IMPORTANCE: To our knowledge, there has been little research conducted on the attitudes of residents toward their pregnant peers and parental leave. OBJECTIVE: To examine the perceptions of current ...surgery residents regarding parental leave. DESIGN, SETTING, AND PARTICIPANTS: A 36-item survey was distributed to current US general surgery residents and residents in surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. Questions were associated with general information/demographics, parental leave, having children, and respondents’ knowledge regarding the current parental leave policy as set by the American Board of Surgery. The study was conducted from August to September 2018 and the data were analyzed in October 2018. MAIN OUTCOMES AND MEASURES: Main outcomes included the attitudes of residents toward pregnancy and parental leave, parental leave policy, and the association of parental leave with residency programs. RESULTS: A total of 2188 completed responses were obtained; of these, 1049 (50.2%) were women, 1572 (75.8%) were white, 164 (7.9%) were Hispanic/Latinx, 75 (3.6%) were African American, 2 (0.1%) were American Indian or Alaskan Native, 263 (12.7%) were Asian, and 5 (0.2%) were Native Hawaiian or Pacific Islander. From the number of residents who had/were expecting children (581 28.6%), 474 (81.6%) had or were going to have a child during the clinical years of residency. Many residents (247 42.5%) took fewer than 2 weeks of parental leave. Many residents did not feel supported in taking parental leave (177 30.4% did not feel supported by other residents and 190 32.71% did not feel supported by the faculty). Only 83 respondents (3.8%%) correctly identified the current American Board of Surgery parental leave policy. Residents who took parental leave identified a lack of a universal leave policy, strain on the residency program, a loss of education/training time, a lack of flexibility of programs, and a perceived or actual lack of support from faculty/peers as the top 5 biggest obstacles to taking leave during the clinical years of residency. CONCLUSIONS AND RELEVANCE: Most of the modifiable factors that inhibit residents from having children during residency are associated with policies (eg, a lack of universal leave policy and lack of flexibility) and personnel (eg, a strain on the residency program and lack of support from peers/faculty). These data suggest that policies at the level of the Accreditation Council for Graduate Medical Education or Resident Review Committee (RRC), as well as education and the normalization of pregnancy during training, may be effective interventions.
Hereditary myopathies are a group of genetically determined muscle disorders comprising more than 300 entities. In Chile, there are no specific registries of the distinct forms of these myopathies. ...We now report the genetic findings of a series of Chilean patients presenting with limb-girdle muscle weakness of unknown etiology. Eighty-two patients were explored using high-throughput sequencing approaches with neuromuscular gene panels, establishing a definite genetic diagnosis in 49 patients (59.8%) and a highly probable genetic diagnosis in eight additional cases (9.8%). The most frequent causative genes identified were DYSF and CAPN3, accounting for 22% and 8.5% of the cases, respectively, followed by DMD (4.9%) and RYR1 (4.9%). The remaining 17 causative genes were present in one or two cases only. Twelve novel variants were identified. Five patients (6.1%) carried a variant of uncertain significance in genes partially matching the clinical phenotype. Twenty patients (24.4%) did not carry a pathogenic or likely pathogenic variant in the phenotypically related genes, including five patients (6.1%) presenting an autoimmune neuromuscular disorder. The relative frequency of the different forms of myopathy in Chile is like that of other series reported from different regions of the world with perhaps a relatively higher incidence of dysferlinopathy.
An ultra-compact planar antenna aiming to be part of an imaging antenna array operating in the broad 3–18 GHz frequency range is presented. The antenna is made of two closely packed wide-band ...monopoles for simultaneous transmission and reception functionalities. A high isolation ( >20 dB) between the two patches is achieved through the insertion of a structured ground plane (decoupling structure). A prototype was fabricated on a Roger R4003c laminate measuring 58 × 33 mm2 and used in inverse synthetic array radar configuration for detecting a steel object with sub-centimetre spatial resolution.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Spinal muscular atrophy (SMA) has gained much attention in the last few years because of the approval of the first intrathecal treatment for this neurodegenerative disease. Latin America needs to ...develop the demographics of SMA, timely access to diagnosis, and appropriate following of the standards of care recommendations for patients. These are essential steps to guide health policies. This was a descriptive study of a cohort of SMA patients from all over Chile. We analyzed the clinical, motor functional, and social data, as well as the care status of nutritional, respiratory and skeletal conditions. We also measured the SMN2 copy number in this population.
