefs among a sample of 715 women ages 18-24 years. Analyses revealed associations between Fifty Shades readership and sexism, as measured through the Ambivalent Sexism Inventory. Namely women who reported reading Fifty Shades had higher levels of ambivalent, benevolent, and hostile sexism. Further, those who interpreted Fifty Shades as "romantic" had higher levels of ambivalent and benevolent sexism. Our findings support prior empirical studies noting associations between interacting with aspects of popular culture, such as television and video games, and individual beliefs and behaviors.

  5. Transplant surgeon formation: vocation, incentives, between old and new surgeon generations. (United States)

    Iaria, G; Cardillo, A


    The training of the transplant surgeon is one of the most difficult paths in medicine. The transplant surgeon must be trained as a general and a vascular surgeon; he has to be skilled and upgraded in transplant surgical technique; he has to decide the suitability of the donor and of the organs as well as the immunosuppressive therapy for each recipient; he must know the intensive care unit, hepatology, and nephrology. The transplant surgeon has to deal with surgical, infectious, and metabolic complications after organ transplantation. Thus, clinical formation of the transplant surgeon is multifactorial and always upgraded. However, transplants never happen in the morning; retrivals are more likely to be in the night (especially the holidays ones). "Weekend" is a word not frequently used by transplant surgeons. Moreover, when the transplant procedure happens, the normal activity of the ward and of the outpatient clinic were have to be done. The transplant surgeon must have a sort of "vocation" for such a job. Organ harvesting setting is a good proof of adaptability, always during nighttime, often in small hospitals with operating room nurses unfamiliar with the procedure, sometimes waiting for some colleagues or delaying the surgery. This vocation is enhanced by enthusiasm, but incentives are necessary to feed this love. Incentives should be professional and economic; transplant surgeons should be allowed to make clinical decisions, to choose the surgical technique of transplantation, to control the decision process. Lastly, due to the "total on call," the surgeon should profit from a right salary avoiding extramural activities.

  6. Carpal tunnel syndrome - electrodiagnostic aspects of fifty seven symptomatic hands.



    Electrodiagnostic data of fifty seven symptomatic extremities with carpal tunnel syndrome (CTS) are described. Practice recommendations made by American Academy of Neurology, American Association of Electrodiagnostic Medicine and American Academy of Physical Medicine and Rehabilitation regarding electrodiagnostic studies were considered while confirming CTS diagnosis by electrodiagnostic studies. Median sensory nerve conduction studies were the commonest abnormalities noted. The median orthod...

  7. 1977 flywheel technology symposium proceedings. [Fifty-two papers

    Energy Technology Data Exchange (ETDEWEB)

    Chang, G.C.; Stone, R.G. (eds.)


    Fifty-two papers, four paper abstracts, and four brief summaries of panel discussions are presented on flywheel energy storage technology. A separate abstract was prepared for each of 41 papers for inclusion in DOE Energy Research Abstracts (ERA). Eleven papers were processed previously for inclusion in the data base. (PMA)

  8. Surgeons and non-surgeons prefer haptic feedback of instrument vibrations during robotic surgery. (United States)

    Koehn, Jacqueline K; Kuchenbecker, Katherine J


    Clinical robotic surgery systems do not currently provide haptic feedback because surgical instrument interactions are difficult to measure and display. Our laboratory recently developed a technology that allows surgeons to feel and/or hear the high-frequency vibrations of robotic instruments as they interact with patient tissue and other tools. Until now, this type of feedback had not been carefully evaluated by users. We conducted two human-subject studies to discover whether surgeons and non-surgeons value the addition of vibration feedback from surgical instruments during robotic surgery. In the first experiment, 10 surgeons and 10 non-surgeons (n = 20) used an augmented Intuitive da Vinci Standard robot to repeatedly perform up to four dry-lab tasks both with and without haptic and audio feedback. In the second experiment, 68 surgeons and 26 non-surgeons (n = 94) tested the same robot at a surgical conference: each participant spent approximately 5 min performing one or two tasks. Almost all subjects in both experiments (95 and 98 %, respectively) preferred receiving feedback of tool vibrations, and all subjects in the second experiment thought it would be useful for surgeons to have the option of such feedback. About half of the subjects (50, 60 %) preferred haptic and audio feedback together, and almost all the rest (45, 35 %) preferred haptic feedback alone. Subjects stated that the feedback made them more aware of tool contacts and did not interfere with use of the robot. There were no significant differences between the responses of different subject populations for any questions in either experiment. This study illustrates that both surgeons and non-surgeons prefer instrument vibration feedback during robotic surgery. Some participants found audio feedback useful but most preferred haptic feedback overall. This strong preference for tool vibration feedback indicates that this technology provides valuable tactile information to the surgeon.

  9. Preoperative Breast MRI: Surgeons' Patient Selection Patterns and Potential Bias in Outcomes Analyses. (United States)

    Lee, Jiyon; Tanaka, Elaine; Eby, Peter R; Zhou, Shouhao; Wei, Wei; Eppelheimer, Christine; Loving, Vilert A


    The purpose of this study is to determine which patient- and tumor-related and clinical variables influence dedicated breast surgeons' and general surgeons' referrals for preoperative breast MRI for patients with newly diagnosed breast cancer. Surgeons who perform breast surgery responded to a survey from June 16, 2014, through August 11, 2014. Participants self-identified as breast or general surgeons and provided professional practice details. They used Likert scores (range, 1-7 with increasing likelihood to order MRI) to weigh numerous patient- and tumor-related and clinical variables. Mean likelihood scores were calculated and compared using a linear mixed model. A p ≤ 0.05 was considered statistically significant. Two hundred eighty-nine surveys from 154 (53%) breast surgeons and 135 (47%) general surgeons showed an overall likelihood to refer for patients with a BRCA mutation (mean Likert score, 6.17), familial (mean Likert score, 5.33) or personal (mean Likert score, 5.10) breast cancer history, extremely dense breasts (mean Likert score, 5.30), age younger than 40 years (mean Likert score, 5.24), axillary nodal involvement (mean Likert score, 6.22), tumor that is mammographically occult (mean Likert score, 5.62) or fixed to the pectoralis (mean Likert score, 5.49), tumor that is a candidate for neoadjuvant treatment (mean Likert score, 5.38), multifocal or multicentric disease (mean Likert score, 5.22), invasive lobular carcinoma (mean Likert score, 5.20), T3 (mean Likert score, 4.48) or T2 (mean Likert score, 4.41) tumor, triple-negative breast cancer (mean Likert score, 4.66), a patient who is a candidate for mastectomy requesting breast conservation therapy (mean Likert score, 5.27), and radiologists' recommendations (mean Likert score, 5.19). Across all patient ages, breast surgeons referred more often than did general surgeons (mean Likert score, 4.32 vs 3.92; p = 0.03), especially for patients with BRCA mutation (mean Likert score, 6.39 vs 5.93; p

  10. Sarcoidosis in a dental surgeon: a case report

    Directory of Open Access Journals (Sweden)

    Mattia Daniele


    Full Text Available Abstract Introduction Although the causes of sarcoidosis are still unknown, past and current studies have provided evidence that this disease may be associated with occupational exposure to specific environmental agents. We describe a case of sarcoidosis in a dental surgeon with long exposure to inorganic dusts. To the best of our knowledge, this is the first report of this kind in the literature. Case presentation At the beginning of 2000, a 52-year-old Caucasian man, who worked as a dental surgeon, presented with shortness of breath during exercise, cough and retrosternal pain. After diagnosis of sarcoidosis, a scanning electronic microscopy with X-ray microanalysis of biopsy specimens was used in order to determine whether the disease could be traced to an occupational environmental agent. Results showed the presence of inorganic dust particles within sarcoidotic granulomas, and demonstrated that the material detected was identical to that found in a powder used by our patient for several years. Conclusions Although these results cannot be considered as definitive proof, they do however provide strong evidence that this disease may be associated with material used by dental surgeons.

  11. The orthopaedic surgeon and manufacturing industry relationship. Ethical guidelines. (United States)

    Lim, E V; Aquino, N J


    Orthopaedic surgery has progressed over the years because of innovative work of pioneering orthopaedic surgeons; new developments in internal fixation techniques and implants codeveloped with the orthopaedic manufacturing industry have improved treatment greatly. This article analyzes and reviews the relationship of orthopaedic surgeons to the orthopaedic implant industry, analyzing three broad categories of the relationship: (1) physicians receiving gifts from industry; (2) the orthopaedic industry's financial support of educational and research endeavors of academic trauma and other centers; and (3) the relationship of the industry with innovators in the field of orthopaedic surgery by retainer fees, royalties, and stock options from industry. The ethical relationship requires: (1) putting the patient's concerns first above vested interests; (2) an awareness of a potential for abuse; and (3) a level of awareness of the relationship and the ability to explain and inculcate this relationship in the teaching program of young residents to maintain the high standards that have been set.

  12. [Gastrointestinal surgeons should master the adjuvant therapy of colorectal cancer]. (United States)

    Gu, Jin; Chen, Pengju


    The diagnosis and treatment of colorectal cancer is one of the main diseases of gastrointestinal surgeons. It is very important to master the adjuvant chemotherapy of colorectal cancer for gastrointestinal surgeons. In recent years, with the development of a number of clinical trials and the appearance of new drugs, fluorouracil combined with oxaliplatin had been established as the standard regimen of adjuvant chemotherapy for colorectal cancer. In the current guidelines, stage III( colon cancer is the indication for adjuvant chemotherapy, while stage II( colon cancer should receive adjuvant chemotherapy is uncertain. Unlike colon cancer, adjuvant therapy of rectal cancer is not evidence-based. Especially, the indication and duration of adjuvant chemotherapy for rectal cancer after neoadjuvant chemoradiotherapy remain controversial. Adjuvant therapy of colorectal cancer still needs further investigation.

  13. Designing a leadership development program for surgeons. (United States)

    Jaffe, Gregory A; Pradarelli, Jason C; Lemak, Christy Harris; Mulholland, Michael W; Dimick, Justin B


    Although numerous leadership development programs (LDPs) exist in health care, no programs have been specifically designed to meet the needs of surgeons. This study aimed to elicit practicing surgeons' motivations and desired goals for leadership training to design an evidence-based LDP in surgery. At a large academic health center, we conducted semistructured interviews with 24 surgical faculty members who voluntarily applied and were selected for participation in a newly created LDP. Transcriptions of the interviews were analyzed using analyst triangulation and thematic coding to extract major themes regarding surgeons' motivations and perceived needs for leadership knowledge and skills. Themes from interview responses were then used to design the program curriculum specifically to meet the leadership needs of surgical faculty. Three major themes emerged regarding surgeons' motivations for seeking leadership training: (1) Recognizing key gaps in their formal preparation for leadership roles; (2) Exhibiting an appetite for personal self-improvement; and (3) Seeking leadership guidance for career advancement. Participants' interviews revealed four specific domains of knowledge and skills that they indicated as desired takeaways from a LDP: (1) leadership and communication; (2) team building; (3) business acumen/finance; and (4) greater understanding of the health care context. Interviews with surgical faculty members identified gaps in prior leadership training and demonstrated concrete motivations and specific goals for participating in a formal leadership program. A LDP that is specifically tailored to address the needs of surgical faculty may benefit surgeons at a personal and institutional level. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. History of the Congenital Heart Surgeons' Society. (United States)

    Mavroudis, Constantine; Williams, William G


    The Congenital Heart Surgeons' Society is a group of over 100 pediatric heart surgeons representing 72 institutions that specialize in the treatment of patients with congenital heart defects. The Society began in 1972 and incorporated as a not-for-profit charitable organization in 2004. It has become the face and voice of congenital heart surgery in North America. In 1985, the Society established a data center for multicenter clinical research studies to encourage congenital heart professionals to participate in improving outcomes for our patients. The goals of the Congenital Heart Surgeons' Society are to stimulate the study of congenital cardiac physiology, pathology, and management options which are instantiated in data collection, multi-institutional studies, and scientific meetings. Honest and open discussion of problems with possible solutions to the challenges facing congenital heart professionals have been the strength of the Congenital Heart Surgeons' Society. It is imperative for the growth of an organization to know from where it came in order to know to where it is going. The purpose of this article is to review the history of the Congenital Heart Surgeons' Society. © The Author(s) 2015.

  15. Do Surgeons Treat Their Patients Like They Would Treat Themselves?

    NARCIS (Netherlands)

    Janssen, S.J.; Teunis, T.; Guitton, T.G.; Ring, D.; Biert, J.


    BACKGROUND: There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. QUESTIONS/PURPOSES: (1) Are surgeons more likely to reco

  16. The business acumen of Canadian plastic surgeons. (United States)

    Bliss, J A; Caputy, G G


    We as plastic surgeons are engrossed and consumed by our quest to optimize patient care. In so doing, we are often distracted by that aspect of our practice which has direct bearing on patient care yet for which we are the least prepared--the business aspect. The entire population of Canadian plastic surgeons was surveyed in an effort to establish real and perceived needs of this group with respect to the business management of their practices. The survey elicited demographic information, information on business educational background, interest, and current commitment in acquiring business knowledge, and a final category of questions dealing with how well these surgeons function as business managers. Of the 315 plastic surgeons surveyed, 122 (39 percent) responded, which, in and of itself, indicates an interest in this aspect of their practices. Twelve respondents were excluded from the study for various reasons. Eighty of the 110 remaining respondents (72 percent) used a hospital-integrated facility for both emergency and elective outpatient procedures. Eighty-four of the 110 respondents (76 percent) indicated that 10 percent of their hours per week of inpatient booked operating time was canceled. Ninety-three percent of respondents felt that a business course to familiarize surgeons with common business situations and areas of personal finance would be beneficial. Few were previously educated in business, and similarly, few had great ongoing interest in business, although the majority of respondents used publications specifically dealing with financial matters (provided by the Canadian Medical Association). Twenty-three percent of respondents saw themselves in a growing role as businesspeople; 24 percent felt this dual role was enjoyable, while 29 percent felt this role was forced on them. A total of 21 percent of respondents did not see themselves as businesspeople at all. The six basic functions of a manager (planning, acquiring, organizing, actuating

  17. Work experiences, professional development and career prospects of New Zealand dental house surgeons. (United States)

    Kim, Jenny J; Antoun, Joseph S


    New dental graduates compete for house surgeon positions every year, despite little being known about the work experience gained from such posts. The main objectives of this study were to identify the nature of house surgeons' work experiences, their continued professional development (CPD) opportunities and the impact of hospital experience on their future career pathways. A questionnaire was mailed to all 31 New Zealand dental house surgeons (response rate 100%). The majority of house surgeons (77.4%) found hospital work enjoyable, with nearly all (93.5%) perceiving themselves as better clinicians from their experience. Oral surgery, restorative dentistry, special needs dentistry and removable prosthodontics were the most commonly practised areas. The average weekly number of working hours was 42.3 hours for a normal week and 61.8 hours for an on-call week. Stress levels during on-call work were significantly higher than during day-to-day hospital work (p surgeons (58.1%) planned to pursue a specialist career, with nearly 13% wishing to return to a New Zealand hospital in the future. A dental house surgeon position remains an attractive choice and offers an enjoyable experience for young graduates. Hospitals provide ample CPD opportunities and appear to play an influential role in a house surgeon's career pathway.

  18. Management of acute dento-alveolar trauma--from the viewpoint of an oral surgeon. (United States)

    Petersen, J K


    Oral and maxillofacial surgeons often deal with acute dento-alveolar trauma in hospital or practice surroundings. They are often called upon by dental colleagues to give their advice or help in a given situation of the acute trauma patient with dental or oral injuries. In this article, the practical viewpoints and clinical experiences of an oral surgeon are offered based upon many years of work in hospital emergency rooms around the world.

  19. Evolution of the management of ranulas: change in a single surgeon's practice 2001-14. (United States)

    Hills, A; Holden, A; McGurk, M


    Excision of the sublingual gland is the traditional cure for ranulas, but is invasive with considerable morbidity. We report techniques that have been developed to minimise this by targeting their specific pathophysiology, which include an intraoral approach to plunging ranulas, and gland-preserving selective excision with a highly conservative suture technique for simple ranulas. Fifty-four ranulas in 53 (20 male and 33 female, mean age 29 (range 7-57) years) consecutive patients were treated by a single surgeon between 2001-14 and their records reviewed retrospectively. Their personal details, operations, types of ranula, and outcomes were recorded. Follow up was for a minimum of six months without recurrent disease before discharge. Of the 54 ranulas treated, 26 had standard traditional sublingual gland excision (17 simple and 9 plunging), nine simple ranulas were selectively excised, 10 were treated with the new suture technique, and nine plunging ranulas were aspirated, after which they were ligated and the sublingual gland excised. Two of the 10 treated by the new suture technique had residual ranulas. The procedure was repeated in both cases, and one had a small residual ranula for which further intervention was declined. One complication developed after excision of a plunging ranula using the traditional intraoral and extraoral approaches, and two developed after aspiration of the sac, ligation, and excision of the gland. Traditional excision of simple ranulas was followed by three complications, but none were reported after simple ranulas had been treated with selective excision or suture. Minimally invasive techniques offer cure, with a lower risk of morbidity.

  20. How helpful is capsule endoscopy to surgeons?

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Bulent Sivri; Yusuf Bayraktar


    Capsule endoscopy is a new technology that, for the first time, allows complete, non-invasive endoscopic imaging of the small bowel. The efficacy of capsule endoscopy in the diagnosis of suspected small bowel diseases has been established. Important applications for surgeons include observations of obscure gastrointestinal bleeding and small bowel neoplasms.

  1. Contemporary social media engagement by breast surgeons. (United States)

    Ekatah, Gregory E; Walker, Stephanie G; McDonald, James J; Dixon, J Michael; Brady, Richard R W


    There continues to be a steady rise in the use of social media among healthcare professionals. We present an overview of social media use among breast surgeons within the United Kingdom including demographic variations and some of the factors that underpin these trends. The benefits and drawbacks of open social media platforms are also considered.

