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Introduction: Early Clinical Exposure (ECE) has been shown to be an effective method in teaching history-taking, physical examination and communication to pre-clinical students. Medical students in their preclinical years at IOM, MMC have been undergoing two year ECE course since 1978, but there is no provision of formative and summative assessment to check its effectiveness. This cross-sectional study was undertaken to fill this gap in evidence. Methods: A 17-station Objective Structured Clinical Examination was administered to 17 pre-clinical students. Of the 17 stations, seven, six and four stations were designed to test their skills in history-taking, clinical-examination and communication domains respectively. Modified borderline regression method was used to calculate the pass-marks for each station. The pass-marks of all the stations were averaged to determine the pass-marks for the entire OSCE. Results: One student passed the entire OSCE whereas four and eight students passed the history taking and communication skills domains; while none could pass the physical examination skills domain. Repeated measure one-way Analysis Of Variance (ANOVA) and post-hoc test using the Bonferroni correction showed that scores in history taking (M = 44.36, SD = 11.09) and communication skills (M = 44.40, SD = 12.12) were significantly better than in physical examination (M = 29.35, SD = 10.50), (p < 0.001 and p = 0.007, respectively). Conclusions: Despite enormous teaching hours allocated to the ECE course, pre-clinical students' performance in an OSCE did not meet the expectation of the curriculum suggesting that the ECE course at MMC, IOM is not fulfilling its objectives. [ABSTRACT FROM AUTHOR]

A regional climate modelling system, the Providing REgional Climates for Impacts Studies developed by the Hadley Centre for Climate Prediction and Research, has been used to study future climate change scenarios over Indus basin for the impact assessment. In this paper we have examined the three Quantifying Uncertainty in Model Predictions simulations selected from 17-member perturbed physics ensemble generated using Hadley Centre Coupled Module. The climate projections based on IPCC SRES A1B scenario are analysed over three time slices, near future (2011-2040), middle of the twenty first century (2041-2070), and distant future (2071-2098). The baseline simulation (1961-1990) was evaluated with observed data for seasonal and spatial patterns and biases. The model was able to resolve features on finer spatial scales and depict seasonal variations reasonably well, although there were quantitative biases. The model simulations suggest a non-uniform change in precipitation overall, with an increase in precipitation over the upper Indus basin and decrease over the lower Indus basin, and little change in the border area between the upper and lower Indus basins. A decrease in winter precipitation is projected, particularly over the southern part of the basin. Projections indicate greater warming in the upper than the lower Indus, and greater warming in winter than in the other seasons. The simulations suggest an overall increase in the number of rainy days over the basin, but a decrease in the number of rainy days accompanied by an increase in rainfall intensity in the border area between the upper and lower basins, where the rainfall amount is highest. [ABSTRACT FROM AUTHOR]

Introduction: Endometrial cancer (EC) is the most common malignancy of the female genital tract. It is now the fourth most common gynecological cancer among women and the sixth worldwide cancer in Western countries. It is the most curable of the 10 most common cancers in women and the most frequent and curable of the gynecologic cancers. The incidence is increasing when life expectancy rise. This study was carried out to evaluate the prognostic factors of Endometrial Cancer. Methods: Clinico-pathological characteristics and follow-up cases of endometrial cancer were analysed retrospectively between January 2000 to December 2007 with its prognostic factors influence were statistically analysed. During the study period total 180 patients were taken. Univariate model revealed that the menopausal status, the FIGO stage, grade, histological type, myometrial invasion, ER, PR, peritoneal cytology, lymph node metastases, adjuvant therapy, and the method of operation were related with the prognosis significantly. The multivarite analysis Cox proprotion hazards regression model showed that the ER (P=0.004), PR (P=0.000), myometrial invasion (P=0.006) and lymph node metastases (P=0.049) were related with the prognosis significantly. Conclusion: The clinico- pathological character of endometrial cancer is responsible for patient's better survival. If the patients had early detection and treated in proper modalities, this might improve the good prognosis. [ABSTRACT FROM AUTHOR]

Aims: To compare the reliability of tap test and shake test for determination of fetal lung maturity in pregnant women between 28 weeks and 36 completed week's gestation either with preterm prelabour rupture of membrane or preterm labour. Methods: Amniotic fluid samples from vaginal pool were obtained from one hundred pregnant women who met the inclusion criteria. Both tap test and shake test were performed in each sample. All deliveries occurred within 72 hours of collection of amniotic fluid. The results of the tests were compared with the incidence of neonatal respiratory distress syndrome. Results: Out of 100 tests performed, tap test predicted 17% as immature and 83% as mature and shake test predicted 51% as immature and 49% as mature. Among 100 newborns, 9 (9%) were found to be true immature as they developed respiratory distress syndrome. The sensitivity, specificity, predictive value for fetal lung immaturity and maturity by tap test was 88.9%, 90.1%, 47.1% and 98.8% respectively and the sensitivity, specificity, predictive value for fetal lung immaturity and maturity by shake test was 100%, 53.8%,17.6% and 100% respectively. Conclusions: In view of very low specificity and predictive value for fetal lung immaturity by shake test compared to that by tap test and lower sensitivity of the tap test than the shake test, neither of the tests is reliable than the other and these two tests can not replace each other. [ABSTRACT FROM AUTHOR]

An abstract of the article "Integrated Product Separation in Bioelectrochemical CO2 Reduction for Improved Process Efficiency," by S. Bajracharya and colleagues is presented.

An abstract of the article "Product Specificity Influenced by Catholyte Conditions during the Microbial Electrosynthesis Process CO2 to Acetate," by S. Bajracharya and colleagues is presented.

Background: Low back pain (LBP) is by far the most prevalent and costly musculoskeletal problem in our society today. Following the recommendations of the Multinational Musculoskeletal Inception Cohort Study (MMICS) Statement, our study aims to define outcome assessment tools for patients with acute LBP and the time point at which chronic LBP becomes manifest and to identify patient characteristics which increase the risk of chronicity.Methods: Patients with acute LBP will be recruited from clinics of general practitioners (GPs) in New Zealand (NZ) and Switzerland (CH). They will be assessed by postal survey at baseline and at 3, 6, 12 weeks and 6 months follow-up. Primary outcome will be disability as measured by the Oswestry Disability Index (ODI); key secondary endpoints will be general health as measured by the acute SF-12 and pain as measured on the Visual Analogue Scale (VAS). A subgroup analysis of different assessment instruments and baseline characteristics will be performed using multiple linear regression models. This study aims to examine: 1. Which biomedical, psychological, social, and occupational outcome assessment tools are identifiers for the transition from acute to chronic LBP and at which time point this transition becomes manifest. 2. Which psychosocial and occupational baseline characteristics like work status and period of work absenteeism influence the course from acute to chronic LBP. 3. Differences in outcome assessment tools and baseline characteristics of patients in NZ compared with CH.Discussion: This study will develop a screening tool for patients with acute LBP to be used in GP clinics to access the risk of developing chronic LBP. In addition, biomedical, psychological, social, and occupational patient characteristics which influence the course from acute to chronic LBP will be identified. Furthermore, an appropriate time point for follow-ups will be given to detect this transition. The generalizability of our findings will be enhanced by the international perspective of this study.Trial Registration: [Clinical Trial Registration Number, ACTRN12608000520336]. [ABSTRACT FROM AUTHOR]