Ethnic differences in success at application for consultant posts among United Kingdom physicians from 2011 to 2019: a retrospective cross-sectional observational study.

OBJECTIVES: To identify associations between success following application for consultant physician posts and demographic factors. DESIGN: Logistic regression analysis of nationwide survey data. SETTING: United Kingdom (UK) physicians with a recent certificate of completion of training (CCT). PARTICIPANTS: All UK trainee physicians who received a CCT between 2010 and 2019 were surveyed. Respondents were excluded if they had not applied for a consultant post or if application data were incomplete. MAIN OUTCOME MEASURES: The primary outcome measure was success over the entire consultant application process, i.e. shortlisted and offered the post following the first application. Secondary outcomes were: shortlisted following first application and offered a consultant post at first interview. RESULTS: From 7037 CCT holders surveyed, 50.7% responded. While 1198 (59.7%) respondents were white, 760 (37.9%) were from minority ethnic groups and 50 (3.5%) were of unknown ethnicity. Primary medical qualification (PMQ) country was the UK in 75.3% (n = 1512). On multivariable logistic regression analysis the independent negative associations with success were: minority ethnicity (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.43-0.71); p < 0.001) vs. white; PMQ from Europe (OR 0.47, 95% CI 0.28-0.79; p = 0.004) or Asia (OR 0.68, 95% CI 0.49-0.96; p = 0.027) vs. UK PMQ; year of CCT 2012 (OR 0.40, 95% CI 0.24-0.68; p = 0.001), 2013 (OR 0.39, 95% CI 0.23-0.65; p < 0.001), and 2014 (OR 0.26, 95% CI 0.15-0.43; p < 0.001) vs. 2019. Specialties associated with lower success rates included Cardiology, Endocrinology, Genitourinary medicine, Palliative care, Renal and Respiratory, compared to Acute medicine. CONCLUSIONS: Minority ethnic group candidates for consultant physician posts had lower success rates compared to white candidates after correction for important variables including specialty, time from and country of PMQ. This finding requires further evaluation to identify the causes for this variation.

Plasma Double Layers at the Boundary Between Venus and the Solar Wind.

The solar wind is slowed, deflected, and heated as it encounters Venus's induced magnetosphere. The importance of kinetic plasma processes to these interactions has not been examined in detail, due to a lack of constraining observations. In this study, kinetic-scale electric field structures are identified in the Venusian magnetosheath, including plasma double layers. The double layers may be driven by currents or mixing of inhomogeneous plasmas near the edge of the magnetosheath. Estimated double-layer spatial scales are consistent with those reported at Earth. Estimated potential drops are similar to electron temperature gradients across the bow shock. Many double layers are found in few high cadence data captures, suggesting that their amplitudes are high relative to other magnetosheath plasma waves. These are the first direct observations of plasma double layers beyond near-Earth space, supporting the idea that kinetic plasma processes are active in many space plasma environments.

Animal industry and veterinary science in eastern New Guinea: World War II to Independence, 1975.

We have described the efforts of the Australian administration of the Territory of Papua and New Guinea (TPNG) to establish a veterinary service and viable animal industries. These efforts began with planning before the end of World War II in 1945 and continued until independence in 1975. Whereas pre-war cattle had mostly been used to control grass on plantations, post-war, the objective was to use the country's extensive, unoccupied grasslands for cattle production. During this period, the cattle population increased from 4000 to more than 150,000. The greatest success was achieved in herds with crosses of Bos indicus and Bos taurus owned by expatriates. The only serious disease constraint on production was myiasis due to Chrysomya bezziana, a parasite throughout New Guinea and South-east Asia. Attempts were made to increase the productivity of the indigenous pig population. Success was limited by a failure to manage inadequate nutrition and internal parasites and to fully understand the cultural aspects of pig ownership. Similar problems inhibited chicken production in villages. The serious viral infections of pigs and birds were absent from TPNG, but a border with Indonesian Papua represents a potential route for the incursion of animal diseases exotic to both Papua New Guinea and to Australia.

Quantification of Trichoderma afroharzianum, Trichoderma harzianum and Trichoderma gamsii inoculants in soil, the wheat rhizosphere and in planta suppression of the crown rot pathogen Fusarium pseudograminearum.

