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Physician faculty learn teaching skills informally while fighting competing professional obligations. One underutilized proven technique to improve teaching skills is peer observation with feedback. We aimed to understand benefits and challenges of a physician faculty development program based on peer observation of teaching and to develop best practice recommendations for future program development. The authors developed a peer observation-based physician faculty development program from 2015 to 2017. Two interviewers conducted and analyzed qualitative interviews with 13 faculty participants and four non-participants using content analysis to identify themes and subthemes in NVivo©. Participant-identified program benefits included conveyed institutional support for teaching, the opportunity for peer observation with direct and timely feedback, the opportunity for community building, and overall program feasibility. Program challenges included competing scheduling demands, variability in feedback quality, and difficulty maintaining engagement for the program duration. Potential areas for improvement included participation incentives, external faculty involvement, assistance with program logistics and administration, and improvement in the consistency of the feedback experience. While peer observation is a valued approach to physician faculty development of teaching skills, competing demands on physicians may still limit program effectiveness. Program sustainability depends on optimizing feedback quality, boosting motivation for participation, and providing administrative support.

Carrie R Howell,1 Caroline N Harada,2 Kevin R Fontaine,3 Michael J Mugavero,4 Andrea L Cherrington1 1Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA; 3Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Al, USA; 4Department of Medicine, Division of General Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Carrie R Howell, Department of Medicine, Division of Preventive Medicine, Medical Towers Suite 638, 1717 11th Avenue South, Birmingham, AL, 35294, USA, Email chowell@uabmc.eduAbstract: The evidence of suboptimal social determinants of health (SDoH) on poor health outcomes has resulted in widespread calls for research to identify ways to measure and address social needs to improve health outcomes and reduce disparities. While assessing SDoH has become increasingly important in diabetes care and prevention research, little guidance has been offered on how to address suboptimal determinants in diabetes-related clinical care, prevention efforts, medical education and research. Not surprisingly, many patients experience multiple social needs – some that are more urgent (housing) than others (transportation/resources), therefore the order in which these needs are addressed needs to be considered in the context of diabetes care/outcomes. Here we discuss how conceptualizing diabetes related health through the lens of Maslow’s hierarchy of needs has potential to help prioritize individual social needs that should be addressed to improve outcomes in the context of population-level determinants in the communities where people live.Keywords: social determinants of health, diabetes, clinical care, clinical education

The purpose of this article is to describe the development of a single-session Interprofessional Team (IPT) Training that incorporates the practice of interprofessional teamwork using a health care case study. We will share how a large-scale training that requires interprofessional teams of students to create a treatment plan of care for a standardized patient developed over time and how this experiential learning activity affects learning outcomes for social work students related to interprofessional awareness and teamwork skills. Additionally, we will explore the use of video technology as a pedagogical approach to presenting standardized patients to students. Student responses from three IPT Training sessions provided the data discussed in this article. While overall results are mixed about students’ learning outcomes, trends in the data show this single-session, interprofessional training involving a standardized patient as a promising practice. Lessons learned for social work education are also discussed. The present study advances the field of interprofessional simulation by contributing to our understanding of how a team-based training combined with a standardized patient can be used to increase social work students’ professional awareness about interprofessional teamwork.

