We have constructed a sample of radio-loud objects with optical spectroscopy from the Galaxy and Mass Assembly (GAMA) project over the Herschel Astrophysical Terahertz Large Area Survey ...(Herschel-ATLAS) Phase 1 fields. Classifying the radio sources in terms of their optical spectra, we find that strong-emission-line sources ('high-excitation radio galaxies') have, on average, a factor of ∼4 higher 250-μm Herschel luminosity than weak-line ('low-excitation') radio galaxies and are also more luminous than magnitude-matched radio-quiet galaxies at the same redshift. Using all five H-ATLAS bands, we show that this difference in luminosity between the emission-line classes arises mostly from a difference in the average dust temperature; strong-emission-line sources tend to have comparable dust masses to, but higher dust temperatures than, radio galaxies with weak emission lines. We interpret this as showing that radio galaxies with strong nuclear emission lines are much more likely to be associated with star formation in their host galaxy, although there is certainly not a one-to-one relationship between star formation and strong-line active galactic nuclei (AGN) activity. The strong-line sources are estimated to have star formation rates at least a factor of 3-4 higher than those in the weak-line objects. Our conclusion is consistent with earlier work, generally carried out using much smaller samples, and reinforces the general picture of high-excitation radio galaxies as being located in lower-mass, less evolved host galaxies than their low-excitation counterparts.
We apply a cross-correlation technique to infer the S > 3 mJy radio luminosity function (RLF) from the NRAO VLA Sky Survey (NVSS) to z ∼ 3.5. We measure Σ the over density of radio sources around ...spectroscopically confirmed quasars. Σ is related to the space density of radio sources at the distance of the quasars and the clustering strength between the two samples, hence knowledge of one constrains the other. Under simple assumptions we find Φ ∝ (1 + z)3.7 ± 0.7 out to z ∼ 2. Above this redshift the evolution slows and we constrain the evolution exponent to <1.01 (2σ). This behaviour is almost identical to that found by previous authors for the bright end of the RLF potentially indicating that we are looking at the same population. This suggests that the NVSS is dominated by a single population; most likely radio sources associated with high-excitation cold-mode accretion. Inversely, by adopting a previously modelled RLF we can constrain the clustering of high-redshift radio sources and find a clustering strength consistent with r
0 = 15.0 ± 2.5 Mpc up to z ∼ 3.5. This is inconsistent with quasars at low redshift and some measurements of the clustering of bright FR II sources. This behaviour is more consistent with the clustering of lower luminosity radio galaxies in the local Universe. Our results indicate that the high-excitation systems dominating our sample are hosted in the most massive galaxies at all redshifts sampled.
Ventral hernias are a complex and costly burden to the health care system. Although preoperative radiologic imaging is commonly performed, the plethora of anatomic features present and available in ...routine imaging are seldomly quantified and integrated into patient selection, preoperative risk stratification, and perioperative planning. We herein aimed to critically examine the current state of computed tomography feature application in predicting surgical outcomes.
A systematic review was conducted in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) checklist. PubMed, MEDLINE, and Embase databases were reviewed under search syntax "computed tomography imaging" and "abdominal hernia" for papers published between 2000 and 2020.
Of the initial 1922 studies, 12 papers met inclusion and exclusion criteria. The most frequently used radiologic features were hernia volume (n = 9), subcutaneous fat volume (n = 5), and defect size (n = 8). Outcomes included both complications and need for surgical intervention. Median area under the curve (AUC) and odds ratio were 0.68 (±0.16) and 1.12 (±0.39), respectively. The best predictive feature was hernia neck ratio > 2.5 (AUC 0.903).
Computed tomography feature selection offers hernia surgeons an opportunity to identify, quantify, and integrate routinely available morphologic tissue features into preoperative decision-making. Despite being in its early stages, future surgeons and researchers will soon be able to integrate 3D volumetric analysis and complex machine learning and neural network models to improvement patient care.
Successful strategies to improve the representation of female and ethnically underrepresented in medicine (UIM) physicians among US plastic and reconstructive surgery (PRS) faculty have not been ...adequately explored. Accordingly, we aimed to identify programs that have had success, and in parallel gather PRS program directors' and chiefs/chairs' perspectives on diversity recruitment intentionality and strategies.
We conducted a cross-sectional analysis of the demographic composition of female and UIM faculty of PRS residency training programs. Separate lists of programs in the top quartile for female and UIM faculty representation were collated. Additionally, a 14-question survey was administered to program directors and chiefs/chairs of all 99 Accreditation Council for Graduate Medical Education-accredited PRS residency programs. The questions comprised three domains: (1) demographic information; (2) perceptions about diversity; and (3) recruitment strategies utilized to diversify faculty.