  2. Has medical history importance for surgeons? (United States)

    Wangensteen, O W


    Surgeons will do well to remember that the two most important contributions to the growth and extension of surgery came from two disciplines, not then regarded as the most innovative. Anesthesia came from dentistry, the work primarily of W.T.G. Morton of Boston; prophylactic surgical antisepsis originated with the obstetrician Semmelweis, who developed a scheme of prophylactic chemical antisepsis that still remains the core of surgical antisepsis. In the mid 1880's, largely as a result of the work of Chamberland and others of the Pasteur school, surgeons in France and Germany substituted thermal for chemical antisepsis, whenever applicable. Whereas Lister's influence was tremendous in fostering acceptance of antisepsis by surgeons, by the end of his professorial career he had begun his capitulation to prophylactic antisepsis, which was complete by 1896 to the very practices that Semmelweis had proved the value of almost five decades previously. These were 19th century innovations. The greatest boon to surgery's advance in this century has been control of cellulitic infections through chemotherapeutic agencies, the sulfonamides and antibiotics. The tremendous upsurge of interest in research at the end of World War II brought surgeons to a fuller realization of the significant part they could play in the advance of their discipline. Intimate alignment of surgeons with physiologists of the circulation begot intracardiac surgery, a significant innovation with consequences of tremendous import for greater medicine's advance. Today, surgeons attacking the problem of tissue transplantation are aligning themselves with biochemists, geneticists, immunologists, experimental pathologists, and pharmacologists in their broad approach to the phenomenon of allograft rejection. The great extension of vascular surgery since World War II has made jewelers of surgeons of small tubular structures. The technical phases of these demanding operative procedures have largely been overcome

  3. An internist's role in perioperative medicine: a survey of surgeons' opinions (United States)

    PausJenssen, Lisa; Ward, Heather A; Card, Sharon E


    Background Literature exists regarding the perioperative role of internists. Internists rely on this literature assuming it meets the needs of surgeons without actually knowing their perspective. We sought to understand why surgeons ask for preoperative consultations and their view on the internist's role in perioperative medicine. Methods Survey of surgeons in Saskatoon, Saskatchewan, Canada regarding an internist's potential role in perioperative care. Results Fifty-nine percent responded. The majority request a preoperative consultation for a difficult case (83%) or specific problem (81%). While almost half feel that a preoperative consultation is to "clear" a patient for surgery, 33% disagree with this statement. The majority believe the internist should discuss risk with the patient. Aspects of the preoperative consultation deemed most important are cardiac medication optimization (93%), cardiac risk stratification (83%), addition of β-blockers (76%), and diabetes management (74%). Conclusion Surgeons perceive the most important roles for the internist as cardiac risk stratification and medication management. Areas of controversy identified amongst the surgeons included who should inform the patient of their operative risk, and whether the internist should follow the patient daily postoperatively. Unclear expectations have the potential to impact on patient safety and informed consent unless acknowledged and acted on by all. We recommend that internists performing perioperative consults communicate directly with the consulting physician to ensure that all parties are in accordance as to each others duties. We also recommend that the teaching of perioperative consults emphasizes the interdisciplinary communication needed to ensure that patient needs are not neglected when one specialty assumes the other will perform a function. PMID:18208614

  4. Differences between endocrinologists and endocrine surgeons in management of the solitary thyroid nodule

    DEFF Research Database (Denmark)

    Walsh, John P; Ryan, Simon A; Lisewski, Dean


    BACKGROUND: It is not known whether management of the solitary thyroid nodule differs between endocrinologists and endocrine surgeons. METHODS: A questionnaire containing a hypothetical case (a 42-year-old euthyroid woman with a 2-x-3-cm solitary thyroid nodule) and 13 clinical variations was sent...... to endocrinologists and endocrine surgeons in Australia. RESULTS: The response rate was 51%, including 122 endocrinologists and 48 endocrine surgeons. For the index case, serum thyroid-stimulating hormone (TSH), fine needle aspiration biopsy (FNAB) and ultrasonography were widely used by both groups, but thyroid...... Thyroid Association members (predominantly endocrinologists) demonstrated considerable international differences in management. CONCLUSION: There are clinically significant differences between Australian endocrinologists and endocrine surgeons in management of the solitary thyroid nodule...

  5. Mathematical card magic fifty-two new effects

    CERN Document Server

    Mulcahy, Colm


    Mathematical card effects offer both beginning and experienced magicians an opportunity to entertain with a minimum of props. Featuring mostly original creations, Mathematical Card Magic: Fifty-Two New Effects presents an entertaining look at new mathematically based card tricks. Each chapter contains four card effects, generally starting with simple applications of a particular mathematical principle and ending with more complex ones. Practice a handful of the introductory effects and, in no time, you'll establish your reputation as a ""mathemagician."" Delve a little deeper into each chapter

  6. HIV/AIDS: occupational risk, attitude and behaviour of surgeons in southeast Nigeria. (United States)

    Obi, S N; Waboso, P; Ozumba, B C


    Our objective was to evaluate the level of occupational risk, attitude and behaviour of surgeons towards HIV-infected patients. A questionnaire survey of 264 randomly selected surgeons in training or in practice in five different health institutions in southeast Nigeria within a five-month period was carried out. A 94% response rate was obtained with completed questionnaires from 264 surgeons. The respondents included obstetricians and gynaecologists (n = 78), general surgeons (n = 121), orthopaedic surgeons (n = 40), dental surgeons (n = 10), ophthalmologists (n = 6), urologists (n = 5), and ear, nose and throat surgeons (n = 4). Of them, 31% (n = 82) were qualified surgeons in practice, while the remaining 69% (n = 182) were resident surgeons in training. In the past five years, 40.2% (n = 106) and 26% (n = 70) of the respondents reported needle-stick injuries and blood splash, respectively, during surgery. The majority of the victims were resident surgeons, obstetricians and gynaecologists, and orthopaedic surgeons. Level of clinical experience and high patient blood loss are likely to contribute to this observation. In all, 89% (n = 236) were engaged in the risky practice of operating on patients with open wounds in their hand and the wounds were contaminated with blood in 5% of cases. During surgical procedures, all (100%) respondents wore protective apron, 65.2% (n = 172) wore double gloves and 30.3% (n = 80) used protective goggles. The use of double gloves and protective eye wear increased remarkably over the past decade, probably because the fear of occupational transmission of HIV was substantial. In total, 83% (n = 220) of the respondents had some reservations about treating patients infected with HIV, while 13.3% (n = 35) viewed them with fear. The remaining 3.4% (n = 9) had a more positive attitude towards HIV-infected patients. Further, 92% advocated preoperative screening, with special precaution during surgery, if the results are positive. In

  7. Smart apps for the smart plastic surgeon

    Directory of Open Access Journals (Sweden)

    Aniketh Venkataram


    Full Text Available Smartphones have the ability to benefit plastic surgeons in all aspects of patient care and education. With the sheer number of applications available and more being created everyday, it is easy to miss out on apps which could be of great relevance. Moreover, the range of android applications available has not been extensively discussed in the literature. To this end, we have compiled an exhaustive list of android smartphone applications, which we feel can help our day to day functioning. The apps have been extensively reviewed and neatly described along with all their potential uses. In addition, we have made an effort to highlight ′non-medical′ or efficiency apps which can improve departmental functioning. These apps have not been described in prior articles, and their functionality might not be known to all. We believe that the technology savvy plastic surgeon can make maximum use of these apps to his benefit.

  8. Professionalism and Commercialism on Cosmetic Surgeons' Websites. (United States)

    Park, Sung-Yeon; Park, SangHee


    This study analyzed the homepages of 250 cosmetic surgeons' websites by focusing on the representation of cosmetic surgery providers, cosmetic surgery recipients, and cosmetic surgery practice itself. Based on a literature review, some common elements of the webpages were preidentified as the indicators of professionalism or commercialism. Subsequently, each homepage was scrutinized for their presence and salience. Overall, cosmetic surgeons' websites were high in professionalism and low in commercialism in their representation of the service providers. In depicting the recipients, the websites were moderate in both professionalism and commercialism. The representation of practice was low in professionalism and moderate in commercialism. Implications of these findings for doctors, regulators, and consumer advocates are discussed and directions for future research are proposed.

  9. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

    Amirian, Ilda; Andersen, Lærke T; Rosenberg, Jacob


    BACKGROUND: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts. METHODS: Surgeons were monitored...... prospectively for 4 days: pre call, on call, post call day 1 (PC1), and post call day 2 (PC2). The urinary metabolite of melatonin and cortisol in saliva were measured to assess the circadian rhythm. Sleep and activity were measured by actigraphy. Subjective measures were assessed by the Karolinska Sleepiness...... Scale and Visual Analog Scale of fatigue, general well-being, and sleep quality. RESULTS: For both metabolite of melatonin and cortisol, a significant difference (P sleep time during the day on call...

  10. Ethics and the facial plastic surgeon. (United States)

    Sethi, Neeraj


    The facial plastic surgeon potentially has a conflict of interest when confronted with the patients requesting surgery, due to the personal gain attainable by agreeing to perform surgery. The aim of this review is to discuss the potential harm the surgeon can inflict by carrying out facial plastic surgery, beyond the standard surgical complications of infection or bleeding. It will discuss the desire for self-improvement and perfection and increase in the prevalence facial plastic surgery. We address the principles of informed consent, beneficence and non-maleficence, as well as justice and equality and how the clinician who undertakes facial plastic surgery is at risk of breaching these principles without due care and diligence.

  11. Students to Surgeons: Increasing Matriculation in Surgical Specialties. (United States)

    Grover, Karan; Agarwal, Prateek; Agarwal, Nitin; Tabakin, Marcia D; Swan, Kenneth G


    Introduction Our nation suffers from a shortage in surgeons. This deficiency must be addressed at the medical student level. Increasing faculty and resident interaction with junior students augments surgical interest. Our surgical interest group has recently redefined its role to address these concerns. Methods A multifocal approach has been implemented to increase interest in the surgical specialties. Each academic year, senior students recruit first and second year students to our group to establish early exposure. Members receive didactic presentations from surgical faculty, addressing various topics, on a biweekly basis. In addition, scrubbing, knot-tying, and suturing workshops address technical skills throughout the semester. Membership and match data were collated and analyzed. Results Over the past 5 years, the enrollment in the student interest group increased significantly from 112 to 150. Accordingly, we have observed a parallel increase in the number of students who have successfully matched into surgical residencies. A record number of students (37) from the class of 2013 matched into surgical specialties, representing an 85% increase over the last decade. After creating bylaws and electing societal officers, the group has been recognized by the school's Student Council and given financial support. At present, the group is fiscally solvent with support from the institution, surgery department, and faculty. Conclusion As the demand for surgeons increases so too does the need to increase student interest in surgery. Our school has been successful because of our surgical interest group, and we encourage other schools to adopt a similar approach. © The Author(s) 2016.

  12. Hip resurfacing: a large, US single-surgeon series. (United States)

    Brooks, P J


    Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system.

  13. Think small: nanotechnology for plastic surgeons. (United States)

    Nasir, Amir R; Brenner, Sara A


    The purpose of this article is to introduce the topic of nanotechnology to plastic surgeons and to discuss its relevance to medicine in general and plastic surgery in particular. Nanotechnology will be defined, and some important historical milestones discussed. Common applications of nanotechnology in various medical and surgical subspecialties will be reviewed. Future applications of nanotechnology to plastic surgery will be examined. Finally, the critical field of nanotoxicology and the safe use of nanotechnology in medicine and plastic surgery will be addressed.

  14. Eulogy John Ludbrook: surgeon, physiologist and biostatistician. (United States)

    Evans, Roger G; Johnston, Colin I


    On the morning of Friday June 9, Professor John Ludbrook died peacefully in his sleep at the age of 87. John will be deeply missed by his family, friends and colleagues. John Ludbrook had a long and distinguished career as a teacher, educator, surgeon, physiologist and lastly as a statistician. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. Emergency neurosurgery in Darwin: still the generalist surgeons' responsibility. (United States)

    Luck, Tara; Treacy, Peter John; Mathieson, Matthew; Sandilands, Jessica; Weidlich, Stephanie; Read, David


    Royal Darwin Hospital (RDH) is the only major hospital for the 'Top End' of Northern Territory and Western Australia. As retrieval distances exceed 2600 km, resident generalist surgeons undertake all emergency neurosurgery. Retrospective clinical study from RDH records and review of prospectively collected datasets from RDH Intensive Care Unit and National Critical Care Trauma Response Centre for all emergency neurosurgery patients between 2008 and 2013. Data were obtained from 161 patients with 167 admissions (73% male, 39% indigenous) who underwent 195 procedures (33 per year), including burr hole, craniotomy, cerebral and posterior fossa craniectomy, elevation fracture and ventricular drain. Trauma accounted for 68%, with alcohol as a known factor in 57%. Subdural haematoma (SDH) accounted for 53%. Severity of head injury at presentation correlated with outcome (R(2) = 0.12, P 24 h (P = 0.023) and specific diagnoses of acute SDH (P = 0.006), acute-on-chronic SDH (P = 0.053) and infection (P = 0.052). Indigenous patients were younger (40 versus 55 years, P < 0.001) and more likely to have alcohol as a factor in trauma cases (71% versus 49%, P = 0.027). Time from injury to hospital was high for accidents at a remote location (12.9 versus 1.3 h, P < 0.001); however, Glasgow Outcome Scales (P = 0.13) were no different to accident at metropolitan Darwin. General surgeons at RDH perform a wide range of emergency neurosurgical procedures primarily for trauma. Factors contributing to poor outcomes included remote location of trauma and delay in reaching the hospital. Outcomes at 3 months appear acceptable. © 2015 Royal Australasian College of Surgeons.

  16. Plaster of Paris: the orthopaedic surgeon heritage. (United States)

    Hernigou, Philippe


    Plastering is one of the most ancient of the building handicrafts. Plaster is the common name for calcium sulphate hemi hydrate made by heating the mineral gypsum, the common name for sulphate of lime. In the tenth century the Arabs used liquid plaster in orthopaedic treatment. At the beginning of the nineteenth century, patients with fractures of the lower extremities-and often of the upper extremities as well-were treated in bed with restriction of all activity for many weeks until the fractures united. It was the practice of surgeons to dress wounds and fractures at frequent intervals. The bandages, pads, and splints were removed, the fractures manipulated, and the dressings reapplied. The search for simpler, less cumbersome methods of treatment led to the development of occlusive dressings, stiffened at first with starch and later with plaster of Paris. The ambulatory treatment of fractures was the direct result of these innovations. Two military surgeons, Antonius Mathijsen of the Netherlands, and Nikolai Ivanovitch Pirogov of Russia, were responsible for the introduction of the new plaster bandage technique. At the beginning of the twentieth century the technique was improved by Jean-François Calot, a French surgeon, who invented the hand manufacture of plaster bandage as a roll. During the twentieth century, walking cast and ambulation for fresh fractures were developed with plaster and pin incorporated in plaster; the open fracture care concept was introduced with plaster of Paris by Trueta before the external fixation.

  17. Motivado por cirujanos Motivated by Surgeons

    Directory of Open Access Journals (Sweden)

    Carlos Salazar-Vargas


    interrogate and to examine those individuals, and every gesture, every question, every maneuver they did, was jealously kept in our minds. However even at an early stage, we clearly perceived, the differences between medical branches and practitioners, and involuntarily, every one was leaning towards this or that specialty. It was during those years when 7 wonderful persons and excellent surgeons, crossed the path of my life, inspiring me to follow their steps and to embrace a surgical career. Two were classic academicians, Dr. Manuel Aguilar Bonilla and Dr. Andres Vesalio Guzman Calleja, 3 were determined, tireless and highly skilled, Dr. Longino Soto Pacheco, Dr. Claudio Orlich Carranza, y el Dr. Carlos Prada Diaz, and 2 were, although well prepared, unassuming, practical and openly friendly, Dr. Fernando Valverde Soley y el Dr. Randall Ferris Iglesias....

  18. Choosing a Breast Reconstruction Surgeon and Questions to Ask (United States)

    ... Reconstruction Surgery Questions to Ask Your Surgeon About Breast Reconstruction If you’ve had surgery to treat your ... reconstruction. Finding the right plastic surgeon for your breast reconstruction If you decide to have breast reconstruction, you’ ...

  19. Surgeon-industry conflict of interest: survey of North Americans' opinions regarding surgeons consulting with industry. (United States)

    DiPaola, Christian P; Dea, Nicolas; Noonan, Vanessa K; Bailey, Christopher S; Dvorak, Marcel F S; Fisher, Charles G


    Surgeon-industry conflict of interest (COI) has become a source of considerable interest. Professional medical societies, industry, and policy makers have attempted to regulate potential COI without consideration for public opinion. The objective of this study was to report on the opinions of individuals representing the general public regarding surgeon-industry consulting relationships. Web-based survey. Survey was administered using a "spine Web site," and opinions are collected on surgeon-industry consulting and regulation. Associations among responses to similar questions were assessed to ensure validity and subgroup analysis performed for respondent age, sex, education, insurance, employment, and patient status. Six hundred ten of 642 surveys had complete data. The sample population comprised more females and was older and more educated than the American population. About 80% of respondents felt it was ethical and either beneficial or of no influence to the quality of health care if surgeons were consultants for surgical device companies. Most felt disclosure of an industry relationship was important and paying surgeons royalties for devices, other than those they directly implant, would not affect quality of care. Respondents support multidisciplinary surgeon-industry COI regulation and trust doctors and their professional societies to head this effort. Despite the known potential negative impact of surgeon-industry COI on patient care, this study revealed that this does not seem to be reflected in the opinion of the general public. The respondents felt that disclosure is deemed one of the most important means of self-regulation and COI management, which is in agreement with current trends of most spine societies and journals that are increasing the stringency of disclosure policies. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Chronic stress and coping among cardiac surgeons: a single center study

    Directory of Open Access Journals (Sweden)

    Kyriakos Spiliopoulos


    Full Text Available Introduction: Cardiac surgeons stress may impair their quality of life and professional practice. Objective: To assess perceived chronic stress and coping strategies among cardiac surgeons. Methods: Twenty-two cardiac surgeons answered two self-assessment questionnaires, the Trier Inventory for Chronic Stress and the German SGV for coping strategies. Results: Participants mean age was 40±14.1 years and 13 were male; eight were senior physicians and 14 were residents. Mean values for the Trier Inventory for Chronic Stress were within the normal range. Unexperienced physicians had significantly higher levels of dissatisfaction at work, lack of social recognition, and isolation (P<0.05. Coping strategies such as play down, distraction from situation, and substitutional satisfaction were also significantly more frequent among unexperienced surgeons. "Negative" stress-coping strategies occur more often in experienced than in younger colleagues (P=0.029. Female surgeons felt more exposed to overwork (P=0.04 and social stress (P=0.03. Conclusion: Cardiac surgeons show a tendency to high perception of chronic stress phenomena and vulnerability for negative coping strategies.

  1. Worth the "Likes"? The Use of Facebook among Plastic Surgeons and Its Perceived Impact. (United States)

    Chang, Jessica B; Woo, Shoshana L; Cederna, Paul S


    Facebook is the leading online media platform used by plastic surgeons. This study examined Facebook use among plastic surgeons and its perceived impact. A survey on Facebook use was distributed to two groups of plastic surgeons: 500 with professional Facebook pages and 500 without Facebook pages. Responses were stripped of identifying information and analyzed for statistical significance (p exposure (67 percent). Many surgeons (15 to 36 percent) did not follow the direct impact of Facebook on their practices. Some reported that Facebook was responsible for only one to 50 professional Web site hits and less than 5 percent of their new patient referrals in the past year. Estimated conversion-to-surgery rates were highly variable for Facebook users and nonusers. Most Facebook nonusers (67 percent) expected a "neutral" impact, expressing more concerns about unsolicited advertising (51 percent) and wasting time (47 percent). Plastic surgeons tend to perceive Facebook's impact on their practices as positive, but most do not track its direct effects on professional Web site hits, new referrals, or conversion-to-surgery rates. Plastic surgeons using Facebook are encouraged to monitor these parameters to determine whether its continued use is actually worthwhile.

  2. Breast conserving surgery versus mastectomy: cancer practice by general surgeons in Iran

    Directory of Open Access Journals (Sweden)

    Hashemi Esmat


    Full Text Available Abstract Background There appear to be geographical differences in decisions to perform mastectomy or breast conserving surgery for early-stage breast cancer. This study was carried out to evaluate general surgeons' preferences in breast cancer surgery and to assess the factors predicting cancer practice in Iran. Methods A structured questionnaire was mailed to 235 general surgeons chosen from the address list of the Iranian Medical Council. The questionnaire elicited information about the general surgeons' characteristics and about their work experience, posts they have held, number of breast cancer operations performed per year, preferences for mastectomy or breast conserving surgery, and the reasons for these preferences. Results In all, 83 surgeons returned the completed questionnaire. The results indicated that only 19% of the surgeons routinely performed breast conserving surgery (BCS and this was significantly associated with their breast cancer case load (P Conclusion The findings indicate that Iranian surgeons do not routinely perform BCS as the first and the best treatment modality. Further research is recommended to evaluate patients' outcomes after BCS treatment in Iran, with regard to available radiotherapy facilities and cultural factors (patients' compliance.

