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Locus-specific amplicon sequencing was used to HLA type 336 participants of Maasai ethnicity at the HLA-A, -B, -C, -DRB1, -DQB1 and -DPB1 loci. Participants were recruited from three study villages in North Tanzania, for the purpose of investigating risk factors for trachomatous scarring in children. Other than HLA-A, all loci significantly deviated from Hardy-Weinberg equilibrium, possibly due to high relatedness between individuals: 238 individuals shared a house with at least one another participant. The most frequent allele for each locus were A*68:02 (14.3 %), B*53:01 (8.4 %), C*06:02 (19.2 %), DRB1*13:02 (17.7 %), DQB1*02:01 (16.9 %) and DPB1*01:01 (15.7 %), while the most common inferred haplotype was A*68:02 ∼ B*18:01 ∼ C*07:04 ∼ DRB1*08:04 ∼ DQB1*04:02 ∼ DPB1*04:01 (1.3 %).

Class II HLA loci DRB1, DQB1 and DPB1 were typed for a total of 939 Gambian participants by locus-specific amplicon sequencing. Participants were from multiple regions of The Gambia and drawn from two studies: a family study aiming to identify associations between host genotype and trachomatous scarring (N = 796) and a cohort study aiming to identify correlates of immunity to trachoma (N = 143). All loci deviated from Hardy-Weinberg equilibrium, likely due to the family-based nature of the study: 608 participants had at least one other family member included in the study population. The most common alleles for HLA-DRB1, DQB1 and DPB1 respectively were DRB1*13:04 (18.8 %), DQB1*03:19 (27.9 %) and DPB1*01:01 (25.4 %). Participants belonged to a variety of ethnicities, including the Mandinka, Fula, Wolof and Jola ethnic groups.

Surgery has a rich history, and in order to understand the various training pathways for aspiring surgeons one must have an appreciation of the evolution of surgery. This manuscript aims to deliver a brief review of the history of surgery, and explore the historical moments that have shaped the training pathway of surgeons in the United Kingdom (UK), and in doing so disseminate the latest information about surgical training in the UK. doi: https://doi.org/10.12669/pjms.37.5.4628 How to cite this:Payne T, Toms JD, Zaidi A, Thrumurthy SG. The history of surgery and surgical training in the UK. Pak J Med Sci. 2021;37(5):1532-1535. doi: https://doi.org/10.12669/pjms.37.5.4628 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

IntroductionThere are no disease-modifying treatments for Parkinson’s disease (PD). We undertook the first drug screen in PD patient tissue and idntified ursodeoxycholic acid (UDCA) as a promising mitochondrial rescue agent. The aims of this trial are to determine safety and tolerability of UDCA in PD at 30 mg/kg, confirm the target engagement of UDCA, apply a novel motion sensor-based approach to quantify disease progression objectively, and estimate the mean effect size and its variance on the change in motor severity.Methods and analysisThis is a phase II, two-centre, double-blind, randomised, placebo-controlled trial of UDCA at a dose of 30 mg/kg in 30 participants with early PD. Treatment duration is 48 weeks, followed by an 8-week washout phase. Randomisation is 2:1, drug to placebo. Assessments are performed at baseline, week 12, 24, 36, 48 and 56. The primary outcome is safety and tolerability. Secondary outcomes will compare the change between baseline and week 48 using the following three approaches: the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part 3 in the practically defined ‘OFF’ medication state; confirmation of target engagement, applying 31Phosphorus MR Spectroscopy to assess the levels of ATP and relevant metabolites in the brain; and objective quantification of motor impairment, using a validated, motion sensor-based approach. The primary outcome will be reported using descriptive statistics and comparisons between treatment groups. For each secondary outcome, the change from baseline will be summarised within treatment groups using summary statistics and appropriate statistical tests assessing for significant differences. All outcomes will use an intention-to-treat analysis population.Ethics and disseminationThis trial has been approved by the East of England – Cambridgeshire and Hertfordshire Research Ethics committee. Results will be disseminated in peer-reviewed journals, presentations at scientific meetings and to patients in a lay-summary format.Trial registration numberNCT03840005.

Despite significant advances in materials and manufacturing techniques applied to sports protective equipment in recent years, sports injuries due to impact, contusions in particular, continue to occur. In this paper, a test methodology aimed at collecting data from laboratory-simulated human-on-human impacts in Basketball is presented. The study was executed in three stages with data being collected from: i) human on instrumented bag; ii) impactor on instrumented bag and iii) impactor on instrumented human impacts. In all cases, high-speed video and/or kinematic motion data capture systems were used to obtain parameters such as inbound/outbound velocities, contact durations while resistive ink technology pressure sensing films were used to estimate parameters such as pressure distributions, peak pressures, contact areas, impact forces. Elite-level athletes were used in all human trials to ensure that impact techniques and levels representative of the elite game were obtained and that tolerance to impacts was similarly representative. Two common strikes were simulated: knee on thigh and elbow on rib/torso. Five participants were used to collect the human-on-bag data while 12 participants were used to collect the impactor-on-human data. Between three and five impacts per scenario were performed to enable noise averaging and, importantly, likely injurycausing outlier capture. © 2014 Published by Elsevier Ltd.