Female and UIM faculty representation ranged from 0% to 63% and 0% to 50%, respectively. Survey responses were received from program directors and chiefs/chairs of 55 institutions (55% response rate). Twenty-five (43%) respondents felt their program was diverse. Fifty-one (80%) respondents felt diversity was important to the composition of PRS faculty. Active recruitment of diverse faculty and the implementation of a diversity, equity, and inclusion committee were among the most frequently cited strategies to establish a culturally sensitive and inclusive environment.
These findings reveal that female and UIM representation among US PRS faculty remains insufficient; however, some programs have had success through deliberate and intentional implementation of diversity, equity, and inclusion strategies.
BACKGROUNDOncologic resection of the scalp confers several obstacles to the reconstructive surgeon dependent upon patient-specific and wound-specific factors. We aim to describe our experiences with ...various reconstructive methods, and delineate risk factors for coverage failure and complications in the setting of scalp reconstruction. METHODSA retrospective chart review was conducted, examining patients who underwent resection of fungating scalp tumors with subsequent soft-tissue reconstruction from 2003 to 2019. Patient demographics, wound and oncologic characteristics, treatment modalities, and outcomes were recorded and analyzed. RESULTSA total of 189 patients were appropriate for inclusion, undergoing a range of reconstructive methods from skin grafting to free flaps. Thirty-three patients (17.5%) underwent preoperative radiation. In all, 48 patients (25.4%) suffered wound site complications, 25 (13.2%) underwent reoperation, and 47 (24.9%) suffered from mortality. Preoperative radiation therapy was an independent risk factor for wound complications (odds ratio OR, 2.85; 95% confidence interval CI, 1.1-7.3; p = 0.028) and reoperations (OR, 4.45; 95% CI, 1.5-13.2; p = 0.007). Similarly, the presence of an underlying titanium mesh was an independent predictor of wound complications (OR, 2.49; 95% CI, 1.1-5.6; p= 0.029) and reoperations (OR, 3.40; 95% CI, 1.2-9.7; p= 0.020). Both immunosuppressed status (OR, 2.88; 95% CI, 1.2-7.1; p= 0.021) and preoperative radiation therapy (OR, 3.34; 95% CI, 1.2-9.7; p= 0.022) were risk factors for mortality. CONCLUSIONBoth preoperative radiation and the presence of underlying titanium mesh are independent risk factors for wound site complications and increased reoperation rates following oncologic resection and reconstruction of the scalp. Additionally, preoperative radiation, along with an immunosuppressed state, may predict patient mortality following scalp resection and reconstruction.
BACKGROUND:Retromuscular hernia repairs (RHRs) decrease hernia recurrence and surgical site infections but can cause significant pain. We aimed to determine if pain and postoperative outcomes ...differed when comparing suture fixation (SF) of mesh to fibrin glue fixation (FGF).
METHODS:Patients undergoing RHR (n = 87) between December 1, 2015 and December 31, 2017 were retrospectively identified. Patients received SF of mesh (n = 59, 67.8%) before the senior author changing his technique to FGF (n = 28, 32.2%). These 2 cohorts were matched (age, body mass index, number of prior repairs, mesh type, defect size, and wound class). Outcomes were analyzed using a matched pairs design with multivariable linear regression.
RESULTS:Two matched groups (21 FGF and 21 SF) were analyzed (45.2% female, average age 56 years, average body mass index 34.7 kg/m, and average defect size 330 cm). Statistical significance was observed for FGF compared with SFlength of stay (3.7 versus 7.1 days, P = 0.032), time with a drain (17.2 versus 27.5 days, P = 0.012), 30-day postoperative visits (2 versus 3, P = 0.003), pain scores (5.2 versus 3.1, P = 0.019) and activity within the first 24 hours (walking versus sitting, P = 0.002). Operative time decreased by 23.1 minutes (P = 0.352) and postoperative narcotic represcription (3 versus. 8 patients, p=0.147) also decreased. Average cost for patients receiving SF was $36,152 compared to $21,782 for FGF (P = 0.035).
CONCLUSIONS:Sutureless RHR using FGF may result in decreased pain when compared with a matched cohort receiving SF, translating to enhanced recovery time, shortened hospital stay, and decreased costs.