AIMS: Develop quantitative assays (qPCR) to determine the detection threshold limits, colonization and persistence of Trichoderma gamsii, Trichoderma afroharzianum and T. harzianum inoculants in cropping soils, the wheat rhizosphere and their in planta suppressive efficacy against the crown rot pathogen Fusarium pseudograminearum. METHODS AND RESULTS: Trichoderma qPCR primers were designed from the internal transcribed spacer region of 5.8S rDNA and from sequences of DNA fragments diagnostic for each inoculant genotype. The minimum detection thresholds of qPCR assays varied between 1 × 103 (log 3) and 8 × 104 (log 4·9) conidia (genome) equivalents per gram of soil for multi- and single-copy target sequences, respectively and were independent of soil type. There was a strong correlation (r > 0·974) between culture-dependent and culture-independent (qPCR) quantification methods. In wheat bioassays, Trichoderma inoculants colonized rhizosphere soils and wheat roots at 56-112 days postemergence to a depth of 20 cm but were more abundant (P < 0·001) at 0-10 cm root depth, means ranging from 2 × 102 (log 2·3) to 4 × 105 (log 5·6) conidia equivalents per gram of rhizosphere soil or root tissue. Inoculants reduced (P < 0·001) F. pseudograminearum biomass in wheat crown and root tissue by up to 5754-fold and increased (P = 0·008) plant biomass, relative to the pathogen control. CONCLUSIONS: The qPCR assays provided sensitive and accurate assessment of wheat root and rhizosphere soil colonization of Trichoderma inoculants. Strains persisted through to grain maturity at levels shown to significantly suppress F. pseudograminearum in planta. SIGNIFICANCE AND IMPACT OF THE STUDY: The qPCR assays developed here were used to determine the wheat rhizosphere dynamics of T. harzianum, T. afroharzianum and T. gamsii inoculants and their suppressive efficacy against F. pseudograminearum in planta. These assays can be applied to monitor inoculant dynamics in suppressing crown rot and other wheat root diseases in the field.

Highly structured slow solar wind emerging from an equatorial coronal hole.

During the solar minimum, when the Sun is at its least active, the solar wind1,2 is observed at high latitudes as a predominantly fast (more than 500 kilometres per second), highly Alfvénic rarefied stream of plasma originating from deep within coronal holes. Closer to the ecliptic plane, the solar wind is interspersed with a more variable slow wind3 of less than 500 kilometres per second. The precise origins of the slow wind streams are less certain4; theories and observations suggest that they may originate at the tips of helmet streamers5,6, from interchange reconnection near coronal hole boundaries7,8, or within coronal holes with highly diverging magnetic fields9,10. The heating mechanism required to drive the solar wind is also unresolved, although candidate mechanisms include Alfvén-wave turbulence11,12, heating by reconnection in nanoflares13, ion cyclotron wave heating14 and acceleration by thermal gradients1. At a distance of one astronomical unit, the wind is mixed and evolved, and therefore much of the diagnostic structure of these sources and processes has been lost. Here we present observations from the Parker Solar Probe15 at 36 to 54 solar radii that show evidence of slow Alfvénic solar wind emerging from a small equatorial coronal hole. The measured magnetic field exhibits patches of large, intermittent reversals that are associated with jets of plasma and enhanced Poynting flux and that are interspersed in a smoother and less turbulent flow with a near-radial magnetic field. Furthermore, plasma-wave measurements suggest the existence of electron and ion velocity-space micro-instabilities10,16 that are associated with plasma heating and thermalization processes. Our measurements suggest that there is an impulsive mechanism associated with solar-wind energization and that micro-instabilities play a part in heating, and we provide evidence that low-latitude coronal holes are a key source of the slow solar wind.

The FIELDS Instrument Suite for Solar Probe Plus: Measuring the Coronal Plasma and Magnetic Field, Plasma Waves and Turbulence, and Radio Signatures of Solar Transients.

NASA's Solar Probe Plus (SPP) mission will make the first in situ measurements of the solar corona and the birthplace of the solar wind. The FIELDS instrument suite on SPP will make direct measurements of electric and magnetic fields, the properties of in situ plasma waves, electron density and temperature profiles, and interplanetary radio emissions, amongst other things. Here, we describe the scientific objectives targeted by the SPP/FIELDS instrument, the instrument design itself, and the instrument concept of operations and planned data products.

