USMLE Scores Do Not Predict the Clinical Performance of Emergency Medicine Residents

Background: Scores on “high-stakes” multiple choice exams such as the United States Medical Licensing Examination® (USMLE) are important screening and applicant ranking criteria used by residencies.Objective: We tested the hypothesis that USMLE scores do not predict overall clinical performance of emergency medicine (EM) residents.Methods: All graduates from our University-based EM residency between the years 2008 and 2015 were included. Residents who had incomplete USMLE records were terminated, transferred out of the program, or did not graduate within this timeframe were excluded from the analysis. Clinical performance was defined as a gestalt of the residency program’s leadership and was classified into three sets: top, average, and lowest clinical performer. Dissimilarities of the initial blind rankings were adjudicated during a consensus conference.Results: During the eight years of the study period, there were a total of 115 graduating residents: 73 men (63%) and 42 women. Nearly all of them (109; 95%) had allopathic medical degrees; the remainder had osteopathic degrees. There was not a statistically significant correlation between our ranking of clinical performance and the Step 2 Clinical Knowledge score. There was a non-significant correlation between clinical performance and the Step 1 score.Conclusion: Neither USMLE Step 1 nor Step 2 Clinical Knowledge were good predictors of the actual clinical performance of residents during their training. We feel that their scores are overemphasized in the resident selec­tion process

Investigation of thermal behavior of α-PbO and β-PbO in O2 atmosphere

The compounds α-lead oxide (α-PbO) and β-lead oxide (β-PbO) were purchased from Merck co. and used for thermal investigations in laboratory. The compound was heated in a thermogravimeter at different temperature, from 25 to 400 °C. The used gas atmosphere was O2. The received products were investigated by X-ray diffraction (XRD) technique. The received product Pb3O4 was confirmed by XRD. The textures of two different morphologies of α-PbO, β-PbO and the product Pb3O4 is investigated by scanning electron microscope (SEM) and transmission electron microscope (TEM) techniques

Effects of Peer Education and Orientation Tour on Anxiety in Patient Candidates for Coronary Angiography

Background: Coronary angiography is a stressful procedure for most patients. The physiological responses caused by anxiety during coronary angiography increase the likelihood of dysrhythmia, coronary artery spasm, and rupture. Objectives: This study compared the effects of peer education and an orientation tour on anxiety in patients who were candidates for coronary artery angiography. Patients and Methods: This single blind quasi-experimental study was conducted in 2014. A total of 177 patients who were candidates for coronary artery angiography were divided into three groups: a peer education group, an orientation tour group, and a control group. The patients in the peer education group were trained by a peer educator, and the patients in in the orientation tour group were trained by the researcher, who worked in the angiography unit. The DASS-21 questionnaire was used to measure the patients’ anxiety levels before the intervention and two hours before undergoing the coronary angiography. The data were analyzed using a Chi-square test, analysis of variance, the Kruskal-Wallis, Wilcoxon, Mann-Whitney U tests, and an interquartile range. Results: The three groups did not significantly differ regarding the mean anxiety scores before the intervention. However, a significant difference was observed between the mean anxiety scores of the three groups after the intervention (P = 0.0001). In the peer education group, the mean anxiety score was 5.34 ± 2.52 and decreased to 3.69 ± 2.87 after the intervention (P = 0.0001). In the orientation tour group, the mean anxiety was 5.53 ± 3.49, which and changed to 3.10 ± 2.22 (P = 0.0001). However, the mean anxiety score significantly increased in the control group (5.66 ± 2.94 vs. 6.53 ± 3.43, P = 0.017). Conclusions: Both methods of peer education and orientation tour decreased the anxiety levels in patients undergoing coronary artery angiography. Therefore, these approaches should be carried out according to the hospital condition and facilities

A framework for business model with strategic innovation in ICT firms: the importance of information

Purpose – What is a business model framework with the strategic innovation approach in the SMEs of ICT industry? What are the components of this model and the relations between them? Business model is a logical response to how a business can create value. Changing business environment means that business models are rapidly growing; accordingly, innovation is no longer optional. However, innovation is important in general, but the kind of innovation that is widely and directly dependent on business model will be quite critical for all parts of the organization. In fact, Business Model Innovation is an exquisite technic to create, deliver, and earn value by changing one or more components of a typical business model. Design/methodology/approach – The present paper focuses upon SMEs in ICT. Grounded Theory had used for this purpose with 15 interviews. Findings – Emerging market is the market in which commercial exchanges of a particular industry between the countries are relatively new but with great investment attractiveness and also a high potential to grow (such as Iran).Since the ICT industry of Iran is a leader industry, and the country itself is an emerging market, the main purpose of this study is to provide a framework for designing an innovative information-based business to help fledgling businesses development in ICT industry of Iran. Originality/value – The purpose for writing the article is to help accurate and distinct understanding of the business model concept and critical steps in designing an appropriate business model. The conducted studies that simultaneously dealt with the business model and strategic innovations are few and there was no research observed in Persian sources by the time the proposal was written

Fulminant Meningoencephalitis as the First Clinical Sign of an Invasive Pituitary Macroadenoma

We report the case of a young woman who presented with an acute fulminant meningoencephalitis as the first sign of an invasive pituitary macroadenoma. This rare and dramatic complication is described in detail, and the different management steps, from the lumbar puncture to the bifrontal craniectomy, are discussed. In conclusion, this clinical presentation highlights the importance of early diagnosis and urgent management of this uncommon complication