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OBJECTIVE: An expert panel made recommendations to optimize surgical education and training based on the effects of contemporary challenges. BACKGROUND: The inaugural Blue Ribbon Committee (BRC I) proposed sweeping recommendations for surgical education and training in 2004. In light of those findings, a second BRC (BRC II) was convened to make recommendations to optimize surgical training considering the current landscape in medical education. METHODS: BRC II was a panel of 67 experts selected on the basis of experience and leadership in surgical education and training. It was organized into subcommittees which met virtually over the course of a year. They developed recommendations, along with the Steering Committee, based on areas of focus and then presented them to the entire BRC II. The Delphi method was chosen to obtain consensus, defined as ≥80% agreement among the panel. Cronbach α was computed to assess the internal consistency of 3 Delphi rounds. RESULTS: Of the 50 recommendations, 31 obtained consensus in the following aspects of surgical training (# of consensus recommendation/# of proposed): Workforce (1/5); Medical Student Education (3/8); Work Life Integration (4/6); Resident Education (5/7); Goals, Structure, and Financing of Training (5/8); Education Support and Faculty Development (5/6); Research Training (7/9); and Educational Technology and Assessment (1/1). The internal consistency was good in Rounds 1 and 2 and acceptable in Round 3. CONCLUSIONS: BRC II used the Delphi approach to identify and recommend 31 priorities for surgical education in 2024. We advise establishing a multidisciplinary surgical educational group to oversee, monitor, and facilitate implementation of these recommendations.

Since the nineteenth century, Orientalist scholars have been preoccupied with recovering the original order of the Qur’an. In the past fifty years, the question appears to have reached an impasse with no sign of an emerging consensus. Divergences over the anchoring in space and time of the Qur’an have contributed to the diagnosis of “crisis” in (Western) Qur’anic studies. What do the project of determining Qur’anic chronology and its failure tell us about Qur’anic studies in Western academia? What do the current impasses reveal about the nature of the Qur’an as a text and as a theological object? This study analyses disagreements over the Qur’an’s space and time by drawing on tools from literary theory and hermeneutics. It argues for a shift from a positivist to an interpretative paradigm. Moving away from the question of the actual historical order of the Qur’an, this article examines the making and the workings of diachronic readings of the Muslim scripture, with a particular focus on the works of two of the most prominent scholars in the field, Angelika Neuwirth and Nicolai Sinai. The aim of the exercise is double: first, to perform a critical reflection on the networks of meaning that we construct or inherit in our engagement with the Muslim scripture; and second, to apprehend better the nature of the Qur’an as an “open text” (Eco 1962) whose textual characteristics make it particularly prone to a number of interpretations.

Abstract Background In males with end stage renal disease biochemical hypogonadism is a frequent finding. Testosterone and sex hormone binding globulin (SHBG) have been associated with insulin resistance, a well-known condition in uremia. The aim of the present study was to investigate in males on chronic hemodialysis the relationship of testosterone and SHBG serum levels with insulin resistance. Methods In a cross-sectional study we enrolled men treated with chronic hemodialysis who did not suffer from an acute illness or other endocrinopathy, as well as primary hypogonadism, and were not hospitalised. Diabetes mellitus, diabetic nephropathy or previous transplantation were not exclusion criteria. As controls we used a community-based group of healthy males matched for age and Body Mass Index (BMI). We assessed the BMI (kg/m2) from body weight and height, the body fat content (%) by bioelectrical impedance and serum testosterone (ng/ml), SHBG (nmol/L) and estradiol (pg/ml) by standard methods. Testosterone