Peer-led training and assessment in basic life support for healthcare students: synthesis of literature review and fifteen years practical experience.

BACKGROUND: In 1995, the University of Birmingham, UK, School of Medicine and Dentistry replaced lecture-based basic life support (BLS) teaching with a peer-led, practical programme. We present our 15-yr experience of peer-led healthcare undergraduate training and examination with a literature review. METHODS: A literature review of healthcare undergraduate peer-led practical skills teaching was performed though Pubmed. The development of the Birmingham course is described, from its inception in 1995-2011. Training methods include peer-led training and assessment by senior students who complete an European Resuscitation Council-endorsed instructor course. Student assessors additionally undergo training in assessment and communication skills. The course has been developed by parallel research evaluation and peer-reviewed publication. Course administration is by an experienced student committee with senior clinician support. Anonymous feedback from the most recent courses and the current annual pass rates are reported. RESULTS: The literature review identified 369 publications of which 28 met our criteria for inclusion. Largely descriptive, these are highly positive about peer involvement in practical skills teaching using similar, albeit smaller, courses to that described below. Currently approximately 600 first year healthcare undergraduates complete the Birmingham course; participant numbers increase annually. Successful completion is mandatory for students to proceed to the second year of studies. First attempt pass rate is 86%, and close to 100% (565/566 students, 99.8%) following re-assessment the same day. 97% of participants enjoyed the course, 99% preferred peer-tutors to clinicians, 99% perceived teaching quality as "good" or "excellent", and felt they had sufficient practice. Course organisation was rated "good" or "excellent" by 91%. Each year 3-4 student projects have been published or presented internationally. The annual cost of providing the course is currently £15,594.70 (Eur 18,410), or approximately £26 (Eur 30) per student. CONCLUSIONS: This large scale, peer-led BLS course demonstrates that such programmes can have excellent outcomes with outstanding participant satisfaction. Peer-tutors and assessors are competent, more available and less costly than clinical staff. Student instructors develop skills in teaching, assessment and appraisal, organisation and research. Sustainability is possible given succession-planning and consistent leadership.

Design of a radiative surface coil array element at 7 T: the single-side adapted dipole antenna.

Ultra high field MR imaging (≥7 T) of deeply located targets in the body is facing some radiofrequency-field related challenges: interference patterns, reduced penetration depth, and higher Specific Absorbtion Ratio (SAR) levels. These can be alleviated by redesigning the elements of the transmit or transceive array. This is because at these high excitation field (B(1) ) frequencies, conventional array element designs may have become suboptimal. In this work, an alternative design approach is presented, regarding coil array elements as antennas. Following this approach, the Poynting vector of the element should be oriented towards the imaging target region. The single-side adapted dipole antenna is a novel design that fulfills this requirement. The performance of this design as a transmit coil array element has been characterized by comparison with three other, more conventional designs using finite difference time domain (FDTD) simulations and B +1 measurements on a phantom. Results show that the B +1 level at the deeper regions is higher while maintaining relatively low SAR levels. Also, the B +1 field distribution is more symmetrical and more uniform, promising better image homogeneity. Eight radiative antennas have been combined into a belt-like surface array for prostate imaging. T(1) -weighted (T1W) and T(2) -weighted (T2W) volunteer images are presented along with B +1 measurements to demonstrate the improved efficiency.

Dynamics of introduced populations of Phragmidium violaceum and implications for biological control of European blackberry in Australia.