  3. Surgeons' work engagement: influencing factors and relations to job and life satisfaction. (United States)

    Mache, Stefanie; Vitzthum, Karin; Klapp, Burghard F; Danzer, Gerhard


    Work engagement has become a topic of great interest in recent years. However, clinicians' work engagement has rarely been studied and relatively little is known about its predictors and consequences. Therefore the objective of this cross-sectional questionnaire study was to test a model of possible institutional and personal predictors and significant relations to job and life satisfaction. 123 clinicians specializing in Surgery Medicine participated in the study. Self-administered questionnaires, including the Copenhagen Psychosocial Questionnaire, the Utrecht Work Engagement Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism, were administered. Bivariate analyses and a stepwise regression analysis were performed. The whole sample of surgeons rated work engagement with a high mean of M = 4.38; SD = .91. Job satisfaction and perceived quality of life have been rated with moderate scores. The results show that job resources have a greater impact on surgeons' work engagement than their job demands. Significant correlations between surgeons' work engagement, their job satisfaction and quality of life were found. Moreover, work engagement mediated the relation between institutional factors and surgeons' job satisfaction. Our research suggests that strengthening surgeons' work engagement will contribute to a more sustainable workplace, in terms of both individual and hospital performance. Therefore, increasing work engagement among surgeons should be of concern for supervisors and hospital managers. Future research should focus on further predictors that may have an influence on health professionals' work engagement. Another field for future research is to study potential effects of interventions on work engagement. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  4. Career and lifestyle satisfaction among surgeons: what really matters? The National Lifestyles in Surgery Today Survey. (United States)

    Troppmann, Kathrin M; Palis, Bryan E; Goodnight, James E; Ho, Hung S; Troppmann, Christoph


    Optimizing recruitment of the next surgical generation is paramount. Unfortunately, many nonsurgeons perceive surgeons' lifestyle as undesirable. It is unknown, however, whether the surgeons-important opinion makers about their profession-are indeed dissatisfied. We analyzed responses to a survey mailed to all surgeons who were certified by the American Board of Surgery in 1988, 1992, 1996, 2000, and 2004. We performed multivariate analyses to study career dissatisfaction and inability to achieve work-life balance, while adjusting for practice characteristics, demographics, and satisfaction with reimbursement. A total of 895 (25.5%) surgeons responded: mean age was 46 years; 80% were men; 88% were married; 86% had children; 45% were general surgeons; 72% were in urban practice; and 83% were in nonuniversity practice. Surgeons worked 64 hours per week; ideally, they would prefer to work 50 hours per week (median). Fifteen percent were dissatisfied with their careers. On multivariate analysis, significant (p career to their own children. On multivariate analysis, significant risk factors were nonuniversity practice (OR 2.5) and dissatisfaction with reimbursement (OR 3.4). In all, 33.5% did not achieve work-life balance. On multivariate analysis, dissatisfaction with reimbursement (OR 3.0) was a significant risk factor. Respondents' lives could be improved by "limiting emergency call" (77%), "diminishing litigation" (92%), and "improving reimbursement" (94%). Most surgeons are satisfied with their careers. Areas in need of improvement, particularly for nonuniversity surgeons, include reimbursement, work hours, and litigation. Strong local and national advocacy may not only improve career satisfaction, but could also render the profession more attractive for those contemplating a surgical career.

  5. [Abdominal compartment syndrome: survey on the awareness of Portuguese general surgeons]. (United States)

    Costa, Sílvia; Gomes, Aline; Graça, Susana; Ferreira, António; Fernandes, Gonçalo; Esteves, Joana; Costa, Alexandre; Fernandes, Paula; Castelões, Paula; Maciel, Jorge


    The Abdominal Compartment Syndrome (ACS) is a clinical entity recognized for over a century, but only recently its risk criteria, monitorization and treatment have been defined by the World Society of the Abdominal Compartment Syndrome (WSACS). The general surgeon's involvement is vital since this syndrome is common in surgical patients and because its treatment may culminate in a laparostomy. 250 questionnaires of 17 questions were distributed among general surgeons attending the XXVIII Portuguese Congress of Surgery. The data were analyzed using SPSS® v16. We received 36,4% (91) of the delivered questionnaires, most of which from male surgeons (63,7%), from central hospitals (75,8%), working 42 h per week (70.3%), whose average of age was 38 years. About half of the respondents received training in Intensive Care Units. All surgeons had already heard about measuring the Intra- abdominal Pressure (IAP), which was being performed at 89% of their hospitals. About 40% of surgeons only admitted intra-abdominal hypertension above 20 mmHg (only 22% indicated the correct value of 12 mmHg). 36,3% of surgeons suggested that a decompressive laparostomy must be carried out for primary ACS if IAP greater then 20 mmHg with new organ failure; 36.3% favoured the "Vacuum-pack"-like system, and 56% only re-operate the patients "as needed". 48,4% of surgeons had already performed decompressive laparostomy, 66% of which had residence training in a ICU (p = 0,005). Respondents also pointed an average mortality related to ACS of 81% without laparostomy, and a reduction to 38,5% after performing that procedure. Only 26% of the surgeons were aware of the WSACS consensus definitions and recommendations, of those, 83% had already performed a laparostomy (Pdivulgation.

  6. From 2000 Bush-Gore to 2006 Italian elections: Voting at fifty-fifty and the Contrarian Effect

    CERN Document Server

    Galam, S


    A sociophysical model for opinion dynamics is shown to embody a series of recent western hung national votes all set at the unexpected and very improbable edge of a fifty-fifty score. It started with the Bush-Gore 2000 American presidential election, followed by the 2002 Stoiber-Schr\\H{o}der, then the 2005 Schr\\H{o}der-Merkel German elections, and finally the 2006 Prodi-Berlusconi Italian elections. In each case, the country was facing drastic choices, the running competing parties were advocating very different programs and millions of voters were involved. Moreover, polls were given a substantial margin for the predicted winner. While all these events were perceived as accidental and isolated, our model suggests that indeed they are deterministic and obey to one single universal phenomena associated to the effect of contrarian behavior on the dynamics of opinion forming. The not hung Bush-Kerry 2005 presidential election is shown to belong to the same universal frame. To conclude, the existence of contraria...

  7. 21 CFR 878.4470 - Surgeon's gloving cream. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgeon's gloving cream. 878.4470 Section 878.4470...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4470 Surgeon's gloving cream. (a) Identification. Surgeon's gloving cream is an ointment intended to be used to lubricate the...

  8. Surgeons' Knowledge and Practices Regarding the Role of Radiation Therapy in Breast Cancer Management

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jessica [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Hawley, Sarah T.; Zikmund-Fisher, Brian J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Janz, Nancy K. [Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan (United States); Sabel, Michael S. [Department of Surgery, University of Michigan, Ann Arbor, Michigan (United States); Katz, Steven J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Jagsi, Reshma, E-mail: [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)


    Purpose: Population-based studies suggest underuse of radiation therapy, especially after mastectomy. Because radiation oncology is a referral-based specialty, knowledge and attitudes of upstream providers, specifically surgeons, may influence patients' decisions regarding radiation, including whether it is even considered. Therefore, we sought to evaluate surgeons' knowledge of pertinent risk information, their patterns of referral, and the correlates of surgeon knowledge and referral in specific breast cancer scenarios. Methods and Materials: We surveyed a national sample of 750 surgeons, with a 67% response rate. We analyzed responses from those who had seen at least 1 breast cancer patient in the past year (n=403), using logistic regression models to identify correlates of knowledge and appropriate referral. Results: Overall, 87% of respondents were general surgeons, and 64% saw >10 breast cancer patients in the previous year. In a scenario involving a 45-year-old undergoing lumpectomy, only 45% correctly estimated the risk of locoregional recurrence without radiation therapy, but 97% would refer to radiation oncology. In a patient with 2 of 20 nodes involved after mastectomy, 30% would neither refer to radiation oncology nor provide accurate information to make radiation decisions. In a patient with 4 of 20 nodes involved after mastectomy, 9% would not refer to radiation oncology. Fewer than half knew that the Oxford meta-analysis revealed a survival benefit from radiation therapy after lumpectomy (45%) or mastectomy (32%). Only 16% passed a 7-item knowledge test; female and more-experienced surgeons were more likely to pass. Factors significantly associated with appropriate referral to radiation oncology included breast cancer volume, tumor board participation, and knowledge. Conclusions: Many surgeons have inadequate knowledge regarding the role of radiation in breast cancer management, especially after mastectomy. Targeted educational

  9. Arthur Rainsford Mowlem (1902-1986), plastic surgeon. (United States)

    Griffiths, Richard W


    Arthur Rainsford Mowlem, the junior of the 'big four' plastic surgeons, with Harold Delf Gillies, Thomas Pomfret Kilner and Archibald Hector McIndoe, came to prominence managing casualties of the Second World War. Rainsford Mowlem's ancestor was John Mowlem, the creator of the construction firm. Rainsford worked his passage to the United Kingdom from New Zealand in 1927 and did not return to New Zealand but retired at the age of 60 to enjoy 23 more years in Spain. He was the driving force between 1934 and 1939 at the Plastic Surgery Unit at St James's Hospital, Balham, and instigated the North London Plastic Surgery Unit at Hill End, St Albans, from 1939 to 1953 and subsequently developed the Unit after moving to Mount Vernon Hospital, Northwood, Middlesex. After successfully hosting the International Meeting of Plastic Surgeons in London in 1959, he received recognition and honours in America but soon afterwards he surprised colleagues by retiring in 1962. Despite his significant contributions, he did not receive national honours but his life outside surgery was active including Trusteeship of the Mowlem Estate at Swanage in Dorset for 40 years.

  10. Carpal tunnel syndrome - electrodiagnostic aspects of fifty seven symptomatic hands.

    Directory of Open Access Journals (Sweden)

    Murthy J


    Full Text Available Electrodiagnostic data of fifty seven symptomatic extremities with carpal tunnel syndrome (CTS are described. Practice recommendations made by American Academy of Neurology, American Association of Electrodiagnostic Medicine and American Academy of Physical Medicine and Rehabilitation regarding electrodiagnostic studies were considered while confirming CTS diagnosis by electrodiagnostic studies. Median sensory nerve conduction studies were the commonest abnormalities noted. The median orthodromic sensory latencies were prolonged in 86% and sensory nerve action potential amplitude abnormalities were seen in 82%. Prolongation of the conduction in the short segment across the wrist in the median nerve was seen in 96.5% and the difference in the conduction between median and ulnar nerve across the wrist was significant in all the 57 extremities. The median motor latencies were prolonged in 67% of hands. Higher incidence of electrodiagnostic abnormalities observed in this study might be due to inclusion of patients with severe disease.

  11. The decision book fifty models for strategic thinking

    CERN Document Server

    Krogerus, Mikael


    Most of us face the same questions every day: What do I want? And how can I get it? How can I live more happily and work more efficiently? A worldwide bestseller, The Decision Book distils into a single volume the fifty best decision-making models used on MBA courses and elsewhere that will help you tackle these important questions - from the well known (the Eisenhower matrix for time management) to the less familiar but equally useful (the Swiss Cheese model). It will even show you how to remember everything you will have learned by the end of it. Stylish and compact, this little black book is a powerful asset. Whether you need to plot a presentation, assess someone's business idea or get to know yourself better, this unique guide will help you simplify any problem and take steps towards the right decision.


    Directory of Open Access Journals (Sweden)

    Raquel Sánchez Ruiz


    Full Text Available The popularity of Fifty Shades of Grey trilogy is beyond doubt. This great impact has also been reflected on academic literature dealing with the novel from different perspectives. However, while there is substantial research on the novels, little attention has been paid to the author's usage of language. Bearing in mind that erotic stories are a common euphemistic and dysphemistic ground, the aim of this paper is to explore euphemism, dysphemism and x-phemism (quasieuphemism and quasidysphemism in a corpus which consists of the three books of the mentioned trilogy so as to observe if the use of these devices depends on sexes and how these phenomena merge with metaphorical or metonymical devices to avoid a possible loss of face or highlight a taboo. The conclusions will show that the male and female main characters in the novels use language differently and employ these verbal devices with several intentions.


    Institute of Scientific and Technical Information of China (English)



    Objective: To observe the clinical effect of Fifty-ying acupuncture therapy for treatment of chronic bronchitis, and to explore its underlying mechanisms. Methods: A total of 36 out- and in-patients with chronic bronchitis including 10 cases of asthma were subjected into this study. Among them, 20 cases were qi-deficiency type and 16 qi-yin-deficiency with phlegm-clamp type. The changes of symptoms, T-lymphocyte subgroups of CD3+, CD4+, CD8+,CD4+/CD8+, soluble interleuki-2 receptor ( SIL-2R), interleukin-6(IL-6), IgG, IgA and IgM before and after treatment were observed and detected using monoclonal indirect fluorescence method, enzyme linked immunosorbent assay (ELISA) and nephelometry respectively. Results: (1)The effective rate of qi-dificiency type was 100% and that of qi-yin-deficiency with phlegm-damp type 87.5%. (2) After acupuncture treatment, in qi-deficiency type patients, serum IgG, IgA and IgM contents increased significantly (P< 0. 001) in comparison with pre-treatment and in qi-yin-deficiency with phlegm-damp type patients, IgG level lowered obviously. Serum SIL-2R and CD4+/CD8+ decreased obviously(P<0.01, 0.001), CD3+, CD4+ and CD8+ increased evidently (P<0.01). Conclusion: The Fifty-ying acupuncture therapy can better clinical symptoms of chronic bronchitis patients through its resultant up-regulation of the immune system function.

  14. Choosing a cancer surgeon: analyzing factors in patient decision making using a best-worst scaling methodology. (United States)

    Ejaz, Aslam; Spolverato, Gaya; Bridges, John F; Amini, Neda; Kim, Yuhree; Pawlik, Timothy M


    Surgeon experience has been shown to influence outcomes for many types of cancer. The factors that patients consider when selecting a hospital or surgeon for cancer treatment remain poorly defined. All patients with a cancer diagnosis seeking treatment at a surgical clinic at Johns Hopkins Hospital were asked to participate. A survey utilizing a best-worst scaling methodology was constructed to elicit the importance of various factors when selecting a cancer surgeon. Attributes were grouped into four categories: surgeon reputation, surgeon qualifications, hospital-related factors, and nonclinical factors. Two hundred fourteen patients with a cancer diagnosis participated in the study (82.0 % response rate). Patients placed the highest value on physician qualifications and hospital-related factors. Specifically, surgeon case-specific experience (coefficient 2.56, SE 0.06) and the receipt of specialized training by the surgeon (coefficient 2.32, SE 0.06) ranked highest (both P < 0.001). Among hospital-related factors, hospital case-specific volume (coefficient 1.32, SE 0.06; P < 0.001) was most important. The lowest rated factors were parking availability (coefficient -2.81, SE 0.06) and home-to-clinic distance (coefficient -2.12, SE 0.06) (both P < 0.001). The majority of patients reported their ideal surgeon to have at least 6 years of experience (n = 143, 68.1 %) and to have performed their specific procedure at least 50 times (n = 156, 75.3 %). Patients consider several factors when choosing a cancer surgeon. Surgeon qualifications and hospital-related factors appear to be most influential in their decision. Easier and more widespread dissemination of surgeon and hospital cancer data such as case volume may be useful for patients.

  15. Outcomes of manual extracapsular versus phacoemulsification cataract extraction by beginner resident surgeons. (United States)

    Meeks, Landen A; Blomquist, Preston H; Sullivan, Brian R


    To evaluate the safety and efficacy of phacoemulsification cataract extraction and manual extracapsular cataract extraction (ECCE) performed by beginning resident surgeons. Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. Retrospective cohort study. A review was performed of each resident's series of initial cataract surgery procedures as a late first-year or second-year resident. Data were collected for cases performed over almost a 6-year period during which initially the first primary surgeon cases were ECCE and later, the first primary surgeon cases were phacoemulsification. For each case, the following data were gathered: technique of cataract extraction, laterality, resident, vitreous loss or dropped nucleus, placement of posterior chamber intraocular lens (IOL), and need for reoperation within 90 days of surgery. Complications occurred in 6 (2.5%) of 244 cases in which phacoemulsification was performed by a beginner resident primary surgeon and in 7 (4.1%) of 172 cases in which ECCE was used (P=.40). Posterior chamber IOLs were placed in all but 2 phacoemulsification cases and 4 ECCE cases (P=.24). Moreover, 3 cases in the phacoemulsification group and 1 case in the ECCE group required a reoperation within 90 days (P=.65). Phacoemulsification cataract extraction can be taught safely and effectively to residents with no cataract surgery experience as a primary surgeon. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Pediatric Thoracoscopic Surgical Simulation Using a Rapid-Prototyped Chest Model and Motion Sensors Can Better Identify Skilled Surgeons Than a Conventional Box Trainer. (United States)

    Takazawa, Shinya; Ishimaru, Tetsuya; Harada, Kanako; Deie, Kyoichi; Fujishiro, Jun; Sugita, Naohiko; Mitsuishi, Mamoru; Iwanaka, Tadashi


    We previously developed a pediatric thoracoscopic surgical simulator and showed its construct validity. In this study, the same skill assessment experiments were conducted in an additional 31 surgeons and the results of 53 surgeons in total were analyzed. A suture pad with force sensors was placed in a rapid-prototyped pediatric chest model of a 1-year-old patient. Participants completed the endoscopic intracorporeal suturing and knot-tying task, both in the pediatric chest model setup and in a box trainer setup. The task was evaluated using eight metrics: the 29-point checklist score, error score, number of manipulations, task completion time, force index, width of the pad's slit after suturing, and right and left tool paths. The 53 participants included skilled surgeons certified by the Endoscopic Surgical Skill Qualification (ESSQ) system (n = 8) and unskilled surgeons without the certification (n = 45). The skilled surgeons showed significantly better performance than the unskilled surgeons in six metrics in the pediatric chest model setup. In contrast, no significant differences between the two groups were observed in the box trainer setup. Upon comparison between the setups, the unskilled surgeons showed worse results in six metrics in the pediatric chest model than in the box trainer, whereas the skilled surgeons showed equivalent performance in both setups. Our pediatric thoracoscopic surgical simulator was superior to the conventional box trainer for identifying skilled surgeons. The skilled surgeons showed excellent performance even in the intricate pediatric chest model, providing quantified targets for young pediatric surgeons' training.

  17. Emil Theodor Kocher (1841-1917)--orthopaedic surgeon and the first surgeon Nobel Prize winner. (United States)

    Bumbasirević, Marko Z; Zagorac, Slavisa G; Lesić, Aleksandar R


    Theodor Emil Kocher (1841-1917), born in Bern, educated in many universities in Europe. Kocher as many surgeons of that time performed orthopedic surgery, general surgery, neurosurgery and endocrine surgery, but he become famous in orthopaedic surgery and endocrine surgery. He is remember as a surgeon who described the approach to the hip joint, elbow joint, maneuver for the reduction of dislocated shoulder joint. He introduced many instruments and many of them, such as Kocher clamp is still in use. Most important Kocher work was the thyroid gland surgery, and he received the Nobel Prize for Medicine in 1909, for-in this matter. His nature of meticulous surgeon, scientific and hard working person, dedicated to his patients and students made- found him the place in a history of medicine.

  18. Surgeons' motivation for choice of workplace. (United States)

    Kähler, Lena; Kristiansen, Maria; Rudkjøbing, Andreas; Strandberg-Larsen, Martin


    To ensure qualified health care professionals at public hospitals in the future, it is important to understand which factors attract health care professionals to certain positions. The aim of this study was to explore motives for choosing employment at either public or private hospitals in a group of Danish surgeons, as well as to examine if organizational characteristics had an effect on motivation. Eight qualitative interviews were conducted with surgeons from both public and private hospitals sampled using the snowball method. The interviews were based on a semi-structured interview guide and analyzed by means of phenomenological theory. Motivational factors such as personal influence on the job, the opportunity to provide the best possible patient care, challenging work tasks colleagues, and ideological reasons were emphasized by the surgeons as important reasons for their choice of employment. Motivational factors appeared to be strongly connected to the structure of the organization; especially the size of the organization was perceived to be essential. It is worth noting that salary, in contrast to the general belief, was considered a secondary benefit rather than a primary motivational factor for employment. The study revealed that motivational factors are multidimensional and rooted in organizational structure; i.e. organizational size rather than whether the organization is public or private is crucial. There is a need for further research on the topic, but it seems clear that future health care planning may benefit from taking into account the implications that large organizational structures have for the staff working within these organizations. not relevant. not relevant.