[Context] Methanol masers of Class I (collisionally pumped) and Class II (radiatively pumped) have been studied in great detail in our Galaxy in a variety of astrophysical environments such as shocks and star-forming regions and are they are helpful to analyze the properties of the dense interstellar medium. However, the study of methanol masers in external galaxies is still in its infancy., [Aims] Our main goal is to search for methanol masers in the central molecular zone (CMZ; inner 500 pc) of the nearby starburst galaxy NGC 253., [Methods] Covering a frequency range between 84 and 373 GHz (λ = 3.6–0.8 mm) at high angular (1.″6 ∼ 27 pc) and spectral (∼8–9 km s−1) resolution with ALCHEMI (ALMA Comprehensive High-resolution Extragalactic Molecular Inventory), we have probed different regions across the CMZ of NGC 253. In order to look for methanol maser candidates, we employed the rotation diagram method and a set of radiative transfer models., [Results] We detect for the first time masers above 84 GHz in NGC 253, covering an ample portion of the J−1 → (J − 1)0 − E line series (at 84, 132, 229, and 278 GHz) and the J0 → (J − 1)1 − A series (at 95, 146, and 198 GHz). This confirms the presence of the Class I maser line at 84 GHz, which was already reported, but now being detected in more than one location. For the J−1 → (J− 1)0 − E line series, we observe a lack of Class I maser candidates in the central star-forming disk., [Conclusions] The physical conditions for maser excitation in the J−1 → (J − 1)0 − E line series can be weak shocks and cloud-cloud collisions as suggested by shock tracers (SiO and HNCO) in bi-symmetric shock regions located in the outskirts of the CMZ. On the other hand, the presence of photodissociation regions due to a high star-formation rate would be needed to explain the lack of Class I masers in the very central regions., PH is a member of and received financial support for this research from the International Max Planck Research School (IMPRS) for Astronomy and Astrophysics at the Universities of Bonn and Cologne. PH is grateful to Arnaud Belloche, Dario Colombo, Yu Gao, and Sudeep Neupane, for their constructive advice and fruitful discussions along a variety of aspects covered in this work. VMR is funded by the Comunidad de Madrid through the Atracción de Talento Investigador (Doctores con experiencia) Grant (COOL: Cosmic Origins Of Life; 2019–T1/TIC–15379), and from the Agencia Estatal de Investigación (AEI) through the Ramón y Cajal programme (grant RYC2020-029387-I). L.C. has received partial support from the Spanish State Research Agency (AEI; project number PID2019-105552RB-C41). KS thanks MOST grant 109-2112-M-001-020. NH acknowledges support from JSPS KAKENHI Grant Number JP21K03634. This work makes use of the following ALMA data: ADS/JAO.ALMA#2017.1.00161.L and ADS/JAO.ALMA#2018.1.00162.S. ALMA is a partnership of ESO (representing its member states), NSF (USA) and NINS (Japan), together with NRC (Canada), MOST and ASIAA (Taiwan), and KASI (Republic of Korea), in cooperation with the Republic of Chile. The Joint ALMA Observatory is operated by ESO, AUI/NRAO and NAOJ.

Phosphorus (P) is a crucial element for life given its central role in several biomolecules. P-bearing molecules have been discovered in different regions of the Milky Way, but not yet towards an extragalactic environment. We have searched for P-bearing molecules towards the nearby starburst Galaxy NGC 253. Using observations from the ALMA Comprehensive High-resolution Extragalactic Molecular Inventory (ALCHEMI) project, we used the MADCUBA package to model the emission of P-bearing molecules assuming Local Thermodynamic Equilibrium (LTE) conditions. We have also performed a non-LTE analysis using SpectralRadex. We report the detection of a P-bearing molecule, phosphorus nitride (PN), for the first time in an extragalactic environment, towards two giant molecular clouds (GMCs) of NGC 253. The LTE analysis yields total PN beam-averaged column densities $N$=(1.20$\pm$0.09)$\times$10$^{13}$ cm$^{-2}$ and $N$=(6.5$\pm$1.6)$\times$10$^{12}$ cm$^{-2}$, which translate into abundances with respect to H$_2$ of $\chi$=(8.0$\pm$1.0)$\times$10$^{-12}$ and $\chi$=(4.4$\pm$1.2)$\times$10$^{-12}$. We derived a low excitation temperature of $T_{\rm ex}$=(4.4$\pm$1.3) K towards the GMC with the brightest PN emission, which indicates that PN is sub-thermally excited. The non-LTE analysis results in column densities consistent with the LTE values. We have also searched for other P-bearing molecules (PO, PH$_{3}$, CP and CCP), and upper limits were derived. The derived PO/PN ratios are $, Comment: 14 pages, 14 figures, 4 tables. Accepted for publication in A&A

Background: Long-term hemodialysis (HD) treatment requires the establishment of a cannulatable vascular access (VA) point. While the arteriovenous fistula (AVF) is considered the gold standard, the arteriovenous graft (AVG) is a viable alternative especially in patients with poor superficial venous anatomy. Few studies have assessed the efficacy of the brachial-brachial arteriovenous graft (BB-AVG) for long-term HD access. By analyzing one surgeon’s experience in creating, surveilling and maintaining BB-AVGs, this retrospective study aims to add to the body of literature in assessing patency outcomes of BB-AVGs. Methods: We identified 57 BB-AVGs that met inclusion criteria and were created between October 6, 2005 and May 1, 2019 by a single surgeon in 54 patients. We analyzed primary failures, patency, complications and interventions. Patency rates were calculated by the Kaplan–Meier method. The incidence of complications and interventions were expressed as number of events per person-year. Results: A total of 54 patients (median age of 65 years) were analyzed. Primary patency rates at 12, 24, and 36 months were 20.4% 7.4%, and 5.0%. Primary assisted patency rates at 12, 24, and 36 months were 46.7%, 33.5%, and 15.1%. The secondary patency rates at 12, 24, and 36 months were 81.8%, 63.8%, and 60.1%, respectively. The incidence of complications and interventions was 2.164 per person-year. Most complications and interventions were due to stenosis (1.202 per person-year) or thrombosis (0.802 per person-year). Conclusion: In patients with poor superficial veins, the brachial vein is a reasonable alternative to use as the venous outflow. However, in order to achieve acceptable patency rates, close monitoring of the VA, as well as aggressive treatment of complications within the brachial vein is necessary. Overall, the BB-AVG should be considered in patients who lack adequate superficial veins and require preservation of the more proximal veins.

