Coal: A Significant Factor in Germany’s Defeat in World War I

More than a hundred years have passed since the outbreak of the World War I, but there are still fundamental gaps in our understanding of the conflict. It has been generally recognized that the British blockade of Germany played the central role in bringing about Germany’s surrender. The German economy, industry and military came to suffer as a result of domestic shortages of all kinds, but especially of coal. In the gridlock of devastation and military force that had developed by 1916 coal came to represent a most effective tool of British allied force that Germany could not counter and so became a decisive factor in Germany’s collapse by 1918

Clinical Performance Measures and Quality Improvement System Considerations for Dental Education

Quality improvement and quality assurance programs are an integral part of providing excellence in health care delivery. The Dental Quality Alliance and the Commission on Dental Accreditation recognize this and have created standards and recommendations to advise health care providers and health care delivery systems, including dental schools, on measuring the quality of the care delivered to patients. Overall health care expenditures have increased, and the Affordable Care Act has made health care, including dentistry, available to more people in the United States. These increases in cost and in the number of patients accessing care contribute to a heightened interest in measurable quality improvement outcomes that reflect efficiency, effectiveness, and overall value. Practitioners and administrators, both in academia and in the “real world,” need an understanding of various quality improvement methodologies available in order to select approaches that support effective monitoring of the quality of care delivered. This article compares and contrasts various quality improvement approaches, programs, and systems currently in use in order to assist dental providers and administrators in choosing quality improvement methodologies pertinent to their practice or institution

Li+/H+ exchange of Li7La3Zr2O12 single and polycrystals investigated by quantitative LIBS depth profiling

Li7La3Zr2O12 (LLZO) garnets are highly attractive to be used as solid electrolyte in solid-state Li batteries. However, LLZO suffers from chemical interaction with air and humidity, causing Li+/H+ exchange with detrimental implication on its performance, processing and scalability. To better understand the kinetics of the detrimental Li+/H+ exchange and its dependence on microstructural features, accelerated Li+/H+ exchange experiments were performed on single crystalline and polycrystalline LLZO, exposed for 80 minutes to 80 °C hot water. The resulting chemical changes were quantified by analytical methods, i.e. inductively coupled plasma optical emission spectroscopy (ICP-OES) and laser induced breakdown spectroscopy (LIBS). From the time dependence of the Li+ enrichment in the water, measured by ICP-OES, a bulk interdiffusion coefficient of Li+/H+ could be determined (7 × 10−17 m2 s−1 at 80 °C). Depth dependent concentrations were obtained from the LIBS data for both ions after establishing a calibration method enabling not only Li+ but also H+ quantification in the solid electrolyte. Short interdiffusion lengths in the 1 μm range are found for the single crystalline Ga:LLZO, in accordance with the measured bulk diffusion coefficient. In polycrystalline Ta:LLZO, however, very long diffusion tails in the 20 μm range and ion exchange fractions up to about 70% are observed. Those are attributed to fast ion interdiffusion along grain boundaries. The severe compositional changes also strongly affect the electrical properties measured by impedance spectroscopy. This study highlights that microstructural effects may be decisive for the Li+/H+ ion exchange kinetics of LLZO

Assessment of musculoskeletal examination skills of 4th year medical students using a novel OSCE

Objective: Despite the high prevalence of musculoskeletal complaints presenting to physicians in the United States, there are very few opportunities for University of Michigan clinical medical students to receive formative or summative assessment of their ability to evaluate patients with these complaints. The purpose of this study was to assess 4th year students’ ability to examine and diagnose several common musculoskeletal disorders using a novel objective structured clinical examination (OSCE). Methods: A multidisciplinary team of musculoskeletal specialists developed the content and structure of three OSCE stations focusing on examination of the shoulder, back and knee. For each station, volunteer M4 students were provided a clinical vignette with three possible diagnoses to consider, and were instructed to anticipate physical examination maneuvers or findings that would discriminate between the three diagnoses. Then they would examine a professional patient simulating findings associated with one of the diagnoses and choose their favored diagnosis. Their encounter was directly observed by a faculty member who scored their performance on selected physical examination maneuvers based on a checklist (0 = not done, 1 = partially done, 2 = fully done). Each encounter was recorded to allow for later review by another faculty. Immediate feedback was provided to students at the end of the OSCE, making this a formative as well as summative assessment experience. Faculty received verbal and written instruction on how to score students. IRB exemption was obtained for this study. Results: 44 M4 students participated in the OSCE during the spring of 2012. General performance of M4 students in examining regional musculoskeletal complaints will be reported. Performance of individuals will be correlated with: anticipation of discriminatory features prior to examining the patients; self-assessment on ability to perform the relevant exam and anticipated need to do so in their future career; previous musculoskeletal elective exposure; future career choice; and performance on the M4 Comprehensive Clinical Assessment “Back pain” and “Abdominal pain” stations. Conclusions: Initial validity evidence for a multistation musculoskeletal OSCE will be presented, as will the performance of a sampling of the 2012 graduating UM medical student class. This data will be used as part of ongoing evaluation of the longitudinal musculoskeletal curriculum at the University of Michigan medical school.http://deepblue.lib.umich.edu/bitstream/2027.42/91291/1/MedEdDay2012-poster-monradetal.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/91291/3/MEDC22poster.pd

7,8,9,10-Tetra­hydro-2-methyl­cyclo­hepta­[b]indol-6(5H)-one

The title compound, C14H15NO, was synthesized from 2-hydroxy­methyl­enecyclo­hepta­none via a Japp–Klingemann acid-catalyzed cyclization. The seven-membered ring exhibits a slightly distorted envelope conformation. N—H⋯O hydrogen bonds form a centrosymmetric dimer; C—H⋯O hydrogen bonds and π–π stacking inter­actions (the centers of the atoms involved in the stacking interaction are separated by 3.504 Å) give rise to another type of centrosymmetric dimer. In combination, these inter­actions create a stair-like chain of mol­ecules that inter­acts only loosely with neighboring chains via van der Waals inter­actions and weak C—H⋯π contacts

Gli3 utilizes Hand2 to synergistically regulate tissue-specific transcriptional networks.

Despite a common understanding that Gli TFs are utilized to convey a Hh morphogen gradient, genetic analyses suggest craniofacial development does not completely fit this paradigm. Using the mouse model (Mus musculus), we demonstrated that rather than being driven by a Hh threshold, robust Gli3 transcriptional activity during skeletal and glossal development required interaction with the basic helix-loop-helix TF Hand2. Not only did genetic and expression data support a co-factorial relationship, but genomic analysis revealed that Gli3 and Hand2 were enriched at regulatory elements for genes essential for mandibular patterning and development. Interestingly, motif analysis at sites co-occupied by Gli3 and Hand2 uncovered mandibular-specific, low-affinity, \u27divergent\u27 Gli-binding motifs (dGBMs). Functional validation revealed these dGBMs conveyed synergistic activation of Gli targets essential for mandibular patterning and development. In summary, this work elucidates a novel, sequence-dependent mechanism for Gli transcriptional activity within the craniofacial complex that is independent of a graded Hh signal

Hantavirus in Northern Short-tailed Shrew, United States

Phylogenetic analyses, based on partial medium- and large-segment sequences, support an ancient evolutionary origin of a genetically distinct hantavirus detected by reverse transcription–PCR in tissues of northern short-tailed shrews (Blarina brevicauda) captured in Minnesota in August 1998. To our knowledge, this is the first evidence of hantaviruses harbored by shrews in the Americas