Search

The purpose of this study was to evaluate whether models based on pre-admission testing, including performance on the Medical College Admission Test (MCAT), performance on required courses in the medical school curriculum, or a combination of both could accurately predict performance of medical students on the United States Medical Licensing Examination (USMLE) Steps 1 and 2. Models were produced using stepwise linear regression and feed forward neural networks. Notable accuracy in predicting Step 1 and Step 2 scores were achieved from models integrating pre-admission variables with medical school coursework grades. Of interest, the coursework grades contributed far greater to these models than the pre-admission variables except the MCAT. (Contains 2 tables.)

This research aimed at investigating the effectiveness of STEM approach in developing visual reasoning and learning independence for preparatory stage students. To achieve this aim, the researcher designed a program based on STEM approach in light of the principles of nanotechnology. Twenty one preparatory stage students participated in the research. The researcher applied one-group research design through application of the research instruments to the selected group before the program, administration of the program, and post application of the instruments. This research design is appropriate for educational researches which present new processes in the content of programs or curricula that the students have not previously studied and these processes may take the form of new information, skills, or teaching methods. After data collection and application of the appropriate statistical treatments, the researcher reached the following results: there is a statistically significant difference at the 0.01 level between the students' mean scores in the pre and post-application of the achievement and visual reasoning tests in favor of the post-application. The results of the portfolio assessment of students also indicate the development of the students' ability to take responsibility of their learning, their ability to choose, their confidence, and consequently their competency in the aspects of learning independence.

Background: Burnout affects >50% of physicians, especially women. This study aimed to examine how negative workplace interactions can predict burnout, and whether positive social interactions can mitigate risk. Materials and Methods: In a study of 1627 physician mothers who responded to a survey by the Physician Moms Group, an online Facebook group, we first examined the association between workplace sexual harassment and burnout. In an embedded experiment, we then measured the causal impact of priming perceived social support and connectedness on the three dimensions of employee burnout. Results: Two-thirds of respondents reported having experienced sexual harassment in the past year. Sexual harassment by patients was associated with 0.27 points higher emotional exhaustion, one dimension of burnout (95% confidence interval [CI] 0.12–0.41), equivalent to the predicted impact of an additional 22 weekly work hours on emotional exhaustion. Sexual harassment by patients was also associated with 0.40 points higher patient depersonalization, another dimension of burnout (95% CI 0.27–0.53). Sexual harassment by colleagues was associated with 0.16 points higher emotional exhaustion (95% CI 0.02–0.30), but not other dimensions of burnout. We found no significant relationship between experiences of sexual harassment and levels of personal accomplishment (the third dimension of burnout) among this sample. Priming physician mothers to reflect on their connectedness with other physician mothers significantly increased their sense of personal accomplishment. The priming intervention did not yield a significant effect on emotional exhaustion or depersonalization. Conclusions: Negative and positive social interactions each affect different dimensions of burnout. Sexual harassment—a pervasive type of negative social interaction—strongly predicts emotional exhaustion and depersonalization. Reflecting on social connectedness—a type of positive social interaction—can improve one's sense of personal accomplishment with an effect similar in magnitude to more intensive in-person interventions, suggesting that social connectedness through online groups merits further consideration as a tool to mitigate burnout. [ABSTRACT FROM AUTHOR]

ChatGPT has recently been shown to pass the United States Medical Licensing Examination (USMLE). We tested ChatGPT (Feb 13, 2023 release) using a typical clinical toxicology case of acute organophosphate poisoning. ChatGPT fared well in answering all of our queries regarding it. [ABSTRACT FROM AUTHOR]

Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail. [ABSTRACT FROM PUBLISHER]

