Development, Implementation, and Evaluation of an Open Access, Level-Specific, Core Content Curriculum for Emergency Medicine Residents

ABSTRACT Background Leaders in graduate medical education must provide robust clinical and didactic experiences to prepare residents for independent practice. Programs traditionally create didactic experiences individually, requiring tremendous resources with variable content exposure and quality. Objective We sought to create and implement a free, open access, learner-centric, level-specific, emergency medicine (EM) residency curriculum. Methods We developed Foundations of Emergency Medicine (FoEM) Foundations I and II courses using Kern's model of curriculum development. Fundamental topics were identified through content guidelines from the American Board of Emergency Medicine. We incorporated learner-centric strategies into 2 flipped classroom, case-based courses targeting postgraduate year (PGY) 1 and PGY-2 residents. The curriculum was made freely available online in 2016. Faculty and resident users were surveyed annually for feedback, which informed iterative refinement of the curriculum. Results Between 2016 and 2020, registration for FoEM expanded from 2 sites with 36 learners to 154 sites and 4453 learners. In 2019, 98 of 102 (96%) site leaders and 1618 of 2996 (54%) learners completed the evaluative survey. One hundred percent of responding leaders and 93% of learners were “satisfied” or “very satisfied” with FoEM content. Faculty and residents valued FoEM's usability, large volume of content, quality, adaptability, organization, resident-faculty interaction, and resident-as-teacher opportunities. Challenges to implementation included resident attendance, conference structure, technology limitations, and faculty engagement. Conclusions We developed and implemented a learner-centric, level-specific, national EM curriculum that has been widely adopted in the United States.

Quick-traffic slurry surfacing mix with orthophosphoric acid

Bitumen emulsions for slurry surfacing mix technology using oxidized bitumen and hydrochloric and orthophosphoric acids on laboratory DenimoTech bitumen-emulsion plant are made in the work. Methylene blue adsorption index of granite aggregate for use in slurry surfacing mix was investigated. Comparatively mix time and cohesion strength build-up of selected compositions slurry surfacing mix with hydrochloric and orthophosphoric acids depending on the variable content of bitumen emulsion. The advantage of using orthophosphoric acid in slurry surfacing mix according to the cohesion strength build-up criterion has been proved. The importance of correct distribution of bitumen drops in the emulsion was confirmed using a sedimentograph Mastersizer 2000. Two emulsions of the same component composition were compared, which differed in particle size. It has been established that it is not possible to design a slurry surfacing mix using the mix time criterion with the help of coarse bitumen emulsion.

Vinculin recruitment to α-catenin halts the differentiation and maturation of enterocyte progenitors to maintain homeostasis of the Drosophila intestine.

Mechanisms communicating changes in tissue stiffness and size are particularly relevant in the intestine, because it is subject to constant mechanical stresses caused by peristalsis of its variable content. Using the Drosophila intestinal epithelium, we investigate the role of vinculin, one of the best characterised mechanoeffectors, which functions in both cadherin and integrin adhesion complexes. We discovered that vinculin regulates cell fate decisions, by preventing precocious activation and differentiation of intestinal progenitors into absorptive cells. It achieves this in concert with α-catenin at sites of cadherin adhesion, rather than as part of integrin function. Following asymmetric division of the stem cell into a stem cell and an enteroblast, the two cells initially remain connected by adherens junctions, where vinculin is required, only on the enteroblast side, to maintain the enteroblast in a quiescent state and inhibit further divisions of the stem cell. Removing vinculin increases enteroblast differentiation and numbers, resulting in an enlarged gut with improved ability to recover after starvation. Thus, mechanical regulation at the contact between stem cells and their progeny is used to control tissue cell number.

A Systematic Review on Fenton Optimization for Leachate Treatment Via Response Surface Methodology from 2005 to 2015

The high polluting potential and variable content of the landfill leachate makes it a significant source of environmental contamination. Advanced oxidation processes (AOPs) such as Fenton process, arises as leachate treatment. Application of response surface methodology (RSM) from previous literatures evaluates the synergistic effects of independent variables to optimize the Fenton process. This paper presents systematic review on articles published from 2005 to 2015 reported on optimum conditions of Fenton treatment landfill leachate treatment using RSM. Papers were selected from different database according to defined inclusion criteria and then, evaluated. The best conditions identified were: pH around 3, [H2O2]/[Fe2+] molar ratio from 2.38 to 24.00, [H2O2]/[CODraw leachate] mass ratio around 1 and reaction time from 30 min to 331.2 min. All models presented R2 > 0.75, indicating a good correlation between the experimental data and the values predicted by the models.

Interjections (Oxford Handbook of Word Classes)

No class of words has better claims to universality than interjections. At the same time, no category has more variable content than this one, traditionally the catch-all basket for linguistic items that bear a complicated relation to sentential syntax. Interjections are a mirror reflecting methodological and theoretical assumptions more than a coherent linguistic category that affords unitary treatment. This chapter focuses on linguistic items that typically function as free-standing utterances, and on some of the conceptual, methodological, and theoretical questions generated by such items. A key move is to study these items in the setting of conversational sequences, rather than from the “flatland” of sequential syntax. This makes visible how some of the most frequent interjections streamline everyday language use and scaffold complex language. Approaching interjections in terms of their sequential positions and interactional functions has the potential to reveal and explasin patterns of universality and diversity in interjections.

