What is the Best Evidence Medical Education?

Best Evidence Medical Education (BEME) is defined as: “The implementation by teachers and educational bodies in their practice, of methods and approaches to education based on the best evidence available.” Five steps have been recognized in the practice of BEME. These are: framing the question, developing a search strategy, evaluating the evidence, implementing change and evaluating that change. In this paper, I described the concept of BEME, its steps, and challenges

Resilience-based decision framework to determine performance targets for the built environment, A

2018 Spring.Includes bibliographical references.Current design codes and standards focus on the design of individual facilities. A typical building is designed with the objective of the life safety of occupants. Even performance-based design approaches assess the required physical performance of an individual structure in order to satisfy prescribed criteria for that structure individually. Thus, even these performance objectives are likely not sufficient for a broad view of community-resilience goals. A modern community is made up of highly coupled networks, and disruptions within one or more networks may lead to disruptions to other networks. If a large number of buildings within a community become non-functional for a long time following an event, either because of physical damage or loss of utilities such as electric power and/or water, the consequences may affect other parts of the community such that, eventually, significant socioeconomic losses occur. Therefore, the current approach for designing individual physical components within a community can be reimagined such that it not only takes into account the performance of a component individually after a catastrophic event but also considers the consequences its design has on a community. The main purpose of this dissertation is to develop a methodology that links the performance of components within the built environment to community-level resilience goals by considering the dependencies and cross-dependencies between components and networks. Therefore, ultimately, this methodology enables disaggregation of the community-level objectives into a set of performance targets for the components of the built environment, which leads itself to the needs of policymakers and community leaders in order to make long-term planning decisions for a community

Stress & Cities: A Design Perspective

The urban environment creates spatial experiences and has a significant impact on people’s state of mind. This project intends to propose an objective way of identifying the state of affect by means of mapping the physiological responses. Hence, devising a wearable biosensor and integrating with a mobile phone to obtain geo-referenced data in relation to spatial surroundings. The objective is to illustrate a layer of the responses spatially over the geographical map to investigate the inter-dependency between the state of affect with the urban environmen

Thrombolytic effect of streptokinase infusion assessed by ST-segment resolution between diabetic and non-diabetic myocardial infarction patients

Background: Recently, it has been hypothesized that type 2 diabetes might interfere with acute intravenous thrombolysis effectiveness as estimated by angiographic or electrocardiographic criteria. In our study, we compared the thrombolytic effect of streptokinase infusion between diabetic and non-diabetic myocardial infarction (MI) patients. Methods: In a prospective interventional study, 240 consecutive patients who were admitted to the emergency ward and diagnosed with ST-elevation MI (STEMI) were enroled and classified into diabetics (n = 85) and non-diabetics (n = 155). Streptokinase was given to each patient at a dose of 1.5 million units in 1 h. Twelve-lead ECG was recorded immediately before the start of thrombolytic therapy and at 180 min afterwards for the patients with STEMI. The ST-segment elevation resolution was calculated and stratified as complete resolution (> 70% ST-resolution), partial resolution (30&#8211;70% ST-resolution), or failed resolution (< 30% ST-resolution). Results: Complete ST-resolution occurred in 31.6% of diabetic and 51.0% of non-diabetic patients, respectively (p < 0.001). The incidence of partial ST-resolution in diabetic and non- -diabetic patients was 40.5% and 40.0%, whereas 27.8% of patients in the diabetic group and 9.0% of patients in the non-diabetic group showed failed ST resolution. ST-resolution was independent of the location of MI. Multivariate analysis showed that diabetes mellitus, as well as higher Killip class and lower ejection fraction, could effectively predict ST-resolution failure. Conclusions: Failure of ST-segment resolution 180 min after streptokinase infusion is notably higher in diabetic vs non-diabetic patients. This failure rate is correlated with higher Killip class and lower ejection fraction. (Cardiol J 2012; 19, 2: 168&#8211;173

Oxidative Stress and DNA Damage in Mice Kidneys Exposed to Cadmium Chloride

Background: Cadmium is one of the most toxic heavy metals in our environments having a very strong ability to accumulate in body organs especially in kidney. Our aim of this study is to determine of the genotoxicity and cytotoxicity in mice kidneys exposed to cadmium. Material and Method: In this study we sacrificed 30 male mice and randomly divided into 2 different groups (control&amp; case). Every 5 mice remained in one cage at the same standard conditions. After a week, the mice were exposed to Cd (300µm/Kg.b.wt) on 0, 6, 12, 24, 48 hrs by peritoneal injections. After 24hrs from the latest injection, the mice were killed and obtained their kidneys, and then the oxidative stress markers (malondialdehide (MDA), glutathione (GSH) and superoxide dismutase (SOD)) were assayed on homogenized kidneys in order to study of cytotoxicity, genotoxicity and DNA damage. We used Comet assay on separated kidney cells. Finally, for analyzing statistical data, we used T-test and ANOVA using SPSS15 software. Results: In treated group, MDA and GSH concentration and also SOD (ρ&lt;0.05) activity significantly increased in comparison with control group. Conclusion: The comet assay results obviously showed DNA breakage stimulated by Cd in treated group it was not seen in the control group

Layer-wise Learning of Kernel Dependence Networks

Due to recent debate over the biological plausibility of backpropagation (BP), finding an alternative network optimization strategy has become an active area of interest. We design a new type of kernel network, that is solved greedily, to theoretically answer several questions of interest. First, if BP is difficult to simulate in the brain, are there instead "trivial network weights" (requiring minimum computation) that allow a greedily trained network to classify any pattern. Perhaps a simple repetition of some basic rule can yield a network equally powerful as ones trained by BP with Stochastic Gradient Descent (SGD). Second, can a greedily trained network converge to a kernel? What kernel will it converge to? Third, is this trivial solution optimal? How is the optimal solution related to generalization? Lastly, can we theoretically identify the network width and depth without a grid search? We prove that the kernel embedding is the trivial solution that compels the greedy procedure to converge to a kernel with Universal property. Yet, this trivial solution is not even optimal. By obtaining the optimal solution spectrally, it provides insight into the generalization of the network while informing us of the network width and depth

Effects of Inter-Layer Time Interval on Temperature Gradients in Direct Laser Deposited Ti-6Al-4V

Parts fabricated via additive manufacturing (AM) methods are prone to experiencing high temperature gradients during manufacture resulting in internal residual stress formation. In the current study, a numerical model for predicting the temperature distribution and residual stress in Directed Energy Deposited (DED) Ti–6Al–4V parts is utilized for determining a relationship between local part temperature gradients with generated residual stress. Effects of time-interval between successive layer deposits, as well as layer deposition itself, on the temperature gradient vector for the first and each layer is investigated. The numerical model is validated using thermographic measurements of Ti-6Al-4V specimens fabricated via Laser Engineered Net Shaping® (LENS), a blown-powder/laser-based DED method. Results demonstrate the heterogeneity in the part’s spatiotemporal temperature field, and support the fact that as the part number, or single part size or geometry, vary, the resultant residual stress due to temperature gradients will be impacted. As the time inter-layer time interval increases from 0 to 10 second, the temperature gradient magnitude in vicinity of the melt pool will increase slightly.Mechanical Engineerin