Phragmidium violaceum causes leaf rust on the European blackberry (Rubus fruticosus L. aggregate). Multiple strains of this pathogen have been introduced into southern Australia for the biological control of at least 15 taxa of European blackberry, a nonindigenous, invasive plant. In climates conducive to leaf rust, the intensity of disease varies within and among infestations of the genetically variable host. Genetic markers developed from the selective amplification of microsatellite polymorphic loci were used to assess the population genetic structure and reproductive biology of P. violaceum within and among four geographically isolated and diseased infestations of the European blackberry in Victoria, Australia. Despite the potential for long-distance aerial dispersal of urediniospores, there was significant genetic differentiation among all populations, which was not associated with geographic separation. An assessment of multilocus linkage disequilibrium revealed temporal and geographic variation in the occurrence of random mating among the four populations. The presence of sexual spore states and the results of genetic analyses indicated that recombination, and potentially random migration and genetic drift, played an important role in maintaining genotypic variation within populations. Recombination and genetic differentiation in P. violaceum, as well as the potential for metapopulation structure, suggest the need to release additional, genetically diverse strains of the biocontrol agent at numerous sites across the distribution of the Australian blackberry infestation for maximum establishment and persistence.

The effect of Penicillium fungi on plant growth and phosphorus mobilization in neutral to alkaline soils from southern Australia.

The phosphate solubilizing fungi Penicillium radicum, Penicillium bilaiae (strain RS7B-SD1), and an unidentified Penicillium sp. designated strain KC6-W2 were tested for their ability to increase the growth and phosphorus (P) nutrition of wheat, medic, and lentil in three soils of neutral to alkaline pH reaction. The strongest plant growth promoting (PGP) strain was Penicillium sp. KC6-W2, which stimulated significant increases in shoot growth and dry mass in seven of the nine experiments conducted. Levels of PGP by Penicillium sp. KC6-W2 ranged from 6.6% to 19% and were associated with increased uptake of P to the shoot. The PGP properties of Penicillium sp. KC6-W2 were evident on each of the three different plant species and soil types, a level of reliability not observed in other strains tested. Inoculation of seed with P. radicum increased lentil growth by 5.5% (P < 0.05) in soil from Tarlee but did not affect plant growth in the eight other experiments. Inoculation of plant seed with P. bilaiae RS7B-SD1 resulted in significant PGP in two of the nine experiments conducted. However, when significant, stimulation of PGP by P. bilaiae RS7B-SD1 was strong and resulted in increases in medic dry matter (19%) and lentil shoot dry matter (15%). A soil microcosm experiment investigated the effect of Penicillium fungi on cycling of soil P. Penicillium bilaiae RS7B-SD1 was the only fungus to significantly increase HCO3-extractable P (23% increase; P < 0.05). Production of phosphatase enzymes was not associated with increased HCO3-extractable P. Addition of carbon in the form of ryegrass seed significantly increased microbial respiration and movement of P to the microbial biomass (P < 0.05), but these parameters were irrespective of Penicillium treatment. This work has established the potential for use of Penicillium inoculants to increase plant growth on alkaline soils in Australia. The role of Penicillium fungi in plant P uptake and soil P cycling requires further exploration.

Navigator motion correction of diffusion weighted 3D SSFP imaging.

Diffusion weighted (DW) 3D steady state MR (SSFP) head imaging technique using navigator echo's motion correction is presented. This new scheme enables acquisition of DW images even at regions where severe susceptibility is present. Another advantage is the moderate gradient performance requirements. DW imaging methods are sensitive to any kind of motion, thus, most of these methods might suffer from bulk motion artifacts. The common solution to avoid motion artifacts in a 2D DW SSFP acquisition is multi averaging. To avoid the time consuming multi averaging, the new scheme, described here, utilizes navigator echo's motion correction to remove respiratory bulk motion artifacts. At some brain regions, where the motion is governed by blood or CSF pulsation, the navigator motion correction fails. At these regions the correction is an interpolation of corrections from regions where the motion is particularly of the respiratory type. The combination of a 3D sequence with a navigator echo motion correction, enables acquisition of 10 DW slices within a time of 0:50-2:30 min.

Genetic diversity and biological control activity of novel species of closely related pseudomonads isolated from wheat field soils in South Australia.