Martín, S., et al., [Context] The interstellar medium is the locus of physical processes affecting the evolution of galaxies which drive or are the result of star formation activity, supermassive black hole growth, and feedback. The resulting physical conditions determine the observable chemical abundances that can be explored through molecular emission observations at millimeter and submillimeter wavelengths. [Aims] Our goal is to unveiling the molecular richness of the central region of the prototypical nearby starburst galaxy NGC 253 at an unprecedented combination of sensitivity, spatial resolution, and frequency coverage. [Methods] We used the Atacama Large Millimeter/submillimeter Array (ALMA), covering a nearly contiguous 289 GHz frequency range between 84.2 and 373.2 GHz, to image the continuum and spectral line emission at 1.6″(∼28 pc) resolution down to a sensitivity of 30 - 50 mK. This article describes the ALMA Comprehensive High-resolution Extragalactic Molecular Inventory (ALCHEMI) large program. We focus on the analysis of the spectra extracted from the 15″ (∼255 pc) resolution ALMA Compact Array data. [Results] We modeled the molecular emission assuming local thermodynamic equilibrium with 78 species being detected. Additionally, multiple hydrogen and helium recombination lines are identified. Spectral lines contribute 5 to 36% of the total emission in frequency bins of 50 GHz. We report the first extragalactic detections of C2H5OH, HOCN, HC3HO, and several rare isotopologues. Isotopic ratios of carbon, oxygen, sulfur, nitrogen, and silicon were measured with multiple species. [Concluison] Infrared pumped vibrationaly excited HCN, HNC, and HC3N emission, originating in massive star formation locations, is clearly detected at low resolution, while we do not detect it for HCO+. We suggest high temperature conditions in these regions driving a seemingly "carbon-rich"chemistry which may also explain the observed high abundance of organic species close to those in Galactic hot cores. The Lvib/LIR ratio was used as a proxy to estimate a 3% contribution from the proto super star cluster to the global infrared emission. Measured isotopic ratios with high dipole moment species agree with those within the central kiloparsec of the Galaxy, while those derived from 13C/18O are a factor of five larger, confirming the existence of multiple interstellar medium components within NGC 253 with different degrees of nucleosynthesis enrichment. The ALCHEMI data set provides a unique template for studies of star-forming galaxies in the early Universe.

Background: Future physicians should feel comfortable educating patients on disease-specific diets, and culinary medicine is an innovative approach to preparing medical students for this task. We present an engaged-learning program where medical students give community cooking demonstrations to gain experience counseling adults on nutrition and simultaneously develop understanding of the social determinants of health. Student volunteers undergo training in culinary skills, nutrition, motivational interviewing, and social determinants of health. They then lead cooking demonstrations at a local farmers’ market and later participate in a group debriefing session with faculty. Methods: Postexperience surveys were obtained. The primary outcome evaluated was feasibility of this educational intervention. Secondary outcomes were (1) student perception of the value of the program and (2) student self-rated learning of nutrition science, nutrition education, and social determinants of health. Results: A total of 117 students participated in the program over 3 years and 57% answered the postexperience survey. Students filled 91% of available volunteer slots (79 first-, 26 second-, 3 third-, and 9 fourth-year students). In a postexperience survey, 94.7% responded that the experience resulted in learning about nutrition education and 82.4% reported learning about social determinants of health. In commentary, students note that medical education was enhanced by interacting with community members. Discussion: Culinary education in a community setting is a feasible medical school service-learning activity that is well received by students. It can enhance learning of nutrition counseling skills and improve student understanding of the social determinants of health.

