National Primary Care Day \u2797

No abstract available

The Balanced Budget Act of 1997: Implications for Medicare Reimbursement and Graduate Medical Education

No abstract available

Ariel - Volume 11 Number 3

Executive Editors Ellen Feldman Leonardo S. Nasca, Jr. Business Managers Barbara L. Davies Martin B. Getzow News Editor Hugh A. Gelabert Features Editor Aaron D. Bleznak CAHS Editor Joan M. Greco Editorial Page Editor Samuel Markind Photography Editor Todd Demmy Sports Editor Paul F. Mansfiel

Effects of glossy privet's invasion on the water dynamics of the Argentinean Yungas forest

Las Yungas argentinas (bosques de montaña) tienen alta biodiversidad y un rol clave en la regulación hídrica. El ligustro (Ligustrum lucidum) es una de las especies exóticas que dominan sus bosques secundarios. Debido a sus altas tasas de crecimiento y follaje verde todo el año, se planteó la hipótesis de que la disponibilidad de agua en el suelo se reduciría en bosques de ligustro en comparación con bosques nativos, principalmente durante la época seca (invierno-primavera). Se trabajó en seis pares de parcelas de bosques nativos y bosques secundarios monodominantes de ligustro en la Sierra San Javier, Tucumán, Argentina. Se registró la humedad edáfica mediante mediciones de contenido volumétrico y potencial hídrico y se estimó la productividad de los distintos tipos de bosque mediante el índice de vegetación de diferencia normalizada (NDVI). Durante la época seca de 2011 y 2012, los suelos en ligustrales presentaron un contenido volumétrico de agua 32,5 % y 24 % y un potencial hídrico en el suelo ocho y cuatro veces menor. Se observaron mayores valores de NDVI (8,5 %) en bosques de ligustro que en bosques nativos, principalmente en las selvas localizadas a menor altura y con mayor déficit hídrico inverno-primaveral. Los resultados sugieren que el bosque de ligustro estaría consumiendo mayor cantidad de agua, sobre todo en la época seca, debido a una actividad fenológica más prolongada respecto al bosque nativo y que su invasión en las Yungas podría alterar el funcionamiento hídrico de este ecosistema.Argentinean Yungas (subtropical montane forests) have high biodiversity and play a key role in regional watershed regulation. Ligustrum lucidum (glossy privet), native of China, is one of the dominant exotic tree species in secondary forests of this ecoregion. Due to its high growth rates and green foliage throughout the year -in contrast to native forests which are partially deciduous- the hypothesis is that water availability is reduced in glossy privet forests, especially during dry season (winter-spring). Six pairs of plots both in native and secondary glossy privet dominated forests in Sierra San Javier, Tucumán, Argentina were sampled. Soil moisture, by measuring both volumetric water content and water potential, and estimated productivity of different types of forests, through normalized difference vegetation index (NDVI derived from satellite imagery), were monitored. During 2011 - 2012 dry seasons, soil volumetric water content in glossy privet forests was 32.5 % and 24 % lower than in native forests; while soil water potential was respectively eight and four times lower. In glossy privet forests NDVI values were 8.5 % higher than in native forests; particularly in lower altitude forests and those with a higher winter-spring water deficit. These results suggest that the glossy privet forest would be consuming more water, especially during the dry season, due to more prolonged phenology activity compared to native forests. In consequence, glossy privet invasion in Argentinean Yungas could alter water functioning of this ecosystem.Fil: Zamora Nasca, Lucia Belén. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales E Instituto Miguel Lillo. Instituto de Ecología Regional; ArgentinaFil: Montti, Lia Fernanda. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales E Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Centro de Investigaciones del Bosque Atlantico; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Grau, Hector Ricardo. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales E Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Paolini, Leonardo. Universidad Nacional de Tucumán. Facultad de Ciencias Naturales E Instituto Miguel Lillo. Instituto de Ecología Regional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Human papillomavirus-associated increase in p16INK4A expression in penile lichen sclerosus and squamous cell carcinoma

Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2·5, which does not permit commercial exploitationBackground: Human papillomaviruses (HPVs) are sexually transmitted human carcinogens that may play a role in the oncogenesis of penile cancer. Objectives: To investigate the role of HPV infection and expression of the tumour suppressor protein p16INK4A in the pathogenesis of penile cancer. Methods: By means of polymerase chain reaction amplification and reverse hybridization line probe assay to detect HPV infection, and immunohistochemical staining for p16INK4A and Ki67, we analysed 26 penile squamous cell carcinomas (SCCs) and 20 independent penile lichen sclerosus (LS) lesions from 46 patients. Results: HPV DNA was found in 54% of penile SCCs and 33% of penile LS cases in single and multiple infections. High-risk HPV 16 was the predominant HPV type detected. No relationship between Ki67 expression and HPV infection was observed. Strong immunostaining for p16INK4A correlated with HPV 16/18 infection in both penile LS and penile SCC. In our penile SCC series the cancer margins were also associated with penile LS in 13 of 26 lesions, and HPV was detected in seven of the 13 SCC cases associated with LS and in six of the 11 SCC lesions not involving LS. Conclusions: Our study shows a high prevalence of HPV 16 and p16INK4A expression in penile lesions, consistent with an active role for HPV in interfering with the retinoblastoma pathway. High-risk HPV infection could be involved in the tumorigenic process in 50% of penile cancers, and the use of prophylactic HPV vaccines has the potential to prevent these cancers.Peer reviewedFinal Published versio

Ariel - Volume 11 Number 2

Executive Editors Ellen Feldman Leonardo S. Nasca, Jr. Business .Managers Barbara L. Davies Martin B. Getzow News Editor Aaron D. Bleznak Features Editor Hugh A. Gelabert CAHS Editor Joan M. Greco Editorial Page Editor Samuel Markind Photography Editor Leonardo S. Nasca, Jr. Sports Editor Paul F. Mansfiel

Ariel - Volume 10 Number 3

Executive Editors Madalyn Schaefgen David Reich Business Manager David Reich News Editors Medical College Edward Zurad CAHS John Guardiani World Mark Zwanger Features Editors Meg Trexler Jim O\u27Brien Editorials Editor Jeffrey Banyas Photography and Sports Editor Stuart Singer Commons Editor Brenda Peterso

Industrial application of selected lactic acid bacteria isolated from local semolinas for typical sourdough bread production

Four obligate heterofermentative lactic acid bacteria (LAB) strains (Weissella cibaria PON10030 and PON10032 and Leuconostoc citreum PON 10079 and PON10080) were tested as single strain starters, mono-species dual strain starters, and multiple strain starter for the preparation and propagation of sourdoughs for the production of a typical bread at industrial level. The kinetics of pH and TTA during the daily sourdough refreshments indicated a correct acidification process for all trials. The concentration of lactic and acetic acid increased consistently during fermentation. The resulting molar ratios between these two organic acids in the experimental trials were lower than those observed in the control trial. The microbiological investigation showed levels of approximately 109 CFU/mL in almost all sourdoughs and the comparison of the genetic polymorphisms of the dominating LAB with those of the pure cultures evidenced the persistence of the added strains over time. The resulting breads were evaluated for several quality parameters. The breads with the greatest height were obtained with the quadruple combination of leuconostocs and weissellas. The highest softness was registered for the breads obtained from fermentations performed by W. cibaria PON10032 alone and in combination. The different inocula influenced also the color, the void fraction, the cell density and the mean cell area of the breads. Different levels of acids, alcohols, aldehydes, esters, hydrocarbons, ketones, terpenes, furans and phenol were emitted by the breads. The sensory tests indicated the breads from the sourdoughs fermented with the seven LAB inocula as sweeter and less acidic than control breads and the breads from the trials with the highest complexity of LAB inoculums were those more appreciated by tasters. A multivariate approach found strong differences among the trials. In particular, control breads and the breads obtained with different starter LAB were quite distant and a more strict relation was found among the productions carried out by W. cibaria strains. This study proved the suitability of the selected strains of L. citreum and W. cibaria for industrial-scale level applications in sourdough bread production

An operational measure of physician lifelong learning: its development, components and preliminary psychometric data

Despite the emphasis placed on physicians’ lifelong learning, no psychometrically sound instrument has been developed to provide an operational measure of the concept and its components among physicians. The authors designed this study to develop a tool for measuring physician lifelong learning, to identify its underlying components and to assess its psychometric properties. A 37-item questionnaire was developed, based on a review of literature and the results of two pilot studies. Psychometric analyses of the responses of 160 physicians identified 19 items that were included in the Jefferson Scale of Physician Lifelong Learning. Factor analysis of the 19 items showed five meaningful factors that were consistent with the definition and major features of lifelong learning. They were ‘need recognition’, ‘research endeavor’, ‘self-initiation’, ‘technical skills’ and ‘personal motivation’. The method of contrasted groups provided evidence in support of the validity of the five factors. The factors’ reliability was assessed by coefficient alpha. It is concluded that lifelong learning is a multifaceted concept, and its operational measure is feasible for evaluating different educational programs and for studying group differences among physicians