Rhizobacteria closely related to two recently described species of pseudomonads, Pseudomonas brassicacearum and Pseudomonas thivervalensis, were isolated from two geographically distinct wheat field soils in South Australia. Isolation was undertaken by either selective plating or immunotrapping utilizing a polyclonal antibody raised against P. brassicacearum. A subset of 42 isolates were characterized by amplified 16S ribosomal DNA restriction analysis (ARDRA), BIOLOG analysis, and gas chromatography-fatty acid methyl ester (GC-FAME) analysis and separated into closely related phenetic groups. More than 75% of isolates tested by ARDRA were found to have >95% similarity to either Pseudomonas corrugata or P. brassicacearum-P. thivervalensis type strains, and all isolates had >90% similarity to either type strain. BIOLOG and GC-FAME clustering showed a >70% match to ARDRA profiles. Strains representing different ARDRA groups were tested in two soil types for biological control activity against the soilborne plant pathogen Gaeumannomyces graminis var. tritici, the causative agent of take-all of wheat and barley. Three isolates out of 11 significantly reduced take-all-induced root lesions on wheat plants grown in a red-brown earth soil. Only one strain, K208, was consistent in reducing disease symptoms in both the acidic red-brown earth and a calcareous sandy loam. Results from this study indicate that P. brassicacearum and P. thivervalensis are present in Australian soils and that a level of genetic diversity exists within these two novel species but that this diversity does not appear to be related to geographic distribution. The result of the glasshouse pot trial suggests that some isolates of these species may have potential as biological control agents for plant disease.

A keyhole echo planar hybrid imaging technique.

A hybrid keyhole imaging method is presented which demonstrates the combination of two distinctly different MR imaging techniques. In this work single shot EPI was used as a dynamic update scan for a conventional high resolution gradient echo acquisition. Problems associated with the integration of MR data from distinctly different imaging techniques are addressed. Illustration is provided by way of diffusion weighted imaging. This novel development requires further investigation which need not be limited to the hybridization of strictly Cartesian based scanning methods.

Rapid iterative reconstruction for echo planar imaging.

A rapid automated method for reconstructing echo planar imaging (EPI) data has been developed and is shown to improve image quality by suppressing the troublesome ghost artifact. The algorithm can be applied without prior knowledge obtained from either reference scans or operator intervention. It first estimates, then improves iteratively, the parameters for a linear phase correction applied directly to the complex image data derived from odd and even echoes. The theory used to derive the criteria employed in the iteration provides insight into mechanisms that allow the process to work. Magn Reson Med 42:541-547, 1999.

Modular gradient coil: A new concept in high-performance whole-body gradient coil design.

A new concept in high-performance MR gradient coil design is presented which we have called the Modular Gradient Coil (MGC). This novel design approach results in an actively shielded whole-body gradient coil containing multiple and independent elements, integrated onto a single former, for generating gradient fields along each of the three axes (x, y, and z). These elements can be energized in a number of configurations, using a single gradient power supply unit (PSU), to generate a whole range of gradient performance levels. The design criteria for the MGC also include a requirement to prohibit peripheral nerve stimulation in all of its modes of operation. This requirement is achieved, while simultaneously providing high performance, by specifying different volumes of gradient linearity for each of the operating modes. Magn Reson Med 42:561-570, 1999.

The modular (twin) gradient coil--high resolution, high contrast, diffusion weighted EPI at 1.0 Tesla.

The modular (twin) gradient coil is a novel and effective approach to obtaining flexible and high power gradient performance without (i) peripheral nerve stimulation and (ii) the need for resonant or expensive high voltage gradient power supply units (PSU). This whole-body gradient system contains, on the same former, two independent sets of gradient coils, the conventional coil set and the short-body coil set. Each gradient axis is able to operate, independently, in any one of three modes. The third, combined, mode is realized by connecting the conventional coils and short-body coils in series. Through careful design of the shape and size of the linear volume of each mode of operation, the modular gradient coil is able to utilize the power, from a single gradient PSU, more efficiently and more appropriately, as determined by the application. In the short-body and combined modes the gradient fields are linear over a volume suitable for whole head/neck, liver and cardiovascular applications. In the conventional mode, a reduced performance is possible but over a much larger (conventional) imaging volume. Utilizing a semi-conductor switching arrangement it is possible to switch between modes in as little as 1 ms. By mixing different modes of operation on different gradient axes it is possible to utilize more efficiently, and safely, the properties of gradient performance best suited to the sequence requirements. Diffusion weighted EPI (DW-EPI) is a particular technique that demands the extremes of gradient system performance in terms of both amplitude and slew rate. DW-EPI has been implemented, using the modular gradient system, on a 1.0 Tesla whole-body MRI system. The preliminary results presented here serve to illustrate the advantages of the modular gradient coil in of itself as well as the direct benefits it provides for DW imaging at 1.0 Tesla.

