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2.
Biol Psychiatry ; 93(6): 512-523, 2023 03 15.
Article in English | MEDLINE | ID: mdl-36494220

ABSTRACT

BACKGROUND: Obesity is a chronic relapsing disorder that is caused by an excess of caloric intake relative to energy expenditure. There is growing recognition that food motivation is altered in people with obesity. However, it remains unclear how brain circuits that control food motivation are altered in obese animals. METHODS: Using a novel behavioral assay that quantifies work during food seeking, in vivo and ex vivo cell-specific recordings, and a synaptic blocking technique, we tested the hypothesis that activity of circuits promoting appetitive behavior in the core of the nucleus accumbens (NAc) is enhanced in the obese state, particularly during food seeking. RESULTS: We first confirmed that mice made obese with ad libitum exposure to a high fat diet work harder than lean mice to obtain food, consistent with an increase in food motivation in obese mice. We observed greater activation of D1 receptor-expressing NAc spiny projection neurons (NAc D1SPNs) during food seeking in obese mice relative to lean mice. This enhanced activity was not observed in D2 receptor-expressing neurons (D2SPNs). Consistent with these in vivo findings, both intrinsic excitability and excitatory drive onto D1SPNs were enhanced in obese mice relative to lean mice, and these measures were selective for D1SPNs. Finally, blocking synaptic transmission from D1SPNs, but not D2SPNs, in the NAc core decreased physical work during food seeking and, critically, attenuated high fat diet-induced weight gain. CONCLUSIONS: These experiments demonstrate the necessity of NAc core D1SPNs in food motivation and the development of diet-induced obesity, establishing these neurons as a potential therapeutic target for preventing obesity.


Subject(s)
Motivation , Nucleus Accumbens , Mice , Animals , Nucleus Accumbens/physiology , Mice, Obese , Neurons/physiology , Obesity , Receptors, Dopamine D1/metabolism , Mice, Inbred C57BL
3.
J Geophys Res Space Phys ; 127(5): e2021JA030121, 2022 May.
Article in English | MEDLINE | ID: mdl-35865128

ABSTRACT

We investigate the impact of conjugate photoelectrons (CPEs) on the topside (∼600 km altitude) ionosphere at low and midlatitudes using measurements of the ion temperature, density, and composition from the first Republic of China satellite during a period of the high to moderate solar activity (March 1999 to June 2004). Elevated ion temperatures and densities are observed in the dark Northern American-Atlantic sector during the December solstice and in the Australian sector during the June solstice. The oxygen ion fraction and density are also elevated at these locations. These observations indicate that photoelectrons from the conjugate hemisphere heat the local ionospheric plasma. The morphology of the ion temperature in the winter hemisphere is well represented by the solar zenith angle in the sunlit conjugate hemisphere. The CPE hypothesis for the observed ionospheric heating is confirmed by coincident nighttime enhancements of the far ultraviolet airglow measured by the Global Ultraviolet Imager onboard the Thermosphere Ionosphere Mesosphere Energetics and Dynamics satellite.

4.
Front Syst Neurosci ; 16: 1044686, 2022.
Article in English | MEDLINE | ID: mdl-36591324

ABSTRACT

Due to the prevalence of chronic pain worldwide, there is an urgent need to improve pain management strategies. While opioid drugs have long been used to treat chronic pain, their use is severely limited by adverse effects and abuse liability. Neurostimulation techniques have emerged as a promising option for chronic pain that is refractory to other treatments. While different neurostimulation strategies have been applied to many neural structures implicated in pain processing, there is variability in efficacy between patients, underscoring the need to optimize neurostimulation techniques for use in pain management. This optimization requires a deeper understanding of the mechanisms underlying neurostimulation-induced pain relief. Here, we discuss the most commonly used neurostimulation techniques for treating chronic pain. We present evidence that neurostimulation-induced analgesia is in part driven by the release of endogenous opioids and that this endogenous opioid release is a common endpoint between different methods of neurostimulation. Finally, we introduce technological and clinical innovations that are being explored to optimize neurostimulation techniques for the treatment of pain, including multidisciplinary efforts between neuroscience research and clinical treatment that may refine the efficacy of neurostimulation based on its underlying mechanisms.

