Predicting success in graduate entry medical students undertaking a graduate entry medical program (GEM)

Background: Success in undergraduate medical courses in the UK can be predicted by school exit examination (A level) grades. There are no documented predictors of success in UK graduate entry medicine (GEM) courses. This study looks at the examination performance of GEM students to identify factors which may predict success; of particular interest was A level score. Methods: Data was collected for students graduating in 2004, 2005 and 2006, including demographic details (age and gender), details of previous academic achievement (A level total score and prior degree) and examination results at several points during the degree course. Results: Study group comprised 285 students. Statistical analyses identified no significant variables when looking at clinical examinations. Analysis of pass/fail data for written examinations showed no relationship with A level score. However, both percentage data for the final written examination and the analysis of the award of honours showed A level scores of AAB or higher were associated with better performance (p < 0.001). Discussion: A prime objective of introducing GEM programs was to diversify admissions to medical school. In trying to achieve this, medical schools have changed selection criteria. The findings in this study justify this by proving that A level score was not associated with success in either clinical examinations or passing written examinations. Despite this, very high achievements at A level do predict high achievement during medical school. Conclusions: This study shows that selecting graduate medical students with the basic requirement of an upper-second class honours degree is justifiable and does not disadvantage students who may not have achieved high scores in school leaver examinations

A frequentist framework of inductive reasoning

Reacting against the limitation of statistics to decision procedures, R. A. Fisher proposed for inductive reasoning the use of the fiducial distribution, a parameter-space distribution of epistemological probability transferred directly from limiting relative frequencies rather than computed according to the Bayes update rule. The proposal is developed as follows using the confidence measure of a scalar parameter of interest. (With the restriction to one-dimensional parameter space, a confidence measure is essentially a fiducial probability distribution free of complications involving ancillary statistics.) A betting game establishes a sense in which confidence measures are the only reliable inferential probability distributions. The equality between the probabilities encoded in a confidence measure and the coverage rates of the corresponding confidence intervals ensures that the measure's rule for assigning confidence levels to hypotheses is uniquely minimax in the game. Although a confidence measure can be computed without any prior distribution, previous knowledge can be incorporated into confidence-based reasoning. To adjust a p-value or confidence interval for prior information, the confidence measure from the observed data can be combined with one or more independent confidence measures representing previous agent opinion. (The former confidence measure may correspond to a posterior distribution with frequentist matching of coverage probabilities.) The representation of subjective knowledge in terms of confidence measures rather than prior probability distributions preserves approximate frequentist validity.Comment: major revisio

Methods for estimating the case fatality ratio for a novel, emerging infectious disease.

During the course of an epidemic of a potentially fatal disease, it is important that the case fatality ratio be well estimated. The authors propose a novel method for doing so based on the Kaplan-Meier survival procedure, jointly considering two outcomes (death and recovery), and evaluate its performance by using data from the 2003 epidemic of severe acute respiratory syndrome in Hong Kong, People's Republic of China. They compare this estimate obtained at various points in the epidemic with the case fatality ratio eventually observed; with two commonly quoted, naïve estimates derived from cumulative incidence and mortality statistics at single time points; and with estimates in which a parametric mixture model is used. They demonstrate the importance of patient characteristics regarding outcome by analyzing subgroups defined by age at admission to the hospital

A single sub-km Kuiper Belt object from a stellar Occultation in archival data

The Kuiper belt is a remnant of the primordial Solar System. Measurements of its size distribution constrain its accretion and collisional history, and the importance of material strength of Kuiper belt objects (KBOs). Small, sub-km sized, KBOs elude direct detection, but the signature of their occultations of background stars should be detectable. Observations at both optical and X-ray wavelengths claim to have detected such occultations, but their implied KBO abundances are inconsistent with each other and far exceed theoretical expectations. Here, we report an analysis of archival data that reveals an occultation by a body with a 500 m radius at a distance of 45 AU. The probability of this event to occur due to random statistical fluctuations within our data set is about 2%. Our survey yields a surface density of KBOs with radii larger than 250 m of 2.1^{+4.8}_{-1.7} x 10^7 deg^{-2}, ruling out inferred surface densities from previous claimed detections by more than 5 sigma. The fact that we detected only one event, firmly shows a deficit of sub-km sized KBOs compared to a population extrapolated from objects with r>50 km. This implies that sub-km sized KBOs are undergoing collisional erosion, just like debris disks observed around other stars.Comment: To appear in Nature on December 17, 2009. Under press embargo until 1800 hours London time on 16 December. 19 pages; 7 figure