The International Adaptation Trial (IAT) is a special purpose nursery designed to investigate the genotype-by-environment interactions and worldwide adaptation for grain yield of Australian and CIMMYT spring bread wheat (Triticum aestivum L.) and durum wheat (T. turgidum L. var. durum). The IAT contains lines representing Australian and CIMMYT wheat breeding programs and was distributed to 91 countries between 2000 and 2004. Yield data of 41 reference lines from 106 trials were analysed. A multiplicative mixed model accounted for trial variance heterogeneity and inter-trial correlations characteristic of multi-environment trials. A factor analytic model explained 48% of the genetic variance for the reference lines. Pedigree information was then incorporated to partition the genetic line effects into additive and non-additive components. This model explained 67 and 56% of the additive by environment and non-additive by environment genetic variances, respectively. Australian and CIMMYT germplasm showed good adaptation to their respective target production environments. In general, Australian lines performed well in south and west Australia, South America, southern Africa, Iran and high latitude European and Canadian locations. CIMMYT lines performed well at CIMMYT's key yield testing location in Mexico (CIANO), north-eastern Australia, the Indo-Gangetic plains, West Asia North Africa and locations in Europe and Canada. Maturity explained some of the global adaptation patterns. In general, southern Australian germplasm were later maturing than CIMMYT material. While CIANO continues to provide adapted lines to northern Australia, selecting for yield among later maturing CIMMYT material in CIANO may identify lines adapted to southern and western Australian environments.

A transformation/regeneration system was developed for the common garden Lobelia (Lobelia erinus). Using an Agrobacterium-based protocol, over 40 transformants have been generated with four different binary vectors. The explant source was hypocotyl-root sections from axenically grown seedlings. Stable transformation was demonstrated by Southern hybridization analysis, β-glucuronidase staining, and transmission of the T-DNA to progeny. This extends the ever-widening range of transformable plant species to the Campanulaceae and will allow molecular studies of development and physiology in this easily cultured and popular garden plant.

Image quality is proportional to radiation dose. Improvements in image quality come at a cost of increased radiation dose. CT scanners are more robust today than even 5 years ago. X-ray tubes are capable of producing high levels of almost continuous radiation for rapid CT volume acquisitions and angiographic studies. All parameters of modern CT scanners provide rapid subsecond, large-volume CT acquisitions. How high we go needs to be tempered by how high we should go regarding radiation dose from CT examinations. Radiologists, referring physicians, medical physicists, CT technologists, CT equipment manufacturers, and regulators need to evaluate the appropriateness of radiation dose for different CT studies.

The ACR CT accreditation program, begun in 2002, requires the submission of approximately 20 images, several completed data sheets and printouts of three Excel worksheets. The procedure manual is very detailed, yet participants unfamiliar with the program or having minimal CT experience have needed to redo aspects of their submission, or in some cases do not receive accreditation, due to mistakes made by the physicist. This review of the phantom portion of the ACR CT accreditation program supplements the ACR provided instructions with additional photos of phantom setup, region-of-interest (ROI), and image placement on the film sheets, and examples of completed portions of actual (but anonymous) submissions. Common mistakes, as well as uncommon but interesting images, are shown and explanations are given as to what could have been done to avoid the problem. Additionally, a review of CT dose measurement techniques and calculations will enable the physicist to better assist sites where typical exam doses are above the ACR reference values.

A study of spring bread wheat (Triticum aestivum) germ plasm developed at the International Maize and Wheat Improvement Center (CIMMYT) showed highly significant phenotypic variability for each component of partial resistance (namely, uredial appearance period, latency period, uredial number and uredial size) to Puccinia recondita f. sp. tritici. All of the wheat genotypes displayed longer uredial appearance and latency periods and decreased uredial number and uredial size when compared to the susceptible check cultivar ‘Morocco’. Positive correlations between uredial appearance period and latency period, and uredial number and uredial size, and negative correlations between uredial appearance and latency periods and uredial number and uredial size, inclusive, suggested that the components of partial resistance were either tightly linked or under pleiotropic genetic control. Compared to ‘Morocco’, all entries had slow disease progress in the field and variation occurred in the germ plasm for the area under the leaf rust progress curve. Disease progress was negatively correlated with uredial appearance and latency periods, whereas a positive correlation was observed with uredial number and uredial size. Certain genotypes displayed high levels of partial resistance resulting in low disease incidence in the field.

Impact injuries are a common occurrence in sport such that personal protective equipment (PPE) is often mandatory to ensure participant safety. Current tests to assess PPE effectiveness often use unrepresentative human surrogates, insufficient to accurately assess human impact response. More refined surrogates typically use “off the shelf” silicone elastomers to better represent human tissue, however using a single simulant material for all soft tissues means some phenomena associated with injury are not adequately represented. This study presents an evaluation of the effectiveness of a bespoke muscular tissue simulant using a proprietary blend of additive cure silicones. The mechanical response has been compared and validated with porcine tissue properties and provides improved behaviour when compared with a previously used silicone elastomer, Silastic 3481. The material has also been modelled computationally using a two-term Ogden model and exhibits a significantly different response to Silastic 3481 under a low-speed knee-strike loading condition.

The immediate goal of clinically based x-ray-transmission computed tomography (CT) is to provide a measurement of the x-ray linear attenuation coefficient in cross section with the ultimate goal of impacting on patient management and care. To do this with the accuracy needed for clinical goals requires the careful integration of x-ray physics, detector technology, and mathematical reconstruction theory. Performance evaluation and quality assurance are necessary adjuncts to a CT scanning program. A number of investigative studies are underway.

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