5.
Plant Cell Physiol ; 62(7): 1199-1214, 2021 Oct 29.
Article in English | MEDLINE | ID: mdl-34015110

ABSTRACT

The strength of the stalk rind, measured as rind penetrometer resistance (RPR), is an important contributor to stalk lodging resistance. To enhance the genetic architecture of RPR, we combined selection mapping on populations developed by 15 cycles of divergent selection for high and low RPR with time-course transcriptomic and metabolic analyses of the stalks. Divergent selection significantly altered allele frequencies of 3,656 and 3,412 single- nucleotide polymorphisms (SNPs) in the high and low RPR populations, respectively. Surprisingly, only 110 (1.56%) SNPs under selection were common in both populations, while the majority (98.4%) were unique to each population. This result indicated that high and low RPR phenotypes are produced by biologically distinct mechanisms. Remarkably, regions harboring lignin and polysaccharide genes were preferentially selected in high and low RPR populations, respectively. The preferential selection was manifested as higher lignification and increased saccharification of the high and low RPR stalks, respectively. The evolution of distinct gene classes according to the direction of selection was unexpected in the context of parallel evolution and demonstrated that selection for a trait, albeit in different directions, does not necessarily act on the same genes. Tricin, a grass-specific monolignol that initiates the incorporation of lignin in the cell walls, emerged as a key determinant of RPR. Integration of selection mapping and transcriptomic analyses with published genetic studies of RPR identified several candidate genes including ZmMYB31, ZmNAC25, ZmMADS1, ZmEXPA2, ZmIAA41 and hk5. These findings provide a foundation for an enhanced understanding of RPR and the improvement of stalk lodging resistance.


Subject(s)
Zea mays/genetics , Cell Wall/metabolism , Evolution, Molecular , Gene Expression Profiling , Gene Frequency , Metabolomics , Polymorphism, Single Nucleotide/genetics , Quantitative Trait, Heritable , Zea mays/anatomy & histology
6.
Integr Comp Biol ; 2020 Sep 24.
Article in English | MEDLINE | ID: mdl-32970803

ABSTRACT

A gene's response to an environment is tightly bound to the underlying genetic variation present in an individual's genome and varies greatly depending on the tissue it is being expressed in. Gene co-expression networks provide a mechanism to understand and interpret the collective transcriptional responses of genes. Here, we use the Camoco co-expression network framework to characterize the transcriptional landscape of adipose and gluteal muscle tissue in 83 domestic horses (Equus caballus) representing 5 different breeds. In each tissue, gene expression profiles, capturing transcriptional response due to variation across individuals, were used to build two separate, tissue-focused, genotypically-diverse gene co-expression networks. The aim of our study was to identify significantly co-expressed clusters of genes in each tissue, then compare the clusters across networks to quantify the extent that clusters were found in both networks as well as to identify clusters found in a single network. The known and unknown functions for each network were quantified using complementary, supervised and unsupervised approaches. First, supervised ontological enrichment was utilized to quantify biological functions represented by each network. Curated ontologies (GO and KEGG) were used to measure the known biological functions present in each tissue. Overall, a large percentage of terms (40.3% of GO and 41% of KEGG) were co-expressed in at least one tissue. Many terms were co-expressed in both tissues, however a small proportion of terms exhibited single tissue co-expression suggesting functional differentiation based on curated, functional annotation. To complement this, an unsupervised approach not relying on ontologies was employed. Strongly co-expressed sets of genes defined by Markov clustering identified sets of unannotated genes showing similar patterns of co-expression within a tissue. We compared gene sets across tissues and identified clusters of genes the either segregate in co-expression by tissue or exhibit high levels of co-expression in both tissues. Clusters were also integrated with GO and KEGG ontologies to identify gene sets containing previously curated annotations versus unannotated gene sets indicating potentially novel biological function. Coupling together these transcriptional datasets, we mapped the transcriptional landscape of muscle and adipose setting up a generalizable framework for interpreting gene function for additional tissues in the horse and other species.

7.
Vet Clin North Am Equine Pract ; 36(2): 183-193, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32534852

ABSTRACT

High-quality genomic tools have been integral in understanding genomic architecture and function in the modern-day horse. The equine genetics community has a long tradition of pooling resources to develop genomic tools. Since the equine genome was sequenced in 2006, several iterations of high throughput genotyping arrays have been developed and released, enabling rapid and cost-effective genotyping. This review highlights the design considerations of each iteration, focusing on data available during development and outlining considerations in selecting the genetic variants included on each array. Additionally, we outline recent applications of equine genotyping arrays as well as future prospects and applications.


