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Data from 51 medical students (DL = 27; SL = 24) were analyzed. Mean pretest scores were comparable between groups. A 2 (groups) by 2 (sessions) mixed-design analysis of variance yielded a significant group by session interaction effect (p < 0.001). The DL group significantly increased its mean score from 8.7 (standard deviation [SD] = 1.8) pretest to 11.6 (SD = 1.9) posttest; there was no improvement in the SL group (pretest 9.3 [SD = 1.5], posttest 10.0 [SD = 2.0]).
A DL model combining clinical and enhanced didactic requirements for an EM clerkship led to greater knowledge gain than the standard curriculum. This model may suggest ways to improve the educational experience in the EM clerkship.
A DL model combining clinical and enhanced didactic requirements for an EM clerkship led to greater knowledge gain than the standard curriculum. This model may suggest ways to improve the educational experience in the EM clerkship.
The Froedtert Acute Stroke Team (FAST) is composed of various health professionals who respond to stroke calls, but it does not formally include a pharmacist at this time. However, emergency department (ED) pharmacists have been actively involved in patient evaluation and facilitation of i.v. recombinant tissue plasminogen activator (rtPA) preparation and administration in the ED. ED pharmacists are qualified to dose and prepare rtPA, as well as screen for contraindications to therapy.
The primary objective was to compare the accuracy of rtPA dosing, mean door-to-rtPA time, and identification of contraindications to rtPA therapy when a pharmacist was present vs. absent in the ED.
This is a retrospective study of 105 patients who received rtPA for acute ischemic stroke in the ED at a comprehensive stroke center from January 1, 2008 to October 1,2012.
A total of 105 patients were included in this study. Dosing accuracy was similar when a pharmacist was present vs. TGF-beta inhibitor review absent (96.6% vs. 95.6%; p=0.8953). The median door-to-rtPA time when a pharmacist was present was statistically significantly shorter than when a pharmacist was absent (69.5 vs. 89.5min; p=0.0027). When a pharmacist was present, a door-to-rtPA time of < 60min was achieved 29.9% of the time, as compared with 15.8% in the pharmacist-absent group (p=0.1087).
Pharmacist involvement on stroke teams may have a beneficial effect on door-to-rtPA time and patient care in the ED.
Pharmacist involvement on stroke teams may have a beneficial effect on door-to-rtPA time and patient care in the ED.
Little is known about the mental health impact of workplace violence (WPV) among emergency physicians (EPs) working in emergency departments (EDs) in Pakistan and whether this impact varies across specialties.
Our aim was to measure the prevalence of WPV among EPs in 4 of the largest hospitals in Karachi, Pakistan; to measure the association between the experience of WPV and self-report of post-traumatic stress disorder (PTSD), depression, anxiety, and burnout; to compare the same factors across medical specialties; and to explore the coping strategies used by physicians in dealing with job-related stressors.
A cross-sectional survey was conducted among 179 physicians from 5 specialties (response rate, 92.2%) using standard questionnaires for WPV, PTSD, burnout, current mental distress, and methods of coping.
One in 6 physicians reported experiencing a physical attack and 3 in 5 verbal abuse on the job in the previous 12months. Pathologists were less likely to report any form of WPV compared to all other specialties. There was, however, no difference in experience of WPV between EPs and internists, surgeons, or pediatricians. One in 6 physicians screened positive for PTSD, and 2 in 5 for current anxiety and depression. There was significant comorbidity of mental distress with PTSD. Those who reported experiencing physical attack were 6.7 times more likely to report PTSD symptoms. We also found high rates of burnout (42.4% emotional exhaustion; 72.9% depersonalization) among physicians.
Experience of WPV was not uniform across specialties but was generally high among Pakistani physicians. Prevention of WPV should be a high priority for health care policy makers.