Abstract
We investigate the properties (e.g. star formation rate, dust attenuation, stellar mass and metallicity) of a sample of infrared (IR) luminous galaxies at z ∼ 1 via near-IR spectroscopy with ...Subaru-FMOS. Our sample consists of Herschel SPIRE and Spitzer MIPS selected sources in the COSMOS field with photometric redshifts in the range of 0.7 < z
phot < 1.8, which have been targeted in two pointings (0.5 deg2) with FMOS. We find a modest success rate for emission-line detections, with candidate Hα emission lines detected for 57 of 168 SPIRE sources (34 per cent). By stacking the near-IR spectra we directly measure the mean Balmer decrement for the Hα and Hβ lines, finding a value of 〈E(B − V)〉 = 0.51 ± 0.27 for 〈L
IR〉 = 1012 L⊙ sources at 〈z〉 = 1.36. By comparing star formation rates estimated from the IR and from the dust-uncorrected Hα line we find a strong relationship between dust attenuation and star formation rate. This relation is broadly consistent with that previously seen in star-forming galaxies at z ∼ 0.1. Finally, we investigate the metallicity via the N2 ratio, finding that z ∼ 1 IR-selected sources are indistinguishable from the local mass-metallicity relation. We also find a strong correlation between dust attenuation and metallicity, with the most metal-rich IR sources experiencing the largest levels of dust attenuation.
•Drawing and sculpting in surgical education is rare despite a variety of advantages•Creating art builds observation and judgement integral for all surgical specialties•Clay modeling and sketching ...can help solidify surgical anatomy for junior residents
Historically, surgery was developed through the visual work of artist-scientists, yet visual art in modern surgical education is rare. The aim of this review is to evaluate the existing literature of learner creation of visual art as an educational tool in surgery and to discuss its potential in augmenting surgical learning.
A systematic review of surgical educational interventions involving learner drawing, painting, and sculpting was conducted in 2020.
Our search yielded 388 unique articles, and 12 met inclusion criteria. Seven articles described drawing and sculpting courses designed to develop judgement or aesthetic sense, and five described initiatives to teach or assess surgical anatomy or knowledge. Common goals included the measurement and observation of live models to enhance judgement of proportions, understanding of three-dimensional (3D) anatomical structure, hand-eye coordination, and communicative drawing ability for patient education and medical documentation. Notable outcomes included improved retention of anatomy, correlation of drawing and image labeling with in-service exam scores, and correlation of procedural drawing with ability to perform the same procedure in a simulation.
Our review suggests that all surgical disciplines could benefit from artistic training through improved visual communication and deeper understanding of 3D anatomy. Such benefits can be translated into Accreditation Council for Graduate Medical Education (ACGME) Core Competencies to guide surgical residency programming. We propose that visual art serves as an educational tool to improve perceptual skill and anatomical understanding in the modern surgeon; however more research is needed to clarify the best modality for incorporation.
The Herschel-Astrophysical Terahertz Large Area Survey (H-ATLAS) provides an unprecedented opportunity to search for blazars at sub-mm wavelengths. We cross-matched the Faint Images of the Radio Sky ...at Twenty-cm (FIRST) radio source catalogue with the 11 655 sources brighter than 35 mJy at 500 μm in the ∼135 deg2 of the sky covered by the H-ATLAS equatorial fields at 9h and 15h, plus half of the field at 12h. We found that 379 of the H-ATLAS sources have a FIRST counterpart within 10 arcsec, including eight catalogued blazars (plus one known blazar that was found at the edge of one of the H-ATLAS maps). To search for additional blazar candidates we have devised new diagnostic diagrams and found that known blazars occupy a region of the log (S
500 μm/S
350 μm) versus log (S
500 μm/S
1.4 GHz) plane separated from that of sub-mm sources with radio emission powered by star formation, but shared with radio galaxies and steep-spectrum radio quasars. Using this diagnostic we have selected 12 further possible candidates that turn out to be scattered in the (r − z) versus (u − r) plane or in the Wide-Field Infrared Survey Explorer colour-colour diagram, where known blazars are concentrated in well defined strips. This suggests that the majority of them are not blazars. Based on an inspection of all the available photometric data, including unpublished VISTA Kilo-degree Infrared Galaxy survey photometry and new radio observations, we found that the spectral energy distributions (SEDs) of only one out of the 12 newly selected sources are compatible with being synchrotron dominated at least up to 500 μm, i.e. with being a blazar. Another object may consist of a faint blazar nucleus inside a bright star-forming galaxy. The possibility that some blazar hosts are endowed with active star formation is supported by our analysis of the SEDs of Planck Early Release Compact Source Catalogue blazars detected at both 545 and 857 GHz. The estimated rest-frame synchrotron peak frequencies of H-ATLAS blazars are in the range 11.5 ≤ log (νpeak, Hz) ≤ 13.7, implying that these objects are low synchrotron peak. Six of them also show evidence of an ultraviolet excess that can be attributed to emission from the accretion disc. Allowing for the possibility of misidentifications and of contamination of the 500 μm flux density by the dusty torus or by the host galaxy, we estimate that there are seven or eight pure synchrotron sources brighter than S
500 μm = 35 mJy over the studied area, a result that sets important constraints on blazar evolutionary models.
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