Internal medicine clerkship characteristics associated with enhanced student examination performance.

Purpose: To determine which internal medicine (IM) clerkship characteristics are associated with better student examination performance.

Method: The authors collected data from 17 U.S.

Microcrystalline hexagonal tungsten bronze. 2. Dehydration dynamics.

Low-temperature (25-600 degrees C) thermal transformations have been studied for hydrothermally prepared, microcrystalline hexagonal tungsten bronze (HTB) phases A(x)WO(3+x/2).zH(2)O as a function of temperature, where A is an exchangeable cation (in this case Na(+) or Cs(+)) located in hexagonal structural tunnels. Thermal treatment of the as-prepared sodium- and cesium-exchanged phases in air were monitored using a conventional laboratory-based X-ray diffractometer, while thermal transformations in vacuum were studied using synchrotron X-ray and neutron diffraction.

Microcrystalline hexagonal tungsten bronze. 1. Basis of ion exchange selectivity for cesium and strontium.

The structural basis of selectivity for cesium and strontium of microcrystalline hexagonal tungsten bronze (HTB) phase Na(x)WO(3+x/2).zH(2)O has been studied using X-ray and neutron diffraction techniques, 1D and 2D (23)Na magic angle spinning (MAS) nuclear magnetic resonance (NMR) spectroscopy, and radiochemical ion exchange investigations. For the HTB system, this study has shown that scattering techniques alone provide an incomplete description of the disorder and rapid exchange of water (with tunnel cations) occurring in this system.

Global circulation as the main source of cloud activity on Titan.

Clouds on Titan result from the condensation of methane and ethane and, as on other planets, are primarily structured by circulation of the atmosphere. At present, cloud activity mainly occurs in the southern (summer) hemisphere, arising near the pole and at mid-latitudes from cumulus updrafts triggered by surface heating and/or local methane sources, and at the north (winter) pole, resulting from the subsidence and condensation of ethane-rich air into the colder troposphere. General circulation models predict that this distribution should change with the seasons on a 15-year timescale, and that clouds should develop under certain circumstances at temperate latitudes ( approximately 40 degrees ) in the winter hemisphere.

Phenotypic variability in trisomy 13 mosaicism: two new patients and literature review.

Trisomy 13 mosaicism occurs when two cell lines, one with a normal complement of chromosomes and the other with an additional chromosome 13, are present in the same individual. We present two children with trisomy 13 mosaicism and summarize the literature in 47 published cases. Our first patient is a 4-year-old male with normal development and dysmorphic features that include right microtia, tall forehead, bulbous nose, and high arched palate.

Disinfection methods used in decontamination of bottles used for feeding powdered infant formula.

Infant susceptibility and the risks posed by infections associated with bottle-fed powdered infant formula (PIF) have received increased attention in recent years. Intrinsic contamination of PIF with pathogens has been reported and extrinsic contamination can be introduced from the handler or the environment during reconstitution. Recommended disinfection advice and bottle decontamination have changed in recent years and the aim of this study was to validate the efficacy of four current disinfection methods using bottles that had contained reconstituted PIF spiked with either a representative mixed bacterial culture or specific pathogens.

Regulatory T cells are reduced during anti-CD25 antibody treatment of multiple sclerosis.

Objective: Maintenance therapy with anti-CD25 antibody has emerged as a potentially useful treatment for multiple sclerosis (MS). Constitutive CD25 expression on CD4+CD25+ regulatory T cells (Treg) suggests that anti-CD25 antibody treatment may potentially target a subset of T cells that exhibit immune suppressive properties. We examined changes to CD4+CD25+ Treg in patients with MS receiving maintenance anti-CD25 monoclonal antibody treatment to determine the effect of treatment on Treg and, consequently, on immunological tolerance.

Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health.

Aims: Microbial contamination of powdered infant formula (PIF) is known to cause gastrointestinal infections in infants. Of concern is intrinsic contamination of the formula with (for example) Salmonella enterica as well as extrinsic contamination from inappropriate handling or ineffective disinfection. The aim of this study was to evaluate organic and microbial contamination of 'in-use' bottles used for feeding infants powdered formula milk in South Wales, UK.

The importance of hygiene in the domestic kitchen: implications for preparation and storage of food and infant formula.

Aims: Public concerns relating to food safety remain high with most attention focused on manufactured foods and those served in catering operations. However, previous data have suggested that the home may be the main location for cases of food-borne disease. The aim of this paper is to review the microbiological risks associated with hygiene in the domestic kitchen related to food and infant formula safety.

Choline for diagnosis and prognostication of acute coronary syndromes in the Emergency Department.

Objectives: Choline has been identified as a promising marker of coronary inflammation, plaque destabilisation and ischaemia. We sought to evaluate plasma choline levels for rapid confirmation or exclusion of acute myocardial infarction (AMI) in the Emergency Department (ED) and for predicting major adverse cardiac events (MACE).

Methods: We prospectively recruited 361 patients who presented to the ED with suspected cardiac chest pain within the previous 24 h.

The effect of hypoxia on in vitro prevascularization of a thick soft tissue.

Prevascularizing an implantable tissue is one strategy to improve oxygen (O(2)) transport throughout larger tissues upon implantation. This study examined the role of hypoxia both during (i.e.

Changes in internal medicine residents' attitudes about resuscitation after cardiac arrest over a decade.

Background: Resident physicians' beliefs about cardiopulmonary resuscitation (CPR) may impact their communication with patients about end-of-life care. We sought to understand how these perceptions and experiences have changed in the past decade because both medical education and American society have focused more on this domain.

