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1.
Science ; 364(6441)2019 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-31097641

RESUMO

The Kuiper Belt is a distant region of the outer Solar System. On 1 January 2019, the New Horizons spacecraft flew close to (486958) 2014 MU69, a cold classical Kuiper Belt object approximately 30 kilometers in diameter. Such objects have never been substantially heated by the Sun and are therefore well preserved since their formation. We describe initial results from these encounter observations. MU69 is a bilobed contact binary with a flattened shape, discrete geological units, and noticeable albedo heterogeneity. However, there is little surface color or compositional heterogeneity. No evidence for satellites, rings or other dust structures, a gas coma, or solar wind interactions was detected. MU69's origin appears consistent with pebble cloud collapse followed by a low-velocity merger of its two lobes.

2.
J Surg Educ ; 75(6): e150-e155, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30100323

RESUMO

OBJECTIVE: To quantify the replacement cost of patient care provided by surgical residents and build a Graduate Medical Education (GME) value analysis model. DESIGN: Our Graduate Medical Education Executive Steering Committee designed a resident replacement cost model, based on patient care hours (adjusted for educational activities and a clinical efficiency factor, differential cost of faculty supervision for residents vs. APPs, and current program financials (revenue minus expenses). Strategic value planning included: academic productivity (local and national conference presentations, book chapters and publications and Senior Staff recruitment and retention. SETTING: Department of Surgery at Baylor Scott & White Medical Center, a tertiary institution located in Temple, TX. PARTICIPANTS: Our replacement model was applied to a sample 30-position residency program. RESULTS: Modeling a 30-position residency program, replacement cost approaches 4.5 million dollars, based on a 1:3 Senior Staff-to-APP replacement ratio. A complete APP replacement complement has a projected cost of 3.1 million dollars, while replacement with Senior Staff approaches 9 million dollars. CONCLUSIONS: We present a novel model for residency value analysis allowing for reproducible and standardized results across multiple residency programs. Challenges inherent to GME, such as clinical efficiency and the cost of faculty supervision, are accounted for. Quantifying resident replacement cost and financial value is a powerful tool when discussing institutional workforce planning within the current financial climate of healthcare.


Assuntos
Custos e Análise de Custo , Cirurgia Geral/educação , Internato e Residência/economia , Modelos Econômicos
3.
Free Radic Biol Med ; 98: 144-158, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26855422

RESUMO

Despite over 50 years of research, the field of sports nutrition continues to grow at a rapid rate. Whilst the traditional research focus was one that centred on strategies to maximise competition performance, emerging data in the last decade has demonstrated how both macronutrient and micronutrient availability can play a prominent role in regulating those cell signalling pathways that modulate skeletal muscle adaptations to endurance and resistance training. Nonetheless, in the context of exercise performance, it is clear that carbohydrate (but not fat) still remains king and that carefully chosen ergogenic aids (e.g. caffeine, creatine, sodium bicarbonate, beta-alanine, nitrates) can all promote performance in the correct exercise setting. In relation to exercise training, however, it is now thought that strategic periods of reduced carbohydrate and elevated dietary protein intake may enhance training adaptations whereas high carbohydrate availability and antioxidant supplementation may actually attenuate training adaptation. Emerging evidence also suggests that vitamin D may play a regulatory role in muscle regeneration and subsequent hypertrophy following damaging forms of exercise. Finally, novel compounds (albeit largely examined in rodent models) such as epicatechins, nicotinamide riboside, resveratrol, ß-hydroxy ß-methylbutyrate, phosphatidic acid and ursolic acid may also promote or attenuate skeletal muscle adaptations to endurance and strength training. When taken together, it is clear that sports nutrition is very much at the heart of the Olympic motto, Citius, Altius, Fortius (faster, higher, stronger).


Assuntos
Exercício Físico/fisiologia , Ciências da Nutrição e do Esporte , Metabolismo dos Carboidratos , Dieta Hiperlipídica , Proteínas Alimentares , Humanos , Fenômenos Fisiológicos da Nutrição Esportiva/genética
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