Transfer RNA-derived small RNAs in the cancer transcriptome

The cellular lifetime includes stages such as differentiation, proliferation, division, senescence and apoptosis.These stages are driven by a strictly ordered process of transcription dynamics. Molecular disruption to RNA polymerase assembly, chromatin remodelling and transcription factor binding through to RNA editing, splicing, post-transcriptional regulation and ribosome scanning can result in significant costs arising from genome instability. Cancer development is one example of when such disruption takes place. RNA silencing is a term used to describe the effects of post-transcriptional gene silencing mediated by a diverse set of small RNA molecules. Small RNAs are crucial for regulating gene expression and microguarding genome integrity.RNA silencing studies predominantly focus on small RNAs such as microRNAs, short-interfering RNAs and piwi-interacting RNAs. We describe an emerging renewal of inter-est in a‘larger’small RNA, the transfer RNA (tRNA).Precisely generated tRNA-derived small RNAs, named tRNA halves (tiRNAs) and tRNA fragments (tRFs), have been reported to be abundant with dysregulation associated with cancer. Transfection of tiRNAs inhibits protein translation by displacing eukaryotic initiation factors from messenger RNA (mRNA) and inaugurating stress granule formation.Knockdown of an overexpressed tRF inhibits cancer cell proliferation. Recovery of lacking tRFs prevents cancer metastasis. The dual oncogenic and tumour-suppressive role is typical of functional small RNAs. We review recent reports on tiRNA and tRF discovery and biogenesis, identification and analysis from next-generation sequencing data and a mechanistic animal study to demonstrate their physiological role in cancer biology. We propose tRNA-derived small RNA-mediated RNA silencing is an innate defence mechanism to prevent oncogenic translation. We expect that cancer cells are percipient to their ablated control of transcription and attempt to prevent loss of genome control through RNA silencing

Urban noise affects song structure and daily patterns of song production in Red-winged Blackbirds (Agelaius phoeniceus)

Traffic noise is becoming a more prominent fixture in urban environments as cities and highways expand to accommodate the growing human population. Birds, in particular, rely heavily on vocal communication and have recently been shown to change the structure of their signals in response to environmental noise. Our objective was to determine the impact of traffic noise on Red-winged Blackbird (Agelaius phoeniceus) song structure and song timing. We recorded bird songs using a directional microphone and installed permanent recording devices to monitor daily song patterns at both high traffic noise sites and low traffic noise sites throughout southern Ontario, Canada. Our results indicate that at sites with high traffic noise, Red-winged Blackbirds sing songs with fewer introductory syllables, which are an important component of individual recognition and repertoire formation. In addition, the typical diurnal singing pattern of birds associated with noisy urban sites is more homogeneous than that of birds associated with quiet rural marshes. In the early morning and evening, singing effort was higher at rural sites than at urban sites, while in the midday singing effort at urban sites was higher than at rural sites. Birds at our noisy urban sites appear to be avoiding acoustic masking by increasing song production during the quiet part of the day and decreasing song production during the noisy rush hour periods. Based on our results, urban noise is impacting communication structure and the daily pattern of song production in a marsh-nesting species. These results have important implications for avian conservation and land use planning for urban development. © 2013 Springer Science+Business Media New York

The meta-crisis of secular capitalism

The current global economic crisis concerns the way in which contemporary capitalism has turned to financialisation as a double cure for both a falling rate of profit and a deficiency of demand. Although this turning is by no means unprecedented, policies of financialisation have depressed demand (in part as a result of the long-term stagnation of average wages) while at the same time not proving adequate to restore profits and growth. This paper argues that the current crisis is less the ‘normal’ one that has to do with a constitutive need to balance growth of abstract wealth with demand for concrete commodities. Rather, it marks a meta-crisis of capitalism that is to do with the difficulties of sustaining abstract growth as such. This meta-crisis is the tendency at once to abstract from the real economy of productive activities and to reduce everything to its bare materiality. By contrast with a market economy that binds material value to symbolic meaning, a capitalist economy tends to separate matter from symbol and reduce materiality to calculable numbers representing ‘wealth’. Such a conception of wealth rests on the aggregation of abstract numbers that cuts out all the relational goods and the ‘commons’ on which shared prosperity depends