In order to understand the evolution and feedback of Active Galactic Nuclei (AGN) and star formation it is important to use molecular lines as probes of physical conditions and chemistry. We use H$_{2}$S to investigate the impact of starburst and AGN activity on the chemistry of the molecular interstellar medium in luminous infrared galaxies. Using the APEX single dish telescope, we have observed the $1_{10}$--$1_{01}$ transition of ortho-H$_{2}$S at 168 GHz towards the centres of twelve nearby luminous infrared galaxies. We have also observed the same line towards the ultra luminous infrared galaxy (ULIRG) Mrk~231 with the NOEMA interferometer. We have detected H$_{2}$S towards NGC~253, NGC~1068, NGC~3256, NGC~4418, NGC~4826, NGC~4945, Circinus, M~83 and Mrk~231. Four galaxies show elevated H$_{2}$S emission relative to HCN. We suggest that the high line ratios are caused by elevated H$_{2}$S abundances in the dense gas. However, we do not find any clear connection between the H$_{2}$S/HCN line intensity ratio, and the presence (or speed) of molecular outflows in the sample galaxies. Therefore H$_{2}$S abundances do not seem to be globally affected by the large-scale outflows. We discuss possible mechanisms behind the suggested H$_{2}$S abundance enhancements in NGC~4418, Circinus, NGC~3256 and NGC~4826. These include radiative processes (for example X-rays or cosmic-rays) or smaller scale shocks. We suggest that $L_{\mathrm{H_{2}S}}$ serves as a tracer of the dense gas content, similar to $L_{\mathrm{HCN}}$, and that the correlation between $L_{\mathrm{H_{2}S}}$ and $M_{\rm outflow}$(H$_2$) implies a relation between the dense gas reservoir and the properties and evolution of the molecular feedback. This potential link requires further study since it holds important keys to our understanding of how the properties of molecular outflows relate to that of their host galaxies., Accepted for publication in A&A.16 pages, 6 figures

This poster was presented during the Ph.D. days at Sorbonne University doctoral school in 2019. It presents results on thin films doped with rare-earth ions for quantum technologies.

Room-temperature photoluminescence intensity from Germanium (Ge) quantum dots (QDs) is highly enhanced by the Phosphorous (P) δ -doping at Ge QDs/Si interfaces since stronger confinements of electrons at the interfaces can be realized by the doping. Suppression of surface segregation of the doped P atoms, which is essential for the δ -doping with a sharp profile, is realized by the control of growth temperatures of Ge QDs and spacer-Si layers after P doping. It is, therefore, concluded that higher efficiency light emitting devices can be realized based on Ge QDs with optimal n-type doping and growth conditions.

Background The purpose of this study was to determine the best color-flow duplex ultrasound (US) criteria for the detection of significant stenoses in arteriovenous fistulas (AVFs) by comparing US with the angiographic gold standard. Methods Included in this retrospective study were all patients who had both US scans and angiograms of their AVFs performed from December 2008 to July 2015. Comparisons were made between the preoperative US peak systolic velocity (PSV) measurements and the angiographic images looking at the percent diameter reduction in the stenosis. The PSV ratio between the area of stenosis and the normal segment on the inflow side of the stenosis (systolic velocity ratio [SVR]) was also compared with the angiograms. Sensitivity and positive predictive values (PPV) with 95% confidence intervals were calculated. Results This study included 780 cases of stenotic accesses (47 brachiobasilic, 361 brachiocephalic, and 372 radiocephalic). PSVs of ≥500 cm/s predicted a 50% or greater stenosis with a sensitivity of 89% (95% confidence interval 87–91) and PPV of 99% (99–100). At lower PSVs, sensitivity and PPV remained high; however, there were an increased number of false positive cases compared with those at 500 cm/sec or greater. The SVR was unreliable in predicting the degree of stenosis in AVF. Conclusion PSVs of ≥500 cm/sec are generally reliable in predicting stenosis of 50% or greater in AVFs.

