Search

Purpose: Understand how participation in service-learning activities in medical school influenced physicians' early careers., Methods: Researchers conducted semi-structured interviews with physicians who had completed residency training and held leadership positions within an established medical-student-run, service-learning initiative. The research team analyzed the interviews iteratively, using an editing coding strategy to identify categories, and identified themes by prolonged data immersion. The team sought disconfirming evidence and conducted member-checking. Researchers stopped interviews after no new themes emerged (saturation)., Results: The research team identified four main themes: service-learning activities provided an outlet for individuals predisposed to service; participants reported actively seeking underserved populations in their practice; participants described increased sensitivity towards the underserved; and participants reported gaining leadership, organizational, and administrative skills., Conclusions: Physicians who participated in medical school service-learning activities indicated these experiences influenced their professional development and approach to practice. Future studies may consider these outcomes when evaluating service-learning projects.

Yarrowia lipolytica, an oleaginous yeast, is capable of accumulating significant cellular mass in lipid making it an important source of biosustainable hydrocarbon-based chemicals. In spite of a similar number of protein-coding genes to that in other Hemiascomycetes, the Y. lipolytica genome is almost double that of model yeasts. Despite its economic importance and several distinct strains in common use, an independent genome assembly exists for only one strain. We report here a de novo annotated assembly of the chromosomal genome of an industrially-relevant strain, W29/CLIB89, determined by hybrid next-generation sequencing. For the first time, each Y. lipolytica chromosome is represented by a single contig. The telomeric rDNA repeats were localized by Irys long-range genome mapping and one complete copy of the rDNA sequence is reported. Two large structural variants and retroelement differences with reference strain CLIB122 including a full-length, novel Ty3/Gypsy long terminal repeat (LTR) retrotransposon and multiple LTR-like sequences are described. Strikingly, several of these are adjacent to RNA polymerase III-transcribed genes, which are almost double in number in Y. lipolytica compared to other Hemiascomycetes. In addition to previously-reported dimeric RNA polymerase III-transcribed genes, tRNA pseudogenes were identified. Multiple full-length and truncated LINE elements are also present. Therefore, although identified transposons do not constitute a significant fraction of the Y. lipolytica genome, they could have played an active role in its evolution. Differences between the sequence of this strain and of the existing reference strain underscore the utility of an additional independent genome assembly for this economically important organism., Competing Interests: The authors have declared that no competing interests exist.

In the light you will find the road (Led Zeppelin): Visible-light photoredox catalysis leads the way in overcoming the reactivity limitations of alkyl nucleophiles in cross-coupling reactions. Iridium-triggered oxidative photoredox activation of alkyltrifluoroborate or carboxylic acids affords alkyl radicals, which undergo nickel-catalyzed cross-coupling reactions., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The GLP-1-receptor-agonist liraglutide (Victoza) has been approved for the treatment of diabetes mellitus type 2 in Europe. Liraglutide is the first human GLP-1 analogue which is applied once a day. Efficacy and safety of liraglutide were investigated in the broad LEAD-study-programme in comparison with placebo and other common therapeutics for the treatment of diabetes mellitus type 2. Liraglutide has been approved for the combination with metformin and/or a sulfonylurea or with metformin and a thiazolidinedione, if treatment with one or a combination of these drugs is not sufficient for an adequate blood glucose control.

Hypertension, particularly among African Americans, has been increasing in importance in the past 10 years. One aspect of this problem is poor disease management. This study examined illness beliefs, behaviors, and hypertension control among 102 African American outpatients. Participants were interviewed about their commonsense beliefs concerning hypertension and its management in accordance with Leventhal's commonsense model of self-regulation (CSM). Also assessed were medication adherence, stress-reducing behaviors, and lifestyle behaviors recommended for blood pressure control. Blood pressure was measured at about the time of interviewing. Results indicated that endorsement of a medical belief model of hypertension (i.e., caused and controlled by factors such as diet, age, and weight) was cross-sectionally associated with lower systolic blood pressure, a relationship that was statistically mediated by lifestyle behaviors (e.g., cut down salt, exercise). Endorsement of a stress belief model (i.e., stress is the main factor in hypertension cause and control) was associated with engagement in stress-related behaviors but not with blood pressure. These results further support the utility of the CSM for understanding patients' disease management behaviors.