Subject(s)
Genotyping Techniques/veterinary , Horses/genetics , Animals , Genomics , Genotype , Horse Diseases/genetics , Polymorphism, Single Nucleotide
8.
J Agric Food Chem ; 67(43): 12026-12036, 2019 Oct 30.
Article in English | MEDLINE | ID: mdl-31589432

ABSTRACT

Peanut is an important legume providing products with nutrient dense including mineral nutrition. However, the genetic basis underlying the variations in the mineral composition in peanut is still unknown. Genome-wide association studies (GWAS) of the concentrations of 13 mineral elements combined with coexpression network were performed using a diverse panel of 120 genotypes mainly selected from the U.S. peanut mini core collection. A total of 36 significant quantitative trait loci (QTLs) associated with five elemental concentrations were identified with phenotypic variation explained (PVE) from 18.35% to 27.56%, in which 24 QTLs were for boron (B), 2 QTLs for copper (Cu), 6 QTLs for sodium (Na), 3 QTLs for sulfur (S), and 1 QTL for zinc (Zn). A total of 110 nonredundant candidate causal genes identified were significantly associated with elemental accumulation, which included one high-priority overlap (HPO) candidate gene arahy.KQD4NT, an important elemental/metal transporter gene located on LGB04 with position 5,413,913-5,417,353.


Subject(s)
Arachis/genetics , Boron/metabolism , Copper/metabolism , Plant Proteins/genetics , Sodium/metabolism , Sulfur/metabolism , Zinc/metabolism , Arachis/growth & development , Arachis/metabolism , Genome-Wide Association Study , Genotype , Plant Proteins/metabolism , Quantitative Trait Loci
9.
Sci Rep ; 9(1): 6095, 2019 04 15.
Article in English | MEDLINE | ID: mdl-30988347

ABSTRACT

Analysis of the Y chromosome is the best-established way to reconstruct paternal family history in humans. Here, we applied fine-scaled Y-chromosomal haplotyping in horses with biallelic markers and demonstrate the potential of our approach to address the ancestry of sire lines. We de novo assembled a draft reference of the male-specific region of the Y chromosome from Illumina short reads and then screened 5.8 million basepairs for variants in 130 specimens from intensively selected and rural breeds and nine Przewalski's horses. Among domestic horses we confirmed the predominance of a young'crown haplogroup' in Central European and North American breeds. Within the crown, we distinguished 58 haplotypes based on 211 variants, forming three major haplogroups. In addition to two previously characterised haplogroups, one observed in Arabian/Coldblooded and the other in Turkoman/Thoroughbred horses, we uncovered a third haplogroup containing Iberian lines and a North African Barb Horse. In a genealogical showcase, we distinguished the patrilines of the three English Thoroughbred founder stallions and resolved a historic controversy over the parentage of the horse 'Galopin', born in 1872. We observed two nearly instantaneous radiations in the history of Central and Northern European Y-chromosomal lineages that both occurred after domestication 5,500 years ago.


Subject(s)
Haplotypes , Horses/genetics , Y Chromosome/genetics , Animals , Breeding , Domestication , Female , Genetic Variation , Male , Pedigree , Phylogeny
11.
Plant Cell ; 30(12): 2922-2942, 2018 12.
Article in English | MEDLINE | ID: mdl-30413654

ABSTRACT

Genome-wide association studies (GWAS) have identified loci linked to hundreds of traits in many different species. Yet, because linkage equilibrium implicates a broad region surrounding each identified locus, the causal genes often remain unknown. This problem is especially pronounced in nonhuman, nonmodel species, where functional annotations are sparse and there is frequently little information available for prioritizing candidate genes. We developed a computational approach, Camoco, that integrates loci identified by GWAS with functional information derived from gene coexpression networks. Using Camoco, we prioritized candidate genes from a large-scale GWAS examining the accumulation of 17 different elements in maize (Zea mays) seeds. Strikingly, we observed a strong dependence in the performance of our approach based on the type of coexpression network used: expression variation across genetically diverse individuals in a relevant tissue context (in our case, roots that are the primary elemental uptake and delivery system) outperformed other alternative networks. Two candidate genes identified by our approach were validated using mutants. Our study demonstrates that coexpression networks provide a powerful basis for prioritizing candidate causal genes from GWAS loci but suggests that the success of such strategies can highly depend on the gene expression data context. Both the software and the lessons on integrating GWAS data with coexpression networks generalize to species beyond maize.