main predictors of the development of this arrhythmia. Material and methods.A single-center, cross-control study was conducted. Of all 6630 protocols analyzed, according to 24-hour ECG monitoring, AF paroxysm was detected in 97 people as an accidental finding. These patients were included in the main study group. The control group consisted of 99 patients from the same cohort without paroxysmal AF, having the anthropometric and comorbidity parameters similar to the patients of the main group. Results.In the absolute majority (97.9%) of patients in the main group in whom paroxysmal AF was detected, a special variant of extrasystole was revealed – early atrial “P on T” type (versus 4.0% in patients in the control group) [OR 8461.648 (382.1983;187336)]. The number of supraventricular single, paired and group extrasystoles was significantly higher in the main group, but the number of ventricular extrasystoles did not differ significantly. Conclusion.One of the main ECG predictors for the development of paroxysmal AF in asymptomatic patients is the appearance of supraventricular extrasystole of the “P on T” type. In the mechanism of formation of AF paroxysm during supraventricular extrasystole of the “P on T” type, not only electrophysiological mechanisms play a role, but also the heart biomechanics.

In this work, novel numerical models were developed and validated to offer new strategies in modelling sonochemical reactors. More specifically, in our original approach the non-linear Louisnard model was coupled with heat and mass transport equations to predict gradients in temperature and species concentration in a sonicated reactor. Additionally, a new operating window was investigated by modelling mixtures of increasing viscosity on both micro- and macroscale sonochemical effects. On the microscale, the effects of increasing viscosity on bubble dynamics were determined by solving the Keller-Miksis equation. Various cavitation threshold definitions were evaluated. The bubble collapse temperature was determined for all investigated mixtures and the energy dissipation of a single bubble was calculated. On the macroscale, different acoustic attenuation models were compared accounting for either linear or non-linear equations. Specifically, viscous losses were implemented in the non-linear Louisnard model, and model predictions were validated against experimental data. The model was able to predict multiple zones of cavitation in the reactor, as observed experimentally, and to estimate the dissipated energy for the different mixtures. Moreover, it was demonstrated that the cavitation-based attenuation dominates the other dissipation phenomena even for the most viscous solutions. The Louisnard model was coupled with heat transport equations, and using this extended version of the model, the temperature profiles were predicted for mixtures of increasing viscosity during sonication. Using a regression formula available in literature, radical production was related to the acoustic pressure field. By including reactions and mass transport in the acoustic model, for the first time in modelling ultrasonic reactors, the full distribution of light in the reactor during sonochemiluminescence (SCL) experiments for water was quantified.

Ultrasound has shown its benefits in the manufacturing processes of many pharmaceuticals and fine chemicals. This study focused on the reactive crystallization system of an aromatic amine and explored the potential uses of ultrasound in both batch and continuous modes. In batch experiments, we studied the effects of different sonication conditions including power, duration, and starting point on final particle properties. Under ultrasound, the crystal form and crystal morphology remained well maintained. The results of particle size and size distribution suggested that ultrasound reduced the mean sizes by improving the nucleation process and breaking up large particles. Additionally, the presence of ultrasound in continuous experiments was capable of inducing nucleation and the crystal products collected had a suitable distribution. Integrating ultrasound into the beginning of the continuous crystallization process can be an alternative to the seeding technique. The increasing sonication power did not reduce the induction time substantially. This indicated that a rational sonication condition should balance the overall process efficiency and energy consumption. The findings from batch and continuous experiments indicate that ultrasound could intensify industrial crystallization of the aromatic amine. Incorporating energy-efficient ultrasound with the continuous process will potentially lead to increased production efficiency and a well-controlled product quality.

We implemented an annual “Education Day” at Indiana University School of Medicine to promote educational scholarship across our nine-campus system. Held each spring from 2020 to 2023, Education Day showcased the educational scholarship of our faculty, staff, and learners, and provided a forum to share best educational practices and forge new collaborations.