For the first time, a capillary electrophoretic (CE) method with sample stacking induced by a reverse migrating pseudostationary phase (SRMP) technique has been developed and validated for sensitive determination of phenobarbital (PB) and its p-hydroxyphenobarbital (PHPB) metabolite in rat urine samples. Separation and determination were optimized on a fused-silica capillary with a total length of 50 cm (effective length 40 cm) and 75 μm ID. The microemulsion background electrolyte consisted of 0.8% (v/v) ethyl acetate, 6.6% (v/v) butan-2-ol, 1.0% (v/v) acetonitrile, 2.0% (w/v) sodium n-dodecyl sulfate (SDS), and 89.6% (v/v) of 7.5 mM ammonium formate at pH 8. When this preconcentration technique was used, the sample stacking and the separation processes took place successively with changing the voltage with an intermediate polarity switching step. For practical application, a solid-phase extraction (SPE), C18sorbent with n-hexane/ethyl acetate (1 : 1%, v/v) as the elution solvent was used for sample purification and concentration. The SPE method gave good extraction yields for all the analytes, with absolute recovery values of 96.9% and 99.1% for PB and PHPB, respectively. The regression equations for PB and PHPB showed excellent linearity over a concentration range of 55–1386 ng mL−1for PB and PHPB (r= 0.998). The developed microemulsion electrokinetic capillary chromatography (MEEKC) method for separation of the studied compounds with SRMP as the electrophoretic preconcentration technique allowed detection limits in urine samples at 16.8 ng mL−1for PB and PHPB which are 15-fold lower than the reported CE method in the literature. The precision results, expressed by the intra-day and inter-day relative standard deviation (RSD) values range from 3.6 to 7.1% (repeatability) and from 3.2 to 7.2% (intermediate precision) for PB and PHPB, respectively, which were in line with Food and Drug Administration (FDA) criteria. [ABSTRACT FROM AUTHOR]

For the first time, a capillary electrophoretic (CE) method with sample stacking induced by a reverse migrating pseudostationary phase (SRMP) technique has been developed and validated for sensitive determination of phenobarbital (PB) and its p-hydroxyphenobarbital (PHPB) metabolite in rat urine samples. Separation and determination were optimized on a fused-silica capillary with a total length of 50 cm (effective length 40 cm) and 75 μm ID. The microemulsion background electrolyte consisted of 0.8% (v/v) ethyl acetate, 6.6% (v/v) butan-2-ol, 1.0% (v/v) acetonitrile, 2.0% (w/v) sodium n-dodecyl sulfate (SDS), and 89.6% (v/v) of 7.5 mM ammonium formate at pH 8. When this preconcentration technique was used, the sample stacking and the separation processes took place successively with changing the voltage with an intermediate polarity switching step. For practical application, a solid-phase extraction (SPE), C18sorbent with n-hexane/ethyl acetate (1 : 1%, v/v) as the elution solvent was used for sample purification and concentration. The SPE method gave good extraction yields for all the analytes, with absolute recovery values of 96.9% and 99.1% for PB and PHPB, respectively. The regression equations for PB and PHPB showed excellent linearity over a concentration range of 55–1386 ng mL−1for PB and PHPB (r= 0.998). The developed microemulsion electrokinetic capillary chromatography (MEEKC) method for separation of the studied compounds with SRMP as the electrophoretic preconcentration technique allowed detection limits in urine samples at 16.8 ng mL−1for PB and PHPB which are 15-fold lower than the reported CE method in the literature. The precision results, expressed by the intra-day and inter-day relative standard deviation (RSD) values range from 3.6 to 7.1% (repeatability) and from 3.2 to 7.2% (intermediate precision) for PB and PHPB, respectively, which were in line with Food and Drug Administration (FDA) criteria. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate whether models based on pre-admission testing, including performance on the Medical College Admission Test (MCAT), performance on required courses in the medical school curriculum, or a combination of both could accurately predict performance of medical students on the United States Medical Licensing Examination (USMLE) Steps 1 and 2. Models were produced using stepwise linear regression and feed forward neural networks. Notable accuracy in predicting Step 1 and Step 2 scores were achieved from models integrating pre-admission variables with medical school coursework grades. Of interest, the coursework grades contributed far greater to these models than the pre-admission variables except the MCAT. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to describe data assembled on all registered US investment companies on advisory fees using the NSAR filings and to analyze the impact of the structure of the advisory contracts on the fees paid to mutual funds advisors. This analysis is particularly relevant now that mutual funds have to explain the rationale for the choice of the advisory fees in their public filings. Design/methodology/approach -- The paper summarizes data on advisory fees in the NSAR filings and uses regression analysis to examine the determinants of advisory fees. Findings -- The paper summarizes salient features of the mutual fund advisory fee contracts using the NSAR database. The analysis shows that breakpoint fee schedules designed to generate savings, do not automatically translate into lower expenses for the investors. Practical implications -- When determining the renewal of an advisory contract, the board of trustees of a mutual fund will then need to assess myriad factors related to the costs and profits of the fund, including the nature of the fee schedule. Regression models provide objective measures of assessing the reasonableness of advisory fees. Originality/value -- This paper contributes to the ongoing debate on the evaluation of mutual funds advisory fees and highlights the usefulness of the NSAR filings. The debate is especially relevant given the additional SEC disclosure requirements. [ABSTRACT FROM AUTHOR]