Objective: To assess the effect of nebivolol, a highly selective third generation beta1-adrenoceptor antagonist with an endothelium-dependent vasodilatory action, on smoking-induced endothelial dysfunction., Research Design and Methods: This open-label study examined the effect of 14 daily doses of 5 mg nebivolol on forearm blood flow in 21 healthy, young, male, light smokers (< or =5 cigarettes/day), measured by plethysmography on Days 1, 7, and 14. The primary endpoint was the difference in forearm blood flow after smoking one standard cigarette from baseline (Day 1) until treatment end on Day 14. Secondary outcomes included the difference in forearm blood flow between Day 1 and Day 7 compared with Day 14 before and after smoking, the effect of nebivolol on blood coagulation parameters, high-sensitive-C-reactive protein (hs-CRP), and the safety and tolerability of nebivolol., Results: Nebivolol for 14 days did not significantly affect forearm blood flow after smoking. On Day 7 of nebivolol treatment, forearm blood flow after smoking was significantly greater than blood flow before smoking (increase of 0.44 mL/min; p = 0.00656). Serum level ofhs-CRP showed a marked decrease from Day 1 to Day 14. No changes in coagulation parameters were observed over the course of nebivolol treatment. Nebivolol was well tolerated throughout the study., Conclusions: The increase in forearm blood flow and the marked decrease in hs-CRP over 14 days of treatment suggest that nebivolol has a positive effect on endothelial function in light smokers, but larger studies are required to confirm these observations.

Aim: Aim of this retrospective study was to investigate the effect of the fixed functional appliance MARA (Mandibular Anterior Repositioning Appliance) on the position of the lower anteriors., Patients and Methods: For 1.3 years on average, 90 patients with a skeletal and dental Angle Class II malocclusion were treated simultaneously with the MARA and multi-bracket appliances to attain anterior mandibular repositioning. The patients were divided into the following age groups: 36 patients, mean age 10.6 years (children), 28 patients, mean age 14.9 years (adolescents) and 26 patients, mean age 33.7 years (adults). Lateral headfilms were taken at the onset of MARA treatment (T1), upon MARA removal (T2), and one year after MARA removal (T3). IMP angle (IMPA), incisor position with relation to the pogonion perpendicular, ANB angle, overjet and facial type were analyzed using cephalometric software. The degree of crowding was assessed on the study models. The data were subjected to Welch's paired t-test for statistical analysis., Results: In children, an average 0.4 mm mesial shift of the lower incisors (change in proclination +1.7 degrees ) was observed. This movement averaged 1.0 mm in adolescents (change in proclination +3.6 degrees ). The adult age group averaged 1.7 mm (change in proclination +4.5 degrees ). In all age groups, a significant linear correlation was detected between position shift of the lower anteriors and the IMPA angle at T1: strongly protruded lower incisors showed less mesial shift than lingually inclined anteriors., Conclusions: The MARA fixed-functional appliance was an effective device in treating Class II patients in all the age groups studied. The dentoalveolar effect on the lower anteriors was more pronounced in the adult patient group than in the adolescents and children. When the literature on other fixed Class II mechanics is compared, the MARA is revealed as among those with the most Isprinminimal side-effects on the position of the lower anteriors. Ultimately, incisor inclination can be controlled well by therapy with multi-bracket systems.

Purpose: Patients seeking care for medically unexplained physical symptoms pose a major challenge at primary care sites, and there are very few well-accepted and properly evaluated interventions to manage such patients., Methods: We tested the effectiveness of a cognitive behavior therapy (CBT)-type intervention delivered in primary care for patients with medically unexplained physical symptoms. Patients were randomly assigned to receive either the intervention plus a consultation letter or usual clinical care plus a consultation letter. Physical and psychiatric symptoms were assessed at baseline, at the end of treatment, and at a 6-month follow-up. All treatments and assessments took place at the same primary care clinic where patients sought care., Results: A significantly greater proportion of patients in the intervention group had physical symptoms rated by clinicians as "very much improved" or "much improved" compared with those in the usual care group (60% vs 25.8%; odds ratio = 4.1; 95% confidence interval, 1.9-8.8; P<.001). The intervention's effect on unexplained physical symptoms was greatest at treatment completion, led to relief of symptoms in more than one-half of the patients, and persisted months after the intervention, although its effectiveness gradually diminished. The intervention also led to significant improvements in patient-reported levels of physical symptoms, patient-rated severity of physical symptoms, and clinician-rated depression, but these effects were no longer noticeable at follow-up., Conclusions: This time-limited, CBT-type intervention significantly ameliorated unexplained physical complaints of patients seen in primary care and offers an alternative for managing these common and problematic complaints in primary care settings.

1. Hypertensive men treated with beta-blockers frequently complain of erectile dysfunction. The present study investigated the effects of two beta(1)-adrenoceptor-selective antagonists, namely nebivolol and metoprolol, on erectile function in hypertensive men. 2. Male out-patients (age range 40-55 years) with newly diagnosed or existing stage 1 essential hypertension (mean seated systolic blood pressure 140-159 mmHg; diastolic blood pressure 90-99 mmHg) were enrolled in the study. All patients lived in a stable, heterosexual partnership and had no history of sexual dysfunction. After a 2-week placebo run-in period, patients were randomized double-blind to either Treatment group A (comprising nebivolol 5 mg once daily for 12 weeks, followed by placebo for 2 weeks and then metoprolol succinate 95 mg once daily for 12 weeks) or Treatment group B (comprising metoprolol succinate 95 mg for 12 weeks, placebo for 2 weeks and then nebivolol 5 mg for 12 weeks). An international index of erectile function (IIEF) questionnaire and a diary documented patients' sexual function and activity. 3. Nebivolol and metoprolol lowered blood pressure to a similar extent. Metoprolol, but not nebivolol, significantly decreased the IIEF erectile function subscore by 0.92 in the first 8 weeks after onset of beta-blocker treatment. In contrast with metoprolol, nebivolol improved secondary sexual activity scores and other IIEF subscores. 4. Despite similar antihypertensive efficacy of the cardioselective beta(1)-adrenoceptor antagonists nebivolol and metoprolol, nebivolol may offer additional benefits by avoiding erectile dysfunction in male hypertensive patients on long-term beta-adrenoceptor antagonist therapy.

