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curriculum development: a how to primer

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Family Medicine and community Health 2019年第2期7卷 24-29页

作者： Jill Schneiderhan Timothy c Guetterman margaret L Dobson Department of Family Medicine University of MichiganAnn ArborMichiganUSA

curriculum development is a topic everyone in the field of medical education will *** to the breadth of ages and types of care provided in Family Medicine,family medicine faculty in particular need to be facile in developing effective curricula for medical students,residents,fellows and for faculty *** the area of medical education,changing and evolving learning environments,as well as changing requirements necessitate new and innovative curricula to address these evolving *** process of developing a medical education curriculum can seem daunting but when broken down into smaller components can become very straightforward and easy to *** paper focuses on the curriculum development process using a six-step approach:performing a needs assessment,determining content,writing goals and objectives,selecting the educational strategies,implementing the curriculum and,finally,evaluating the *** process may serve as a template for Family Medicine educators,and all medical educators looking to design(or redesign)their own medical education curriculum.

关键词： everyone looking straight

Survey concerning internal medicine physicians and prolonged QT interval:Knowledge and treatment practices

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World Journal of cardiology 2021年第3期13卷 42-45页

作者： elizabeth Wendl Nelson Telles Geoff c Wall Department of Medical Education Internal Medicine Residency ProgramIowa Methodist Medical CenterDes MoinesIA 50311United States Department of cardiology Internal Medicine Residency ProgramIowa Methodist Medical CenterDes MoinesIA 50311United States Department of Pharmacy Practice Drake University College of Pharmacy and Health SciencesDes MoinesIA 50311United States Internal Medicine Residency Program Iowa Methodist Medical CenterDes MoinesIA 50311United States

Prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes(TdP).There are multiple mediations that have a known,possible,or conditional risk for prolonged QT interval,but general practitioners’knowledge of these medications is *** conducted a survey to assess internal medicine(IM)providers’knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT.A 17-question,anonymous survey was constructed in 2019 and distributed to IM providers and residents at a tertiary care *** included demographic information,6 Likert-scale questions gauging provider experience with prolonged QT,and 10 multiple choice clinical vignettes to assess clinical *** was analyzed *** was assessed via clinical vignettes and compared by level of ***-one responses were received out of a total of 87 possible respondents(47.1%response rate).About 70%of respondents see patients with acquired prolonged QT once monthly or more.95%rarely see congenital prolonged *** presented with QTc drug issues,73%of providers seldom or sometimes consulted pharmacy,but about half used online *** average correct score on the clinical vignettes was 5.59/10,with the highest scores seen in attending physicians in their first five years of practice(6.96/10).Our survey suggests that IM providers commonly encounter QT prolonging *** efforts to improve knowledge of drug and patient risk factors for TdP may be needed.

关键词： QTc Torsades de pointes Pharmacotherapy Survey Long QT syndrome Drug interactions

chronic non-communicable disease risks presented by lipid oxidation products in fried foods

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Hepatobiliary Surgery and Nutrition 2018年第4期7卷 305-312页

作者： martin Grootveld Benita c. Percival Kerry L. Grootveld Leicester School of Pharmacy De Montfort University The Gateway Leicester UK

Toxic lipid oxidation product (LOP) generation in culinary frying oils (cFOs) during high-temperature frying practices: passage into fried foodsLOPs detectable in fried foods are both cytotoxic and genotoxic, and curr... 详细信息

关键词： passage foods fried

Innate and adaptive resistance mechanisms to arginine deprivation therapies in sarcoma and other cancers

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cancer Drug Resistance 2019年第3期2卷 516-526页

作者： Leonard c.Rogers Brian A.Van Tine Division of Medical Oncology Washington University in St.LouisSt.LouisMO 63110USA Alvin J Siteman cancer center Washington University School of MedicineSt.LouisMO 63110USA

Many cancers lack functional expression of the enzyme argininosuccinate synthetase 1(ASS1)that is necessary for synthesis of *** cancers must import arginine for survival and growth,and this reliance can be targeted by arginine-degrading extracellular enzymatic drugs,most commonly PEGylated arginine *** enzymes can become targets of the immune system,reducing their effectiveness,but PEGylation improves the in vivo *** deprivation causes cell death in some cancers,but others gain resistance by expressing ASS1 after a starvation response is *** resistance mechanisms are possible and explored,but these have not been observed specifically in response to arginine *** studies,especially focusing on the mechanisms of ASS1 upregulation and metabolic adaptations,may yield insights into preventing or taking advantage of resistance adaptations to make arginine deprivation therapy more effective.

