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Objective: Acquisition of a new range of skills occurs during first year anaesthesia training. The first twelve months of specialist anaesthesia training represent the steepest part of the learning curve, and thus large differences in performance should be apparent between the first and last quarters of this period. At present, no published quantitative logbook data exist for the Irish anaesthesia trainee. The aim of this study was to quantify the number of practical procedures performed and supervision required during first year anaesthesia training, in order to better understand the changes in skills occurring in trainees over this defining period. Methods: A retrospective analysis of prospectively maintained logbooks of three first year anaesthesia trainees was performed. Results: In the first three months, mean numbers of cases were 224, endotracheal tube (ETT) 64, laryngeal mask airway (LMA) 55, spinal anaesthetic 12, arterial lines 9.5, central lines 0.5, peripheral nerve blockade (PNB) 2, epidurals 0. There was 91.5% direct supervision and 8.5% indirect supervision. In the final three months, mean numbers of cases were 205.5, ETT 28, LMA 35, spinals 50, arterial line insertions 4.5, central line insertions 1.5, PNB 3.5, epidurals 80. There was 68.5% direct supervision and 31.5% indirect supervision. Conclusions: The use of logbooks to chart progress through training has many advantages. However, the number of procedures or cases logged should not be read in isolation, or compared with hard targets of "proficiency". Rather, logbooks need to be read with reference to the performance of peers in training. This snapshot of training provides a useful flavour of the experience of novice anaesthesia trainees, and their progress within their first year, and could be used as a benchmark for future logbook based assessments.

Large-scale wastewater disposal has led to a fast-paced reawakening of faults in the Oklahoma/Kansas region. High-resolution earthquake relocations show that the inventory of ancient basement faults in the study region differs from results of seismic surveys and geologic mapping focused on the sedimentary cover. We analyze the evolution of seismic activity in the Guthrie-Langston sequence in central Oklahoma in greater detail. Here, seismic activity has reactivated a network of at least 12 subvertical faults in an area less than 10 km across. Recorded activity began in late 2013, peaked about six months later, and includes two M 4 earthquakes. These earthquakes characteristically occur at about 4 km depth below the top of the basement and do not reach the sedimentary cover. The sequence shows a radial growth pattern despite being no closer than 10 km to significant wastewater disposal activity. Hydrologic modeling suggests that activity initiated with a time lag of several years relative to early injection activity. Once initiated, earthquake interactions contribute to the propagation of seismicity along the reactivated faults. As a result, the spatiotemporal evolution of the seismicity mimics a diffusive pattern that is typically thought to be associated with injection activity. Analysis of the fault slip potential shows that most faults are critically stressed in the contemporary stress field. Activity on some faults, for which we find low slip probability, suggests a significant contribution of geomechanical heterogeneities to the reawakening of these ancient basement faults.

Fang Liu-Walsh,1 Neena K Tierney,1 James Hauschild,2 Allison K Rush,1 John Masucci,3 Gregory C Leo,3 Kimberly A Capone1 1Johnson & Johnson Consumer Inc., Skillman, NJ, USA; 2Johnson & Johnson Microbiological Quality & Sterility Assurance, Johnson & Johnson Inc., Raritan, NJ, USA; 3Janssen R&D Companies of Johnson & Johnson, Springhouse, PA, USACorrespondence: Fang Liu-Walsh; Kimberly A CaponeJohnson & Johnson Consumer Inc., 199 Grandview Road, Skillman, NJ 08558-9418, USAEmail fliuwals@ITS.JNJ.com; KCapone@its.jnj.comBackground: Multiple skin conditions have been associated with alterations in the diversity and composition of the skin microbiome, including dry skin and atopic dermatitis. In these conditions, a number of commensal skin bacteria have been implicated in supporting a healthy skin barrier, including Staphylococcus epidermidis. Recent clinical studies in patients with mild-to-moderate atopic dermatitis and dry/itchy skin have shown significantly improved skin barrier function and microbial diversity upon treatment with moisturizers containing 1% colloidal oat. We hypothesized that direct use of colloidal oat by skin microbes contributes to these therapeutic benefits.Methods: Skin bacterial growth was assessed using the BacT/ALERT system. Staphylococcus aureus and S. epidermidis growth rates and metabolism were compared in an in vitro competition assay. The effect of a 1% colloidal oat–containing moisturizer on lactic acid content of the stratum corneum was clinically assessed in subjects with moderate-to-severe dry skin. S. epidermidis gene expression was evaluated by next-generation mRNA sequencing. Short-chain fatty acids were quantified in bacterial culture supernatants.Results: In vitro, colloidal oat increased the growth rate of S. epidermidis vs S. aureus, as well as the metabolism of S. epidermidis. Colloidal oat also significantly increased lactic acid concentrations in supernatants of both strains and decreased pH, consistent with clinical findings that 6-week use of a 1% colloidal oat–containing lotion significantly increased lactic acid on dry skin. Further analyses suggest that colloidal oat alters the gene expression profile of S. epidermidis.Conclusion: Colloidal oat directly affects the growth, metabolism, lactic acid production, and gene expression of skin commensal bacteria, as shown via in vitro studies. The increased production of lactic acid reflects clinical observations with colloidal oat–containing skin moisturizers. Our findings suggest a new mechanism for colloidal oat as a skin prebiotic, which may contribute to improvements in skin and microbiome diversity in various skin conditions, including dry/itchy skin and atopic dermatitis.Keywords: atopic dermatitis, dry skin, colloidal oat, skin barrier function, skin microbiome, skin moisturizer, S. epidermidis

As the development of nanostructured materials continues to blossom, there is increasing attention to functionalised particles. The so-called Janus particles are anisotropic regions having different physicochemical properties. The recent development of their synthesis in a pH field during suspension as bipolar particles between electrodes has opened the door to improved scalability due to the ease of entraining particles as a slurry in a flowing electrolyte stream. Potential application areas span catalysis of chemical synthesis, sustainable energy conversion and pharmaceutical and biomedical sectors of industry. In view of their versatility, the ability to undergo surface modification and opportunities for facile scale-up, Janus particles might be deployed as building blocks to fabricate functional surfaces having tailored chemical, structural and surface anisotropy. They could prove to be valuable feedstock in 3-D printing and surface finishing of fast prototype components and devices. [ABSTRACT FROM AUTHOR]