Dancing Between the Purist and the Practical: Teaching Evidence- Based Medicine in the 3rd Year Family Medicine Clerkship

OBJECTIVE: To teach 3rd year medical students in a Family Medicine rotation the concepts and methods required to practice Evidence-Based Medicine and how to search for that evidence. The course was developed with an emphasis on finding resources and included an extensive epidemiological and statistical component. Using student evaluations, the evolution over five years will be explored. METHODS: The didactic and experimental curriculum was developed with a strict interpretation of search strategies and EBM philosophy and rationale. In 1999, the class contained a detailed component on epidemiology and statistical interpretation of the four clinical study categories (etiology, diagnosis, therapy and prognosis). Following each session, student evaluations were solicited and changes were made to the curriculum based on student feedback and follow-up faculty discussion. Today, a more treatment-centered ethics-based curriculum is taught. While Evidence-Based vocabulary and some statistics such as Absolute Risk and Number Needed to Treat and Harm are included, emphasis is now placed on teaching students to look for good evidence and to use these findings within an effective patient interaction. Collected student evaluations from across the five-year time span will be analyzed to demonstrate the evolutionary steps of the curriculum. RESULTS & CONCLUSIONS: “More time for searching!” This is always a top comment on student evaluations. Ways to make this happen are consistently being identified and put into practice. As class time is limited, what is taught and how it is taught has become very selective. One recently incorporated tool is the use of a pre-session WebCT-based orientation. Material is always being added within this format to free up class time for more interactive practice. Two other practical content areas that have recently been introduced into the course are a) talking with patients about relative risk and b) understanding bias in the medical literature. The very simple evaluation form remains a device with which to collect further student feedback. The course will continue to be updated as EBM methodologies and outlooks within the medical community change and grow

Iridium-Functionalized Cellulose Microcrystals as a Novel Luminescent Biomaterial for Biocomposites

Microcrystalline cellulose (MCC) is an emerging material with outstanding properties in many scientific and industrial fields, in particular as an additive in composite materials. Its surface modification allows for the fine-tuning of its properties and the exploitation of these materials in a plethora of applications. In this paper, we present the covalent linkage of a luminescent Ir-complex onto the surface of MCC, representing the first incorporation of an organometallic luminescent probe in this biomaterial. This goal has been achieved with an easy and sustainable procedure, which employs a Bronsted-acid ionic liquid as a catalyst for the esterification reaction of -OH cellulose surface groups. The obtained luminescent cellulose microcrystals display high and stable emissions with the incorporation of only a small amount of iridium (III). Incorporation of MCC-Ir in dry and wet matrices, such as films and gels, has been also demonstrated, showing the maintenance of the luminescent properties even in possible final manufacturers

Synthesis and functionalization of casein nanoparticles with aptamers for triple-negative breast cancer targeting

This work shows the synthesis of a drug delivery system made of casein nanoparticles able to host hydrophobic molecules and be functionalized with aptamers targeting the epidermal growth factor receptor. In vitro cell viability and uptake analyses, performed on triple-negative breast cancer cells, confirmed the safety profile and the target selectivity

A study on the stability of carbon nanoforms–polyimidazolium network hybrids in the conversion of co2 into cyclic carbonates: Increase in catalytic activity after reuse

Three different carbon nanoforms (CNFs), single-walled and multi-walled carbon nanotubes (SWCNTs, MWCNTs) and carbon nanohorns (CNHs), have been used as supports for the direct polymerization of variable amounts of a bis-vinylimidazolium salt. Transmission electron microscopy confirmed that all CNFs act as templates on the growth of the polymeric network, which perfectly covers the nanocarbons forming a cylindrical (SWCNTs, MWCNTs) or spherical (CNHs) coating. The stability of these hybrid materials was investigated in the conversion of CO2 into cyclic carbonate under high temperature and CO2 pressure. Compared with the homopolymerized monomer, nanotube-based materials display an improved catalytic activity. Beside the low catalytic loading (0.05–0.09 mol%) and the absence of Lewis acid co-catalysts, all the materials showed high TON values (up to 1154 for epichlorohydrin with SW-1:2). Interestingly, despite the loss of part of the polymeric coating for crumbling or peeling, the activity increases upon recycling of the materials, and this behaviour was ascribed to their change in morphology, which led to materials with higher surface areas and with more accessible catalytic sites. Transmission electron microscopy analysis, along with different experiments, have been carried out in order to elucidate these findings