Subject(s)
Genome-Wide Association Study/methods , Zea mays/genetics , Linkage Disequilibrium/genetics , Software
12.
J Eur CME ; 7(1): 1506202, 2018.
Article in English | MEDLINE | ID: mdl-30206501

ABSTRACT

In Europe, there are currently some 30 different jurisdictions and no overarching legislation regarding CME-CPD accreditation, since legislative competency related to national health-care systems lies with national authorities. Thus, public demonstration of professional agreement regarding the principles, rules and practice of CME-CPD as well as its accreditation is a highly desirable professional and political objective in Europe, where free movement and freedom to offer professional (medical) services is a key feature of the EU vision of the single market. The newly formed association of independent European accreditors, Continuing Medical Education - European Accreditors (CME-EA) is committed to offering a platform for dialogue between individuals and organisations involved in definition of professional codes in general, and accreditation of CME-CPD in particular on the national level. The aim is to reach a European consensus on principles and rules applied in planning and delivery of CME-CPD. This includes consensus on constituent characteristics of accreditors as well as principles and practice of accreditation.

13.
BMC Genomics ; 19(1): 581, 2018 Aug 02.
Article in English | MEDLINE | ID: mdl-30071827

ABSTRACT

BACKGROUND: Severe equine asthma, also known as recurrent airway obstruction (RAO), is a debilitating, performance limiting, obstructive respiratory condition in horses that is phenotypically similar to human asthma. Past genome wide association studies (GWAS) have not discovered coding variants associated with RAO, leading to the hypothesis that causative variant(s) underlying the signals are likely non-coding, regulatory variant(s). Regions of the genome containing variants that influence the number of expressed RNA molecules are expression quantitative trait loci (eQTLs). Variation associated with RAO that also regulates a gene's expression in a disease relevant tissue could help identify candidate genes that influence RAO if that gene's expression is also associated with RAO disease status. RESULTS: We searched for eQTLs by analyzing peripheral blood mononuclear cells (PBMCs) from two half-sib families and one unrelated cohort of 82 European Warmblood horses that were previously treated in vitro with: no stimulation (MCK), lipopolysaccharides (LPS), recombinant cyathostomin antigen (RCA), and hay-dust extract (HDE). We identified high confidence eQTLs that did not violate linear modeling assumptions and were not significant due to single outlier individuals. We identified a mean of 4347 high confidence eQTLs in four treatments of PBMCs, and discovered two trans regulatory hotspots regulating genes involved in related biological pathways. We corroborated previous RAO associated single nucleotide polymorphisms (SNPs), and increased the resolution of past GWAS by analyzing 1,056,195 SNPs in 361 individuals. We identified four RAO-associated SNPs that only regulate gene expression of dexamethasone-induced protein (DEXI), however we found no significant association between DEXI gene expression and presence of RAO. CONCLUSIONS: Thousands of genetic variants regulate gene expression in PBMCs of European Warmblood horses in cis and trans. Most high confidence eSNPs are significantly enriched near the transcription start sites of their target genes. Two trans regulatory hotspots on chromosome 11 and 13 regulate many genes involved in transmembrane cell signaling and neurological development respectively when PBMCs are treated with HDE. None of the top fifteen RAO associated SNPs strongly influence disease status through gene expression regulation.


Subject(s)
Asthma/veterinary , Gene Expression Profiling/veterinary , Horse Diseases/genetics , Polymorphism, Single Nucleotide , Quantitative Trait Loci , Animals , Asthma/chemically induced , Asthma/genetics , Dust , Gene Expression Regulation , Gene Regulatory Networks/drug effects , Genetic Predisposition to Disease , Genome-Wide Association Study/veterinary , Horse Diseases/chemically induced , Horses , Leukocytes, Mononuclear/drug effects , Lipopolysaccharides/adverse effects
14.
Front Genet ; 9: 249, 2018.
Article in English | MEDLINE | ID: mdl-30105047