Expression of connexins, the proteins which comprise gap junction channels, is regulated by ovarian hormones in the female reproductive tract of rodents. In order to determine if these hormones also affect connexin expression in the human uterus, the distribution patterns of different connexins (cx26, cx32, cx43) were investigated by immunohistochemistry in human endometrial tissue collected throughout the menstrual cycle. During the early proliferative phase of the cycle extremely low staining for connexin 43 was observed and connexin 26 antigens could not be detected. An increase in the amount of connexin 43 in stromal cells and of connexin 26 in glandular and luminal epithelial cells was seen from days 11-15 of the cycle. Following ovulation, the expression of both connexins was suppressed and was completely abolished in the late secretory phase. Weak staining for connexin 32 was found mainly in the late proliferative and the early secretory phase and was restricted to the basal membrane region of the glandular cells. These results suggest that the different connexins could represent cell biological markers for the proliferation and differentiation of the human endometrium throughout the menstrual cycle.

The expression of two different gap junction transcripts, connexin26 and connexin43, has been investigated in rat endometrium during implantation and early chorionic-allantoic placentation. An induction of connexin26 protein is detected locally in the epithelium of the implantation chamber prior to trophoblast invasion. At the same stage connexin43 is found exclusively in the primary decidual zone. By the sixth day of pregnancy the uterine epithelium of the implantation chamber has degenerated and the invading trophoblast is directly confronted with the developing decidua. Connexin26 is then detected in decidual cells accompanying the invading trophoblast, whereas connexin43 has spread through the decidual tissue up into the myometrial layers. This distribution pattern of connexin43 and connexin26 is maintained until at least Day 9 of pregnancy. In decidual cells adjacent to the trophoblast both connexins seem to be coexpressed in the same gap junctional plaque. In these early stages of pregnancy a clear correlation exists between levels of connexin43 mRNA and protein expression. In regard to connexin26 mRNA a similar correlation is found from Day 5 of pregnancy onward. The amount of mRNA on Day 4, however, does not correspond to the amount of connexin26 antigen in the endometrium at that stage. The spatial and temporal expression pattern of connexin26 accompanies the process of embryo implantation in the surrounding endometrium, pointing to a specialized function of these cells.

An investigation on blade implants is in process. These implants represent endstanding abutments of fixed bridgework. It was found that the implants, adapting to heavy masticatory stresses, show a response in the bone representing a connective tissue suspension.

Localization and synthesis of dopamine and serotonin in the cerebral and buccal ganglia of Limax maximus were studied. A combination of fluorescence histochemistry, immunocytochemistry, and microchemical analysis showed that both amines were localized to particular cell groups and fiber tracts within and between the two sets of ganglia. Since these ganglia control feeding behavior, which is readily modified by associative learning, these studies have direct bearing on analysis of both motor control and learning mechanisms.

As we have communicated previously, the fungal opportunist Candida albicans produces an angiotensin-1 liberating proteinase and a serine proteinase that acts as a converter of the coagulation factor X in vitro (25). Both enzymes are attached to delipidated cell fragments of fungal blastospores. They copurify upon ion exchange chromatography and gel filtration. The enzymes could be separated by hydrophobic chromatography on Phenylsepharose. According to their substrate and inhibition pattern, the enzymes have been classified as an aspartyl proteinase and a chymotrypsin-like proteinase. Their partial characterization includes estimates of the molecular weight and isoelectric points.

Sixty-one Holstein cows were used at varying stages of lactation to evaluate the feeding value of high moisture shelled corn ensiled in conventional silos. Control rations consisted of comparable amounts of conventional shelled corn dried in commercial drying facilities. Cows fed high moisture corn produced milk of higher fat content (3.09 versus 2.64%) and greater quantities of fat (.73 versus .64 kg) while they consumed less concentrate (9.28 versus 9.84 kg), resulting in the crude fiber content of the dry matter being 14.60% compared to 13.82% for control cows. Covariate adjustment of treatment means to equal intake of crude fiber eliminated differences above. Milk, 4% fat corrected milk, silage, total dry matter intake, and rumen volatile fatty acids were not significantly different between groups. Dry matter recovery following the ensiling process was 96.0 plus or minus 1.9% with 3.0 plus or minus 1.1% classified as spoiled corn, resulting in a total of 7% loss. Recoveries of all proximate constituents were similar to dry matter with the exception of ash (82.4%). Costs of the two systems were evaluated for varying corn prices and moisture.