Modular training in vascular and endovascular surgery exemplified by the Vascular International Foundation and School

The partial shift from patient to model is a reasonable and necessary paradigm shift in surgery in order to increase patient safety and to adapt to the reduced training time periods in hospitals and increased quality demands. Since 1991 the Vascular International Foundation and School has carried out many training courses with more than 2,500 participants. The modular build training system allows to teach many open vascular and endovascular surgical techniques on lifelike models with a pulsatile circulation. The simulation courses cannot replace training in operating rooms but are suitable for supporting the cognitive and associative stages for achieving motor skills. Scientific evaluation of the courses has continually shown that the training principle established since 1991 can lead to significant learning success. They are extremely useful not only for beginners but also for experienced vascular surgeons. They can help to shorten the learning curve, to learn new techniques or to refine previously used techniques in all stages of professional development. Keywords Advanced training · Advanced training regulations · Training model · Vascular International · Certification

The Initial Slope of the Variogram, Foundation of the Trabecular Bone Score, Is Not or Poorly Associated With Vertebral Strength

Trabecular bone score (TBS) rests on the textural analysis of DXA to reflect the decay in trabecular structure characterising osteoporosis. Yet, its discriminative power in fracture studies remains incomprehensible as prior biomechanical tests found no correlation with vertebral strength. To verify this result possibly due to an unrealistic set-up and to cover a wide range of loading scenarios, the data from three previous biomechanical studies using different experimental settings was used. They involved the compressive failure of 62 human lumbar vertebrae loaded 1) via intervertebral discs to mimic the in vivo situation (“full vertebra”), 2) via the classical endplate embedding (“vertebral body”) or 3) via a ball joint to induce anterior wedge failure (“vertebral section”). HR-pQCT scans acquired prior testing were used to simulate anterior-posterior DXA from which areal bone mineral density (aBMD) and the initial slope of the variogram (ISV), the early definition of TBS, were evaluated. Finally, the relation of aBMD and ISV with failure load (Fexp) and apparent failure stress (σexp) was assessed and their relative contribution to a multi-linear model was quantified via ANOVA. We found that, unlike aBMD, ISV did not significantly correlate with Fexp and σexp, except for the “vertebral body” case (r2 = 0.396, p = 0.028). Aside from the “vertebra section” set-up where it explained only 6.4% of σexp (p = 0.037), it brought no significant improvement to aBMD. These results indicate that ISV, a replica of TBS, is a poor surrogate for vertebral strength no matter the testing set-up, which supports the prior observations and raises a fortiori the question of the deterministic factors underlying the statistical relationship between TBS and vertebral fracture risk.

Prehistoric genomes reveal the genetic foundation and cost of horse domestication

The domestication of the horse revolutionized warfare, trade, and the exchange of people and ideas. This at least 5,500-y-long process, which ultimately transformed wild horses into the hundreds of breeds living today, is difficult to reconstruct from archeological data and modern genetics alone. We therefore sequenced two complete horse genomes, predating domestication by thousands of years, to characterize the genetic footprint of domestication. These ancient genomes reveal predomestic population structure and a significant fraction of genetic variation shared with the domestic breeds but absent from Przewalski’s horses. We find positive selection on genes involved in various aspects of locomotion, physiology, and cognition. Finally, we show that modern horse genomes contain an excess of deleterious mutations, likely representing the genetic cost of domestication.

Medical Practice and International Networks. A Swiss National Foundation Funded project based ath the University of Bern

Project presentation

Community health workers: The critical link to sustainable, healthy societies in low-resource settings---A model for the Baylor Shoulder to Shoulder Foundation

Community health workers (CHWs) can serve as a bridge between healthcare providers and communities to positively impact social determinants of health and, thus, the overall health of the population. The potential to effect lasting change is particularly significant within resource-poor settings with limited access to formally trained health care providers such as the small, rural village of Santa Ana Intibucá, Honduras and surrounding areas—located on the geographically and politically isolated border of Honduras and El Salvador. The Baylor Shoulder to Shoulder Foundation (BSTS) works in conjunction with Santa Ana's volunteer health committee to bring a health brigade that has provided health care and public health projects to the area at least twice a year since 2001. They have also hired a full-time Honduran physician, a Honduran in-country administrative director, and built a clinic; yet, no community health worker program exists. This CHW program model is the response to a clear need for a CHW program within the area served by BSTS and presents a CHW program model specific to Santa Ana Intibucá and surrounding areas to be implemented by BSTS. Methods used to develop this model include reviewing the literature for recommendations from leading authorities as well as successfully implemented CHW programs in comparable regions. This information was incorporated into existing knowledge and materials currently being used in the area. Using the CHW model proposed here, each brigade, in conjunction with the communities served, can help develop new modules to respond to the specific health priorities of the region at that time, incorporating consistent modes of contact with the local physician and the CHWs to provide refresher courses, training in new topics of interest, and to be reminded of the importance of community health workers' role as the critical link to healthy societies. With cooperation, effort, and support, the brigade can continue to help integrate a sustainable CHW system in which communities may be able to maximize the care they receive while also learning to care for their own health and the future of their communities.^