Accumulation of unconjugated bilirubin in cholesterol pellets implanted in swine gallbladders.

BACKGROUND & AIMS: Most cholesterol gallstones have a pigmented center, but it is unclear whether its presence is primary or secondary. This study was performed to determine if bilirubin would accumulate in a gallstone model consisting of cholesterol pellets. METHODS: Cholesterol was compressed into pellets at 2500 psi, producing a pellet that behaved like human cholesterol gallstones in regard to penetration of solutes into the stone. Pellets were implanted into gallbladders of pigs and harvested after 4 weeks. Bilirubin species were measured by high-performance liquid chromatography. RESULTS: The proportions of bilirubin species in bile were not changed by the presence of pellets, i.e., diconjugates (mean +/- SD, 1.9% +/- 1.0% vs. 0.7% +/- 0.8%), monoconjugates (83.8% +/- 5.5% vs. 87.8% +/- 6.6%), and unconjugated bilirubin (14.2% +/- 5.3% vs. 11.5% +/- 5.6%) were similar at the time of implantation and removal. The cut surfaces of the pellets were pigmented. Pellets contained 5.46 +/- 1.38 micrograms bilirubin/g sample at harvesting, and 98.6% +/- 2.3% of bilirubin in pellets was unconjugated. In in vitro studies, there was a large increase in unconjugated bilirubin in the bile. Pellets also became pigmented in vitro, but there was considerable variability in the bilirubin species present in the pellets. CONCLUSIONS: Unconjugated bilirubin accumulates in cholesterol pellets and pigments them. This provides a mechanism by which cholesterol gallstones could become secondarily pigmented.

Echo-volumar imaging (EVI) at 0.5 T: first whole-body volunteer studies.

Improvements in the echo-volumar imaging (EVI) technique and its application in whole-body studies are described. Using an in-house built 0.5 T echo-planar imaging system, complete modulus three-dimensional image data are acquired in 102 ms with real-time display. Hardware limitations have restricted the maximum array size achievable to 64 x 32 x 8 voxels. Representative voxel dimensions are x = 6.0 mm; y = 4.0 mm, and z = 10.0 mm. Results on human volunteers are presented, showing cardiac, liver, and bladder images. Also shown are the first EVI gastric filling and emptying results.

The influence of prostaglandin E1 on platelet adherence and injury in preserved rat liver allografts.

We have previously shown that part of the injury sustained by cold-preserved livers on reperfusion is the consequence of platelet adhesion to sinusoidal endothelium. The purpose of the present study was to determine whether prostaglandin E1 (PGE1) can reduce the injury and if so, how to maximize this beneficial effect. Rat livers were cold-preserved in University of Wisconsin solution for 30 hours then subjected to 1-hour warm ischemia after which they were reperfused at 37 degrees C with oxygenated Krebs-Henseleit solution with or without isolated platelets. PGE1 was used to treat the donor liver during harvesting, cold preservation, and reperfusion. In some studies, PGE1 was used to pretreat platelets before exposing them to the liver, and in other studies, both liver and platelets were treated. Pretreatment of platelets with paraformaldehyde, which inactivates them, or ADP, which activates them, was also studied. Treatment of livers with PGE1 significantly decreased preservation injury when livers were reperfused in the absence of platelets. However, when platelets were added to the perfusate, prior treatment of the liver with PGE1 had relatively minor beneficial effects. Pretreatment of platelets alone with PGE1 was also beneficial, but again the effect was small. However, when both liver and platelets were treated with PGE1 there was a highly significant decrease in the extent of liver injury and platelet adhesion. Perfusate transaminase levels were lower, bile flow was improved, and histologically, livers appeared less injured. Pretreatment of platelets with paraformaldehyde produced similar results to pretreatment with PGE1. When platelets were preactivated with adenosine diphosphate, extensive hepatic injury occurred upon reperfusion despite PGE1 treatment of the liver. PGE1 can lessen preservation-reperfusion injury impressively when administered to both liver and platelets but has little effect when platelets have been preactivated.