Diastereoselective additions of organometallic reagents to (SFc)-2-p-tolylsulfanylferrocene carboxyaldehyde and to (SFc)-2-p-tolylsulfanyl ferrocenyl imines. Synthesis of new central and planar chiral ferrocenyl alcohols and amines

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Itaconic-Acid-Based Sustainable Poly(ester amide) Resin for Stereolithography

Material science is recognized as a frontrunner in achieving a sustainable future, owing to its primary reliance upon petroleum-based chemical raw materials. Several efforts are made to implement common renewable feedstocks as an alternative to common fossil resources. For this purpose, additive manufacturing (AM) represents promising and effective know-how for the replacement of high energy- and resource-demanding processes with more environmentally friendly practices. This work presents a novel biobased ink for stereolithography, which has been formulated by mixing a photocurable poly(ester amide) (PEA) obtained from renewable resources with citrate and itaconate cross-linkers and appropriate photopolymerization initiators, terminators, and dyes. The mechanical features and the relative biocompatibility of 3D-printed objects have been carefully studied to evaluate the possible resin implementation in the field of the textile fashion industry

Caracterización de un canal "indoor" como resultado de medidas en banda estrecha a 1.6 ghz

Peer ReviewedPostprint (published version

A novel theranostic gold nanorods- and adriamycin-loaded micelle for EpCA M targeting, laser ablation, and photoacoustic imaging of cancer stem cells in hepatocellular carcinoma

Introduction and purpose: Cancer stem cells (CSCs) present a higher capacity to evade being killed by cancer agents and developing chemoresistance, thus leading to failure of conventional anticancer therapeutics. Nanomaterials specifically designed for targeting and treating not only tumor cells, but also CSCs, may encompass therapeutic and diagnostic tools, thus successfully eradicating the tumor. Materials and methods: Polymeric micelles simultaneously loaded with gold nanorods (GNRs) and Adriamycin were prepared and used as a novel therapeutic and diagnostic weapon. Epithelial cell adhesion molecule (EpCAM) is an important CSC surface marker and has been exploited in this work as an active targeting agent. Photoacoustic imaging was applied for GNR individuation and tissue recognition. Results: The nanosystem was demonstrated to be able to elicit effective targeting of cancer cells and cause their killing, in particular under laser ablation. Moreover, ex vivo photoacoustic imaging is able to clearly identify tumor regions thanks to GNR\u2019s contrast. Conclusion: The nanosystem can be considered a powerful and promising theranostic weapon for hepatocellular carcinoma treatment

Reduced salivary oxytocin after an empathic induction task in Intimate Partner Violence perpetrators: Importance of socio-affective functions and its impact on prosocial behavior

Intimate Partner Violence (IPV) has been linked to difficulties in socio-affective functions. Nevertheless, the underlying psychobiological mechanisms that might be responsible for them remain unclear. Oxytocin (OXT) stands out as an important hormone that may favor the salience of social information, due to its relevance in empathy and prosocial behavior. Thus, the study of salivary OXT (sOXT) may provide further information about potential impairments in social cognition in IPV perpetrators. This study analyzed the effects of an empathic induction task, performed through negative emotion-eliciting videos, on endogenous sOXT levels, mood state, and emotional perception in 30 IPV perpetrators compared to 32 controls. Additionally, we explored their performance on prosocial behavior after the empathic induction task, using Hare''s donation procedure. Lower sOXT levels were found in IPV perpetrators after the task compared to controls, along with a general decreasing tendency in their sOXT levels. Additionally, IPV perpetrators exhibited no change in their mood state and perceived others'' emotions as more positive and less intense. Moreover, the mood state response and alexithymia traits, respectively, positively and negatively predicted the sOXT levels after the empathic induction task in the entire sample. Finally, we did not observe a lower appearance of prosocial behaviors in IPV perpetrators; however, higher sOXT levels after the empathic induction task were found in subjects who donated when considering the whole sample. In sum, IPV perpetrators exhibited differences in their sOXT levels when empa-thizing, compared to controls, with alexithymia and the emotional response potentially explaining the sOXT levels after the task. Furthermore, prosocial behavior was more related to these sOXT levels than to IPV. As our knowledge about the emotional processing of IPV perpetrators increases, we will be better able to develop and include coadjutant treatments in current psychotherapeutic programs, in order to focus on their emotional needs, which, in turn, would reduce the future risk of recidivism