Method: We surveyed 2 internal medicine resident cohorts at a large academic medical center in 1995 and 2005.

Enhancing knowledge and clinical skills through an adolescent medicine workshop.

Objective: To determine the effect of a medical school adolescent medicine workshop on knowledge and clinical skills using standardized patients.

Design: Randomized controlled trial.

Setting: The University of Kentucky College of Medicine, Lexington.

Radiographic identification of the primary medial knee structures.

Background: Radiographic landmarks for medial knee attachment sites during anatomic repairs or reconstructions are unknown. If identified, they could assist in the preoperative evaluation of structure location and allow for postoperative assessment of reconstruction tunnel placement.

Methods: Radiopaque markers were implanted into the femoral and tibial attachments of the superficial medial collateral ligament and the femoral attachments of the posterior oblique and medial patellofemoral ligaments of eleven fresh-frozen, nonpaired cadaveric knee specimens.

Radiographic identification of the primary posterolateral knee structures.

Background: It is often difficult to identify the attachment sites of the fibular collateral ligament, popliteus tendon, and popliteofibular ligament for chronic posterolateral knee injuries or during revision surgeries. Descriptions of radiographic landmarks for these attachment sites would assist in the intraoperative identification of their locations and also allow for postoperative assessment of the placement of reconstruction tunnels.

Hypothesis: Identification of qualitative and quantitative radiographic landmarks for the attachments of the main posterolateral knee structures are reproducible among observers of various experience levels and allow for improved intraoperative and postoperative identification of these attachment sites.

Attitudes of Kentucky women regarding mandatory reporting of intimate partner violence.

Background: Kentucky is one of only six states with laws mandating that intimate partner violence be reported to authorities. The purpose of this project was to understand the attitudes of women clinic patients in Kentucky regarding mandatory reporting of intimate partner violence and how these attitudes may differ by abuse status.

Methods: Women presenting to an internal medicine clinic in the summer of 2003 were asked to complete an anonymous 30-item questionnaire, including personal history of abuse and their opinions about mandatory reporting of intimate partner violence to the police.

Service design projects sponsored by the Kansas State University Student Chapter of the IEEE EMBS.

Service projects offer volunteer student organizations a means to generate interest and focus activity outside of the context of the classroom. This paper addresses efforts by the Kansas State University (KSU) Student Chapter of the IEEE Engineering in Medicine and Biology Society (EMBS) to initiate and guide service projects in two primary areas: (1) research to aid persons with disabilities (RAPD) and (2) hands-on efforts to interest young women in the quantitative fields of science and engineering. Three RAPD projects are presented: a computer mouse design that helps to alleviate productivity problems associated with Parkinson's tremors, a battery removal tool for arthritic individuals with limited dexterity, and a wireless door control and communication system to assist mobility-limited individuals.

Successful AV fistula creation does not lead to higher catheter use: the experience by the Northwest Renal Network 16 Vascular Access Quality Improvement Program. Four years follow-up.

Background: In 2002, the Center for Medicare and Medicaid Services (CMS) required all 18 Renal Networks to participate in a Vascular Access Quality Improvement Program (QIP). The Northwest Renal Network (NWRN 16) chose to increase arteriovenous fistula (AVF) use. NWRN 16 hypothesized that strategies which targeted the improvement of AVF rate and the reduction of catheter use were the same.

Storms, polar deposits and the methane cycle in Titan's atmosphere.

In Titan's atmosphere, the second most abundant constituent, methane, exists as a gas, liquid and solid, and cycles between the atmosphere and the surface. Similar to the Earth's hydrological cycle, Titan sports clouds, rain and lakes. Yet, Titan's cycle differs dramatically from its terrestrial counterpart, and reveals the workings of weather in an atmosphere that is 10 times thicker than the Earth's atmosphere, that is two orders of magnitude less illuminated, and that involves a different condensable.

Prevascularization of a fibrin-based tissue construct accelerates the formation of functional anastomosis with host vasculature.

One critical obstacle facing tissue engineering is the formation of functional vascular networks that can support tissue survival in vivo. We hypothesized that prevascularizing a tissue construct with networks of well-formed capillaries would accelerate functional anastomosis with the host upon implantation. Fibrin-based tissues were prevascularized with capillary networks by coculturing human umbilical vein endothelial cells (HUVECs) and fibroblasts in fibrin gels for 1 week.

Mesoporous zirconium titanium oxides. Part 1: Porosity modulation and adsorption properties of xerogels.

A series of zirconium titanium oxide mesophases containing 33 atom % Zr have been prepared using carboxylic acids of different alkyl chain lengths (Cy ) from y=4-18 through organic-inorganic polymer phase segregation as the gel transition is approached. Thermal treatment of these transparent gels up to 450 degrees C eliminated the organic template, and domain coarsening occurred affording stable worm-hole mesoporous materials of homogeneous composition and pore diameters varying from about 3 to 4 nm in fine increments. With such materials, it was subsequently possible to precisely study the adsorption of vanadium oxo-anions and cations from aqueous solutions and, more particularly, probe the kinetics of intraparticle mass transport as a function of the associated pore dimension.

Mesoporous zirconium titanium oxides. Part 2: Synthesis, porosity, and adsorption properties of beads.

Mesoporous zirconium titanium mixed-oxide beads having disordered wormhole textures and mole fractions of Zr (x) ranging from x=0.25 to 0.67 have been prepared.