Resident Physicians' Preparedness to Provide Cross-Cultural Care: Implications for Clinical Care and Medical Education Policy

Recommends integrating cross-cultural training into medical school curricula, training faculty to ensure useful instruction and mentoring, and mandatory and formal evaluation of residents' cross-cultural communication skills

Comparing the physical and psychological effects of food security and food insecurity

Although much research exists on how food insecurity impacts one\u27s quality of life, there are no studies to date that have compared the quality of life between food insecure and food secure individuals. This mixed-methods study explores these comparisons. The online survey assessed quality of life in the areas of performance at school/work, psychological and physical health, and quality of relationships. The survey included closed and open-ended questions and was analyzed using quantitative and qualitative methods. This study reveals that food insecure individuals had a poorer quality of life in most of the areas that were assessed. The results are intended to give a deeper and more personal perspective of what it means to be food insufficient and how food insecurity may impact one\u27s quality of life

Are there compact heavy four-quark bound states?

We present an exact method to study four-quark systems based on the hyperspherical harmonics formalism. We apply it to several physical systems of interest containing two heavy and two light quarks using different quark-quark potentials. Our conclusions mark the boundaries for the possible existence of compact, non-molecular, four-quark bound states. While $QQ\bar n \bar n$ states may be stable in nature, the stability of $Q\bar Qn \bar n$ states would imply the existence of quark correlations not taken into account by simple quark dynamical modelsComment: 10 pages, 1 figure. Accepted for publication in Phys. Rev.

Aging in the Relaxor Ferroelectric PMN/PT

The relaxor ferroelectric (PbMn$_{1/3}$Nb$_{2/3}$O$_3$)$_{1-x}$(PbTiO$_3$)$_{x}$, $x=0.1$, (PMN/PT(90/10)) is found to exhibit several regimes of complicated aging behavior. Just below the susceptibility peak there is a regime exhibiting rejuvenation but little memory. At lower temperature, there is a regime with mainly cumulative aging, expected for simple domain-growth. At still lower temperature, there is a regime with both rejuvenation and memory, reminiscent of spin glasses. PMN/PT (88/12) is also found to exhibit some of these aging regimes. This qualitative aging behavior is reminiscent of that seen in reentrant ferromagnets, which exhibit a crossover from a domain-growth ferromagnetic regime into a reentrant spin glass regime at lower temperatures. These striking parallels suggest a picture of competition in PMN/PT (90/10) between ferroelectric correlations formed in the domain-growth regime with glassy correlations formed in the spin glass regime. PMN/PT (90/10) is also found to exhibit frequency-aging time scaling of the time-dependent part of the out-of-phase susceptibility for temperatures 260 K and below. The stability of aging effects to thermal cycles and field perturbations is also reported.Comment: 8 pages RevTeX4, 11 figures; submitted to Phys. Rev.

Barkhausen Noise in a Relaxor Ferroelectric

Barkhausen noise, including both periodic and aperiodic components, is found in and near the relaxor regime of a familiar relaxor ferroelectric, PbMg$_{1/3}$Nb$_{2/3}$O$_3$, driven by a periodic electric field. The temperature dependences of both the amplitude and spectral form show that the size of the coherent dipole moment changes shrink as the relaxor regime is entered, contrary to expectations based on some simple models.Comment: 4 pages RevTeX4, 5 figures; submitted to Phys Rev Let

Appetite suppressants and valvular heart disease - a systematic review

Background Although appetite suppressants have been implicated in the development of valvular heart disease, the exact level of risk is still uncertain. Initial studies suggested that as many as 1 in 3 exposed patients were affected, but subsequent research has yielded substantially different figures. Our objective was to systematically assess the risk of valvular heart disease with appetite suppressants. Methods We accepted studies involving obese patients treated with any of the following appetite suppressants: fenfluramine, dexfenfluramine, and phentermine. Three types of studies were reviewed: controlled and uncontrolled observational studies, and randomized controlled trials. Outcomes of interest were echocardiographically detectable aortic regurgitation of mild or greater severity, or mitral regurgitation of moderate or greater severity. Results Of the 1279 patients evaluated in seven uncontrolled cohort studies, 236 (18%) and 60 (5%) were found to have aortic and mitral regurgitation, respectively. Pooled data from six controlled cohort studies yielded, for aortic regurgitation, a relative risk ratio of 2.32 (95% confidence intervals 1.79 to 3.01, p < 0.00001) and an attributable rate of 4.9%, and for mitral regurgitation, a relative risk ratio of 1.55 (95% confidence intervals 1.06 to 2.25, p = 0.02) with an attributable rate of 1.0%. Only one case of valvular heart disease was detected in 57 randomized controlled trials, but this was judged unrelated to drug therapy. Conclusions The risk of valvular heart disease is significantly increased by the appetite suppressants reviewed here. Nevertheless, when considering all the evidence, valvulopathy is much less common than suggested by the initial, less methodologically rigorous studies

LYVE1 Marks the Divergence of Yolk Sac Definitive Hemogenic Endothelium from the Primitive Erythroid Lineage.

The contribution of the different waves and sites of&nbsp;developmental hematopoiesis to fetal and adult blood production remains unclear. Here, we identify lymphatic vessel endothelial hyaluronan receptor-1 (LYVE1) as a marker of yolk sac (YS) endothelium and definitive hematopoietic stem and progenitor cells (HSPCs). Endothelium in mid-gestation YS and&nbsp;vitelline vessels, but not the dorsal aorta and placenta, were labeled by Lyve1-Cre. Most YS HSPCs and erythro-myeloid progenitors were Lyve1-Cre lineage traced, but primitive erythroid cells were not, suggesting that they represent distinct lineages. Fetal liver (FL) and adult HSPCs showed 35%-40% Lyve1-Cre marking. Analysis of circulation-deficient Ncx1-/- concepti identified the YS as a major source of Lyve1-Cre labeled HSPCs. FL proerythroblast marking was extensive at embryonic day (E) 11.5-13.5, but decreased to hematopoietic stem cell (HSC) levels by E16.5, suggesting that HSCs from multiple sources became responsible for erythropoiesis. Lyve1-Cre thus marks the divergence between YS primitive and definitive hematopoiesis and provides a tool for targeting YS definitive hematopoiesis and FL colonization