  19. Australia's female military surgeons of World War I. (United States)

    Neuhaus, Susan J


    The war service of Lilian Violet Cooper, the first female surgeon of the Royal Australasian College of Surgeons, is well recognized. Not so well known however, are the other pioneering female doctors who also undertook work as military surgeons during World War I. At least four of the 14 Australian female doctors that undertook overseas war service during World War I were engaged as surgeons and treated Australian, British and Allied casualties. These women operated in London, in Egypt and on the frontlines of the Macedonian campaign. While none of these other women became Fellows of the Royal Australasian College of Surgeons, their war efforts deserve recognition.

  20. American Orthopaedic Surgeons in World War I. (United States)

    Green, David P; DeLee, Jesse C


    On April 6, 1917, the United States declared war on Germany and entered what was then called the Great War. Among the first officers sent to Europe were 21 orthopaedic surgeons in the so-called First Goldthwait Unit. Prior to the war, orthopaedics had been a nonoperative "strap-and-buckle" specialty that dealt primarily with infections, congenital abnormalities, and posttraumatic deformity. The Great War changed all of that forever, creating a new surgical specialty with emphasis on acute treatment, prevention of deformity, restoration of function, and rehabilitation.

  1. [The cardiovascular surgeon and the Syntax score]. (United States)

    Gómez-Sánchez, Mario; Soulé-Egea, Mauricio; Herrera-Alarcón, Valentín; Barragán-García, Rodolfo


    The Syntax score has been established as a tool to determine the complexity of coronary artery disease and as a guide for decision-making among coronary artery bypass surgery and percutaneous coronary intervention. The purpose of this review is to systematically examine what the Syntax score is, and how the surgeon should integrate the information in the selection and treatment of patients. We reviewed the results of the SYNTAX Trial, the clinical practice guidelines, as well as the benefits and limitations of the score. Finally we discuss the future directions of the Syntax score.

  2. "Einsatzchirurgie"--experiences of German military surgeons in Afghanistan. (United States)

    Willy, Christian; Hauer, Thorsten; Huschitt, Niels; Palm, Hans-Georg


    the training of military surgeons (specialisation general surgery plus a second sub-specialisation either in visceral surgery or orthopaedics/trauma surgery) has been developed in the Joint Medical Service of the German Bundeswehr. Other relevant skills, such as emergency neurotraumatology, battlefield surgery with integrated oral and craniomaxillofacial surgery, and emergency gynaecology are also integrated into this concept and will be addressed in special courses. On successful completion of this training programme, military surgeons will be officially appointed as "Einsatzchirurg" for a duration of 5 years. After this time, it will be obligatory to renew this "combat ready" status. The buildings and materials in German military medical treatment facilities provide for excellent working conditions. The training programme for military surgeons in its end-2010 version has been designed specifically with data about injury pattern and non-battle diseases as well as the political situation and professional requirements in the civilian sphere in mind.

  3. Discordance between patient and surgeon satisfaction after total joint arthroplasty. (United States)

    Harris, Ian A; Harris, Anita M; Naylor, Justine M; Adie, Sam; Mittal, Rajat; Dao, Alan T


    We surveyed 331 patients undergoing total hip or knee arthroplasty pre-operatively, and patients and surgeons were both surveyed 6 and 12 months post-operatively. We identified variables (demographic factors, operative factors and patient expectations) as possible predictors for discordance in patient-surgeon satisfaction. At 12 months, 94.5% of surgeons and 90.3% of patients recorded satisfaction with the outcome. The discordance between patient and surgeon satisfaction was mainly due to patient dissatisfaction-surgeon satisfaction. In an adjusted analysis, the strongest predictors of discordance in patient-surgeon satisfaction were unmet patient expectations and the presence of complications. Advice to potential joint arthroplasty candidates regarding the decision to proceed with surgery should be informed by patient reported outcomes, rather than the surgeon's opinion of the likelihood of success.

  4. Work-life balance of female versus male surgeons in Hong Kong based on findings of a questionnaire designed by a Japanese surgeon. (United States)

    Kwong, Ava; Chau, Wai Wang; Kawase, K


    We evaluated the attitudes of female and male surgeons in Hong Kong to work, personal life, and work-life balance, through a questionnaire survey. We sent an online questionnaire survey designed by a female Japanese surgeon to 142 female surgeons practicing in Hong Kong, while its customized version was sent to 953 of their male counterparts. "Home life" and "Work" were the first and second priorities for both the women and the men. More of the female surgeons reported that they could not find enough time to participate in community activities (p = 0.038) or rest (p = 0.024). Both reported moderate satisfaction at work (p = 0.114) and in their life outside work (p = 0.346), as well as equality at home (p = 0.548) and at work (p = 0.177). Of the men, 89 % agreed with the necessity for granting paternity leave and reported that they would like to work part-time during the child-rearing years (p = 0.013). The number of female surgeons involved in key roles is increasing in parallel with the increasing number of female medical students. The introduction of paternity leave for male surgeons is an important concern. The issues of work-life balance may need to be addressed to attract more talent into an important specialty in Hong Kong and this is likely to apply to other parts of Asia as well.

  5. Surgeon ownership in medical device distribution: does it actually reduce healthcare costs? (United States)

    Steinmann, John C; Edwards, Charles; Eickmann, Thomas; Carlson, Angela; Blight, Alexis


    Surgeon ownership in medical device distribution is a new model that proposes to reduce the costs associated with surgical implants. In surgeon-owned distributorships (SDs), the surgeon becomes the purchaser through ownership and management of a distributorship. The purpose of this study is to determine whether significant cost savings can result from SDs. Five existing SDs were retrospectively reviewed, and their implant pricing was compared with non-SDs. The hospital pricing for implants supplied by the SDs was compared with 2010 pricing from the best contract/capitated rate for like implants from non-SDs. The average first-year cost savings for the SDs was 36%, with US$2,456,521 total savings in 2010. For distributorships in business for over 2 years, the average annual price from the SDs actually decreased by 1.41%. This study demonstrates that SDs are capable of providing substantial healthcare savings through lower implant costs and reduced annual price escalations.

  6. Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

    Directory of Open Access Journals (Sweden)

    Marcello Barbosa Barros

    Full Text Available CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

  7. John M. T. Finney: distinguished surgeon and Oslerphile (United States)


    John Finney (1863–1942) was born near Natchez, Mississippi. After receiving his medical degree from Harvard, he interned at Massachusetts General Hospital and then went to Baltimore to become one of the first interns at the new Johns Hopkins Hospital. He met William Osler the day the hospital opened and became a lifelong admirer of “the Chief.” Finney specialized in gastrointestinal surgery and was recognized for his expertise in the field. Osler recommended Finney to a physician colleague, writing, “You could not be in better hands…. Finney has been most successful and his judgment is so good.” Finney served for 33 years under William Halsted at Hopkins. After Halsted's death, Finney was offered the chair of surgery at Johns Hopkins but declined. He was a founder and first president of the American College of Surgeons. He also served as president of the American Surgical Association and the Society of Clinical Surgery. Finney became chief surgical consultant for the Allied Expeditionary Forces in World War I. He was decorated by the United States, France, and Belgium. Finney was a master surgeon and a role model for generations of students and physicians. PMID:26722185

  8. Research articles published by Korean spine surgeons: Scientific progress and the increase in spine surgery. (United States)

    Lee, Soo Eon; Jahng, Tae-Ahn; Kim, Ki-Jeong; Hyun, Seung-Jae; Kim, Hyun Jib; Kawaguchi, Yoshiharu


    There has been a marked increase in spine surgery in the 21st century, but there are no reports providing quantitative and qualitative analyses of research by Korean spine surgeons. The study goal was to assess the status of Korean spinal surgery and research. The number of spine surgeries was obtained from the Korean National Health Insurance Service. Research articles published by Korean spine surgeons were reviewed by using the Medline/PubMed online database. The number of spine surgeries in Korea increased markedly from 92,390 in 2004 to 164,291 in 2013. During the 2000-2014 period, 1982 articles were published by Korean spine surgeons. The annual number of articles increased from 20 articles in 2000 to 293 articles in 2014. There was a positive correlation between the annual spine surgery and article numbers (particles with Oxford levels of evidence 1, 2, and 3. The mean five-year impact factor (IF) for article quality was 1.79. There was no positive correlation between the annual IF and article numbers. Most articles (65.9%) were authored by neurosurgical spine surgeons. But spinal deformity-related topics were dominant among articles authored by orthopedics. The results show a clear quantitative increase in Korean spinal surgery and research over the last 15years. The lack of a correlation between annual IF and published article numbers indicate that Korean spine surgeons should endeavor to increase research value.

  9. Congenital Ulnar Drift in a Surgeon

    Directory of Open Access Journals (Sweden)

    Desirae McKee


    Full Text Available Windblown hand is a term used in many instances to describe ulnar deviations of the fingers with or without other malformations. In 1994 Wood reviewed all of the descriptions of cases of windblown hand and pointed out how many variants of congenital ulnar drift there are, suggesting that the many variations seen may all belong to a larger type of arthrogryposis. While the most common cause of ulnar deviation of the fingers is rheumatoid arthritis, it can also be caused by other conditions such as windblown hand or Jaccoud’s arthropathy. While most hand surgeons are familiar with presentations of congenital ulnar drift, few of them are knowledgeable about Jaccoud’s arthropathy as this is usually discussed within medical communities such as Rheumatology. We present a case of a surgeon who has had noticeable ulnar deviation of the digits at the level of the metacarpophalangeal joint since his early 20s. We propose that the current case is a demonstration of a type of windblown hand that has some hereditary component but is not immediately obvious at birth and presents physically more like Jaccoud’s arthropathy than traditional windblown hand.

  10. Training cardiac surgeons: the Indiana University experience. (United States)

    Brown, John W


    In this article, I will outline the origin of cardiothoracic surgical (CTS) training at Indiana University (IU) and its evolution to the present. I will describe my educational background, surgical training in this specialty, and my role as an educator of CT surgeons. I will describe our faculty and the structure of the CTS residency. Finally, I will describe a newly adopted smart phone "App" called SIMPL, which allows the resident and faculty to quickly (50% of the most critical aspects of each surgical procedure, the resident's performance during the critical portion of the operation from poor to excellent, and the degree of difficulty of the operation from simple to complex. The attending surgeon and the resident data are then forwarded to the SIMPL database where the SIMPL software aggregates data for each resident and procedure producing a report at the end of the rotation of the resident's performance relative to his peers. This additional evaluation process will better ensure that our CTS residents are "practice ready" when they complete their training.

  11. Denis Browne: maverick or master surgeon? (United States)

    Smith, D E


    The current generation of surgeons may remember Denis Browne only as an inventor of surgical instruments which few people use, an innovator of procedures condemned as inadequate, and a personality bristling with controversy: a maverick indeed. And yet this assessment belies his influence as the founder of modern paediatric surgery in the development of British surgery. Further, his innovative operations in a range of paediatric lesions were revolutionary in the context of the time. Browne was born in 1892 and educated in Australia, although his whole surgical career was in England. He had a remarkable family background; unique Australian experiences in childhood, when he commenced to display independence and individuality of spirit, through University, where he gained 'Blues' in tennis and shooting, to war, where he served in Gallipoli and France; and to controversies that surrounded him in his battle to establish paediatric surgery as a legitimate surgical discipline. He certainly had a prickly personality and a particular venom reserved for orthopaedic surgeons and anatomists, but his achievements may have been possible only by one possessed of such a strong and towering character.

  12. Perspectives of being spouse, parent, and surgeon. (United States)

    Murtha, Yvonne


    Achieving a balance between one's career and personal life is a never-ending challenge. As a surgeon, add-on cases and double-booked clinics can lead to long hours at work and make availability for family time unpredictable. It may seem like the threat of interruption because of patient needs always loom. Disruptions to family time extend beyond the long hours spent in surgery and clinics. Inattentiveness at home because of the technology tethers that keep one available for constant questions and patient care issues can also distract from time spent with family. Although the practice of an orthopaedic trauma surgeon can involve unpredictable schedules and patient care issues, there are means of mitigating the chaos that can envelop one's personal life as a result of a chosen career track. Clear priorities and expectations in both personal and professional arenas can improve the work-life balance. Flexible jobs that allow for more time with family do exist. Negotiating for this flexibility and self-assurance in holding fast to personal ideals are important in achieving a successful balance.

  13. The combined effects of hospital and surgeon volume on short-term survival after hepatic resection in a population-based study.

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    Chun-Ming Chang

    Full Text Available BACKGROUND: The influence of different hospital and surgeon volumes on short-term survival after hepatic resection is not clearly clarified. By taking the known prognostic factors into account, the purpose of this study is to assess the combined effects of hospital and surgeon volume on short-term survival after hepatic resection. METHODS: 13,159 patients who underwent hepatic resection between 2002 and 2006 were identified in the Taiwan National Health Insurance Research Database. Data were extracted from it and short-term survivals were confirmed through 2006. The Cox proportional hazards model was used to assess the relationship between survival and different hospital, surgeon volume and caseload combinations. RESULTS: High-volume surgeons in high-volume hospitals had the highest short-term survivals, following by high-volume surgeons in low-volume hospitals, low-volume surgeons in high-volume hospitals and low-volume surgeons in low-volume hospitals. Based on Cox proportional hazard models, although high-volume hospitals and surgeons both showed significant lower risks of short-term mortality at hospital and surgeon level analysis, after combining hospital and surgeon volume into account, high-volume surgeons in high-volume hospitals had significantly better outcomes; the hazard ratio of other three caseload combinations ranging from 1.66 to 2.08 (p<0.001 in 3-month mortality, and 1.28 to 1.58 (p<0.01 in 1-year mortality. CONCLUSIONS: The combined effects of hospital and surgeon volume influenced the short-term survival after hepatic resection largely. After adjusting for the prognostic factors in the case mix, high-volume surgeons in high-volume hospitals had better short-term survivals. Centralization of hepatic resection to few surgeons and hospitals might improve patients' prognosis.

  14. Impact of surgeon subspecialty training on surgical outcomes in open globe injuries

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    Han IC


    Full Text Available Ian C Han,1 Sidharth Puri,1 Jiangxia Wang,2 Shameema Sikder1 1Wilmer Eye Institute, Johns Hopkins University School of Medicine, 2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Purpose: The purpose of this study was to evaluate whether subspecialty training of the initial treating surgeon affects visual acuity and surgical outcomes in patients with open globe injuries.Design: This study is a single-institution, retrospective case series.Methods: The charts of adult patients with open globe injuries requiring surgical repair at the Wilmer Eye Institute between July 1, 2007 and July 1, 2012 were retrospectively reviewed. Clinical findings at presentation were recorded, and details of initial repair and follow-up surgeries were analyzed. Differences in visual acuity and surgical outcomes were compared based on subspecialty training of the initial surgeon.Results: The charts of 282 adult patients were analyzed, and 193 eyes had at least 6 months of follow-up for analysis. Eighty-six eyes (44.6% required follow-up surgery within the first year, and 39 eyes (20.2% were enucleated. Eyes initially treated by a vitreoretinal (VR surgeon were 2.3 times (P=0.003 more likely to improve by one Ocular Trauma Score (OTS visual acuity category and 1.9 times (P=0.027 more likely to have at least one more follow-up surgery at 6 months compared to eyes treated by non-VR surgeons. Patients with more anterior injuries treated by a VR surgeon were more likely to improve by one OTS visual acuity category compared to those treated by non-VR surgeons (P=0.004 and 0.016 for Zones I and II, respectively. There was no difference in visual acuity outcomes for eyes with posterior injuries (P=0.515 for Zone III.Conclusion: Eyes initially treated by a VR surgeon are more likely to improve by one OTS visual acuity category than those initially treated by a non-VR surgeon. However, patients initially treated by a VR surgeon also undergo more

  15. Comparison of pediatric surgical outcomes by the surgeon's degree of specialization in children. (United States)

    Rhee, Daniel; Papandria, Dominic; Yang, Jessica; Zhang, Yiyi; Ortega, Gezzer; Colombani, Paul M; Chang, David C; Abdullah, Fizan


    Improved surgical outcomes in children have been associated with pediatric surgical specialization, previously defined by surgeon operative volume or fellowship training. The present study evaluates pediatric surgical outcomes through classifying surgeons by degrees of pediatric versus adult operative experience. A cross-sectional study was performed using nationally representative hospital discharge data from 1998 to 2007. Patients under 18 years of age undergoing inpatient operations in neurosurgery, otolaryngology, cardiothoracic, general surgery, orthopedic surgery, and urology were included. An index was created, calculating the proportion of children treated by each surgeon. In-hospital mortality and length of stay were compared by index quartiles. Multivariate analysis was adjusted for patient and hospital characteristics. A total of 119,164 patients were operated on by 13,141 surgeons. Within cardiothoracic surgery, there were 1.78 (p=0.02) and 2.61 (ppediatric specialization respectively with the highest quartile. For general surgery, a 2.15 (p=0.04) increase in odds for mortality was found when comparing surgeons between the lowest and the highest quartiles. Comparing the least to the most specialized surgeons, length of stay increased 1.14 days (p=0.02) for cardiothoracic surgery, 0.58 days (p=0.04) for neurosurgery, 0.23 days (p=0.02) for otolaryngology, and decreased by 1.06 days (psurgery. The present study demonstrates that surgeons caring preferentially for children-as a proportion of their overall practice-generally have improved mortality outcomes in general and cardiothoracic surgery. These data suggest a benefit associated with increased referral of children to pediatric practitioners, but further study is required. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Surgeons' Perspectives on Surgery of Breast Cancer in Iran: The Pattern and Determinants

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    Massoome Najafi


    Full Text Available Background: The purpose of this study was to assess Iranian surgeons' perceptions toward mastectomy and breast conserving therapy (BCT and determine the contributing factors.Methods: In this cross-sectional study, a structured questionnaire was devised and hosted on and a link to the questionnaire was emailed to surgeons registered in Iranian Medical Council, branch of Tehran. The results of the current study were compared to a similar study which was performed in 2004 on a comparable sample of surgeons in Tehran, Iran.Results: A total 166 surgeons filled out the study questionnaire. Only 24 surgeons declared that they have not performed BCT before. Variables that showed a significant association with performing BCT were attending a breast surgery or surgical oncology fellowship (P = 0.010 and breast surgery workshop (P = 0.042. No associations were observed between performance of BCT and age category (P = 0.951, gender (P = 0.416, duration of practice (P = 0.821, number of breast cancer patients per year (P = 0.083, and setting of practice categorized as teaching – nonteaching hospitals (P = 0.417. Comparing the results of the current study with the study performed in 2004 revealed a significant increase in the frequency of surgeons who performed BCT (85.5% vs 19.3%, respectively (P < 0.001. Participants of the current study were more likely to mention "lack of experience" as the reason for not performing BCT compared to the previous study (P = 0.004.Conclusions: Our results delineated that there was a significant increase in the percentage of surgeons performing BCT compared to the previous study. Factors significantly associated with performing BCT were participating in a surgical oncology or breast surgery fellowship or short courses in breast surgery.