We recruited 92 patients: 50 male; 23 SMA type-1, 36 SMA type-2 and 33 SMA type-3. The median age at genetic diagnosis was 5, 24 and 132 months. We evaluated the SMN2 copy number in 57 patients. The SMA type-1 patients were tracheostomized and fed by gastrostomy in a 69.6 % of cases, 65% of SMA type-2 patients received nocturnal noninvasive ventilation, and 37% of the whole cohort underwent scoliosis surgery.
Ventilatory care for SMA type-1 is still based mainly on tracheostomy. This Chilean cohort of SMA patients had timely access to genetic diagnosis, ventilatory assistance, nutritional support, and scoliosis surgery. In this series, SMA type-1 is underrepresented, probably due to restrictions in access to early diagnosis and the high and early mortality rate.
In this brief, we propose to use a transformer-based resonator to build a dual-mode oscillator, e.g., a system capable of oscillating at two different frequencies without recurring to switched ...inductors, switched capacitors, or varactors. The behavior of the resonator configured as a one-port and a two-port network is studied analytically, and the dependence of the quality factor on the design parameters is thoroughly explored. These results, combined with the use of traditional frequency tuning techniques, are applied to the design of a wide-band voltage-controlled oscillator (VCO) that covers the frequency range 3.6-7.8 GHz. The performance of the designed VCO, implemented in a digital 0.13-mum CMOS technology, has been studied by transistor-level and 2.5D electromagnetic simulation (Agilent Momentum). A typical phase noise performance at 1-MHz offset of -104 dBc/Hz has been predicted, while the power consumption ranges from 1 to 8 mW, depending on the VCO configuration
Aims
The aim of this research was to study the effect of time, temperature, sugar content and addition of diammonium phosphate (DAP) on ochratoxin A (OTA) removal by two strains of Saccharomyces ...cerevisiae using a completely randomized design.
Methods and Results
The strains were grown in a medium containing OTA (2 μg l−1), two sugar levels (200 and 250 g l−1), with or without DAP (300 mg l−1), and incubated at 25–30°C. The yeasts were able to decrease the toxin amount by c. 70%, with the highest removing effect observed after 3 days at 30°C in the presence of 250 g l−1 of sugars and with DAP; after 10 days, the toxin was partially released into the medium. The strains produced high ethanol and glycerol contents, showed high tolerance to single/combined stress conditions and possessed β‐d‐glucosidase, pectinase and xylanase activities.
Conclusions
Ochratoxin A removal was affected by time, temperature, sugar and addition of DAP. Moreover, the phenomenon was reversible.
Significance and Impact of the Study
Ochratoxin A removal could be an interesting trait for the selection of promising strains; however, the strains removing efficiently the toxin could release it back; thus, the selection of the starter should take into account both the removal and the binding ability of OTA.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Tephra fallout hazard assessment is undertaken with probabilistic maps that rely on numerical models. Regarding maps production, the input parameters of the model (including atmospheric conditions), ...the physical approximations of the numerical simulations, and the probabilities of occurrence of different eruption types in specific time frames are among the most critical sources of uncertainty. We therefore present a tephra fallout hazard assessment study for two active volcanoes (Cotopaxi and Guagua Pichincha) in Ecuador. We utilize PLUME‐MoM/HYSPLIT models, and a procedure for uncertainty quantification where: (a) the uncertainty on eruptive source parameters and eruption type occurrence is quantified through expert elicitation; (b) we implement a new procedure for correlations between the different parameters, and (c) we use correction coefficients to take into account the uncertainty of the numerical model. Maps of exceedance probability given a deposit thickness threshold, and thickness maps given a probability of exceedance, are produced (a) for two eruptive scenarios (sub‐Plinian and Plinian) and (b) as a combination of these scenarios in case the next eruption will be sub‐Plinian or Plinian. These maps are described according to the uncertainty distribution of eruption type occurrence probabilities, considering their 5th percentile, mean, and 95th percentile values. We finally present hazard curves describing exceeding probabilities in 10 sensitive sites within the city of Quito. Additional information includes the areal extent and the population potentially affected by different isolines of tephra accumulation. This work indicates that full uncertainty quantification helps in providing more robust scientific information, improving the hazard assessment reliability.
Plain Language Summary
We present a tephra fallout (i.e., volcanic ash accumulation on the ground due to sedimentation from volcanic clouds) hazard assessment for two Ecuadorian volcanoes (Cotopaxi and Guagua Pichincha) threatening Quito, the capital city of Ecuador. The novelties of this study are that (a) we use coupled models for eruptive column and ash transport and (b) we quantify the main sources of uncertainties that normally affect probabilistic hazard maps. In particular, we present probability maps, for which a certain deposit thickness is overcome, and thickness maps, which show the expected thickness for a given probability. For the two volcanoes, the maps are related to the case that a next eruption will be of medium to large size (i.e., sub‐Plinian or Plinian). Moreover, we also present hazard curves for 10 sensitive sites within the city of Quito. These curves are used to infer, for each site, the probabilities for a given accumulation of ash. Finally, we show the areal extent and the population potentially affected by different tephra accumulations. Our study points toward the necessity to perform a full uncertainty quantification for volcanic hazard assessment.
