What do clinicians think of the anatomical knowledge of medical students? Results of a survey

Human anatomy is one of basic courses in medical education. It usually takes place during the first year of the medical school syllabus. However, the results of the course, if defined as profound anatomical knowledge, are not applied by the students until several years after the final anatomy examination. The aim of the study was to evaluate the anatomical knowledge of senior medical students. For this reason a survey was distributed among teachers responsible for clinical rotas. The results of the study were intended to give the answer to the question, "What do students remember several years after the anatomy examination?" as expressed by their clinical teachers. The questionnaire included four closed questions and one open question. The closed questions concerned general anatomical knowledge, whether the anatomy course should be extended and whether additional courses should be introduced and included a question about student knowledge of particular systems. The open question concerned ways of improving anatomical education. As a result of the survey it was observed that surgical specialists had a significantly lower opinion of the medical knowledge of their students than had medical specialists. Most of the suggestions for improving anatomical education were related to introducing clinical applications of anatomical knowledge

Torrefaction Processing for Human Solid Waste Management

This study involved a torrefaction (mild pyrolysis) processing approach that could be used to sterilize feces and produce a stable, odor-free solid product that can be stored or recycled, and also to simultaneously recover moisture. It was demonstrated that mild heating (200-250 C) in nitrogen or air was adequate for torrefaction of a fecal simulant and an analog of human solid waste (canine feces). The net result was a nearly undetectable odor (for the canine feces), complete recovery of moisture, some additional water production, a modest reduction of the dry solid mass, and the production of small amounts of gas and liquid. The liquid product is mainly water, with a small Total Organic Carbon content. The amount of solid vs gas plus liquid products can be controlled by adjusting the torrefaction conditions (final temperature, holding time), and the current work has shown that the benefits of torrefaction could be achieved in a low temperature range (< 250 C). These temperatures are compatible with the PTFE bag materials historically used by NASA for fecal waste containment and will reduce the energy consumption of the process. The solid product was a dry material that did not support bacterial growth and was hydrophobic relative to the starting material. In the case of canine feces, the solid product was a mechanically friable material that could be easily compacted to a significantly smaller volume (approx. 50%). The proposed Torrefaction Processing Unit (TPU) would be designed to be compatible with the Universal Waste Management System (UWMS), now under development by NASA. A stand-alone TPU could be used to treat the canister from the UWMS, along with other types of wet solid wastes, with either conventional or microwave heating. Over time, a more complete integration of the TPU and the UWMS could be achieved, but will require design changes in both units

The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs

Axial Concentration Profiles and NO Flue Gas in a Pilot-Scale Bubbling Fluidized Bed Coal Combustor

Atmospheric bubbling fluidized bed coal combustion of a bituminous coal and anthracite with particle diameters in the range 500-4000 ím was investigated in a pilot-plant facility. The experiments were conducted at steady-state conditions using three excess air levels (10, 25, and 50%) and bed temperatures in the 750-900 °C range. Combustion air was staged, with primary air accounting for 100, 80, and 60% of total combustion air. For both types of coal, high NO concentrations were found inside the bed. In general, the NO concentration decreased monotonically along the freeboard and toward the exit flue; however, during combustion with high air staging and low to moderate excess air, a significant additional NO formation occurred near the secondary air injection point. The results show that the bed temperature increase does not affect the NO flue gas concentration significantly. There is a positive correlation between excess air and the NO flue gas concentration. The air staging operation is very effective in lowering the NO flue gas, but there is a limit for the first stage stoichiometry below which the NO flue gas starts rising again. This effect could be related with the coal rank

Thermal Decomposition Kinetics of Woods with an Emphasis on Torrefaction

The pyrolysis kinetics of Norwegian spruce and birch wood was studied to obtain information on the kinetics of torrefaction. Thermogravimetry (TGA) was employed with nine different heating programs, including linear, stepwise, modulated and constant reaction rate (CRR) experiments. The 18 experiments on the 2 feedstocks were evaluated simultaneously via the method of least-squares. Part of the kinetic parameters could be assumed common for both woods without a considerable worsening of the fit quality. This process results in better defined parameters and emphasizes the similarities between the woods. Three pseudo-components were assumed. Two of them were described by distributed activation energy models (DAEMs), while the decomposition of the cellulose pseudo-component was described by a self-accelerating kinetics. In another approach, the three pseudo-components were described by n-order reactions. Both approaches resulted in nearly the same fit quality, but the physical meaning of the model, based on three n-order reactions, was found to be problematic. The reliability of the models was tested by checking how well the experiments with higher heating rates can be described by the kinetic parameters obtained from the evaluation of a narrower subset of 10 experiments with slower heating. A table of data was calculated that may provide guidance about the extent of devolatilization at various temperature residence time values during wood torrefaction

An interlaboratory comparison of mid-infrared spectra acquisition: Instruments and procedures matter

Diffuse reflectance spectroscopy has been extensively employed to deliver timely and cost-effective predictions of a number of soil properties. However, although several soil spectral laboratories have been established worldwide, the distinct characteristics of instruments and operations still hamper further integration and interoperability across mid-infrared (MIR) soil spectral libraries. In this study, we conducted a large-scale ring trial experiment to understand the lab-to-lab variability of multiple MIR instruments. By developing a systematic evaluation of different mathematical treatments with modeling algorithms, including regular preprocessing and spectral standardization, we quantified and evaluated instruments' dissimilarity and how this impacts internal and shared model performance. We found that all instruments delivered good predictions when calibrated internally using the same instruments' characteristics and standard operating procedures by solely relying on regular spectral preprocessing that accounts for light scattering and multiplicative/additive effects, e.g., using standard normal variate (SNV). When performing model transfer from a large public library (the USDA NSSC-KSSL MIR library) to secondary instruments, good performance was also achieved by regular preprocessing (e.g., SNV) if both instruments shared the same manufacturer. However, significant differences between the KSSL MIR library and contrasting ring trial instruments responses were evident and confirmed by a semi-unsupervised spectral clustering. For heavily contrasting setups, spectral standardization was necessary before transferring prediction models. Non-linear model types like Cubist and memory-based learning delivered more precise estimates because they seemed to be less sensitive to spectral variations than global partial least square regression. In summary, the results from this study can assist new laboratories in building spectroscopy capacity utilizing existing MIR spectral libraries and support the recent global efforts to make soil spectroscopy universally accessible with centralized or shared operating procedures

The Differences in the Prevalence of Cardiovascular Disease, Its Risk Factors, and Achievement of Therapeutic Goals among Urban and Rural Primary Care Patients in Poland: Results from the LIPIDOGRAM 2015 Study

A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (p = 43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs