life as medical student on rotation

A reflection of the stress and wonder surrounding M3 yearhttps://digitalcommons.unmc.edu/chri_forum/1024/thumbnail.jp

An Evaluation of Current Stormwater Best Management Practice Relationships Between Design and Efficiency: A Series of Local and National Case Studies

Water quality continues to be threatened by human development activities such as stormwater runoff from urbanization. This study addresses the question of how stormwater Best Management Practice (BMP) system design choices affect pollutant removal efficiency, through the examination of 12 case study sites (across five states) that use three common BMP system design types (detention, retention, and wetland channel). Water quality information was obtained from the International Stormwater Database and site composite grab samples. Development conditions were inventoried by orthophotos and assessed using Geographic Information System (GIS) and AutoCAD data. This study relates Total Suspended Solid (TSS) load removal efficiency with a series of form-based design variables, which landscape architects can control through their scope of services. System design characteristics of age, size, form, and material selection, along with site-specific precipitation regimens and extent-of-development, were compared with use of TSS removal efficiency in order to determine possible design relationships. Primary removal efficiency methods of individual design types were then evaluated to prioritize conclusions for practical applications. Mixed findings from this study report that one material-based and two form-based design variables hold significant correlation with the TSS removal efficiency. However, site-contextual variables, especially the Natural Resource Conservation Service (NRCS) hydrologic weighted curve value, play an important role in BMP performance and may supersede possible design impacts. The study also reveals that for some BMP sites, a deviation from original design intent may jeopardize system removal efficiency

Friendship Formation and Maintenance: Examining Friendship Patterns of Homosexual Men and Heterosexual Women in Close Relationships

The study of friendship has focused on various types of relationships involving same-sex and cross-sex friends. Heterosexuality has usually been assumed in these relationships, although recently research has been done involving homosexual friendships. The present study provides a quantitative analysis of personal-social characteristics and relational expectations, and a qualitative analysis of friendship formation, maintenance strategies, and relational importance of homosexual men and heterosexual women in close relationships with each other. These analyses help in understanding why and how close friendships between homosexual men and heterosexual women are formed and maintained. A questionnaire combining elements of one developed by Savin-Williams (1990) to measure personal-social characteristics, and portions of one used by Nardi and Sherrod (1994) to measure relational expectations was modified for present use. In addition to the questionnaire, interviews were conducted to measure maintenance strategies and the importance of the relationship. Responses from homosexual men and heterosexual women in close relationships were compared to responses from homosexual men and heterosexual women in casual relationships. Quantitative analysis showed some support suggesting that homosexual men and heterosexual women in close relationships have more similar social-personal characteristics and relational expectations than do homosexual men and heterosexual women in casual relationships. Homosexual men in close relationships with heterosexual women reported being more forceful and aggressive than homosexual men in casual relationships with heterosexual women; heterosexual women in close relationships with homosexual men reported being more forceful and aggressive, and having more close homosexual male friends than heterosexual women in casual relationships with homosexual men; homosexual men in close relationships with heterosexual women report being open, trusting, and truly themselves, discussing topics such as personal strengths and weaknesses, resolving conflicts as important, having conversational involvement, spending enjoyable time together, and engaging in social activities more than homosexual I men in casual relationships with heterosexual women; heterosexual women in close relationships with homosexual men report discussing topics such as personal strengths and weaknesses and spending enjoyable time together more than heterosexual women in casual relationships with homosexual men; and homosexual men and heterosexual women in close relationships may be more discrepant in their self-reported forcefulness than homosexual men and heterosexual women in casual relationships. A cluster analysis of the interviews was conducted and dendograms were used to identify concepts that were important to friendships between homosexual men and heterosexual women. The analysis revealed clusters containing word pairs which were interpreted within the context of the text of the interviews. The results suggest that homosexual men and heterosexual women in close relationships with each other are different from homosexual men and heterosexual women in casual relationships with each other. It also suggests that homosexual men and heterosexual women in close relationships with each other maintain their relationships using many of the strategies used in other relationships, but that their relationships with each other offer something that other relationships do not

A case of abdominal sarcoidosis in a patient with acute myeloid leukemia.

The allogeneic bone marrow transplantation usually preceded by induction chemotherapy, in fit patients, represents the gold standard in the acute myeloid leukaemia. In the last years, many trials have been set up with the view of improving the number of remissions during the induction by adding new drugs. Several early or late side effects have been described in the literature. We herein present a patient with acute myeloid leukaemia patient who, after chemotherapy, developed ascites that turned out to be abdominal sarcoidosis

Daybreak Community Landscape Performance Benefits Assessment

Daybreak is a 4,127-acre model mixed-use community for comprehensive sustainable design. The project was planned on surplus mining land and will accommodate over 20,000 residential units, approximately 9.1 million sf of commercial space, and 20,000 jobs at build-out. The extensive parks and open space integrates stormwater management, merges with natural systems, and is enlivened by social and recreational programming. The full range of sustainable features includes walkable streets, an extensive trail system, native and drought-tolerant plants, habitat conservation, recycled materials, and a vibrant mix of amenities and services. Landscape Performance Benefits • Retains 100% of storm water that falls on the site for up to a 100-year storm with no impacts on or connections to the municipal storm sewer system. • Saves approximately 1.5 million gallons of potable water each year by using an innovative drip irrigation design. Projected annual savings at build-out are 18.7 million gallons, saving approximately $54,000 annually. • Promotes species diversity with nearly 2.5 times the national average for comparable wetland bird populations present in man-made Oquirrh Lake and the surrounding wetlands. • Reduces auto trips with 88$1.6 million in concrete and transportation costs by reusing materials onsite and recycling construction waste

Biochemical Basis of Respiratory Disease Role of integrin-mediated TGFβ activation in the pathogenesis of pulmonary fibrosis

Abstract IPF (idiopathic pulmonary fibrosis) is a chronic progressive disease of unknown aetiology without effective treatment. IPF is characterized by excessive collagen deposition within the lung. Recent evidence suggests that the lung epithelium plays a key role in driving the fibrotic response. The current paradigm suggests that, after epithelial injury, there is impaired epithelial proliferation and enhanced epithelial apoptosis. This in turn promotes lung fibrosis through impaired basement membrane repair and increased epithelial-mesenchymal transition. Furthermore, fibroblasts are recruited to the wounded area and adopt a myofibroblast phenotype, with the up-regulation of matrix-synthesizing genes and down-regulation of matrix-degradation genes. There is compelling evidence that the cytokine TGFβ (transforming growth factor β) plays a central role in this process. In normal lung, TGFβ is maintained in an inactive state that is tightly regulated temporally and spatially. One of the major TGFβ-activation pathways involves integrins, and the role of the αvβ6 integrin has been particularly well described in the pathogenesis of IPF. Owing to the pleiotropic nature of TGFβ, strategies that inhibit activation of TGFβ in a cell-or disease-specific manner are attractive for the treatment of chronic fibrotic lung conditions. Therefore the molecular pathways that lead to integrinmediated TGFβ activation must be precisely defined to identify and fully exploit novel therapeutic targets that might ultimately improve the prognosis for patients with IPF

Exploring the dimensionality of morphological knowledge for adolescent readers

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135649/1/jrir12064.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135649/2/jrir12064_am.pd

Hyperandrogenism and Obesity: Ominous Co-Morbidities

This review has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, and Acanthosis Nigricans (HAIR-AN). With the childhood obesity epidemic, the metabolic syndrome and the associated abnormalities are routinely seen in clinical practice and these have a tremendous economic burden on the society and the quality of life

Explorations of Classroom Talk and Links to Reading Achievement in Upper Elementary Classroo

The current study reports on a large-scale quantitative analysis of classroom talk practices and links to different measures of reading achievement within upper elementary classrooms. Data involving 745 fourth- and fifth-grade teachers and 18,844 students from the Measures of Effective Teaching (MET) study were used. Talk was quantified via various talk-related indicators from 2 observation protocols and a student survey. Dimensionality analyses suggest these indicators represent 4 factors consisting of teacher explaining, questioning, encouraging of student talk, and big-picture communicating. Links to 2 different standardized reading achievement measures were also modeled with improved ratings of teacher explanations and questioning predicting higher standardized reading scores. Relationships varied, though, by different measures of classroom talk (i.e., observational protocols vs. student surveys) and levels of analysis (i.e., the student, class period, or school level). Students’ but not observers’ ratings of talk practices linked to standardized reading at the class period level, whereas observers’ ratings related to standardized reading performance at the school level. Interpretations, implications for future research, and connections to educational practice are conveyed

Obesity and Hyperandrogenism

This chapter has a two-fold objective. One, it addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this article will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, and Acanthosis Nigricans (HAIR-AN). With the childhood obesity epidemic, the metabolic syndrome and the associated abnormalities are routinely seen in clinical practice and these have a tremendous economic burden on the society and the quality of life