Key Points
We develop tephra fallout probabilistic hazard maps for Cotopaxi and Guagua Pichincha volcanoes using the PLUME‐MoM/HYSPLIT model
We incorporate the quantification of the uncertainty on the input parameters, the model, and the occurrence of different eruption types
Our study indicates that full uncertainty quantification is essential in volcanic hazard assessment in order to provide robust information
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The preparation and characterization of thin dense sulfonated poly-ether-ether-ketone with cardo group (PEEK-WC) membranes for proton exchange membrane fuel cell (PEMFC) applications are described. ...The sulfonation of PEEK-WC polymer was realized via chloro-sulfonic acid and different kinds of membrane samples were prepared with a sulfonation degree ranging from 67 to 99%. The degree of sulfonation, homogeneity and thickness significantly affect both the membrane transport properties and the electrochemical performances. The dense character of the membranes was confirmed by SEM analysis. Proton conductivity measurements were carried out in a temperature range from 30 to 80 °C and at 100% of relative humidity, reaching 5.40×10
−3 S/cm
−1 as best value at 80 °C and with a sulfonation degree (DS) of 99%. At the same conditions, a water uptake of 17% was achieved. DSC and TGA characterizations were used in order to determine the thermal stability of the membranes, confirming a
T
g
ranging between 206 and 216 °C depending on the DS, whereas FT-IR yielded indication about intermolecular interactions and water uptake at various sulfonation degrees.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Kinetic energy models, also called kinetic models, are simple tools able to provide a fast estimate of the inundation area of pyroclastic density currents (PDCs). They are based on the calculation of ...the PDC front kinetic energy as a function of the distance from a source point. On a three‐dimensional topography, the PDC runout distance is estimated by comparing the flow kinetic energy with the potential energy associated with the topographic obstacles encountered by the PDC. Since kinetic models do not consider the occurrence of channelization processes, the modeled inundation areas can be significantly different from those observed in real deposits. To address this point, we present a new strategy that allows improving kinetic models by considering flow channelization processes, and consists in the inclusion of secondary source points in the expected channelization zones, adopting a tree branch‐like structure. This strategy is based on the redistribution of a key physical variable, such as the flow energy or mass depending on the considered kinetic model, and requires the adoption of appropriate equations for setting the characteristics of the secondary sources. Two models were modified by applying this strategy: the energy cone and the box model. We tested these branching models by comparing their results with those derived from their traditional formulations and from a two‐dimensional depth‐averaged model, considering two specific volcanoes (Chaitén and Citlaltépetl). Thereby, we show the capability of this strategy of improving the accuracy of kinetic models and considering flow channelization processes without including additional, unconstrained input parameters.
Key Points
We present a new strategy for modifying kinetic models to consider the occurrence of channelization processes of pyroclastic material
Two widely used kinetic models are modified by implementing this strategy: the energy cone and the box model
We improve the accuracy of kinetic models without adding new, unconstrained input parameters
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Functional decline among patients with mental illness is not unique to individuals with psychotic disorders. Despite this, research on early predictors of functional outcome mainly focused on ...individuals thought to have an 'at risk mental state' (ARMS) for psychosis. There is evidence suggesting that certain early vulnerability markers, such as neurological soft signs (NSS), may explain variability in functional outcomes independent of the level of psychosis risk and the traditional diagnostic classification.
Structural equation modeling was applied to baseline data from a prospective longitudinal study of 138 young individuals in treatment with secondary services for non-psychotic disorders. We evaluated theoretically based models of pathways to functional outcome starting from NSS. The intervening variables were established according to previous evidence and drawn from two general categories: cognition (neuro- and social-) and negative symptoms (expressive and experiential).
A final trimmed model was a single path running from NSS to neurocognition to experiential negative symptoms to outcome. It could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from NSS to outcome was significant. The validity of the model was independent of the ARMS status and the psychiatric diagnosis.
Our results provide evidence for a single pathway model in which the starting and intervening variables represent modifiable trans-diagnostic therapeutic targets to improve functional trajectories in young individuals with a recent-onset psychiatric diagnosis and different levels of psychosis risk.
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