  17. Attitudes to contralateral risk reducing mastectomy among breast and plastic surgeons in England (United States)

    Basu, NN; Littlechild, S; Barr, L; Ross, GL; Evans, DG


    Introduction Rates of contralateral risk reducing mastectomy (CRRM) are rising despite a paucity of data to support this practice. Surgeons work as part of the multidisciplinary team (MDT). They may counsel women on these requests without the benefit of established guidelines or agreed protocol. This study assessed the practices and perceptions of breast and plastic surgeons in England on CRRM. Methods A postal questionnaire was sent to 455 breast and 364 plastic surgeons practising in England. Basic demographics, trends in CRRM, risk assessment, role of the MDT and knowledge base were assessed. Results The response rate among breast surgeons was 48.3% (220/455) and 12.6% (46/364) among plastic surgeons. Nearly half (44%) of the respondents felt there had been an increase in rates of CRRM over the last three years. Seventy-one per cent of those surveyed performed 1–5 CRRMs annually while sixteen per cent did not perform this procedure at all. A third (32%) of respondents correctly quoted their patients an annual risk of 0.5–0.7%. Funding was refused in 4% of cases and 43% of the surgeons felt that in the future they would have to apply to relevant clinical commissioning groups. Over half (58%) of all respondents reported that decisions for CRRM are always discussed in the MDT meeting but 6% stated that these cases are never discussed by the MDT. BRCA mutation was perceived as the main risk factor for contralateral breast cancer by 81% of respondents. Surgeons felt that women requested CRRM mainly to alleviate anxiety. The next most common reasons were carriage of BRCA mutation and a desire to have reconstructions match. Conclusions A wide variation of surgical practices and perceptions exist in assessing women for CRRM. Guidelines to standardise practices are required. PMID:26741657

  18. Development of a charting method to monitor the individual performance of surgeons at the beginning of their career.

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    Antoine Duclos

    Full Text Available BACKGROUND: Efforts to provide a valid picture of surgeons' individual performance evolution should frame their outcomes in relation to what is expected depending on their experience. We derived the learning curve of young thyroidectomy surgeons as a baseline to enable the accurate assessment of their individual outcomes and avoid erroneous conclusions that may derive from more traditional approaches. METHODS: Operative time and postoperative recurrent laryngeal nerve palsy of 2006 patients who underwent a thyroidectomy performed by 19 young surgeons in five academic hospitals were monitored from April 2008 to December 2009. The database was randomly divided into training and testing datasets. The training data served to determine the expected performance curve of surgeons during their career and factors influencing outcome variation using generalized estimating equations (GEEs. To simulate prospective monitoring of individual surgeon outcomes, the testing data were plotted on funnel plots and cumulative sum charts (CUSUM. Performance charting methods were utilized to present outcomes adjusted both for patient case-mix and surgeon experience. RESULTS: Generation of performance curves demonstrated a gradual reduction in operative time from 139 (95% CI, 137 to 141 to 75 (71 to 80 minutes, and from 15.7% (15.1% to 16.3% to 3.3% (3.0% to 3.6% regarding the nerve palsy rate. Charts interpretation revealed that a very young surgeon had better outcomes than expected, whereas a more experienced surgeon appeared to be a poor performer given the number of years that he had already spent in practice. CONCLUSIONS: Not considering the initial learning curve of surgeons exposes them to biased measurement and to misinterpretation in assessing their individual performance for thyroidectomy. The performance chart represents a valuable tool to monitor the outcome of surgeons with the expectation to provide safe and efficient care to patients.

  19. Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States. (United States)

    Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R


    To investigate recent trends in the orthopaedic trauma workforce and to assess whether supply of orthopaedic trauma surgeons (OTS) matches the demand for their skills. Supply estimated using Orthopaedic Trauma Association (OTA) membership and American Academy of Orthopaedic Surgeons census data. The annual number of operative pelvic and acetabular fractures reported by American College of Surgeons verified trauma centers in the National Trauma Data Bank (NTDB) was used as a surrogate of demand. Because surrogates were used, the annual rate of change in OTA membership versus rate of change in operative injuries per NTDB center was compared. From 2002 to 2012, reported operative pelvic and acetabular injuries increased by an average of 21.0% per year. The number of reporting trauma centers increased by 27.2% per year. The number of OTA members increased each year except in 2009, with mean annual increase of 9.8%. The mean number of orthopaedic surgeons per NTDB center increased from 7.98 to 8.58, an average of 1.5% per year. The annual number of operative pelvic and acetabular fractures per NTDB center decreased from 27.1 in 2002 to 19.03 in 2012, down 2.0% per year. In the United States, from 2002 to 2012, the number of OTS trended upward, whereas operative pelvic and acetabular cases per reporting NTDB center declined. These trends suggest a net loss of such cases per OTS over this period.

  20. Publication Productivity of Early-Career Orthopedic Trauma Surgeons. (United States)

    Hake, Mark E; Lee, John J; Goulet, James A


    The goals of this study were to: (1) define the publication productivity of early-career orthopedic trauma surgeons over time; (2) compare the early-career publication productivity of recent orthopedic trauma fellowship graduates vs their more senior colleagues; and (3) determine the proportion of fellowship graduates who meet the Orthopaedic Trauma Association (OTA) publication criteria for active membership early in their careers. Orthopedic trauma fellowship graduates from 1982 to 2007 were analyzed. A literature search was performed for each fellow's publications for the 6-year period beginning the year of fellowship graduation. Publication productivity was compared between early and recent groups of graduates, 1987 to 1991 and 2003 to 2007, respectively. Fulfillment of OTA publication criteria was determined. Seventy-nine percent of graduates contributed to 1 or more publications. The recent group produced more total publications per graduate (4.06 vs 3.29, P=.01) and more coauthor publications (2.60 vs 2.04, P=.019) than the early group. The number of first-author publications did not differ between groups (1.46 vs 1.25, P=.26). A greater percentage of the recent group met current OTA publication criteria compared with the early group (51% vs 35%, P=.04). The findings showed that recent orthopedic trauma graduates had increased publication productivity compared with their more senior colleagues, although a proportion had not qualified for active OTA membership 6 years into their career. Overall, these data are encouraging and suggest that young orthopedic trauma surgeons remain committed to sustaining a high level of academic excellence.

  1. Use of Unsolicited Patient Observations to Identify Surgeons With Increased Risk for Postoperative Complications. (United States)

    Cooper, William O; Guillamondegui, Oscar; Hines, O Joe; Hultman, C Scott; Kelz, Rachel R; Shen, Perry; Spain, David A; Sweeney, John F; Moore, Ilene N; Hopkins, Joseph; Horowitz, Ira R; Howerton, Russell M; Meredith, J Wayne; Spell, Nathan O; Sullivan, Patricia; Domenico, Henry J; Pichert, James W; Catron, Thomas F; Webb, Lynn E; Dmochowski, Roger R; Karrass, Jan; Hickson, Gerald B


    Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations. This retrospective cohort study used data from 7 academic medical centers participating in the National Surgical Quality Improvement Program and the Vanderbilt Patient Advocacy Reporting System from January 1, 2011, to December 31, 2013. Patients older than 18 years included in the National Surgical Quality Improvement Program who underwent inpatient or outpatient operations at 1 of the participating sites during the study period were included. Patients were excluded if the attending surgeon had less than 24 months of data in the Vanderbilt Patient Advocacy Reporting System preceding the date of the operation. Data analysis was conducted from June 1, 2015, to October 20, 2016. Unsolicited patient observations for the patient's surgeon in the 24 months preceding the date of the operation. Postoperative surgical or medical complications as defined by the National Surgical Quality Improvement Program within 30 days of the operation of interest. Among the 32 125 patients in the cohort (13 230 men, 18 895 women; mean [SD] age, 55.8 [15.8] years), 3501 (10.9%) experienced a complication, including 1754 (5.5%) surgical and 2422 (7.5%) medical complications. Prior unsolicited patient observations for a surgeon were significantly associated with the risk of a patient having any complication (odds ratio, 1.0063; 95% CI, 1.0004-1.0123; P = .03), any surgical

  2. Characteristics of cardiothoracic surgeons practicing at the top-ranked US institutions. (United States)

    Rosati, Carlo Maria; Koniaris, Leonidas G; Molena, Daniela; Blitzer, David; Su, Katherine W; Tahboub, Mohammad; Vardas, Panos N; Girardi, Leonard N; Gaudino, Mario


    We aimed to determine which factors distinguish cardiothoracic (CT) surgeons practicing at the top-ranked US institutions from their peers. Using online resources, we collected demographics, training information and academic metrics of 694 cardiac (n=489; 70%) and thoracic (n=205; 30%) surgeons practicing at 57 preeminent US institutions, including those with the highest US News & World Report ranking ("top CT centers"). Two hundred and ninety-nine (43.1%) CT surgeons were practicing at the 18 "top CT centers" and had higher academic productivity (publications, citations) than their peers. While there was no difference in the proportion of international medical graduates (IMGs) (21.4% overall) or of surgeons with a PhD degree (9.4% overall) across institutions, the "top CT centers" had a higher proportion of faculty who received their entire CT training abroad (10.4% vs. 5.8%; P=0.038) or at highly-ranked US institutions. Those who published more during their early career years (residency, fellowship and first 5 years as faculty) were more likely to attain academic (professorship) and institutional leadership (division/department chair) positions and to practice at the "top CT centers". Women represented a minority (7.3% overall; 5.1% of cardiac vs. 12.7% of thoracic surgeons, P<0.001), but with growing prevalence among younger faculty and without differences across institutions. CT surgeons of the best US centers have a more international background and received their training at highly-ranked institutions. Early academic productivity is associated with life-long career achievements, with special importance of the first 5 years as faculty. Women represent a growing proportion of the CT surgical workforce.

  3. Should Advertising by Aesthetic Surgeons be Permitted? (United States)

    Nagpal, Neeraj


    Cosmetic, aesthetic and cutaneous surgical procedures require qualified specialists trained in the various procedures and competent to handle complications. However, it also requires huge investments in terms of infrastructure, trained staff and equipment. To be viable advertising is essential to any establishment which provides cosmetic and aesthetic procedures. Business men with deep pockets establish beauty chains which also provide these services and advertise heavily to sway public opinion in their favour. However, these saloons and spas lack basic medical facilities in terms of staff or equipment to handle any complication or medical emergency. To have a level playing field ethical advertising should be permitted to qualified aesthetic surgeons as is permitted in the US and UK by their respective organisations. PMID:28529421

  4. Mapping a surgeon's becoming with Deleuze. (United States)

    Cristancho, Sayra; Fenwick, Tara


    The process of 'becoming' shapes professionals' capability, confidence and identity. In contrast to notions of rugged individuals who achieve definitive status as experts, 'becoming' is a continuous emergent condition. It is often a process of struggle, and is always interminably linked to its environs and relationships. 'Becoming' is a way of understanding the tensions of everyday practice and knowledge of professionals. In this paper, we explore the notion of 'becoming' from the perspective of surgeons. We suggest that 'becoming', as theorised by Deleuze, offers a more nuanced understanding than is often represented using conventional vocabularies of competence, error, quality and improvement. We develop this conception by drawing from our Deleuze-inspired study of mapping experience in surgery. We argue for Deleuzian mapping as a method to research health professionals' practice and experience, and suggest the utility of this approach as a pedagogical tool for medical education.

  5. John Banister: an Elizabethan surgeon in Brazil. (United States)

    Mello, Amílcar D'Avila de


    In Brazil's sixteenth-century history, very few references are made to health professionals. On the expedition of Edward Fenton, dispatched by the English Crown in 1582 to set up a trading post in Asia, was the famous barber-surgeon and physician John Banister. The naval squadron, diverted from its original route to repeat the feats of Sir Francis Drake, stopped over in Africa, crossed the Atlantic and anchored off the Santa Catarina coast in Brazil. In these waters, the expedition degenerated into piracy and returned unsuccessful to Europe. John Banister is considered the person who liberated English anatomy from mediaeval slavery, shedding upon it the light of the Renaissance. It was the first time that anyone of this importance in the area of health had visited these latitudes.


    SUSSENBACH, Samanta; SILVA, Everton N; PUFAL, Milene Amarante; ROSSONI, Carina; CASAGRANDE, Daniela Schaan; PADOIN, Alexandre Vontobel; MOTTIN, Cláudio Corá


    Background Although Brazilian National Public Health System (BNPHS) has presented advances regarding the treatment for obesity in the last years, there is a repressed demand for bariatric surgeries in the country. Despite favorable evidences to laparoscopy, the BNPHS only performs this procedure via laparotomy. Aim 1) Estimate whether bariatric surgeons would support the idea of incorporating laparoscopic surgery in the BNPHS; 2) If there would be an increase in the total number of surgeries performed; 3) As well as how BNPHS would redistribute both procedures. Methods A panel of bariatric surgeons was built. Two rounds to answer the structured Delphi questionnaire were performed. Results From the 45 bariatric surgeons recruited, 30 (66.7%) participated in the first round. For the second (the last) round, from the 30 surgeons who answered the first round, 22 (48.9%) answered the questionnaire. Considering the possibility that BNPHS incorporated laparoscopic surgery, 95% of surgeons were interested in performing it. Therefore, in case laparoscopic surgery was incorporated by the BNPHS there would be an average increase of 25% in the number of surgeries and they would be distributed as follows: 62.5% via laparoscopy and 37.5% via laparotomy. Conclusion 1) There was a preference by laparoscopy; 2) would increase the number of operations compared to the current model in which only the laparotomy is available to users of the public system; and 3) the distribution in relation to the type of procedure would be 62.5% and 37.5% for laparoscopy laparotomy. PMID:25409964

  7. Canadian Hepatitis C Look-Back Investigation to Detect Transmission from an Infected General Surgeon

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    Meenakshi Dawar


    Full Text Available BACKGROUND: In February 2007, a general surgeon in Charlottetown, Prince Edward Island, tested positive for hepatitis C virus (HCV. The surgeon’s infection onset date could not be determined; however, episodic hepatic enzyme elevations were first detected in November 2004 and again in February 2007. HCV transmission during surgery, alhough rare, has been documented. A phased look-back HCV screening program was conducted to detect HCV transmission from this surgeon to patients who underwent the highest-risk procedures in the three years before his positive test.

  8. [Surgeon 2.0: the challenge is on the Web]. (United States)

    Belda Lozano, Ricardo; Ferrer Márquez, Manuel; García Torrecillas, Juan Manuel; Alvarez García, Antonio; Reina Duarte, Angel


    Numerous articles and opinions have been published in the last few years on how the Internet is changing clinical practice. In this article we focus on describing 2 aspects that we believe are fundamental in the web 2.0 and Medicine-Surgery inter-relationship: a) web 2.0 conceptualisation and its differences with other pre-existing tools, and b) a description of some of the tools that from a medical-surgical view could be of major interest to the professionals, the patients, and interaction between both. The time has arrived to board train 2.0, where the channels of communication between the professionals, and between them and the patients, are improving disease situations daily, to improve learning through contact with other physicians and surgeons, at the same time providing an excellent resource for maintaining health and to know the disease and its treatment.

  9. The Journal of the Experimental Analysis of Behavior at fifty

    National Research Council Canada - National Science Library

    Laties, Victor G


    ...: behavior analysis history, women as journal editors, geographical distribution of editors, online publishing, B.F. Skinner I have lived my professional life by decades. It was 60 years ago, in 1928, that I arrived at Harvard as a graduate student in psychology. Behaviorism was then only 15 years old. Ten years later, in 1938, I published The Behav...

  10. Among Musculoskeletal Surgeons, Job Dissatisfaction Is Associated With Burnout. (United States)

    van Wulfften Palthe, Olivier D R; Neuhaus, Valentin; Janssen, Stein J; Guitton, Thierry G; Ring, David


    Burnout is common in professions such as medicine in which employees have frequent and often stressful interpersonal interactions where empathy and emotional control are important. Burnout can lead to decreased effectiveness at work, negative health outcomes, and less job satisfaction. A relationship between burnout and job satisfaction is established for several types of physicians but is less studied among surgeons who treat musculoskeletal conditions. We asked: (1) For surgeons treating musculoskeletal conditions, what risk factors are associated with worse job dissatisfaction? (2) What risk factors are associated with burnout symptoms? Two hundred ten (52% of all active members of the Science of Variation Group [SOVG]) surgeons who treat musculoskeletal conditions (94% orthopaedic surgeons and 6% trauma surgeons; in Europe, general trauma surgeons do most of the fracture surgery) completed the Global Job Satisfaction instrument, Shirom-Malamed Burnout Measure, and provided practice and surgeon characteristics. Most surgeons were male (193 surgeons, 92%) and most were academically employed (186 surgeons, 89%). Factors independently associated with job satisfaction and burnout were identified with multivariable analysis. Greater symptoms of burnout (β, -7.13; standard error [SE], 0.75; 95% CI, -8.60 to -5.66; p < 0.001; adjusted R(2), 0.33) was the only factor independently associated with lower job satisfaction. Having children (β, -0.45; SE, 0.0.21; 95% CI, -0.85 to -0.043; p = 0.030; adjusted R(2), 0.046) was the only factor independently associated with fewer symptoms of burnout. Among an active research group of largely academic surgeons treating musculoskeletal conditions, most are satisfied with their job. Efforts to limit burnout and job satisfaction by optimizing engagement in and deriving meaning from the work are effective in other settings and merit attention among surgeons. Level II, prognostic study.

  11. A comparison of one hundred and fifty consecutive parotidectomies for tumours and inflammatory disease. (United States)

    Moody, A B; Avery, C M; Taylor, J; Langdon, J D


    The demographic profile and complications are compared and contrasted for 150 consecutive parotidectomies. All patients were under the care of one surgeon (JDL) over a twenty-year period (1977-1997). The case records and contemporaneous database were analysed retrospectively. 111 (74%) procedures were performed for tumours and 39 (26%) for inflammatory disease. The incidence of unexpected permanent facial nerve palsy was 1.8% in the tumour group and zero in the inflammatory group. The overall unexpected palsy rate was 1.3%. Transient paralysis was more common in the inflammatory group than the tumour group (61.5% compared with 33.3%, P<0.02) and was more likely to be panfacial (48.7% compared with 17.1%, P<0.0002). The overall incidence of Frey's syndrome was less than 20% and both salivary fistulae and sialocoeles were infrequent.

  12. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons. (United States)

    Reddy, Vikram; Coffey, M Justin


    Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients.

  13. [Management abilities of the head surgeon: essential for survival!]. (United States)

    Jähne, J


    Due to increased economic challenges in the management of hospitals head surgeons do not only need excellent surgical expertise but also significant management qualities. The personality of head surgeons should include authenticity, sincerity, fairness and the ability to cooperate. Visionary leadership, strategic thinking and strategic management of the personnel are further prerequisites for success. Besides good abilities in communication head surgeons need knowledge of the operating figures for interpretation. To keep up with the own capabilities time and self-management is essential. A survival as head surgeon is likely if these qualities and abilities exist.

  14. Navigating the Strait of Magellan: mapping a new paradigm for neurosurgical residency training. Presidential address to the Society of Neurological Surgeons, May 7, 2007. (United States)

    Popp, A John


    At the conclusion of his year as 81st president of the Society of Neurological Surgeons, the author delivered the following address at the 2007 annual meeting of the Society of Neurological Surgeons in San Francisco. In his address, Dr. Popp used the voyage of Ferdinand Magellan to illustrate the present climate affecting residency training and why the current training paradigm must be examined and, where necessary, changed. Based on this call to action the leaders of the American Association of Neurological Surgeons, The American Board of Neurological Surgeons, The Congress of Neurological Surgeons, The Council of State Neurosurgical Societies, The Residency Review Committee for Neurosurgery, The Society of Neurological Surgeons, and the Washington Committee for Neurosurgery agreed to hold an unprecedented Education Summit meeting to investigate a comprehensive approach to evaluating and changing the current neurosurgical residency training model.

