A Survey of Information Sources Used for Progress Decisions about Medical Students

Although many medical schools have adopted a variety of methods to assess student competency, the extent to which these innovations have changed how decisions about student progress are made is not clear. This paper describes a survey of 126 accredited allopathic U.S. medical schools to determine which information sources are used for decisions related to medical student progress and graduation. Respondents were asked to indicate up to three information sources used for seven specific decisions about student progress. The results indicate that multiple choice questions (MCQs) and faculty ratings remain the most frequently used information sources. Clinical skills education in the pre-clinical curriculum is the area with the broadest use of assessments for progress decisions. Several explanations are suggested for the primacy of MCQs and faculty ratings in student decisions, including familiarity for faculty and students, ease of implementation and the resources required for the adoption of other assessment strategies

Prey – predator model on the interaction between the drawdown level of an aquifer and maize yield

Groundwater is a major source of water for irrigation purposes and for sustainable growth of Agricultural development. In this paper we formulated a mathematical model to analyse the interaction between the Draw-down levels in an unconfined aquifer with maize yield, using the parameters; aquifer recharged rate α, rate of interaction between the draw down level of the aquifer and the maize yield β, draw down level of the aquifer h, and the maize yield y. The aim of this paper is to analyse the interaction between crop yield and water table and to determine the effect of draw down level on maize yield. It was observed that the maize yield depends on the recharge rate of the aquifer α and the water table level h and also as the drawdown level increases, the maize yield increases. Agriculture is of paramount importance to the development of any country, it was established in this paper that a relatively small increase of water table depth beyond the optimum increase the surface irrigation requirement for maximum crop production, water table depth shallower than optimum decreases yield.Key words: Drawdown, recharged rate, maize yield, interactio

Ruptured Splenic Hemangioma Presenting As Small Bowel Obstruction: A Case Report

Introduction: Splenic hemangioma is a rare vascular tumor of the spleen. Typically asymptomatic, these lesions can present with rupture and hemoperitoneum. Clinical Findings: We report the case of a patient with no previous abdominal surgery that presented with symptoms and imaging consistent with small bowel obstruction (SBO), and an incidental finding of a splenic lesion. Main diagnoses, therapeutic interventions, and outcomes: At diagnostic laparoscopy, a ruptured splenic hemangioma was identified, with obstructive ileus due to hemoperitoneum. The patient subsequently underwent splenectomy to prevent recurrent bleeding. Conclusions: Splenic hemangiomas are rare vascular neoplasms of the spleen, which can be complicated by rupture. While obstructive ileus is a common post-operative phenomenon, it is rarely seen in association with vascular anomalies. This case represents a rare presentation of small bowel obstruction, highlighting the utility of diagnostic laparoscopy in patients with no previous abdominal surgery

Effects of Par1a Deletion on Tubulointerstitial Fibrosis in Folic Acid Mouse Models of Renal Injury

Chronic Kidney Disease (CKD) affects 1 out of 7 adults in the United States and causes significant morbidity and mortality. Development of tubulointerstitial fibrosis, and the accompanying loss of functional tubular cells, leads to CKD progression. The Notch signaling pathway is required for renal development, however, sustained Notch activation in adult mice induces tubulointerstitial fibrosis. Dual deletion of Par1a and Par1b, serine threonine kinases, in developing mouse kidneys impaired Notch activation and resulted in the formation of abnormal glomeruli and proximal tubules. Deletion of either Par1a or 1b does not affect kidney development.We hypothesize that Par1a or 1b deletion in mice would protect against folic acid (FA) induced tubulointerstitial fibrosis. FA models of renal fibrosis were induced in Par1a WT and Par1a KO mice with intraperitoneal injections of 250 mg/kg FA dissolved in 300 nM NaHCO3. Mice were examined 7 days after injection—the time of earliest fibrosis and peak Notch expression. Sirius red collagen staining was used to quantify the severity of fibrosis. Immunohistochemical staining for Notch signaling components and Par1a were performed. It was observed that Par1a expression was increased after FA injection. Par1a colocalized in tubules with increased Jag1 expression. Sirius red staining demonstrated less fibrosis in Par1a KO vs. WT mice. Together, our results suggest Par1a deletion may be protective against renal fibrosis. Par1-Notch interactions may be mediated by effects on Jag1. Par1-Notch signaling could be a novel target for therapeutic intervention and potentially attenuate CKD progression