Cellulose-Chitosan-Nanohydroxyapatite Hybrid Composites by One-Pot Synthesis for Biomedical Applications

The development of organic–inorganic hybrid materials deserves special interest for bone tissue engineering applications, where materials must have properties that induce the survival and activation of cells derived from the mesenchyme. In this work, four bio-nanocomposites based on cellulose and variable content of chitosan, from 15 to 50 w% based on cellulose, with nanohydroxyapatite and β-Glycerophosphate as cross-linking agent were synthesized by simplified and low-energy-demanding solvent exchange method to determine the best ratio of chitosan to cellulose matrix. This study analyzes the metabolic activity and survival of human dermal fibroblast cells cultivated in four bio-nanocomposites based on cellulose and the variable content of chitosan. The biocompatibility was tested by the in vitro cytotoxicity assays Live/Dead and PrestoBlue. In addition, the composites were characterized by FTIR, XRD and SEM. The results have shown that the vibration bands of β-Glycerophosphate have prevailed over the other components bands, while new diffraction planes have emerged from the interaction between the cross-linking agent and the biopolymers. The bio-nanocomposite micrographs have shown no surface porosity as purposely designed. On the other hand, cell death and detachment were observed when the composites of 1 and 0.1 w/v% were used. However, the composite containing 10 w% chitosan, against the sum of cellulose and β-Glycerophosphate, has shown less cell death and detachment when used at 0.01 w/v%, making it suitable for more in vitro studies in bone tissue engineering, as a promising economical biomaterial.

The Occurrence of Selected Radionuclides and Rare Earth Elements in Waste at the Mine Heap from the Polish Mining Group

The paper presents the results of research on rare earth elements (REY) and selected radionuclides in barren rocks deposited on a heap at a mine belonging to the Polish Mining Group (the largest producer of hard coal in EU countries). The maximum concentration of REEs determined in silstones was 261.6 mg/kg and in sandstones 221.2 mg/kg. The average uranium and thorium content in silstones was 6.8 mg/kg and 11.6 mg/kg, respectively. On the other hand, the samples of burnt coal shales contain on average 3.5 mg/kg of uranium and 9.7 mg/kg of thorium. In all coal waste samples, the REE values are higher than in hard coal (15.7 mg/kg). Carriers of REY, uranium, and thorium in coal waste are detritic minerals: monazite and xenotime, which are part of the grain skeleton of barren rocks. Coal waste samples are characterized by a variable distribution of REY concentrations as well as a variable content of radionuclides. The 226Ra, 228Ra, and 40K measurements in the investigated samples were performed using the gamma spectrometry technique. The concentrations of the analyzed isotopes differed depending on the mineralogical composition of the investigated samples. The present study results may be important in determining the possibility of utilization of wastes of barren rocks stored in the mine heap and in assessing environmental and radiological hazards.

Iminopyridine Ni(II) Catalysts Affording Oily Hyperbranched Ethylene Oligomers and/or Crystalline Polyethylenes Depending on the Reaction Conditions: Possible Role of In Situ Catalyst Structure Modifications

Nickel-based ethylene polymerization catalysts have unique features, being able to produce macromolecules with a variable content of branches, resulting in polymers ranging from semicrystalline plastics to elastomers to hyperbranched amorphous waxes and oils. In addition to Brookhart’s α-diimine catalysts, iminopyridine Ni(II) complexes are among the most investigated systems. We report that Ni(II) complexes bearing aryliminopyridine ligands with bulky substituents both at the imino moiety and in the 6-position of pyridine afford either hyperbranched low molecular weight polyethylene oils or prevailingly linear crystalline polyethylenes or both, depending on the ligand structure and the reaction conditions. The formation of multiple active species in situ is suggested by analysis of the post-polymerization catalyst residues, showing the partial reduction of the imino function. Some related arylaminopyridine Ni(II) complexes were also synthesized and tested, showing a peculiar behavior, i.e., the number of branches of the produced polyethylenes increases while ethylene pressure increases.

The Effect of Performance and Corporate Governance to Risk Disclosure among Listed Companies in Malaysia

The objective of this study was to determine the presence of risk information within the annual report of Malaysian non-financial listed companies and empirically extend the current literature of corporate governance and risk disclosure by incorporating an interaction effect in the model. The study found that listed companies in Malaysia experienced a positive upward trend in terms of risk disclosure practice for 10 years (2008-2017). A total of 166 companies were randomly extracted from Main Board of Bursa Malaysia from 2008 to 2017. This study used content analysis, descriptive statistics and multiple regression to explain the relationship between corporate governance and risk disclosure with the effect of the interaction variable. The study also found positive and significant relationship between board independence, board size and board gender with risk disclosure practice. It is also revealed that attainment discrepancies positively influence the relationship between corporate governance and risk disclosure practices among listed companies in Malaysia. Keywords: risk disclosure, annual report, corporate governance, interaction variable, content analysis

Iminopyridine Ni(II) Catalysts Affording Oily Hyperbranched Oligoethylenes and/or Crystalline Polyethylenes Depending on the Reaction Conditions: Possible Role of In Situ Catalyst Structure Modifications

Nickel-based ethylene polymerization catalysts have unique features, being able to produce macromolecules with a variable content of branches, resulting in polymers ranging from semicrystalline plastics to elastomers to hyperbranched amorphous waxes and oils. In addition to Brookhart's α-diimine catalysts, iminopyridine Ni(II) complexes are among the most investigated systems. We report that Ni(II) complexes bearing aryliminopyridine ligands with bulky substituents both at the imino moiety and in the 6-position of pyridine afford either hyperbranched low molecular weight polyethylene oils or prevailingly linear crystalline polyethylenes or both depending on the ligand structure and the reaction conditions. The formation of multiple active species in situ is suggested by analysis of the post-polymerization catalyst residues, showing the partial reduction of the imino function. Some related arylaminopyridine Ni(II) complexes were also synthesized and tested, showing a peculiar behavior, i.e. the number of branches of the produced polyethylenes increases while ethylene pressure increases.