  15. Impact of surgeon subspecialty training on surgical outcomes in open globe injuries (United States)

    Han, Ian C; Puri, Sidharth; Wang, Jiangxia; Sikder, Shameema


    Purpose The purpose of this study was to evaluate whether subspecialty training of the initial treating surgeon affects visual acuity and surgical outcomes in patients with open globe injuries. Design This study is a single-institution, retrospective case series. Methods The charts of adult patients with open globe injuries requiring surgical repair at the Wilmer Eye Institute between July 1, 2007 and July 1, 2012 were retrospectively reviewed. Clinical findings at presentation were recorded, and details of initial repair and follow-up surgeries were analyzed. Differences in visual acuity and surgical outcomes were compared based on subspecialty training of the initial surgeon. Results The charts of 282 adult patients were analyzed, and 193 eyes had at least 6 months of follow-up for analysis. Eighty-six eyes (44.6%) required follow-up surgery within the first year, and 39 eyes (20.2%) were enucleated. Eyes initially treated by a vitreoretinal (VR) surgeon were 2.3 times (P=0.003) more likely to improve by one Ocular Trauma Score (OTS) visual acuity category and 1.9 times (P=0.027) more likely to have at least one more follow-up surgery at 6 months compared to eyes treated by non-VR surgeons. Patients with more anterior injuries treated by a VR surgeon were more likely to improve by one OTS visual acuity category compared to those treated by non-VR surgeons (P=0.004 and 0.016 for Zones I and II, respectively). There was no difference in visual acuity outcomes for eyes with posterior injuries (P=0.515 for Zone III). Conclusion Eyes initially treated by a VR surgeon are more likely to improve by one OTS visual acuity category than those initially treated by a non-VR surgeon. However, patients initially treated by a VR surgeon also undergo more follow-up surgical rehabilitation, and improvement in visual acuity is more likely for anterior (Zone I and II injuries) than posterior (Zone III) injuries. PMID:26491240

  16. Temporal and spatial change of climate extremes in Qilian Mountains and Hexi Corridor during last fifty years%近50a来祁连山及河西走廊极端气候的时空变化研究

    Institute of Scientific and Technical Information of China (English)



    Under the condition of global warming, the frequency of extreme climate and damage of meteorological disasters are increasing. Based on daily temperature and precipitation data of 20 weather stations in the Qilian Mountains and Hexi Corridor from 1960 to 2009, the inter-annual change trends of climate extremes were studied by methods of regression analysis and five years moving average, and the spatial distribution characteristics of inter-annual change trends and its significance of climate extremes were analyzed by method of Spline interpolation under ArcGIS environment, and the cycles of climate extremes were discussed by method of Morlet wavelet analysis under Matlab environment, so as to bring scientific accordance for local governments to deal with climate change and disaster prevention and alleviation. The results indicate the annual number of extreme high temperature days ( EHTD) is on the significant rise by the rate of 0. 79 d/a, and the trend of inter-annual change of EHTD is accelerative by larger waving scale after the middle-late of 1980s, especially the rate of EHTD getting higher after the middle-late of 1990s. This is contrary to the extreme low temperature days (ELTD) , the annual number of ELTD is decreasing significantly by the rate of -0. 54 d/a and the trend of inter-annual change of ELTD is reducing by larger waving scale after the middle-latte of 1980s, and the rate of ELTD is lower after the middle-late of 1980s. The annual number of extreme precipitation days (EPD) is increasing significantly by the rate of 0.02 d/a, and the trend of inter-annual change of EPD is rising by larger and smaller waving scale before and after the middle of 1980s respectively, but the trend became contrary after the middle-late of 1990s, and the rate of EPD is higher after the middle of 1970s. The spatial distribution characteristics of inter-annual change trends and its significance of climate extremes have some differences, but the response to the global

  17. Mercury and Copper Accumulation During Last Fifty Years and Their Potential Ecological Risk Assessment in Sediment of Mangrove Wetland of Shenzhen,China%近50年来深圳湾红树林湿地Hg、Cu累积及其生态危害评价

    Institute of Scientific and Technical Information of China (English)

    李瑞利; 柴民伟; 邱国玉; 贺蓓


    pH.Contents of Hg and Cu in the whole depth of core ranged between 92-196 ng·g-1 and 29-83 μg·g-1,respectively.And both of them in sediment increased firstly and then decreased with the increasing soil depth.At 14 cm depth,contents of Hg and Cu reached up to the highest levels.Correspondingly,the ecological risk of Hg and Cu changed similarly with the contents of Hg and Cu.At 14 cm depth,the ecological risk indexes of Hg and Cu were at the highest levels of 39.10 and 13.85,respectively.The potential ecological risks of both Hg and Cu in sediments were mild.The rapid economical development of Hong Kong in 1960-1985 and Shenzhen in 1985-2000 contributed much to the Hg and Cu accumulation in mangrove wetland of Shenzhen Bay,China.Since the year of 2000,the reduction in contents of Hg and Cu has been expected as a consequence of the adoption of contamination control policies,improving the environment for growth of mangrove.In conclusion,the variations of core sediment heavy metal contents and its ecological risk assessment along the vertical profile reveal the interaction processes and extent of anthropogenic influences from the areas around the Shenzhen Bay and the catchments.

  18. A formidable task: Population analysis predicts a deficit of 2000 cardiothoracic surgeons by 2030. (United States)

    Williams, Thomas E; Sun, Benjamin; Ross, Patrick; Thomas, Andrew M


    To estimate the cardiovascular workforce needed by 2030 to meet the needs of our population and to quantify its costs. Our field is changing. The volume of surgery and the nature of the surgery are changing. The nation's population grew from 227,000,000 to 282,000,000 between 1980 and 2000, and by 2030 the population is estimated to be 364,000,000. At the same time, the applications for fellowship in our specialty are decreasing at an alarming rate. The American Board of Thoracic Surgery has certified 4500 cardiothoracic surgeons since 1975, but only 1300 in the last 10 years. The US Department of Health and Human Services predicts only 3620 full-time cardiothoracic surgeons in 2020. Will we have enough cardiovascular and thoracic surgeons? Retrospective examination of the pertinent literature and with a modified Richard Cooper's economic trend analysis, a population algorithm with a ratio of physicians to population of 1.42 per 100,000. Each thoracic surgeon is predicted to practice 30 years from Board certification to retirement. The Balanced Budget Act will not be revised; therefore, we will certify 100 graduates from our programs per year. The assumed salaries will be 50,000 dollars with benefits of 30% and 15,000 dollars of additional Direct Medical Education costs. The population in 2030 will be 364,000,000 with 5169 cardiothoracic surgeons needed at that time. Unfortunately, there will be approximately only 3200 cardiothoracic surgeons in practice with a shortage of approximately 2000. To maintain our current status per 100,000 population from 2011 to 2030, we will have to train 4000 residents. The total person years would be approximately 28,000. The cost for this is more than 2,000,000,000 dollars. The annual cost for this training prorated over 20 years would be more than 110,000,000 dollars. We must train approximately 4000 surgeons, an extra 100 per year, in our specialty to meet the needs of the population by 2030. That will cost approximately 2

  19. Does Surgeon Experience Impact the Risk of Complications After Bernese Periacetabular Osteotomy? (United States)

    Novais, Eduardo N; Carry, Patrick M; Kestel, Lauryn A; Ketterman, Brian; Brusalis, Christopher M; Sankar, Wudbhav N


    Bernese periacetabular osteotomy (PAO) is a technically challenging procedure with potential risk for major complications and a previously reported steep learning curve. However, the impact of contemporary hip preservation fellowships on the learning curve of PAO has not been established. (1) What was the frequency of major complications during the PAO learning curve of two surgeons who recently graduated from hip preservation fellowships? (2) Is increasing level of experience associated with the risk of a complication and with operative time, a possible surrogate measure of surgical performance? We retrospectively studied 81 PAOs performed by one of two surgeons who recently graduated from a hip preservation fellowship during their first 4 years of practice in two institutions. One of the surgeons participated as a fellow in 78 PAOs with an increasing level of responsibility during the course of 1 full year. The other surgeon performed 41 PAOs as a fellow during 6 months, also with an increasing level of responsibility during that time. There were 68 (84%) female and 13 (16%) male patients (mean age, 18 years; range, 10-36 years). The frequency of complications was recorded early and at 1 year after surgery and graded according to a validated classification system describing five grades of complications. Complications that required surgical intervention (Grade III) and life-threatening complications (Grade IV) were considered major complications. Persistent pain after surgery, although considered a failure of PAO, was not considered a surgical complication as a result of the multifactorial etiology of pain after hip-preserving surgery. However, early reoperation and revision surgery were counted as complications. To evaluate the association between increasing level of experience and the occurrence of complications, we divided each surgeon's experience into his first 20 procedures (initial interval) and his second 20 (experienced interval) to test whether the

  20. The Impact of Individual Surgeon Volume on Hysterectomy Costs (United States)

    Shepherd, Jonathan P.; Kantartzis, Kelly L.; Lee, Ted; Bonidie, Michael J.


    Background and Objective: Hysterectomy is one of the most common surgical procedures women will undergo in their lifetime. Several factors affect surgical outcomes. It has been suggested that high-volume surgeons favorably affect outcomes and hospital cost. The objective is to determine the impact of individual surgeon volume on total hospital costs for hysterectomy. Methods: This is a retrospective cohort of women undergoing hysterectomy for benign indications from 2011 to 2013 at 10 hospitals within the University of Pittsburgh Medical Center System. Cases that included concomitant procedures were excluded. Costs by surgeon volume were analyzed by tertile group and with linear regression. Results: We studied 5,961 hysterectomies performed by 257 surgeons: 41.5% laparoscopic, 27.9% abdominal, 18.3% vaginal, and 12.3% robotic. Surgeons performed 1–542 cases (median = 4, IQR = 1–24). Surgeons were separated into equal tertiles by case volume: low (1–2 cases; median total cost, $4,349.02; 95% confidence interval [CI] [$3,903.54–$4,845.34]), medium (3–15 cases; median total cost, $2,807.90; 95% CI [$2,693.71–$2,926.93]) and high (>15 cases, median total cost $2,935.12, 95% CI [$2,916.31–$2,981.91]). ANOVA analysis showed a significant decrease (P < .001) in cost from low-to-medium– and low-to-high–volume surgeons. Linear regression showed a significant linear relationship (P < .001), with a $1.15 cost reduction per case with each additional hysterectomy. Thus, if a surgeon performed 100 cases, costs were $115 less per case (100 × $1.15), for a total savings of $11,500.00 (100 × $115). Conclusion: Overall, in our models, costs decreased as surgeon volume increased. Low-volume surgeons had significantly higher costs than both medium- and high-volume surgeons.

  1. Organism Encumbrance of Cardiac Surgeon During Surgery (United States)

    Karabdic, Ilirijana Haxhibeqiri; Veljovic, Fikret; Straus, Slavenka


    Introduction: Most everyday activities, performed over a long period leads to performance degradation of skeletal muscles as well as spinal column which is reflected in the reduction of maximum force, reduction of the speed of response, reducing control of the movement etc. Although until now many mathematical models of muscles are developed, very small number takes into account the fatigue, and those models that take into account changes in the characteristics of muscles for extended activities, generally considered tiring under certain conditions. Given that the current models of muscle fatigue under arbitrary conditions of activation and load are very limited, this article presents a new model that includes scale of muscles overload. Material and Methods: There are three female cardiac surgeons working performing these surgeries in operating rooms, and their average anthropometric measures for this population is: a) Weight: 62 kg; b) Height: 166 cm. Age: 45 taken in the calculation within the CATIA software, that entity is entitled to 50% of healthy female population that is able to execute these and similar jobs. During the surgery is investigated the two most common positions: position “1” and “2”. We wish to emphasize that the experiment or surgical procedure lasted for two positions for five hours, with the position “1” lasted 0.5 hours, and position “2” lasted about 4.5 hours. The additional load arm during surgery is about 1.0 kg. Results: The analysis was done in three positions: “Operating position 1”, “Operating position 2 ‘, and each of these positions will be considered in its characteristic segments. These segments are: when the body takes the correct position, but is not yet burdened with external load, then when the surgeon receives the load and the third position when the load is lifted at the end of the position. Calculation of internal energy used on the joints is carried out in the context of software analysis of this

  2. Organism Encumbrance of Cardiac Surgeon During Surgery. (United States)

    Karabdic, Ilirijana Haxhibeqiri; Veljovic, Fikret; Straus, Slavenka


    Most everyday activities, performed over a long period leads to performance degradation of skeletal muscles as well as spinal column which is reflected in the reduction of maximum force, reduction of the speed of response, reducing control of the movement etc. Although until now many mathematical models of muscles are developed, very small number takes into account the fatigue, and those models that take into account changes in the characteristics of muscles for extended activities, generally considered tiring under certain conditions. Given that the current models of muscle fatigue under arbitrary conditions of activation and load are very limited, this article presents a new model that includes scale of muscles overload. There are three female cardiac surgeons working performing these surgeries in operating rooms, and their average anthropometric measures for this population is: a) Weight: 62 kg; b) Height: 166 cm. Age: 45 taken in the calculation within the CATIA software, that entity is entitled to 50% of healthy female population that is able to execute these and similar jobs. During the surgery is investigated the two most common positions: position "1" and "2". We wish to emphasize that the experiment or surgical procedure lasted for two positions for five hours, with the position "1" lasted 0.5 hours, and position "2" lasted about 4.5 hours. The additional load arm during surgery is about 1.0 kg. The analysis was done in three positions: "Operating position 1", "Operating position 2 ', and each of these positions will be considered in its characteristic segments. These segments are: when the body takes the correct position, but is not yet burdened with external load, then when the surgeon receives the load and the third position when the load is lifted at the end of the position. Calculation of internal energy used on the joints is carried out in the context of software analysis of this model using CATIA R5v19. The proposed model is based on CATIA software

  3. Richard von Volkmann: surgeon and Renaissance man. (United States)

    Willy, Christian; Schneider, Peter; Engelhardt, Michael; Hargens, Alan R; Mubarak, Scott J


    Richard von Volkmann (1830-1889), one of the most important surgeons of the 19(th) century, is regarded as one of the fathers of orthopaedic surgery. He was a contemporary of Langenbeck, Esmarch, Lister, Billroth, Kocher, and Trendelenburg. He was head of the Department of Surgery at the University of Halle, Germany (1867-1889). His popularity attracted doctors and patients from all over the world. He was the lead physician for the German military during two wars. From this experience, he compared the mortality of civilian and war injuries and investigated the general poor hygienic conditions in civilian hospitals. This led him to introduce the "antiseptic technique" to Germany that was developed by Lister. His powers of observation and creativity led him to findings and achievements that to this day bear his name: Volkmann's contracture and the Hueter-Volkmann law. Additionally, he was a gifted writer; he published not only scientific literature but also books of children's fairy tales and poems under the pen name of Richard Leander, assuring him a permanent place in the world of literature as well as orthopaedics.

  4. Changing perceptions of beauty: a surgeon's perspective. (United States)

    Adamson, Peter A; Zavod, Matthew B


    Beauty is a mystery that has been with us for ages. Scholars and scientists have investigated its roots and effects, and its presence is ubiquitous. Has the construct of beauty changed over time? Is our sense of beauty learned or innate? What IS beauty, and can we quantify it? A substantial amount of work supports a Darwinian theory of selection, which predicts a survival advantage based on physical attractiveness. However, there is evidence that certain perceptions of beauty change with time. Indeed, the recent globalization of modern society has wrought changes in our perceptions of beauty. Are patients electing cosmetic surgery procuring a survival advantage, or are they bypassing genetics and setting a new standard for beauty? As facial plastic surgeons, we must be poised to respond to this metamorphosis and understand its roots. Although there is some equivocation and debate about this elusive subject, it is our duty to stay abreast of the current dynamic to make sound judgments that are in the best interests of our patients.

  5. Fifty Interesting Years: Higher Education Funding and Financial Management 1961-2011 (United States)

    Williams, Gareth


    During the half century of the AUA's existence UK universities have experienced the fastest rate of growth and most far-reaching changes in their history. Funding arrangements in particular have changed radically. Since 1961 the finance office has been transformed from a small group of bean counters into a key management group at the heart of all…

  6. Fifty-thousand-year vegetation and climate history of Noel Kempff Mercado National Park, Bolivian Amazon (United States)

    Burbridge, Rachel E.; Mayle, Francis E.; Killeen, Timothy J.


    Pollen and charcoal records from two large, shallow lakes reveal that throughout most of the past 50,000 yr Noel Kempff Mercado National Park, in northeastern lowland Bolivia (southwestern Amazon Basin), was predominantly covered by savannas and seasonally dry semideciduous forests. Lowered atmospheric CO 2 concentrations, in combination with a longer dry season, caused expansion of dry forests and savannas during the last glacial period, especially at the last glacial maximum. These ecosystems persisted until the mid-Holocene, although they underwent significant species reassortment. Forest communities containing a mixture of evergreen and semideciduous species began to expand between 6000 and 3000 14C yr B.P. Humid evergreen rain forests expanded to cover most of the area within the past 2000 14C yr B.P., coincident with a reduction in fire frequencies. Comparisons between modern pollen spectra and vegetation reveal that the Moraceae-dominated rain forest pollen spectra likely have a regional source area at least 2-3 km beyond the lake shore, whereas the grass- and sedge-dominated savanna pollen spectra likely have a predominantly local source area. The Holocene vegetation changes are consistent with independent paleoprecipitation records from the Bolivian Altiplano and paleovegetation records from other parts of southwestern Amazonia. The progressive expansion in rain forests through the Holocene can be largely attributed to enhanced convective activity over Amazonia, due to greater seasonality of insolation in the Southern Hemisphere tropics driven by the precession cycle according to the Milankovitch Astronomical Theory.

  7. Fifty years after: some experiences of the medical care of prisoners of war. (United States)

    Girdwood, R H


    Mention is made of Italian prisoners-of-war treated in Catterick military hospital but in October 1943 Italy joined the Allied side. An account is given of the medical condition of 78 Japanese POWs and of 228 members of the Japanese Indian Forces (JIFs) in a transit hospital in eastern India (now Bangladesh). Tropical sprue appeared to occur in an epidemic form each June and July in Burma and eastern India, but did not seem to have affected the Japanese or JIFs. A brief account is given of the condition of 180 European or Australian service men who had survived harsh conditions in Japanese POW camps until liberation in September 1945, then being admitted to a military hospital in Rangoon en route for home. Some had suffered from blindness as a result of malnutrition, the precise reason being uncertain, but there was some improvement after the injection of crude liver extract.

  8. Cryogenics for high-energy particle accelerators: highlights from the first fifty years (United States)

    Lebrun, Ph


    Applied superconductivity has become a key technology for high-energy particle accelerators, allowing to reach higher beam energy while containing size, capital expenditure and operating costs. Large and powerful cryogenic systems are therefore ancillary to low-temperature superconducting accelerator devices – magnets and high-frequency cavities – distributed over multi-kilometre distances and operating generally close to the normal boiling point of helium, but also above 4.2 K in supercritical and down to below 2 K in superfluid. Additionally, low-temperature operation in accelerators may also be required by considerations of ultra-high vacuum, limited stored energy and beam stability. We discuss the rationale for cryogenics in high-energy particle accelerators, review its development over the past half-century and present its outlook in future large projects, with reference to the main engineering domains of cryostat design and heat loads, cooling schemes, efficient power refrigeration and cryogenic fluid management.

  9. Draft Budget of the Organization for the Fifty-First Financial Year 2005

    CERN Document Server


    A sa réunion du 15 septembre 2004 , le Comité des finances a recommandé au Conseil d'approuver le projet préliminaire de budget 2005 aux prix de 2004. La présente version tient compte des transferts du budget 2004 présentés dans le document "Budget 2004 - Transferts et dépassements de crédits" , du prélèvement dans la réserve pour imprévus pour le LHC indiqué dans le document "Réserve pour imprévus pour le LHC" et de divers ajustements mineurs. En conséquence, il est demandé au Comité des finances de recommander au Conseil d'approuver les modifications par rapport au projet préliminaire de budget 2005 présentées dans les tableaux de l'annexe 1.