Solid sorbents based on silica and polyethyleneimine (PEI) are intensively investigated in the field of carbon capture and storage (CCS). Pyrolysis was proposed as a thermal process to recover the pure silica from exhausted sorbents and convert PEI into potentially useful products, such as alkylated pyrazines. A GC–MS method based on internal standardisation with 2-methoxypyrazine was developed and evaluated to determine the concentration of six pyrazines in the pyrolysis oils of exhausted silica-PEI sorbent pyrolysed at 400, 500, 600 and 650 °C. The most abundant pyrazines were 2-ethyl and 2,3-dimethyl, occurring at concentrations of 5–28 mg g–1, followed by pyrazine, 2-methyl, 2-ethyl-3-methyl and 2-propylpyrazine. The GC–MS results were compared to those from a HPLC-DAD method using the Welch's test. The 37 % discrepancy of concentrations was attributed to spectral interference in LC-DAD. GC was slightly less precise than HPLC, calibration errors were lower and enabled the identification of highly alkylated pyrazines. Both methods provided comparable values of total pyrazine yields (around 4–7 % by weight).

Extraosseous plasmacytomas (EPs) are rare neoplasms originating from plasma cells, often associated with multiple myeloma. EPs are classified into three subtypes: extramedullary myeloma, solitary extramedullary plasmacytoma (SEP), and multiple solitary plasmacytomas. They can manifest in various anatomical sites, including the lung, mediastinum, breast, liver, pancreas, stomach, mesentery, kidney, small and large bowel, testis, and soft tissue. Despite their rarity, EPs present a diagnostic challenge due to their non-specific imaging appearances, which can mimic other neoplastic and inflammatory conditions. This review aims to describe the radiographic features of EPs in the chest, abdomen, and pelvis based on a thorough analysis of the existing literature. While imaging plays a crucial role in the detection and characterization of EPs, histological confirmation is necessary to differentiate them from other neoplastic entities. The review underscores the importance of considering EPs in the differential diagnosis, particularly in patients with a history of multiple myeloma. Understanding the imaging characteristics of EPs is essential for accurate diagnosis and appropriate management. Early imaging is crucial in these patients to exclude the possibility of EP, as timely diagnosis can significantly impact patient outcomes.

Predictive tools provide a unique opportunity to explain the observed differences in outcome between patients of the COVID-19 pandemic. The aim of this study was to associate individual demographic and clinical characteristics with disease severity in COVID-19 patients and to highlight the importance of machine learning (ML) in disease prognosis. The study enrolled 344 unvaccinated patients with confirmed SARS-CoV-2 infection. Data collected by integrating questionnaires and medical records were imported into various classification machine learning algorithms, and the algorithm and the hyperparameters with the greatest predictive ability were selected for use in a disease outcome prediction web tool. Of 111 independent features, age, sex, hypertension, obesity, and cancer comorbidity were found to be associated with severe COVID-19. Our prognostic tool can contribute to a successful therapeutic approach via personalized treatment. Although at the present time vaccination is not considered mandatory, this algorithm could encourage vulnerable groups to be vaccinated.

Infection with SARS-CoV-2 and the resulting COVID-19 can cause both lung and kidney damage. SARS-CoV-2 can directly infect renal cells expressing ACE2 receptors, resulting in kidney damage, and acute kidney injury (AKI) has been reported in COVID-19 hospitalized patients. The pathophysiology of COVID-19-associated AKI is multifactorial. Local and systemic inflammation, immune system dysregulation, blood coagulation disorders, and activation of the renin-angiotensin-aldosterone system (RAAS) are factors that contribute to the development of AKI in COVID 19 disease. COVID-19 patients with kidney involvement have a poor prognosis, and patients with chronic kidney disease (CKD) infected with SARS-CoV-2 have an increased mortality risk. CKD patients with COVID-19 may develop end-stage renal disease (ESRD) requiring dialysis. In particular, patients infected with SARS-CoV-2 and requiring dialysis, as well as patients who have undergone kidney transplantation, have an increased risk of mortality and require special consideration. Nephrologists and infectious disease specialists face several clinical dilemmas in the prophylaxis and treatment of CKD patients with COVID-19. This entry presents recent data showing the effects of COVID-19 on the kidneys and CKD patients and the challenges in the management of CKD patients with COVID-19, and discusses treatment strategies for these patients.