ABSTRACT

Selective breeding for athletic performance in various disciplines has resulted in population stratification within the American Quarter Horse (QH) breed. The goals of this study were to utilize high density genotype data to: (1) identify genomic regions undergoing positive selection within and among QH subpopulations; (2) investigate haplotype structure within each QH subpopulation; and (3) identify candidate genes within genomic regions of interest (ROI), as well as biological pathways, predicted to play a role in elite performance in each group. For that, 65K SNP genotyping data on 143 elite individuals from 6 QH subpopulations (cutting, halter, racing, reining, western pleasure, and working cow) were imputed to 2M SNPs. Signatures of selection were identified using FST-based (di ) and haplotype-based (hapFLK) analyses, accompanied by identification of local haplotype structure and sharing within subpopulations (hapQTL). Regions undergoing positive selection were identified on all 31 autosomes, and ROI on 2 chromosomes were identified by all 3 methods combined. Genes within each ROI were retrieved and used to identify pathways and genes that might contribute to performance in each subpopulation. These included, among others, candidate genes associated with skeletal muscle development, metabolism, and central nervous system development. This work improves our understanding of equine breed development, and provides breeders with a better understanding of how selective breeding impacts the performance of QH populations.

15.
Appl Opt ; 57(24): 6851-6859, 2018 Aug 20.
Article in English | MEDLINE | ID: mdl-30129569

ABSTRACT

CONTEXT: With ISS-SOLAR-SolACES, a new approach in terms of calibrating solar spectral irradiance (SSI) data was validated during the mission period from 2008 to 2017: an ionization chamber (IC) as primary detector standard, operated in space, allowed daily calibration measurements. ISSUE: Though primary photo-ionization efficiencies and higher-order ionization effects from photoelectrons are constant with time, filter transmissions and signal contributions from solar x-rays are to be determined for the SSI data evaluation, requiring a deeper investigation. AIMS AND METHODS: The experiences made with ionization chambers in the laboratory and aboard the ISS-SOLAR-SolACES mission are presented. They include the determination of higher-order ionization effects, the measured transmission of the filters with time, and the treatment of the solar soft x-ray background. Recommended combinations of IC filling gases and filter materials as well as laboratory and in-space measurements will provide correction procedures for different levels of solar activity to achieve further improvement of SSI data accuracy in the spectral range from 1 nm to 133 nm. Results and Perspectives. The usage of the IC technology aims for establishing absolute SolACES-type calibration equipment in space, providing reference SSI data sets in solar and solar-terrestrial science, as well as in related applications such as global navigation satellite system signal evaluation.

16.
BMC Genomics ; 18(1): 565, 2017 07 27.
Article in English | MEDLINE | ID: mdl-28750625

ABSTRACT

BACKGROUND: To date, genome-scale analyses in the domestic horse have been limited by suboptimal single nucleotide polymorphism (SNP) density and uneven genomic coverage of the current SNP genotyping arrays. The recent availability of whole genome sequences has created the opportunity to develop a next generation, high-density equine SNP array. RESULTS: Using whole genome sequence from 153 individuals representing 24 distinct breeds collated by the equine genomics community, we cataloged over 23 million de novo discovered genetic variants. Leveraging genotype data from individuals with both whole genome sequence, and genotypes from lower-density, legacy SNP arrays, a subset of ~5 million high-quality, high-density array candidate SNPs were selected based on breed representation and uniform spacing across the genome. Considering probe design recommendations from a commercial vendor (Affymetrix, now Thermo Fisher Scientific) a set of ~2 million SNPs were selected for a next-generation high-density SNP chip (MNEc2M). Genotype data were generated using the MNEc2M array from a cohort of 332 horses from 20 breeds and a lower-density array, consisting of ~670 thousand SNPs (MNEc670k), was designed for genotype imputation. CONCLUSIONS: Here, we document the steps taken to design both the MNEc2M and MNEc670k arrays, report genomic and technical properties of these genotyping platforms, and demonstrate the imputation capabilities of these tools for the domestic horse.


Subject(s)
Genotyping Techniques/methods , Horses/genetics , Oligonucleotide Array Sequence Analysis/methods , Polymorphism, Single Nucleotide , Animals , Gene Frequency , Genotyping Techniques/standards , Linkage Disequilibrium , Oligonucleotide Array Sequence Analysis/standards , Reference Standards , Whole Genome Sequencing
17.
Curr Biol ; 27(13): 2029-2035.e5, 2017 Jul 10.
Article in English | MEDLINE | ID: mdl-28669755

ABSTRACT

The Y chromosome directly reflects male genealogies, but the extremely low Y chromosome sequence diversity in horses has prevented the reconstruction of stallion genealogies [1, 2]. Here, we resolve the first Y chromosome genealogy of modern horses by screening 1.46 Mb of the male-specific region of the Y chromosome (MSY) in 52 horses from 21 breeds. Based on highly accurate pedigree data, we estimated the de novo mutation rate of the horse MSY and showed that various modern horse Y chromosome lineages split much later than the domestication of the species. Apart from few private northern European haplotypes, all modern horse breeds clustered together in a roughly 700-year-old haplogroup that was transmitted to Europe by the import of Oriental stallions. The Oriental horse group consisted of two major subclades: the Original Arabian lineage and the Turkoman horse lineage. We show that the English Thoroughbred MSY was derived from the Turkoman lineage and that English Thoroughbred sires are largely responsible for the predominance of this haplotype in modern horses.


Subject(s)
Evolution, Molecular , Genetic Variation , Horses/genetics , Y Chromosome/genetics , Animals , Europe , Haplotypes/genetics , Male , Pedigree
18.
Proc Natl Acad Sci U S A ; 114(12): 3204-3209, 2017 03 21.
Article in English | MEDLINE | ID: mdl-28270601

ABSTRACT

Pseudomonas aeruginosa biofilm infections are difficult to treat with antibiotic therapy in part because the biofilms contain subpopulations of dormant antibiotic-tolerant cells. The dormant cells can repopulate the biofilms following alleviation of antibiotic treatments. While dormant, the bacteria must maintain cellular integrity, including ribosome abundance, to reinitiate the de novo protein synthesis required for resuscitation. Here, we demonstrate that the P. aeruginosa gene PA4463 [hibernation promoting factor (HPF)], but not the ribosome modulation factor (PA3049), is required for ribosomal RNA preservation during prolonged nutrient starvation conditions. Single-cell-level studies using fluorescence in situ hybridization (FISH) and growth in microfluidic drops demonstrate that, in the absence of hpf, the rRNA abundances of starved cells decrease to levels that cause them to lose their ability to resuscitate from starvation, leaving intact nondividing cells. P. aeruginosa defective in the stringent response also had reduced ability to resuscitate from dormancy. However, FISH analysis of the starved stringent response mutant showed a bimodal response where the individual cells contained either abundant or low ribosome content, compared with the wild-type strain. The results indicate that ribosome maintenance is key for maintaining the ability of P. aeruginosa to resuscitate from starvation-induced dormancy and that HPF is the major factor associated with P. aeruginosa ribosome preservation.


Subject(s)
Hibernation , Pseudomonas aeruginosa/physiology , Ribosomal Proteins/metabolism , Ribosomes/metabolism , Energy Metabolism , Gene Expression Regulation, Bacterial , RNA, Ribosomal/genetics , RNA, Ribosomal/metabolism
19.
J Eur CME ; 6(1): 1312062, 2017.
Article in English | MEDLINE | ID: mdl-29644130

ABSTRACT

This position paper is the result of a collaborative approach of several European Specialty Accreditation Boards (ESABs) and, has been stimulated by their current experience in accreditation regarding roles and responsibilities assumed by sponsors of accredited continuing medical education (CME). The suggestions made in this paper aim to preserve the fundamental principle in CME accreditation that the physician in charge of the programme has sole responsibility for the selection of topics, speakers, content and format, as well as mode of presentation, and that sponsors will under no circumstances interfere with this principle. This is considered as a responsibility of an individual physician (or physicians), which cannot be delegated, even in part, to third parties. This responsibility has been extended to include all communication before and after the event. The paper also identifies undecided issues, about which ESABs are committed to elaborate proposals in the future.

20.
J Eur CME ; 6(1): 1314416, 2017.
Article in English | MEDLINE | ID: mdl-29644131

ABSTRACT

The Cologne Consensus Conference 2015 has focused on "Providers in accredited CME[continuing medical education]/CPD [continuing professional development]". As an outcome of the CCC 2015, the authors of this paper, who were part of the faculty, propose a contemporary definition of the roles and responsibilities of stakeholders involved in the different stages of planning, delivery and evaluation of CME/CPD.

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