  10. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning

    NARCIS (Netherlands)

    Ginneken, B. van


    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant techn

  11. One family's use of domestic fuels - a fifty year history

    Energy Technology Data Exchange (ETDEWEB)

    Tipler, W.


    The paper provides a detailed account of energy use (or rather energy purchased, since the records were of bills paid) in a family home since 1948 and discusses the lessons learned. From 1948-1958 the family lived in a 3-bed semi-detached house, from 1959-1967 in three 5-bed detached houses, from mid-1977 to late 1987 in a three-bedroomed terraced house on three floors and a three-bedroom detached house in Norfolk and from 1987 onwards lived in a detached house in London. (UK)

  12. Perspective: Fifty years of density-functional theory in chemical physics. (United States)

    Becke, Axel D


    Since its formal inception in 1964-1965, Kohn-Sham density-functional theory (KS-DFT) has become the most popular electronic structure method in computational physics and chemistry. Its popularity stems from its beautifully simple conceptual framework and computational elegance. The rise of KS-DFT in chemical physics began in earnest in the mid 1980s, when crucial developments in its exchange-correlation term gave the theory predictive power competitive with well-developed wave-function methods. Today KS-DFT finds itself under increasing pressure to deliver higher and higher accuracy and to adapt to ever more challenging problems. If we are not mindful, however, these pressures may submerge the theory in the wave-function sea. KS-DFT might be lost. I am hopeful the Kohn-Sham philosophical, theoretical, and computational framework can be preserved. This Perspective outlines the history, basic concepts, and present status of KS-DFT in chemical physics, and offers suggestions for its future development.

  13. Essay: Fifty years of atomic, molecular and optical physics in Physical Review Letters. (United States)

    Haroche, Serge


    The fiftieth anniversary of Physical Review Letters is a good opportunity to review the extraordinary progress of atomic, molecular, and optical physics reported in this journal during the past half-century. As both a witness and an actor of this story, I recall personal experiences and reflect about the past, present, and possible future of my field of research.

  14. Pediatric oncology at Hospital Infantil de Mexico: fifty-five years of accomplishment. (United States)

    Medina-Sanson, A; Martínez-Avalos, A; Gallegos-Castorena, S; Juárez-Villegas, L E; González-Montalvo, P; Perales-Arroyo, A; Gallegos-González, E; Ayometzi-Ouchi, M T


    The Department of Oncology at Hospital Infantil de México Federico Gómez (HIMFG) was the first unit in our country, and one of the first in Latin America, to specialize in the management of children with cancer. The HIMFG is part of the National Institutes of Health of Mexico, and is a reference hospital with research, educative, and tertiary care medical function. To date, the HIMFG and the Instituto Nacional de Pediatria are the principal medical centers in which children with cancer receive comprehensive care.

  15. Fifty Years since the Coleman Report: Rethinking the Relationship between Schools and Inequality (United States)

    Downey, Douglas B.; Condron, Dennis J.


    In the half century since the 1966 Coleman Report, scholars have yet to develop a consensus regarding the relationship between schools and inequality. The Coleman Report suggested that schools play little role in generating achievement gaps, but social scientists have identified many ways in which schools provide better learning environments to…

  16. Selection and Classification of United States Military Officers: A fifty-Year Bibliography (1937-1986) (United States)


    Printing Office. 64 Michael , W.B. (1947). An investigation of the contribution of factors to tests and to their predictive value in two Army Air Forces...and criterion variables. Educational and Psychological Measurement, 9, 95-111. 83 Michael , W.o. (1949). Factor analyses of tests and criteria: A...Washington, DC: National Research Council, Committee on Selection and Training of Aircraft Pilots. 834 Taussig , J.K., Jr. (1942). A proposed method of

  17. Fifty years since the nuclear accident in Palomares (Almeria). Medical repercussions. (United States)

    Laynez-Bretones, F; Lozano-Padilla, C


    In January 1966, 2 US military aircraft collided over the skies of Palomares (Almeria). One of them carried thermonuclear bombs, which released plutonium and other radioactive materials upon striking the ground. The most contaminated earth and plants were immediately removed. The Indalo Project was launched to study the effects of nuclear material on the inhabitants and environment of Palomares. A total of 1,077 inhabitants have been monitored since then, and the official version is that the ionising radiation has not been related to any type of disease. However, secrecy has surrounded much of the investigations, and no trustworthy epidemiological study has been conducted in the area. Approximately 500g of plutonium and americium remains in Palomares. Although the risk for the population appears to be low, this radioactive material should be removed as soon as possible.

  18. Islamic state or state Islam? Fifty years of state-Islam relations in Indonesia

    NARCIS (Netherlands)

    Bruinessen, M.M. van


    In what appeared like a dramatic reversal of previous policies towards organised Islam, President Soeharto in December 1990 gave his personal endorsement to the establishment of the Association of Indonesian Muslim Intellectuals (Ikatan Cendekiawan Muslim Se-Indonesia, ICMI), a body in

  19. Fifty Years of Yang-Mills Theory and my Contribution to it

    CERN Document Server

    Jackiw, Roman W


    On the fiftieth anniversary of Yang-Mills theory, I review the contribution to its understanding by my collaborators and me. Contents: 1.Gauge Theories and Quantum Anomalies; 2.Mathematical Connections; 3. Gauge Field Dynamics other than Yang-Mills; 4. Gauge Formalism for General Relativity Variables; A. Christoffel connection as a gauge potential, B. Gravitational Chern-Simons term from gauge theory Chern-Simons term, C. Coordinate transformations in general relativity and gauge theory, (i) Response to changes in coordinates (ii) Invariant fields and constants of motion. References.

  20. Review: Fifty Years Plus of Accelerometer History for Shock and Vibration (1940–1996

    Directory of Open Access Journals (Sweden)

    Patrick L. Walter


    Full Text Available This article summarizes the history of accelerometer development and the subsequent evolution of the commercial accelerometer industry. The focus is primarily on piezoelectric and piezoresistive accelerometers, although early resistance-bridge-type accelerometers are also described. The pioneer accelerometer manufacturing companies are identified and a chronology of technology development through today is presented.

  1. Fifty Years of Quasars From Early Observations and Ideas to Future Research

    CERN Document Server

    Marziani, Paola; Sulentic, Jack


    The 50th anniversary of the discovery of quasars in 1963 presents an interesting opportunity to ask questions about the current state of quasar research. Formatted as a series of interviews with noted researchers in the field, each of them asked to address a specific set of questions covering topics selected by the editors, this book deals with the historical development of quasar research and discusses how advances in instrumentation and computational capabilities have benefitted quasar astronomy and have changed our basic understanding of quasars. In the last part of the book the interviews address the current topic of the role of quasars in galaxy evolution. They summarise open issues in understanding active galactic nuclei and quasars and present an outlook regarding what future observational facilities both on the ground and in space might reveal. Its interview format, the fascinating topic of quasars and black holes, and the lively recollections and at times controversial views of the contributors make ...

  2. Islands as model systems in ecology and evolution: prospects fifty years after MacArthur-Wilson

    NARCIS (Netherlands)

    B.H. Warren; D Simberloff; R.E. Ricklefs; R. Aguilée; F.L. Condamine; D. Gravel; H. Morlon; N. Mouquet; J. Rosindell; J. Casquet; E. Conti; J. Cornuault; J.M. Fernández-Palacios; T. Hengl; S.J. Norder; K.F. Rijsdijk; I. Sanmartin; D. Strasberg; K.A. Trantis; L.M. Valente; R.J. Whittaker; R.G. Gillespie; B.C. Emerson; C. Thébaud


    The study of islands as model systems has played an important role in the development of evolutionary and ecological theory. The 50th anniversary of MacArthur and Wilson's (December 1963) article, ‘An equilibrium theory of insular zoogeography’, was a recent milestone for this theme. Since 1963, isl

  3. Fifty Years of Silent Service: A Peek Inside the CIA Library. (United States)

    Newlen, Robert R.


    Describes the CIA (Central Intelligence Agency) library. Highlights include security measures, a day in the life of two CIA librarians, sample reference questions, collection development, the Historical Intelligence Collection, the CIA Web site, and library modernization. (JAK)

  4. The development of soviet optics and spectroscopy during the past fifty years. (United States)

    Frish, S


    A history of Soviet spectroscopy is given, with special emphasis on various areas indicating the earliest workers in each specialty and their principal successors; for example, the work of Rozhdestvenskii (anomalous dispersion); Fok (self-consistant field calculations), Terenin (photochemistry, atomic beams), Mandelstam (combination scattering), Vavilov (luminescence, quantum properties of light), Cerenkov (radiation), Chaika (atomic lifetimes), Gross (excitons), and Volkenstein (molecular vibrations).

  5. Fifty years of Water Resources Research: Legacy and perspectives for the science of hydrology

    National Research Council Canada - National Science Library

    Montanari, Alberto; Bahr, Jean; Blöschl, Günter; Cai, Ximing; Mackay, D. Scott; Michalak, Anna M; Rajaram, Harihar; Sander, Graham


    We present an overview of the contributions collected to celebrate the fiftieth anniversary of Water Resources Research along with a critical discussion of the legacy and perspectives for the science...

  6. Fifty years of Yang-Mills Theories: a phenomenological point of view

    CERN Document Server

    De Rújula, Alvaro


    On the occasion of the celebration of the first half-century of Yang--Mills theories, I am contributing a personal recollection of how the subject, in its early times, confronted physical reality, that is, its "phenomenology". There is nothing original in this work, except, perhaps, my own points of view. But I hope that the older practitioners of the field will find here grounds for nostalgia, or good reasons to disagree with me. Younger addicts may learn that history does not resemble at all what is reflected in current textbooks: it was orders of magnitude more fascinating.

  7. Fifty years of chasing lizards: new insights advance optimal escape theory. (United States)

    Samia, Diogo S M; Blumstein, Daniel T; Stankowich, Theodore; Cooper, William E


    Systematic reviews and meta-analyses often examine data from diverse taxa to identify general patterns of effect sizes. Meta-analyses that focus on identifying generalisations in a single taxon are also valuable because species in a taxon are more likely to share similar unique constraints. We conducted a comprehensive phylogenetic meta-analysis of flight initiation distance in lizards. Flight initiation distance (FID) is a common metric used to quantify risk-taking and has previously been shown to reflect adaptive decision-making. The past decade has seen an explosion of studies focused on quantifying FID in lizards, and, because lizards occur in a wide range of habitats, are ecologically diverse, and are typically smaller and differ physiologically from the better studied mammals and birds, they are worthy of detailed examination. We found that variables that reflect the costs or benefits of flight (being engaged in social interactions, having food available) as well as certain predator effects (predator size and approach speed) had large effects on FID in the directions predicted by optimal escape theory. Variables that were associated with morphology (with the exception of crypsis) and physiology had relatively small effects, whereas habitat selection factors typically had moderate to large effect sizes. Lizards, like other taxa, are very sensitive to the costs of flight.

  8. Fifty Years Later: The Sequence, Structure and Function of Lacewing Cross-beta Silk

    Energy Technology Data Exchange (ETDEWEB)

    Weisman, Sarah; Okada, Shoko; Mudie, Stephen T.; Huson, Mickey G.; Trueman, Holly E.; Sriskantha, Alagacone; Haritos, Victoria S.; Sutherland, Tara D.; (CSIRO/MSE); (CSIRO)


    Classic studies of protein structure in the 1950s and 1960s demonstrated that green lacewing egg stalk silk possesses a rare native cross-beta sheet conformation. We have identified and sequenced the silk genes expressed by adult females of a green lacewing species. The two encoded silk proteins are 109 and 67 kDa in size and rich in serine, glycine and alanine. Over 70% of each protein sequence consists of highly repetitive regions with 16-residue periodicity. The repetitive sequences can be fitted to an elegant cross-beta sheet structural model with protein chains folded into regular 8-residue long beta strands. This model is supported by wide-angle X-ray scattering data and tensile testing from both our work and the original papers. We suggest that the silk proteins assemble into stacked beta sheet crystallites bound together by a network of cystine cross-links. This hierarchical structure gives the lacewing silk high lateral stiffness nearly threefold that of silkworm silk, enabling the egg stalks to effectively suspend eggs and protect them from predators.

  9. Islamic state or state Islam? Fifty years of state-Islam relations in Indonesia

    NARCIS (Netherlands)

    Bruinessen, M.M. van


    In what appeared like a dramatic reversal of previous policies towards organised Islam, President Soeharto in December 1990 gave his personal endorsement to the establishment of the Association of Indonesian Muslim Intellectuals (Ikatan Cendekiawan Muslim Se-Indonesia, ICMI), a body in which former

  10. Cryogenics for high-energy particle accelerators: highlights from the first fifty years

    CERN Document Server



    Applied superconductivity has become a key technology for high-energy particle accelerators, allowing to reach higher beam energy while containing size, capital expenditure and operating costs. Large and powerful cryogenic systems are therefore ancillary to low-temperature superconducting accelerator devices – magnets and high-frequency cavities – distributed over multi-kilometre distances and operating generally close to the normal boiling point of helium, but also above 4.2 K in supercritical and down to below 2 K in superfluid. Additionally, low-temperature operation in accelerators may also be required by considerations of ultra-high vacuum, limited stored energy and beam stability. We discuss the rationale for cryogenics in high-energy particle accelerators, review its development over the past half-century and present its outlook in future large projects, with reference to the main engineering domains of cryostat design and heat loads, cooling schemes, efficient power refrigeration and cryogenic flu...

  11. Fifty years of plutonium exposure to the Mahattan Project plutonium workers: An update

    Energy Technology Data Exchange (ETDEWEB)

    Voelz, G.L.; Lawrence, J.N.P.; Johnson, E.R. [Los Alamos National Lab., TN (United States)


    Twenty-six white male workers who did the original plutonium research and development work at Los Alamos have been examined periodically over the past 50 y to identify possible health effects from internal plutonium depositions. Their effective doses range from 0.1 to 7.2 Sv with a median value of 1.25 Sv. As of the end of 1994, 7 individuals have died compared with an expected 16 deaths based on mortality rates of U.S. white males in the general population. The standardized mortality ratio (SMR) is 0.43. When compared with 876 unexposed Los Alamos workers of the same period, the plutonium worker`s mortality rate was also not elevated (SMR = 0.77). The 19 living persons have diseases and physical changes characteristic of a male population with a median age of 72 y (range = 69 to 86 y). Eight of the twenty-six workers have been diagnosed as having one or more cancers, which is within the expected range. The underlying cause of death in three of the seven deceased persons was from cancer, namely cancer of prostate, lung, and bone. Mortality from all cancers was not statistically elevated. The effective doses from plutonium to these individuals are compared with current radiation protection guidelines. 28 refs., 5 tabs.

  12. The jewel on the mountaintop the European Southern Observatory through fifty years

    CERN Document Server

    Madsen, Claus


    Authored by ESO senior advisor Claus Madsen, the present book comprises 576 action-packed pages of ESO history and dramatic stories about the people behind the organisation. This is the ultimate historical account about ESO and its telescopes in the southern hemisphere, but also about a truly remarkable European success story in research. Spanning the range from the first telescopes to the future platforms of the next generation, it shows how the improvement of the telescopes leads to a continuously changing view of the Universe. With 150 photos and illustrations. Produced especially for ESO's

  13. Draft Budget of the Organization for the Fifty-third Financial Year 2007

    CERN Document Server


    At its meeting of 18 October 20061, the Finance Committee recommended the Council to approve the 2007 Budget2 at 2006 prices. The present version has been up-dated to take into account the transfers from the 2006 Budget as per â? ?2006 Budget, Transfers and Expenditure in Excess of Provisionsâ??3 and various adjustments. The Finance Committee is invited to recommend Council to approve the 2007 Budget as shown in the document reviewed by this Committee in October and the additional up-dating of the present document.

  14. Fifty Years since the Coleman Report: Rethinking the Relationship between Schools and Inequality (United States)

    Downey, Douglas B.; Condron, Dennis J.


    In the half century since the 1966 Coleman Report, scholars have yet to develop a consensus regarding the relationship between schools and inequality. The Coleman Report suggested that schools play little role in generating achievement gaps, but social scientists have identified many ways in which schools provide better learning environments to…

  15. Fifty years of CPGs: two neuroethological papers that shaped the course of neuroscience

    Directory of Open Access Journals (Sweden)

    Brian Mulloney


    Full Text Available Half a century ago, two independent papers that described unexpected results of experiments on locomotion in insects and crayfish appeared almost simultaneously. Together these papers demonstrated that an animal’s central nervous system (CNS was organized to produce behaviorally important motor output without the need for constant sensory feedback. These results contradicted the established line of thought that was based on interpretations of reflexes and ablation experiments, and established that in these animals the CNS contained neural circuits that could produce complex, periodic, multisegmental patterns of activity. These papers stimulated a flowering of research on central pattern-generating mechanisms that displaced reflex-based thinking everywhere except in medical physiology texts. Here we review these papers and their influence on thinking in the 1960s, 1970s, and today. We follow the development of ideas about central organization and control of expression of motor patterns, the roles of sensory input to central pattern-generating circuits, and integration of continuous sensory signals into a periodic motor system. We also review recent work on limb coordination that provides detailed cellular explanations of observations and speculations contained in those original papers.

  16. Fifty years of Moessbauer spectroscopy: from alloys and oxides to glasses and nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, C. E., E-mail: [University of Tennessee Space Institute, Center for Laser Applications (United States); Johnson, J. A. [University of Tennessee Space Institute, Department of Mechanical, Aerospace and Biomedical Engineering (United States)


    The Moessbauer Effect was discovered in 1957. In 1960 Moessbauer spectroscopy was born when two important papers appeared on (i) the magnetic hyperfine interaction and (ii) the electric monopole (isomer shift) and quadrupole interactions. These transformed an interesting phenomenon into a method for probing solids. Applications to magnetism, metals and alloys, chemical compounds, biological molecules, geology, archaeology and other sciences followed and are still of current interest. Two areas of research where Moessbauer spectroscopy is making unique contributions are in determining oxidation states in (i) glasses and (ii) nanoparticles. Some recent measurements are described.

  17. Fifty years of computer analysis in chest imaging: rule-based, machine learning, deep learning

    NARCIS (Netherlands)

    Ginneken, B. van


    Half a century ago, the term "computer-aided diagnosis" (CAD) was introduced in the scientific literature. Pulmonary imaging, with chest radiography and computed tomography, has always been one of the focus areas in this field. In this study, I describe how machine learning became the dominant

  18. Fifty million years of herbivory on coral reefs: fossils, fish and functional innovations (United States)

    Bellwood, D. R.; Goatley, C. H. R.; Brandl, S. J.; Bellwood, O.