Social Work Interventions: Promoting wellbeing and sustainable living conditions for Migrant Workers in Mauritius

Mauritius has a long history of labour migration and has always been an integral part in the socio-economic development of the country. Over the years Mauritius has put in place robust legal framework and has signed several laws to protect and preserve the rights of migrant workers. However, despite all these legislations to protect migrant workers, still there are lot of challenges in terms of poor living conditions, marginalization and exploitation that are still prevalent in our country. This study explores the essence of social work practices and having migrant social workers in enhancing the social and environmental wellbeing in promoting the sustainable living conditions of migrant workers in Mauritius. Qualitative methodology approach using the Grounded Theory by using semi-structured interviews were conducted with thirty migrant workers coming from different countries and working in different sectors. Five key themes emanated from the results as follows: (i) Living conditions, (ii) precarious working conditions, (iii) marginalization, (iv) limited access to social support and (iv) psychosocial problems. The study emphasized on the important role migrant social workers can have in terms of advocacy for policy reforms and fostering integration of the migrant workers within the society. Moreover, Social workers can help in addressing the difficulties that the migrant workers endure within their stay in our country

On Type IIn/Ia-CSM supernovae as exemplified by SN 2012ca

We present the complete set of ultra-violet, optical and near-infrared photometry and spectroscopy for SN 2012ca, covering the period from 6 d prior to maximum light, until 531 d after maximum. The spectroscopic time series for SN 2012ca is essentially unchanged over 1.5 yr, and appear to be dominated at all epochs by signatures of interaction with a dense circumstellar medium (CSM) rather than the underlying supernova (SN). SN 2012ca is a member of the set of type of the ambiguous IIn/Ia-CSM SNe, the nature of which have been debated extensively in the literature. The two leading scenarios are either a Type Ia SN exploding within a dense CSM from a non-degenerate, evolved companion, or a core-collapse SN from a massive star. While some members of the population have been unequivocally associated with Type Ia SNe, in other cases the association is less certain. While it is possible that SN 2012ca does arise from a thermonuclear SN, this would require a relatively high (between 20 and 70 per cent) efficiency in converting kinetic energy to optical luminosity, and a massive (∼2.3–2.6 M$_{⊙}$) circumstellar medium. On the basis of energetics, and the results of simple modelling, we suggest that SN 2012ca is more likely associated with a core-collapse SN. This would imply that the observed set of similar SNe to SN 2012ca is in fact originated by two populations, and while these are drawn from physically distinct channels, they can have observationally similar properties.This work is based on observations collected at the European Organization for Astronomical Research in the Southern hemisphere, Chile as part of PESSTO, (the Public ESO Spectroscopic Survey for Transient Objects Survey) ESO program 188.D-3003, 191.D-0935. It is also based on observations taken at the Panchromatic Robotic Optical Monitoring and Polarimetry Telescope (PROMPT) through the CNTAC proposal CN2012A-103; the Australian National University 2.3m Telescope and the Swift satellite. This work makes use of observations from the LCOGT network. Funded by the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement n° [291222] (SJS). This work was partly supported by the European Union FP7 programme through ERC grant number 320360. SB and AP acknowledge the PRIN-INAF 2011 project ‘Transient Universe: from ESO Large to PESSTO’. Support for GP is provided by the Ministry of Economy, Development, and Tourism's Millennium Science Initiative through grant IC120009, awarded to The Millennium Institute of Astrophysics, MAS. This research has made use of the NASA/IPAC Extragalactic Database (NED) which is operated by the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.This is the final version of the article. It first appeared from Oxford Univeristy Pres via http://dx.doi.org/10.1093/mnras/stw82