The carbon captured by coastal oceans and ecosystems called “blue carbon” is attracting attention to reduce greenhouse gas. Recently, field surveys on air-sea CO2 exchange have been conducted in various coastal seas to reveal the blue carbon function. In this study, we investigated the vertical distribution of the dissolved inorganic carbon (DIC) system in the inner part of Osaka Bay to reveal the air-sea CO2 exchange characteristics in port and harbor area. Field surveys were conducted on a vertical seawall in Naruo-hama of Osaka Bay, Japan, during 12 months from November 2014 to October 2015 and during summer from August to September 2016. The vertical distributions of DIC and pH were measured on site, and the CO2 partial pressure in water (pCO2w) was calculated based on carbon acid equilibrium. Water temperature, salinity and DO were also measured to examine the relationships the vertical distribution of DIC system and water mass structure. Furthermore, the air-sea CO2 flux (FCO2) was estimated to examine the characteristics of the air-sea CO2 exchange. DIC ranged from 787 to 2,111 μmol kg−1, with seasonal and vertical change. DIC in the bottom layer increased during high water temperature period due to CO2 production by respiration and decomposition, and DIC accumulated along with formation density stratification. The correlation between DIC and pCO2w in surface layer was smaller than that in bottom layer because surface pCO2w fluctuated due to inflow of river water or seawater mixing. This study area acts as CO2 sinks under calm conditions (FCO2 = -3.4 mmol-C m−2 d−1), however the site acts CO2 sources (1) when density stratification was relaxed (FCO2 = 2.1 mmol-C m−2 d−1); (2) when water was mixed by disturbance such as typhoon (FCO2 = 1.3 mmol-C m−2 d−1); and (3) when it rained (FCO2 = 15.5 mmol-C m−2 d−1).

Introduction: Little is known about what factors predict student engagement in learning communities (LCs). At our institution, we recently converted from an informal, unfunded program with volunteer mentors and no participation requirement to a formal, funded program with a structured curriculum, dedicated mentors, and required attendance. We sought to identify factors that predict student engagement in this new program. Methods: Medical students from all 4 years were invited to complete a survey that included self-rating of their level of engagement with their LC. We hypothesized that student engagement would be (1) higher in the new, formal program compared with the informal program; (2) lower among older students; and (3) higher among students who value collective activities for stress management. Results: In total, 75% of students completed the survey. Students who participated in the formal LC program reported significantly higher engagement than those who experienced the informal version. Older, out-of-state, and underrepresented in medicine (URiM) students reported lower levels of engagement compared with younger, in-state, and non-URiM students, but gender and campus assignment were not associated with level of engagement. Students who valued participation in extracurricular activities, service work, and time with friends or family all had higher levels of engagement in LCs compared with those who valued more solitary activities. Discussion: The formal, structured LC program was associated with higher levels of engagement than the informal program, and engagement was maintained throughout the 4-year curriculum. Subgroups of students reported lower engagement in LCs, and future research is needed to better understand and address this variability in engagement. This study is limited by the fact that students are only surveyed once annually, at a single institution, and our measure of engagement is brief and dependent on student self-report. In addition, it is not possible to discern from this study which components of the formal LC program were most strongly associated with high engagement.

Problem: Peer mentoring has long been accepted as beneficial in a multitude of fields, but there has been limited description or study of the way these types of relationships may benefit me...

A flow, module steps and key structural elements enabling a surrounding gate transistor (SGT) based 6T-SRAM with 50nm pillar pitch and 0.0205 um2 are presented, with emphasis on process challenges and innovations. A new DTCO/TCAD methodology is used to explore the design space, demonstrate the bit cell functionality and optimize the process. In particular, it is shown that vertical SGT are extremely sensitive to gate misalignment and that buried bottom contact makes the process immune to doping variations and misalignments.

Tuberculosis (TB) is a major global health problem. Routine laboratory tests or newly developed molecular detection are limited to the quality of sputum sample. Here we selected genes specific to TB by a minimum redundancy-maximum relevancy package using publicly available microarray data and determine level of selected genes in blood collected from a Thai TB cohort of 40 active TB patients, 38 healthy controls and 18 previous TB patients using quantitative real-time PCR. FCGR1A, FCGR1B variant 1, FCGR1B variant 2, APOL1, GBP5, PSTPIP2, STAT1, KCNJ15, MAFB and KAZN had significantly higher expression level in active TB individuals as compared with healthy controls and previous TB cases (P

Mesenchymal stem cells (MSCs) are multipotent cells capable of proliferating and differentiating into several lineages. In regenerative medicine, their potential as a resource for tissue-replacement therapy is receiving much attention. However, transplanting MSCs to repair larger bone defects in animal models has so far proved disappointing. Here we report on the healing of both critical-sized (5 mm) and massive (15 mm) full-thickness femur defects in rats by implanting a uniquely fabricated PLGA scaffold seeded with MSCs pre-differentiated in vitro into cartilage-forming chondrocytes (MSC-DCs). This strategy closely mimics endochondral ossification, the process by which long bones develop in nature. It is thought that because the transplanted MSC-DCs induced natural bone formation, the defect size was not critical to the outcome. Crucially, after 8 weeks the mean biomechanical strength of femora with the massive 15 mm implant reached 75% that of a normal rat femur, while in the case of 5 mm implants there was no significant difference. Successful healing was also highly reproducible, with bone union occurring in all treated animals examined radiologically 8 or 16 weeks after surgery.