    The evolution of ecological processes on coral reefs was examined based on Eocene fossil fishes from Monte Bolca, Italy and extant species from the Great Barrier Reef, Australia. Using ecologically relevant morphological metrics, we investigated the evolution of herbivory in surgeonfishes (Acanthuridae) and rabbitfishes (Siganidae). Eocene and Recent surgeonfishes showed remarkable similarities, with grazers, browsers and even specialized, long-snouted forms having Eocene analogues. These long-snouted Eocene species were probably pair-forming, crevice-feeding forms like their Recent counterparts. Although Eocene surgeonfishes likely played a critical role as herbivores during the origins of modern coral reefs, they lacked the novel morphologies seen in modern Acanthurus and Siganus (including eyes positioned high above their low-set mouths). Today, these forms dominate coral reefs in both abundance and species richness and are associated with feeding on shallow, exposed algal turfs. The radiation of these new forms, and their expansion into new habitats in the Oligocene–Miocene, reflects the second phase in the development of fish herbivory on coral reefs that is closely associated with the exploitation of highly productive short algal turfs. PMID:24573852

  19. Fifty Interesting Years: Higher Education Funding and Financial Management 1961-2011 (United States)

    Williams, Gareth


    During the half century of the AUA's existence UK universities have experienced the fastest rate of growth and most far-reaching changes in their history. Funding arrangements in particular have changed radically. Since 1961 the finance office has been transformed from a small group of bean counters into a key management group at the heart of all…

  20. [Fifty years of public service for Quebec community psychiatry services. Part I]. (United States)

    Lesage, Alain


    This essay comprises 2 parts. It aims to recognize the public service of psychiatrists of the Département de psychiatrie de l'Université de Montréal who served at the provincial level of the Ministry of Health and Social Services for deinstitutionalisation of policies and organisation of services, at the service of people with severe mental disorders. First with Dr. Camille Laurin post-face of the 1962 book Les fous crient au secours! (Mentally ill patients cry for help); then the insight on the latest phase of differentiated specialised clinics by Dr. Denis Lazure, who participated in 1962 to the Bédard, Lazure, Roberts commission that launched community psychiatry, but who will also be Social Affairs Minister in the late '70 s; Dr. Arthur Amyot will sail through the budgetary issues when in the beginning of the '80s the mental health directorate was under Social Affairs; Dr. Luc Blanchet will be associated to a rich production of interdisciplinary reports by the advisory Mental Health Committee until its dismissal in 2003; and finally, Dr. André Delorme, who probably has the record of longevity at the head of the mental health directorate, transferred in 2003 under the deputy minister for medical and university affairs.The essay will propose since the beginning a grid or referential of four health services analysis. First; the arguments for community care by British and Italian psychiatrists and researchers, Thornicroft and Tansella. Second; system issues of mental health reforms proposed by Canadian psychiatric nurse and researcher Paula Goering. Third; the model of socio-political regulation of health system proposed by the Université de Montréal' health administration researcher Dr. André-Pierre Contandriopoulos; and Fourth; the structural tension between the medical and social sector signaled by the American medical sociologist, Leutz.The same phases of deinstitutionalization in other countries as UK, took place as followed: a) the asylum phase (before 1960); b) the psychiatry community (1960-2000); and c) the differentiated system (since 2000). The essay will evidence the long march towards hospitals without walls, interdisciplinary work, tension between cure and rehabilitation and a relative decreasing budget. This in conjunction with vulnerability in organisation and leadership, attributed to tension or burn out has revealed system deficits like the trans-institution towards homelessness or towards the judiciary system. The essay will conclude with a discussion on the opportunities and challenges of the very new Law 10 that reforms the general governance of the provincial and regional health and social services and hopes for a more balanced mental health care system in Quebec.

  1. Viewpoint – Fifty Years of Hydroelectric Development in Chile: A History of Unlearned Lessons

    Directory of Open Access Journals (Sweden)

    Michael Nelson


    Full Text Available The development of hydroelectricity in Chile illustrates a situation where water resources can be both well and badly managed when a private or public utility company, in this case ENDESA, is powerful enough to operate largely outside standard policy and bureaucratic processes. It successfully increased hydroelectric capacity more than fourfold over three decades characterised by periods of significant political instability. This was done without noticeable conflict due to its recognised efficiency and absence of environmental concerns in Chilean policy until the late 1980s. Since that time there has been increasing pressure from international agencies and NGOs to place more emphasis on environmental dimensions in development. The interplay among the diversity of agendas and tactics adopted by the interest groups attempting to influence decision on hydroelectric projects has, in some cases, been counterproductive. ENDESA chose to withhold information and modify EIA procedures as tactics to reduce costs. The NGOs’ single-minded dedication to preclusion of dam proposals tended to distort public debate. The government, presumably due to risk aversion, proved unwilling to take a proactive stance by not specifying and implementing requirements for approval of a dam project, providing a comprehensive policy framework for debate or facilitating dialogue on the issues.

  2. Fifty years of human space travel: implications for bone and calcium research. (United States)

    Smith, S M; Abrams, S A; Davis-Street, J E; Heer, M; O'Brien, K O; Wastney, M E; Zwart, S R


    Calcium and bone metabolism remain key concerns for space travelers, and ground-based models of space flight have provided a vast literature to complement the smaller set of reports from flight studies. Increased bone resorption and largely unchanged bone formation result in the loss of calcium and bone mineral during space flight, which alters the endocrine regulation of calcium metabolism. Physical, pharmacologic, and nutritional means have been used to counteract these changes. In 2012, heavy resistance exercise plus good nutritional and vitamin D status were demonstrated to reduce loss of bone mineral density on long-duration International Space Station missions. Uncertainty continues to exist, however, as to whether the bone is as strong after flight as it was before flight and whether nutritional and exercise prescriptions can be optimized during space flight. Findings from these studies not only will help future space explorers but also will broaden our understanding of the regulation of bone and calcium homeostasis on Earth.

  3. Reflections on Over Fifty Years in Research and Development; Some Lessons Learned (United States)


    man is an island, entire of itself…” John Donne, Meditation XVII A statement similar to Donne’s can be made about researchers and research...Feynman’s Lectures in Physics and the Berkeley Course in Physics. These were helpful, but I would have benefited more from classroom study. I

  4. [National Academy of Medicine, one hundred and fifty-four academic year]. (United States)

    Mansilla-Olivares, Armando


    El incalculable valor que atesora la Academia Nacional de Medicina, su enorme influencia y repercusión sobre la toma de decisiones médico-científico-epidemiológicas, radica única y exclusivamente en el dominio del conocimiento, la mente científica y el talento de todos y cada uno de sus miembros, desde su fundación en 1864 hasta nuestros días.

  5. The Armed Forces Epidemiological Board: Its First Fifty Years, 1940-1990 (United States)


    Alexander D. Langmuir, James M. Ruegsegger, and Elias Strauss. Pending the construction ot a Commission laboratory at Fort Bragg, the group spent...Sanders \\1 , Gulli’.er, F D. Forchhiimer, !- 1. , Alexander . R C IEpilenliL KuratoLonjuncti’. iti, CliiaI aand I’.perimental Stud% of anl Outbreak in...fluid of chick embryos infected with influenza virus B. Proc. Soc Exper Biol. & ,... 19,15, 59, 192-195. Meiklejohn , G , Eaton, M. D, and ,an Herick, W

  6. Diathermy awareness among surgeons-An analysis in Ireland

    Directory of Open Access Journals (Sweden)

    P.M. McQuail


    Conclusion: Our results show a dearth of awareness among surgeons regarding diathermy. Given our findings, we urge a shift in attitude towards diathermy, with surgeons adopting a more cautious and safe approach to diathermy use. We recommend that formal training be introduced as a hospital based initiative.

  7. Two surgeons and the ECG-a double blind study

    Directory of Open Access Journals (Sweden)

    Ulf Martin Schilling


    Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

  8. Patients' Opinions about Polish Surgeons and Surgical Treatment. (United States)

    Olakowski, Marek; Hładoń, Aleksandra; Seweryn, Mariusz; Ciosek, Jakub; Świątkiewicz, Wojciech


    In Polish society Stereotypes about the surgeons are deeply rooted, which could really affect their relationship with the patient and the entire treatment process. The aim of the study was to evaluate the results of an opinion survey on the image of the surgeon and operative treatment.

  9. Decreased heart rate variability in surgeons during night shifts

    DEFF Research Database (Denmark)

    Amirian, Ilda; Toftegård Andersen, Lærke; Rosenberg, Jacob


    BACKGROUND: Heart rate variability (HRV) has been used as a measure of stress and mental strain in surgeons. Low HRV has been associated with death and increased risk of cardiac events in the general population. The aim of this study was to clarify the effect of a 17-hour night shift on surgeons'...

  10. Surgeon-industry conflict of interest: survey of opinions regarding industry-sponsored educational events and surgeon teaching: clinical article. (United States)

    DiPaola, Christian P; Dea, Nicolas; Dvorak, Marcel F; Lee, Robert S; Hartig, Dennis; Fisher, Charles G


    Conflict of interest (COI) as it applies to medical education and training has become a source of considerable interest, debate, and regulation in the last decade. Companies often pay surgeons as faculty for educational events and often sponsor and give financial support to major professional society meetings. Professional medical societies, industry, and legislators have attempted to regulate potential COI without consideration for public opinion. The practice of evidence-based medicine requires the inclusion of patient opinion along with best available evidence and expert opinion. The primary goal of this study was to assess the opinion of the general population regarding surgeon-industry COI for education-related events. A Web-based survey was administered, with special emphasis on the surgeon's role in industry-sponsored education and support of professional societies. A survey was constructed to sample opinions on reimbursement, disclosure, and funding sources for educational events. There were 501 completed surveys available for analysis. More than 90% of respondents believed that industry funding for surgeons' tuition and travel for either industry-sponsored or professional society educational meetings would either not affect the quality of care delivered or would cause it to improve. Similar results were generated for opinions on surgeons being paid by industry to teach other surgeons. Moreover, the majority of respondents believed it was ethical or had no opinion if surgeons had such a relationship with industry. Respondents were also generally in favor of educational conferences for surgeons regardless of funding source. Disclosures of a surgeon-industry relationship, especially if it involves specific devices that may be used in their surgery, appears to be important to respondents. The vast majority of respondents in this study do not believe that the quality of their care will be diminished due to industry funding of educational events, for surgeon

  11. Spine Surgeon Selection Criteria: Factors Influencing Patient Choice. (United States)

    Manning, Blaine T; Ahn, Junyoung; Bohl, Daniel D; Mayo, Benjamin C; Louie, Philip K; Singh, Kern


    A prospective questionnaire. The aim of this study was to evaluate factors that patients consider when selecting a spine surgeon. The rise in consumer-driven health insurance plans has increased the role of patients in provider selection. The purpose of this study is to identify factors that may influence a patient's criteria for selecting a spine surgeon. Two hundred thirty-one patients who sought treatment by one spine surgeon completed an anonymous questionnaire consisting of 26 questions. Four questions regarded demographic information; 16 questions asked respondents to rate the importance of specific criteria regarding spine surgeon selection (scale 1-10, with 10 being the most important); and six questions were multiple-choice regarding patient preferences toward aspects of their surgeon (age, training background, etc.). Patients rated board certification (9.26 ± 1.67), in-network provider status (8.10 ± 3.04), and friendliness/bedside manner (8.01 ± 2.35) highest among factors considered when selecting a spine surgeon. Most patients (92%) reported that 30 minutes or less should pass between check-in and seeing their surgeon during a clinic appointment. Regarding whether their spine surgeon underwent training as a neurosurgeon versus an orthopedic surgeon, 25% reported no preference, 52% preferred neurosurgical training, and 23% preferred orthopedic training. Our findings suggest that board certification and in-network health insurance plans may be most important in patients' criteria for choosing a spine surgeon. Advertisements were rated least important by patients. Patients expressed varying preferences regarding ideal surgeon age, training background, proximity, medical student/resident involvement, and clinic appointment availability. The surgeon from whom patients sought treatment completed an orthopedic surgery residency; hence, it is notable that 52% of patients preferred a spine surgeon with a neurosurgical background. In the context

  12. Toward late career transitioning: a proposal for academic surgeons. (United States)

    Richards, Robin; McLeod, Robin; Latter, David; Keshavjee, Shaf; Rotstein, Ori; Fehlings, Michael G; Ahmed, Najma; Nathens, Avery; Rutka, James


    In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future. In this commentary, the literature on the science of aging is reviewed as it pertains to surgeons, and guidelines for late career transition planning are shared. It is hoped that these guidelines will be of some value to academic programs and surgeons across the country as late career transition models are developed and adopted.

  13. [Patient's pain feeling and surgeon's comfort--ECCE versus phacoemulsification]. (United States)

    Kałuzny, Jakub J; Eliks, Iwona; Mierzejewski, Andrzej; Kałuzny, Bartłomiej


    To compare patient's pain and surgeon's comfort during ECCE performed under retrobulbar anesthesia and phacoemulsification under topical anesthesia. 120 patients scheduled for planned routine cataract extraction were divided in 2 groups: group 1-60 eyes, ECCE under retrobulbar anesthesia and group II-60 eyes, phacoemulsification under topical anesthesia. Immediately after operation patients were asked, to answer questions about their feeling during surgery. Simultaneously, the surgeon filled up the questionnaire, concerning patients behavior during the entire procedure. Statistically significant higher level of pain was reported in group I (ECCE). The most painful moment of the procedure was retrobulbar injection. During surgery pain feeling in both groups was similar. Both types of anesthesia provided very good level of surgeon's comfort. The longer operation, the higher level of pain and lower surgeon's comfort were reported in both groups. Patients having ECCE performed under retrobulbar anesthesia reported more pain comparing to phacoemulsification under topical anesthesia. Both anesthesia methods provided high level of surgeon's comfort.

  14. Occupational Stress and Burnout among Surgeons in Fiji. (United States)

    Patel, Rajeev; Huggard, Peter; van Toledo, Annik


    This study examined the levels of occupational stress and burnout among surgeons in Fiji. A document set comprising a cover letter; a consent form; a sociodemographic and supplementary information questionnaire; the Maslach Burnout Inventory (MBI); the 12-item General Health Questionnaire (GHQ-12); the Alcohol Use Disorders Identification Test (AUDIT); and the Professional Quality of Life (ProQOL) questionnaires were provided to surgeons from three public divisional hospitals in Fiji. Thirty-six of 43 (83.7%) invited surgeons participated in the study. According to their MBI scores, surgeons suffered from low (10, 27.8%), moderate (23, 63.9%), and high (3, 8.3%) levels of burnout. Comparatively, 23 (63.9%) demonstrated moderate burnout according to their ProQOL scores. Substantial psychiatric morbidity was observed in 16 (44.0%) surgeons per their GHQ-12 scores. Consumption of alcohol was noted in 29 (80.6%) surgeons, and 12 (33.4%) had AUDIT scores characterizing their alcohol use in excess of low-risk guidelines or as harmful or hazardous drinking. Surgeons of Fijian nationality showed higher MBI emotional exhaustion and depersonalization scores compared with surgeons of other nationalities. Surgeons with an awareness of the availability of counseling services at their hospitals showed low AUDIT and ProQOL burnout scores. Smokers, alcohol drinkers, and kava drinkers showed higher AUDIT scores. This study highlights a level of occupational stress and burnout among surgeons in Fiji and a lack of awareness of their mental and physical well-being. The authors recommend that occupational stress and burnout intervention strategies be put in place in hospitals in Fiji.

  15. How Can We Improve Education of Breast Surgeons Across Europe? (United States)

    Kolacinska, Agnieszka


    Club) research fellowship; SSO/ ESSO fellowshipthrough its partnership with ESSO, SSO provides a grant to attend the SSO Annual Symposium; Reciprocal International Exchange Programmes with Japan, Latin America and North America (2). ESSO courses and masterclasses: expanded portfolio of courses, in- and outside Europe, basic and advanced, international faculty, multidisciplinary approach, learning methods: hands-on with human cadavers, workshops in small groups, live and case demonstrations, interactive sessions, 3D videos (for instance in 2017 ESSO course on ultrasound of breast in Barcelona, advanced course on oncoplastic surgery in Barcelona, advanced course on breast cancer surgery in Naples) (2). Trials: Interantional Nipple- Sparing Mastectomy Registry (INSPIRE), EURECCA (European Cancer Audit) project. The aim of INSPIRE is to provide pooled evidence derived from a prospective collaborative high-quality registry between international centers, oncological safety, patient- reported outcome measures, launched in March, 2016, European Breast Cancer Conference EBCC 10, Amsterdam (2). European Board of Surgery Qualification in Breast Surgery (EBSQ in BS): phase 1-eligibility assessment (CV, logbook, references); phase 2- test; phase 3- oral examination with 2 clinical cases and 1 critical review of academic paper. The applicant must hold a current license to practice as a surgeon (general or plastic or gynaecologist), demonstrate work for one year in a breast surgery unit with at least 150 new primary breast cancer cases per year, attended at least one national/ international training course in breast surgery and has attended at least one well recognized international congress. The applicant should present a signed log book for breast surgery with application; published either one paper or book chapter on breast disease Conclusions 1. The need for certified breast units: Standardised techniques by specialist breast surgeons across Europe should be the aim. 2. No man

  16. Quality of life of indian pediatric surgeons: Results of a survey (of indian association of pediatric surgeons members

    Directory of Open Access Journals (Sweden)

    M M Zameer


    Conclusion: This is the first study which objectively highlights that most surgeons are happy professionally and financially in due course of time and demolishes the common belief that pediatric surgeons are unsatisfied. It also acts as a point of reference and encouragement to newer aspirants in pediatric surgery.

  17. The Core Competencies for General Orthopaedic Surgeons. (United States)

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R


    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These


    Nagayoshi, Kinuko; Mori, Hitomi; Kameda, Chizu; Nakamura, Katsuya; Ueki, Takashi; Tanaka, Masao


    A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

  19. Ethical challenges in surgery as narrated by practicing surgeons

    Directory of Open Access Journals (Sweden)

    Nordam Ann


    Full Text Available Abstract Background The aim of this study was to explore the ethical challenges in surgery from the surgeons' point of view and their experience of being in ethically difficult situations. Methods Five male and five female surgeons at a university hospital in Norway were interviewed as part of a comprehensive investigation into the narratives of nurses and physicians about being in such situations. The transcribed interview texts were subjected to a phenomenological-hermeneutic interpretation. Results No differences in ethical reasoning between male and female surgeons were found. They reasoned in both action and relational ethical perspectives. Surgeons focused on their relationships with patients and colleagues and their moral self in descriptions of the ethical challenges in their work. Dialogue and personal involvement were important in their relationships with patients. The surgeons emphasized the importance of open dialogue, professional recognition, and an inclusive and accepting environment between colleagues. Conclusion The surgeons are personally challenged by the existential realities of human life in their relationships with patients. They realized that ethical challenges are an inherent part of performing surgery and of life itself, and say that they have to learn to "live with" these challenges in a way that is confirmed both socially and by their inner moral self. This means accepting their personal and professional limitations, being uncertain, being fallible, and being humble. Living with the ethical challenges of surgery seems to contribute to the surgeons' confidence and vulnerability in their professional identity.

  20. Surgical complications and their implications for surgeons' well-being. (United States)

    Pinto, A; Faiz, O; Bicknell, C; Vincent, C


    Healthcare professionals can be seriously affected when they are involved in major clinical incidents. The impact of such incidents on staff is of particular relevance to surgery, as the operating room is one of the highest-risk areas for serious complications. This qualitative study aimed to assess the personal and professional impact of surgical complications on surgeons. This single time point study involved semistructured, individual interviews with general and vascular surgeons, consultants and senior registrars from two National Health Service organizations in London, UK. Twenty-seven surgeons participated. Many were seriously affected by major surgical complications. Surgeons' practice was also often affected, not always in the best interest of their patients. The surgeons' reactions depended on the preventability of the complications, their personality and experience, patient outcomes and patients' reactions, as well as colleagues' reactions and the culture of the institution. Discussing complications, deconstructing the incidents and rationalizing were the most commonly quoted coping mechanisms. Institutional support was generally described as inadequate, and the participants often reported the existence of strong institutional blame cultures. Suggestions for supporting surgeons in managing the personal impact of complications included better mentoring, teamwork approaches, blame-free opportunities for the discussion of complications, and structures aimed at the human aspects of complications. Those involved in the management of surgical services need to consider how to improve support for surgeons in the aftermath of major surgical incidents. © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.