Knee Injuries in NFL Lineman -- A Correlation with BMI

Knee Injuries in NFL Linemen - Correlation with BMI Dr. Michael Lem, MD; Dr. John Bianchi, DO; Austin Irwin, OMS II; Dr. Robert Farrell, MD; Cole Siegenfeld, OMS II Purpose: Knee injuries are among the most common injuries suffered in the NFL which in turn can decrease a player\u27s playing time in a given season and thus negatively impact future performance. Understanding characteristics like BMI can help modify and identify players at risk for knee injuries. Methods and Study Design: Data collected for this study was extracted from the official NFL database of injuries. Reported knee injuries for offensive and defensive lineman were collected and organized by week during the 2009-2022 seasons; final data was calculated for players with a BMI over 39.95. Pro-football-reference.com was cited for height, weight, career length and draft status. BMI was calculated based on height and weight. Comparisons were made between BMI and game status. Results: Among the players collected, offensive tackles were the most likely to appear on the injury report. Players with a BMI above 40 appeared most commonly as Probable (n=182), followed by Questionable (157), Out (134) then Doubtful (26). The average BMI for the players listed as probable was x=42.4 (SD=2.69); questionable x=41.2 (1.37); doubtful x=41.0 (.856); out x=40.9 (.991). There is a significant difference in the player’s BMI between “probable” game status and both “questionable” (p=.023) and “out” (p\u3c .001). Players with a BMI= +37 appeared as either out or doubtful 30.07% total. Players with a BMI under 37 appeared as either out or doubtful 30.81%. Conclusions: Based on our data, BMI may play a protective role on injury report placement for knee injuries. The abundance of “probable” game status also supports the notion that the injuries studied are lower-grade. More players appear on the injury list towards the end of the season, which may indicate there is a persisting effect to the injuries

The conceptualisation and measurement of DSM-5 Internet Gaming Disorder: the development of the IGD-20 Test

Background: Over the last decade, there has been growing concern about ‘gaming addiction’ and its widely documented detrimental impacts on a minority of individuals that play excessively. The latest (fifth) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included nine criteria for the potential diagnosis of Internet Gaming Disorder (IGD) and noted that it was a condition that warranted further empirical study. Aim: The main aim of this study was to develop a valid and reliable standardised psychometrically robust tool in addition to providing empirically supported cut-off points. Methods: A sample of 1003 gamers (85.2% males; mean age 26 years) from 57 different countries were recruited via online gaming forums. Validity was assessed by confirmatory factor analysis (CFA), criterion-related validity, and concurrent validity. Latent profile analysis was also carried to distinguish disordered gamers from non-disordered gamers. Sensitivity and specificity analyses were performed to determine an empirical cut-off for the test. Results: The CFA confirmed the viability of IGD-20 Test with a six-factor structure (salience, mood modification, tolerance, withdrawal, conflict and relapse) for the assessment of IGD according to the nine criteria from DSM-5. The IGD-20 Test proved to be valid and reliable. According to the latent profile analysis, 5.3% of the total participants were classed as disordered gamers. Additionally, an optimal empirical cut-off of 71 points (out of 100) seemed to be adequate according to the sensitivity and specificity analyses carried

Probabilistic Segmentation of Small Metastatic Brain Tumors using Liquid State Machine Ensemble

View full abstracthttps://openworks.mdanderson.org/leading-edge/1017/thumbnail.jp

Genetic Testing Reveals Germline Mutations Among Patients Undergoing Surgery for Colorectal Carcinoma in a Community Hospital Setting

Introduction: Defined germline mutations contribute to 5% to 10% of cases of colorectal carcinoma (CRC). While protocols for universal tumor screening have been adopted to detect mismatch repair (MMR) protein deficiency, widespread multigene panel testing has not been achieved. Barriers to implementing testing protocols may occur in community settings. Methods: A total of 160 patients presenting for surgical management of CRC between 2011 and 2020 were considered for retrospective analysis in a single-surgeon, single-institution, community-based cohort. The rate of multigene panel testing and prevalence of germline mutations were calculated, and patient characteristics were assessed. Results: A total of 32/160 (20%) patients underwent multigene panel testing, with 14/160 (9%) patients having germline mutations. While 88% of patients underwent panel testing after CRC diagnosis, 43% of these patients would have met testing criteria before diagnosis. Among the patients meeting criteria before diagnosis, 50% were found to carry a germline mutation. Discussion: The prevalence of germline mutations was similar to previously reported values, while the rate of multigene panel testing was higher than previously reported. These results may be unique to the study setting or result from multidisciplinary conference discussion. A significant number of patients with abnormal panel testing were not tested before CRC diagnosis, despite meeting the criteria. This finding represents a missed opportunity for risk stratification and underscores the importance of addressing testing barriers in the primary care setting. Conclusions: Primary care providers and oncologists in community hospitals must remain cognizant of changing guidelines as multigene panel testing becomes increasingly available

blandaltman: A command to create variants of Bland–Altman plots

Bland–Altman plots can be useful in paired data settings such as measurement-method comparison studies. A Bland–Altman plot has differences, percentage differences, or ratios on the y axis and a mean of the data pairs on the x axis, with 95% limits of agreement indicating the central 95% range of differences, percentage differences, or ratios. This range can vary with the mean. We introduce the community-contributed blandaltman command, which uniquely in Stata can 1) create Bland–Altman plots featuring ratios in addition to differences and percentage differences, 2) allow the limits of agreement for ratios and percentage differences to vary as a function of the mean, and 3) add confidence intervals, prediction intervals, and tolerance intervals to the plots