Drawing on interviews with Muslim parents, students, and teachers in a Midwestern city, as well as one of the author's (Sabry's) own experiences as a member in the local Muslim community, this paper documents and describes the challenges faced by Muslim youth in U.S. schools. Grounded in the theoretical framework of cultural mismatch, the paper presents key themes of the interviews with regards to the areas of curriculum, instruction, and home-school relations. Based on these findings, and using Banks' Multicultural Education Dimensions, a proactive model of cooperation between the families of Muslim students and the public school system is proposed. The paper concludes by urging other scholars to investigate the schooling of Muslim students in the U.S. and encouraging members of the Muslim community to share their U.S. schooling experiences. [ABSTRACT FROM AUTHOR]

Tort costs as a fraction of U.S. GDP have increased over three-fold in the past 50 years, now hovering slightly above two percent. Although there has been much ink spilled blaming the plaintiffs' bar and so-called hellhole jurisdictions, less has been written about the behavior and attitudes of individual plaintiffs. Using a unique survey from the RAND Corporation, this paper empirically analyzes the perceptual and economic factors that affect the decision of an injured party to seek legal action. We find that, independent of economic incentives, perception of fault is the most important factor in the decision to make a claim. On average, a person who blames another person or firm for his or her injury is four times more likely to claim regardless of the type of injury involved. Unsurprisingly, the severity of injury--either as perceived by the claimant or as measured by actual injury during the accident--is another key factor in explaining the claiming rate. Also, as expected, there is a negative relation between age and claiming behavior. Somewhat unexpectedly, whether the person has had experience with filing before has no independent effect on the decision to claim. [ABSTRACT FROM AUTHOR]

