Medical students' comfort levels with performing the basic head and neck examination in practice: follow-up during the core clerkship year.

ObjectiveFollowing our preliminary study on junior medical students' comfort levels in performing the head and neck physical examination (H&NPE) before and after a department-led teaching session, we assessed the longitudinal effect of this session on students during the core clinical clerkship year, in which these skills were performed on real patients.DesignAnonymous cross-sectional survey study as a follow-up to previous intervention.MethodsOverall, 101 and 90 second-year medical students participated in an H&NPE teaching session 1 year before the current survey administration in 2 consecutive years. The same cohorts of students, as third years, were asked to rate their comfort levels (0-5-point Likert scale) in performing the H&NPE and the importance of otolaryngology rotations in medical school and primary care residency training.ResultsOf the 101 and 90 students, 53 and 46 medical students completed the follow-up survey in each respective year. For both classes, compared with before the teaching session, students reported an average comfort level of 2.8 (somewhat to moderately comfortable) in performing the complete H&NPE (p < 0.0001) during the core clinical clerkship year. Similar changes were observed for the individual ear, nose, mouth, and neck components of the examination (all p's < 0.0002). Students at follow-up reported statistically similar comfort levels when compared with immediately after the teaching session for the ear, oral cavity, and neck examinations.ConclusionThe initial teaching session persistently improved medical students' comfort levels in performing the H&NPE, with some attrition in comfort levels with performing the nasal examination and complete H&NPE. An otolaryngologist-directed, practical educational intervention may permanently reinforce the acquisition of complex skills such as the H&NPE

Sharing the transformation: Public relations and the uae come of age

© 2009 Taylor and Francis. Much like the country itself, the practice of public relations in the United Arab Emirates (UAE) has undergone a profound evolution during its short history of 30 years. As the country has grown, so too has the practice of public relations. Once no agencies existed, but today global multinational public relations firms have established a presence in the UAE, some with an equity relationship with their local partners, some as fully owned branches of global firms based in the United States or Europe, and others through affiliates. Companies like Team: Young and Rubicam, Gulf Hill and Knowlton, and Burston-Marsteller operate alongside local, smaller companies, competing for the same dollars and dirhams

Numerical Experimental Investigation of Solidification Thickness around Cylindrical Surfaces for HVAC Cold Storage Systems

Thermal Ice Storage System (TISS) is an innovative way of storing night-time off-peak energy for daytime peak USAge. In many locations, demand for electrical power peaks during summer time. Air-conditioning equipment are the main reason accounting for as much as half of the power demand during the hot mid-day hours when electricity is most expensive. Since utilities have spare electrical generating capacity at night, electricity generated during this ldquo;off-peakrdquo; is much less expensive. In this research a numerical model for Latent Heat Storage (LHS) cylindrical tank has been obtained from a numerical package, ANSYS software ver. 15, and compared to an experimental data gathered from similar tank. The data showed good agreement with the experimental data with an error of 9%. The numerical model can be used to estimate ice thickness and tank geometries for any future work

Gender and Tahrir Square: contesting the state and imagining a new nation

This article argues that the concepts of ‘State’ and ‘Nation’ should be treated as separate from one another, hence, more than one image of the nation is possible at one given time. During the early days of the January 2011 Egyptian revolution, a contestation emerged between Mubarak’s state and the protesters in Tahrir Square over the image and notion of the Egyptian nation. Both the state and the protesters attempted to exclude one another from their respective discourse of the Egyptian nation. While reflecting back on a number of women’s voices who joined the early days of the Tahrir Square protests and using qualitative fieldwork interviews with Cairo-based feminist and political activists, this article points to the complexity of a newly forged image of Egyptian nationhood. In Tahrir Square, this image appeared to be largely framed within gendered criteria where notions of manhood and hyper visible gender equality were intrinsically linked to the broader objective of removing Mubarak and his regime. This raises the question of whether new gender paradigms of equality can continue to exist beyond Tahrir Square’s imagination of a ‘new’ nation

Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation

Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols. Diagnostic ultrasound imaging devices are safe, commonly available systems that may be useful for tUS. However, the feasibility of modifying brain activity with diagnostic tUS is currently unknown.Objective: We aimed to examine the effects of a commercial diagnostic tUS device using an imaging protocol on cortical excitability. We hypothesized that imaging tUS applied to motor cortex could induce changes in cortical excitability as measured using a transcranial magnetic stimulation (TMS) motor evoked potential (MEP) paradigm.Methods: Forty-three subjects were assigned to receive either verum (n = 21) or sham (n = 22) diagnostic tUS in a single-blind design. Baseline motor cortex excitability was measured using MEPs elicited by TMS. Diagnostic tUS was subsequently administered to the same cortical area for 2 min, immediately followed by repeated post-stimulation MEPs recorded up to 16 min post-stimulation.Results: Verum tUS increased excitability in the motor cortex (from baseline) by 33.7% immediately following tUS (p = 0.009), and 32.4% (p = 0.047) 6 min later, with excitability no longer significantly different from baseline by 11 min post-stimulation. By contrast, subjects receiving sham tUS showed no significant changes in MEP amplitude.Conclusion: These findings demonstrate that tUS delivered via a commercially available diagnostic imaging ultrasound system transiently increases excitability in the motor cortex as measured by MEPs. Diagnostic tUS devices are currently used for internal imaging in many health care settings, and the present results suggest that these same devices may also offer a promising tool for noninvasively modulating activity in the central nervous system. Further studies exploring the use of diagnostic imaging devices for neuromodulation are warranted

Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation

Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols. Diagnostic ultrasound imaging devices are safe, commonly available systems that may be useful for tUS. However, the feasibility of modifying brain activity with diagnostic tUS is currently unknown. Objective: We aimed to examine the effects of a commercial diagnostic tUS device using an imaging protocol on cortical excitability. We hypothesized that imaging tUS applied to motor cortex could induce changes in cortical excitability as measured using a transcranial magnetic stimulation (TMS) motor evoked potential (MEP) paradigm. Methods: Forty-three subjects were assigned to receive either verum (n = 21) or sham (n = 22) diagnostic tUS in a single-blind design. Baseline motor cortex excitability was measured using MEPs elicited by TMS. Diagnostic tUS was subsequently administered to the same cortical area for 2 min, immediately followed by repeated post-stimulation MEPs recorded up to 16 min post-stimulation. Results: Verum tUS increased excitability in the motor cortex (from baseline) by 33.7% immediately following tUS (p = 0.009), and 32.4% (p = 0.047) 6 min later, with excitability no longer significantly different from baseline by 11 min post-stimulation. By contrast, subjects receiving sham tUS showed no significant changes in MEP amplitude. Conclusion: These findings demonstrate that tUS delivered via a commercially available diagnostic imaging ultrasound system transiently increases excitability in the motor cortex as measured by MEPs. Diagnostic tUS devices are currently used for internal imaging in many health care settings, and the present results suggest that these same devices may also offer a promising tool for noninvasively modulating activity in the central nervous system. Further studies exploring the use of diagnostic imaging devices for neuromodulation are warranted

Increased Excitability Induced in the Primary Motor Cortex by Transcranial Ultrasound Stimulation

Background: Transcranial Ultrasound Stimulation (tUS) is an emerging technique that uses ultrasonic waves to noninvasively modulate brain activity. As with other forms of non-invasive brain stimulation (NIBS), tUS may be useful for altering cortical excitability and neuroplasticity for a variety of research and clinical applications. The effects of tUS on cortical excitability are still unclear, and further complications arise from the wide parameter space offered by various types of devices, transducer arrangements, and stimulation protocols. Diagnostic ultrasound imaging devices are safe, commonly available systems that may be useful for tUS. However, the feasibility of modifying brain activity with diagnostic tUS is currently unknown. Objective: We aimed to examine the effects of a commercial diagnostic tUS device using an imaging protocol on cortical excitability. We hypothesized that imaging tUS applied to motor cortex could induce changes in cortical excitability as measured using a transcranial magnetic stimulation (TMS) motor evoked potential (MEP) paradigm. Methods: Forty-three subjects were assigned to receive either verum (n = 21) or sham (n = 22) diagnostic tUS in a single-blind design. Baseline motor cortex excitability was measured using MEPs elicited by TMS. Diagnostic tUS was subsequently administered to the same cortical area for 2 min, immediately followed by repeated post-stimulation MEPs recorded up to 16 min post-stimulation. Results: Verum tUS increased excitability in the motor cortex (from baseline) by 33.7% immediately following tUS (p = 0.009), and 32.4% (p = 0.047) 6 min later, with excitability no longer significantly different from baseline by 11 min post-stimulation. By contrast, subjects receiving sham tUS showed no significant changes in MEP amplitude. Conclusion: These findings demonstrate that tUS delivered via a commercially available diagnostic imaging ultrasound system transiently increases excitability in the motor cortex as measured by MEPs. Diagnostic tUS devices are currently used for internal imaging in many health care settings, and the present results suggest that these same devices may also offer a promising tool for noninvasively modulating activity in the central nervous system. Further studies exploring the use of diagnostic imaging devices for neuromodulation are warranted

Behavior Of Trapezoidal Corrugated Girders webs with cutouts: Experimental and Analytical Solution

Corrugated steel-plate girders (GCWs) are nowadays used as structural elements in many applications for their high strength against shear buckling, otherwise cutouts are always provided in these plate elements to enable inspection and servicing. This study presents an experimental and analytical study for investigating the behavior of girders with corrugated webs (GCWs) having cutouts under shear loading. The experimental program was conducted on three full-scale plate girders, which have been tested under central load at mid-span. The theoretical analysis was conducted using ANSYS V20 to perform a nonlinear technique for the determination of the ultimate shear capacity of the tested girders. Finally, experimental, and finite element model were used to define the ratio of decreasing in carrying capacity for corrugated web, having cutout under shear loading. As expected from the ultimate strength, failure mechanism, and load-deflection curves that results of ultimate load carrying capacity decreased with the appearance of one or more cut-outs