关键词： PEGylated arginine deiminase argininosuccinate synthetase 1 resistance metabolism arginine

Is liver biopsy necessary in the management of alcoholic hepatitis?

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World Journal of Gastroenterology 2013年第44期19卷 7825-7829页

作者： Ashwin D Dhanda Peter L collins c Anne Mccune Department of Liver Medicine University Hospitals Bristol NHS Foundation Trust Bristol BS2 8HW United Kingdom School of clinical Sciences University of Bristol Bristol BS2 8HW United Kingdom

Acute alcoholic hepatitis(AAH)is characterised by deep jaundice in patients with a history of heavy alcohol use,which can progress to liver failure.A clinical diagnosis of AAH can be challenging to make in patients without a clear alcohol history or in the presence of risk factors for other causes of acute liver *** causes of acute on chronic liver failure such as sepsis or variceal haemorrhage should be *** biopsy remains the only reliable method to make an accurate ***,there is controversy surrounding the use of liver biopsy in patients with AAH because of the risks of performing a percutaneous biopsy and limitations in access to transjugular *** review the existing literature and find there are few studies directly comparing clinical and histological diagnosis of *** the small number of studies that have been conducted the correlation between a clinical and histological diagnosis of AAH is *** to this lack of agreement together with difficulties in accessing transjugular liver biopsy outside tertiary referral centres and research institutions,we cannot advocate universal biopsy for AAH but there remains a definite role for liver biopsy where there is clinical diagnostic doubt or dual *** adds value in a clinical trial context to ensure a homogeneous trial population and to further our understanding of the disease *** prospective studies are required to determine whether non-invasive markers can be used to accurately diagnose AAH.

关键词： Alcoholic hepatitis Liver biopsy Diagnosis Prognosis Transjugular liver biopsy

Thermodynamic Feedback between clouds and the Ocean Surface Mixed Layer

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Advances in Atmospheric Sciences 1990年第1期7卷 1-10页

作者： P.c.chu Roland W.Garwood Jr. Department of Oceanography. Naval Postgraduate School Monterey CA 93943 U.S.A.Department of Oceanography. Naval Postgraduate School Monterey CA 93943 U.S.A.

A cloud-ocean planetary boundary layer (OPBL) feedback mechanism is presented and tested in this paper. Water vapor, evaporated from the ocean surface or transported by the large-scale air flow, often forms convective clouds under a conditionally unstable lapse rate. The variable cloud cover and rainfall may have positive and negative feedback with the ocean mixed layer temperature and salinity structure. The coupling of the simplified Kuo's (1965) cumulus cloud model to the Kraus-Turner's (1967) ocean mixed layer model shows the existence of this feedback mechanism. The theory also predicts the generation of low frequency oscillation in the atmosphere and oceans.

关键词： cl Feedback Thermodynamic Feedback between clouds and the Ocean Surface Mixed Layer

Waste Materials to Replace Natural Resources

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武汉理工大学学报 2010年第17期32卷 35-42页

作者： VAN DE VEN M F c MOLENAAR A A A POOT M R Delft University of Technology

A number of waste materials were studied on their application into asphalt mixtures. Materials tested were plastic waste as (soft) granular material,ceramic waste from electrical insulators,foundry sand and sintered granulate from burned household waste. Both plastic waste,crushed ceramics and large fractions of sintered household waste could be used as partial replacement for coarse aggregates. Foundry sand could partially replace natural sand in asphalt mixtures. The first step of the study was to find out if the waste materials could satisfy basic requirements and for some if their leaching behavior was acceptable. In the next phase mixtures were designed and mechanical tests were done on several mixtures with waste components to determine indirect tensile strength,stiffness,fatigue. In order to estimate the water sensitivity of some mixtures,retained indirect tension tests were done. The properties are reported and compared with each other and reference mixtures. From the research it becomes clear that it takes a lot of work to replace virgin materials in asphalt mixtures with waste materials.

关键词： waste materials plastic ceramic sintered household waste leaching,mechanical properties

Stress distributions on crown-luting cement-substrate system with finite element method

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Journal of central South University 2012年第8期19卷 2115-2124页

作者： S.SEN M.S.GULER c.GULER Department of Mechanical Engineering Ataturk University Department of Pediatric Dentistry Inonu Univer sityFaculty of Dentistry

The aim of this work is to analyze the stress distributions on a crown-luting cement-substrate system with a finite-element method in order to predict the likelihood of interfacial micro cracks, radial or circumferential cracks, delamination, fracture and delamination with torsion. The contact and layer interface stresses in elastic layered half-space indented by an elastic sphere were examined using finite element method. The model consists of crown, luting cement and substrate. The solutions were carried out for three different elastic moduli of luting cement. It was placed between the cement and the substrate as a middle layer and its elastic module was chosen lower than the elastic module of crown and higher than the elastic module of dentin. An axisymmetric finite element mesh was set up for the stress analysis. Stress distributions on the contact surface and the interfaces of crown-luting cement and luting cement-dentin have been investigated for three different values of luting cement by using ANSYS. The effects of the luting cement which has three different elastic moduli on the pressure distribution and the location of interfacial stresses of the multi-layer model have been examined. The mechanism of crack initiation in the interfaces and interracial delamination was also studied quantitatively. For each luting cement, the pressure distribution is similar at the contact zone. Stress discontinuities occur at the perfect bonding interfaces of the crown-luting cement and the substrate-luting cement. The maximum stress jumps are obtained for the highest and the lowest elastic module of the luting cement. In the crown-luting cement-substrate system, failures may initiate at crown-luting cement region for luting cement with the lowest elastic module value. In addition, failures at luting cement-substrate region may occur for luting cement with the highest elastic module. In the luting cement, the medium elastic module value is more suitable for stress distributio

关键词： finite element modeling stress analysis adhesive and luting cement elastic deformation plastic deformation

corrections in alpha angle following two different operative approaches for cAM-type femoral acetabular impingement-Ganz surgical hip dislocation vs anterior mini-open

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World Journal of Orthopedics 2020年第1期11卷 27-35页

作者： Emanuel c Haug Wendy M Novicoff Quanjun cui Department of Orthopedic Surgery University of Virginia School of Medicine

BAcKGROUND Femoroacetabular impingement(FAI)is a predisposing factor for secondary osteoarthritis of the hip *** two extensively described impingement mechanisms of FAI are cAM and *** managed conservatively,operative intervention should be offered to the persistently symptomatic *** measurement of the alpha angle is considered a standard method of assessing the severity of pathology in cam-type FAI on pre-operative plain *** radiological correction of the alpha angle has not been previously compared between different surgical *** hypothesize that there is no difference in alpha angle correction between Ganz surgical hip dislocation and the anterior mini-open *** To compare the magnitude of alpha angle correction achieved by using the Ganz surgical hip dislocation and the anterior mini-open *** This is a retrospective study assessing seventy-nine patients identified in a 5-year *** patients had preoperative radiographic evidence of FAI and underwent surgery by a single surgeon at our institution,a tertiary care *** with missing radiographic documentation,radiographs with insufficient quality which then precluded accurate measurement of the angleα,a diagnosed congenital condition,isolated type II pathology(Pincer),and history of prior surgery were excluded from the *** the Ganz surgical hip dislocation or the anterior mini open approach was *** radiographic evaluation of the alpha angle between the two surgical methods was done and corrected for age and gender using two-sample t-tests and chi-square *** A total of 79 patients met the inclusion and exclusion ***-seven males(mean age of 35.3,range 16-53)and 32 females(mean age 36.7,range 16-60)were ***-seven patients underwent the anterior mini-open approach,and 32 underwent the Ganz surgical hip *** were no significant differences in age between the t

关键词： Alpha angle Femoroacetabular impingement Ganz surgical hip dislocation Anterior mini-open