Lecturas sobre The Foundation. A Great American Secret (2007), Joel L. Fleishman, New York, Public Affairs

Fil: Quesada, Fernando. Universidad Nacional de Cuyo. Facultad de Filosofía y Letras. Instituto Multidisciplinario de Estudios Sociales Contemporáneos

The shift of paradigm in the organizations like foundation of the style of ethical leadership

La presente investigación tiene por objeto analizar el cambio de paradigma en las organizaciones como fundamento del liderazgo ético desde una realidad postmoderna a fin de detectar la necesidad de un liderazgo ético en las organizaciones donde los líderes sean formadores de valores a través del modelaje directivo; es un estilo de liderazgo en el que la visión ética, sistémica e integradora son unas de las principales aptitudes que el líder ético ha de poner en la práctica. Se han desarrollado teorías de liderazgo centradas no tanto en los rasgos o comportamientos de los líderes, sino en la relación entre líder y sus seguidores

The foundation of the Mexican welfare state and social security reform in the 1990s

Before 1982 Mexico's welfare state regime was a limited conservative one that put priority on the social security of organized labor. But following the country's debt crisis in 1982, this regime changed to a hybrid liberal model. The Ernest Zedillo government (1995-2000) in particular pushed ahead with liberal reform of the social security system. This paper examines the characteristics and the policy making of the social security reforms in the 1990s. The results suggest that underlying these reforms was the restructuring of the economy and the need to cope with the cost of this restructuring. The paper also points out that one of the main factors making possible the rapid execution of the reforms were the weakened political clout of the officialist labor unions due to their steady breakdown during the 1990s and the increase in the monopolistic power of the state vis-a-vis the position of labor during the negotiations on social security reforms.

Towards the foundation of a global modes concept

A contribution is presented, intended to provide theoretical foundations for the ongoing efforts to employ global instability theory for the analysis of the classic boundary-layer flow, and address the associated issue of appropriate inflow/outflow boundary conditions to close the PDE-based global eigenvalue problem in open flows. Starting from a theoretically clean and numerically simple application, in which results are also known analytically and thus serve as a guidance for the assessment of the performance of the numerical methods employed herein, a sequence of issues is systematically built into the target application, until we arrive at one representative of open systems whose instability is presently addressed by global linear theory applied to open flows, the latter application being neither tractable theoretically nor straightforward to solve by numerical means. Experience gained along the way is documented. It regards quantification of the depar- ture of the numerical solution from the analytical one in the simple problem, the generation of numerical boundary layers at artificially truncated boundaries, no matter how far the latter are placed from the region of highest flow gradients and, ultimately the impracti- cally large number of (direct and adjoint) modes necessary to project an arbitrary initial perturbation and follow its temporal evolution by a global analysis approach, a finding which may question the purported robustness reported in the literature of the recovery of optimal perturbations as part of global analyses yielding under-resolved eigenspectra.

Intensive Metrics for the Study of the Evolution of Open Source Projects: Case Studies from Apache Software Foundation Projects

Based on the empirical evidence that the ratio of email messages in public mailing lists to versioning system commits has remained relatively constant along the history of the Apache Software Foundation (ASF), this paper has as goal to study what can be inferred from such a metric for projects of the ASF. We have found that the metric seems to be an intensive metric as it is independent of the size of the project, its activity, or the number of developers, and remains relatively independent of the technology or functional area of the project. Our analysis provides evidence that the metric is related to the technical effervescence and popularity of project, and as such can be a good candidate to measure its healthy evolution. Other, similar metrics -like the ratio of developer messages to commits and the ratio of issue tracker messages to commits- are studied for several projects as well, in order to see if they have similar characteristics.