The goal of this article is to identify industries filing successful petitions in good times according to demand, capacity utilization, concentration, and import-penetration ratio under the U.S. antidumping procedures and using U.S. data. Good times means that the domestic industry is facing increasing consumption prior to filing. This article examines: (a) the relation between the dumping estimates and the conditions facing the petitioning industry prior to filing; (b) the relation between the dumping estimates and the outcome of the petitions; and (c) the factors affecting the probability of filing, the dumping estimates, and the probability of success of a petition. The decision to file and the probability of success of petitions are estimated using univariate probit and a bivariate probit model with sample selection. The dumping estimates are analyzed using a Tobit model. The primary metal products and the stone and concrete industries are also analyzed separately. The empirical analysis indicates that the import-penetration ratio, capacity utilization, and the dumping estimates by the Department of Commerce (DOC) are the significant factors in explaining the outcome of the petitions. The import penetration ratio, the concentration level, and the interaction of concentration and capacity utilization are the significant factors in explaining the decision to file. The analysis shows that in case of high-capacity utilization (proxy for high demand), less concentrated industries are more likely to file, but highly concentrated industries are more likely to receive protection. The results also show that the level of concentration of the petitioning industry, import-penetration, and the dumping estimates provided by the petitioning industries explain the dumping margins estimated by the DOC as the basis for the antidumping duty. This suggests that the relief or protection that the petitioning industry receives may not entirely be based on technical standards. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose of the study was to determine the safety profile and efficacy of intravenous ibuprofen administered over 5 to 10 minutes for the treatment of pain or fever in hospitalized patients. Current evidence supports the use of intravenous infusions of ibuprofen to control pain and reduce the opioid requirements associated with surgical pain. Current dosing guidelines recommend that the drug be administered over 30 minutes. However, a more rapid infusion might yield additional benefits. The safety profile and efficacy of a shortened infusion time requires additional study. Methods: This was a Phase IV multicenter, openlabel, surveillance clinical study. Thirteen clinical centers located in the United States enrolled a total of 150 adult hospitalized patients with pain or fever. Patients experiencing pain received 800 mg intravenous ibuprofen infused over 5 to 10 minutes every 6 hours for up to 24 hours (4 doses) and patients experiencing fever received 400 mg intravenous ibuprofen infused over 5 to 10 minutes every 4 hours for up to 24 hours (6 doses). Vital signs, adverse events, and pain scores were assessed. The exclusion criteria included inadequate intravenous access; patients younger than 18 years of age; history of allergy or hypersensitivity to any component of intravenous ibuprofen, aspirin, or other nonsteroid antiinflammatory drugs; active hemorrhage or clinically significant bleeding; pregnancy or nursing; and patients in the perioperative period in the setting of coronary artery bypass graft surgery. Findings: Adverse events were reported for 43 of 150 patients (29%). The most common adverse events experienced by patients were infusion site pain in 22 of 150 patients (15%) and flatulence (8 of 150 [5%]). Four patients (3%) discontinued the study drug due to infusion-site pain. In the patients experiencing fever, temperature decreased from baseline over 4 hours (mean [SD] reduction of 1.5 [1.25]1F). In patients experiencing pain, patient-reported visual analog scale scores decreased from baseline over 4 hours (mean [SD] reduction of 27.1 [31.29] mm). Implications: The study demonstrates that more rapid administration of intravenous ibuprofen is well tolerated and supports intravenous ibuprofen as an effective treatment for pain and fever in hospitalized patients. [ABSTRACT FROM AUTHOR]

Background: Although antiemetics are commonly used to prevent postoperative nausea or vomiting, the failure rate is appreciable and there is currently no generally accepted standard for rescue treatment of postoperative nausea or vomiting after failed prophylaxis. This prospective, randomized, double-blind, parallel-group, placebo-controlled, multicenter study was designed to test the hypothesis that intravenous amisulpride, a dopamine D2/D3-antagonist, is superior to placebo at treating established postoperative nausea or vomiting after failed prophylaxis.Methods: A total of 2,285 adult patients undergoing surgery under general inhalational anesthesia and receiving standard antiemetic prophylaxis were enrolled at 23 sites in Canada, France, Germany, and the United States. Of these, 702 patients experienced postoperative nausea or vomiting in the 24-h period after surgery and were randomized to receive a single dose of 5 or 10 mg intravenous amisulpride or matching placebo. The primary endpoint was complete response, defined as no emesis or rescue antiemetic use for 24 h after study drug administration, excluding emesis in the first 30 min. Secondary endpoints included incidence of emesis and rescue medication use, nausea burden, time to treatment failure, and length of stay in postanesthesia care unit and hospital.Results: Complete response occurred in significantly more patients receiving 10 mg amisulpride (96 of 230, 41.7%) than placebo (67 of 235, 28.5%), a 13.2% difference (95% CI, 4.6 to 21.8; odds ratio, 1.80; P = 0.006). A 5-mg dose of amisulpride did not show a significant benefit (80 of 237, 33.8%); the difference from placebo was 5.2% (95% CI, 3.1 to 13.6; odds ratio, 1.24; P = 0.109). The total number of adverse events recorded and proportion of patients with at least one adverse event were comparable between the placebo and amisulpride groups. No clinically relevant toxicities were observed.Conclusions: A single 10-mg dose of intravenous amisulpride was safe and more effective than placebo at treating established postoperative nausea or vomiting in patients failing postoperative nausea or vomiting prophylaxis. [ABSTRACT FROM AUTHOR]