Experience of WPV was not uniform across specialties but was generally high among Pakistani physicians. Prevention of WPV should be a high priority for health care policy makers.The inactivation of the LRPPRC gene, which has previously been associated with the neurodegenerative French Canadian Leigh Syndrome, results in a decrease in the production of mitochondria-encoded subunits of complex IV, thereby causing a reduction in complex IV activity. Previously we have shown that reducing complex IV activity triggers a compensatory and conserved mitochondrial hyperfusion response. We now demonstrate that LRPPRC knock-down in mammalian cells leads to an imbalance between mitochondria-encoded and nuclear-encoded subunits of complex IV and that this imbalance triggers the mitochondrial unfolded protein response (UPR(mt)). The inactivation of the LRPPRC-like gene mma-1 in C. elegans also induces UPR(mt), which demonstrates that this response is conserved. Furthermore, we provide evidence that mitochondrial hyperfusion and UPR(mt) are coordinated but mediated by genetically distinct pathways. We propose that in the context of LRPPRC mma-1 knock-down, mitochondrial hyperfusion helps to transiently maintain mitochondrial ATP production while UPR(mt) participates in the restoration of mitochondrial proteostasis. Mitochondrial proteostasis is not only critical in pathophysiology but also during aging, as proteotoxic stress has been shown to increase with age. Therefore, we speculate that the coordination of these two mitochondrial stress responses plays a more global role in mitochondrial proteostasis.Crystal violet lactone (CVL) is a classic halochromic dye which has been widely used as chromogenic reagent in thermochromic and piezochromic systems. In this work, a very first example of CVL-based reversible photochromic compound was developed, which showed distinct color change upon UV-visible light irradiation both in solution and in solid matrix. Moreover, metal complex of CVL salicylaldehyde hydrozone was facilely synthesized, exhibiting reversible photochromic properties with good fatigue resistance. It was served as promising solid material for photo-patterning.The present study was designed to determine the interactive effect of exogenous melatonin and nitric oxide (NO) on sodic alkaline stress mitigation in tomato seedlings. It was observed that exogenous melatonin treatment elevated NO levels in alkaline-stressed tomato roots. However, exogenous NO had little effects on melatonin levels. Importantly, melatonin-induced NO generation was accompanied by increased tolerance to alkaline stress. Chemical scavenging of NO reduced melatonin-induced alkaline stress tolerance and defense genes' expression. However, inhibition of melatonin biosynthesis had a little effect on NO-induced alkaline stress tolerance. These results strongly suggest that NO, acting as a downstream signal, is involved in the melatonin-induced tomato tolerance to alkaline stress. This process creates a new signaling pathway for improving stress tolerance in plant.Slowness of thought is not necessarily a handicap but could be a signature of optimal brain function. Emerging evidence shows that neuroanatomical and dynamical constraints of the human brain shape its functionality in optimal ways, characterized by slowness during task-based cognition in the context of spontaneous resting-state activity. This activity can be described mechanistically by whole-brain computational modeling that relates directly to optimality in the context of theories arguing for metastability in the brain. We discuss the role for optimal processing of information in the context of cognitive, task-related activity, and propose that combining multi-modal neuroimaging and explicit whole-brain models focused on the timing of functional dynamics can help to uncover fundamental rules of brain function in health and disease.The notion that the form of a word bears an arbitrary relation to its meaning accounts only partly for the attested relations between form and meaning in the languages of the world. Recent research suggests a more textured view of vocabulary structure, in which arbitrariness is complemented by iconicity (aspects of form resemble aspects of meaning) and systematicity (statistical regularities in forms predict function). Experimental evidence suggests these form-to-meaning correspondences serve different functions in language processing, development, and communication systematicity facilitates category learning by means of phonological cues, iconicity facilitates word learning and communication by means of perceptuomotor analogies, and arbitrariness facilitates meaning individuation through distinctive forms. Processes of cultural evolution help to explain how these competing motivations shape vocabulary structure.Mental imagery research has weathered both disbelief of the phenomenon and inherent methodological limitations. Here we review recent behavioral, brain imaging, and clinical research that has reshaped our understanding of mental imagery. Research supports the claim that visual mental imagery is a depictive internal representation that functions like a weak form of perception. Brain imaging work has demonstrated that neural representations of mental and perceptual images resemble one another as early as the primary visual cortex (V1). Activity patterns in V1 encode mental images and perceptual images via a common set of low-level depictive visual features. Recent translational and clinical research reveals the pivotal role that imagery plays in many mental disorders and suggests how clinicians can utilize imagery in treatment.We consider two distinct influences that drive conformity behaviour. Whereas informational influences facilitate adaptive and accurate responses, normative influences bias decisions to enhance social acceptance. We explore these influences from a perspective of perceptual and value-based decision-making models and apply these models to classical works on conformity. We argue that an informational account predicts a surprising tendency to conform. Moreover, we detail how normative influences fit into this framework and interact with social influences. Finally, we explore potential neuronal substrates for informational and normative influences based on a consideration of the neurobiological literature, highlighting conceptual shortcomings particularly with regard to a failure to segregate informational and normative influences.Tinnitus and chronic pain are sensory-perceptual disorders associated with negative affect and high impact on well-being and behavior. It is now becoming increasingly clear that higher cognitive and affective brain systems are centrally involved in the pathology of both disorders. We propose that the ventromedial prefrontal cortex and the nucleus accumbens are part of a central 'gatekeeping' system in both sensory modalities, a system which evaluates the relevance and affective value of sensory stimuli and controls information flow via descending pathways. If this frontostriatal system is compromised, long-lasting disturbances are the result. Parallels in both systems are striking and mutually informative, and progress in understanding central gating mechanisms might provide a new impetus to the therapy of tinnitus and chronic pain.
My Website: https://www.selleckchem.com/TGF-beta.html
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