Objective:Disaster hypertension has been considerd to be one of the most contributions to the occurrence of cardiovascular events after disaster. Although there was association between sodium intake and blood pressure (BP) in usual state, data are sparse about the association between salt-intake and

Even those who do not experience dementia or mild cognitive impairment may experience subtle cognitive changes associated with aging. Normal cognitive changes can affect an older adult's everyday function and quality of life, and a better understanding of this process may help clinicians distinguish normal from disease states. This article describes the neurocognitive changes observed in normal aging, followed by a description of the structural and functional alterations seen in aging brains. Practical implications of normal cognitive aging are then discussed, followed by a discussion of what is known about factors that may mitigate age-associated cognitive decline.

Neutropenia during chemotherapy has been reported to be a predictor of better survival in patients with several types of cancer, although there are no reports on stage III colorectal cancer (CRC). The purpose of this study was to examine the association between neutropenia and prognosis in stage III CRC patients receiving adjuvant chemotherapy consisting of oral uracil and tegafur (UFT) plus leucovorin (LV). We retrospectively analysed 123 patients with stage III CRC who received UFT/LV as adjuvant chemotherapy. The end-point was disease-free survival (DFS). Survival curves of the two categories (neutropenia absent vs. present) were estimated using the Kaplan-Meier method and compared by the log-rank test. We estimated the hazard ratio (HR) for DFS according to neutropenia after adjustment for covariates by multivariate analyses using Cox's regression analysis. A total of 33 (26.8%) patients experienced neutropenia. Patients without neutropenia showed a significantly lower DFS than those with neutropenia (3-year DFS 57.3% vs. 81.2%, P = 0.0213). By multivariate analysis, neutropenia and histological type were independent prognostic factors, with HR of 0.410 (neutropenia absent vs. present, P = 0.045) and 4.793 (well to moderately differentiated vs. poorly differentiated, P = 0.004) respectively. We demonstrated that neutropenia occurring during adjuvant chemotherapy consisting of UFT/LV may be a prognostic factor of recurrence in stage III CRC patients.

Successful interprofessional teams are essential when caring for older adults with multiple complex medical conditions that require ongoing management from a variety of disciplines across healthcare settings. To successfully integrate interprofessional education into the healthcare professions curriculum, the most effective learning experiences should utilize adult learning principles, reflect real-life practice, and allow for interaction among trainees representing a variety of health professions. Interprofessional clinical experiences are essential to prepare future healthcare professionals to provide quality patient care and understand the best methods for utilizing members of the healthcare team to provide that care. To meet this need, the University of Alabama at Birmingham Geriatric Education Center has developed an Interprofessional Clinical Experience (ICE) to expose future healthcare providers to an applied training experience with older adults in the nursing home setting. This paper outlines how this program was developed, methods used for program evaluation, and how the outcome data influenced program revisions.

We employed an auto-ethnography approach to explore the affective dimension of life review sessions with community-dwelling older military veterans with minor cognitive impairment (MCI) and early dementia. Using researchers’ analytic memos, we identified facilitators’ interactional strategies that fostered the participant’s sense of personal identity, dignity and social self-worth. Interaction among participant, caregiver, and facilitators evoked a range of emotional responses, offering a window into the affective world of MCI and early dementia. Positive emotional responses outnumbered negative emotional responses by a ratio of two-to-one in the life review sessions; however, negative emotions were more revelatory of current struggles with declines in health and function. Facilitators utilized two interactional strategies, in particular, to foster personhood and social value of participants: focusing on the participant and creating an empathic connection with the participant. Further work is needed to understand the role of emotions in research interactions and to examine the psychosocial mechanisms through which positive affect functions in promoting identity, personhood and social value among persons with MCI and early dementia.

Dizziness affects one in five people over the age of 65 years and is associated with substantial healthcare costs. Serious causes of dizziness are found in 20% of patients over 50 years. The approach to the patient with dizziness is challenging as physical exam and diagnostic tests have suboptimal sensitivities. The risk of vascular events is higher in the first 30 days than after, suggesting some missed diagnoses. Medications and vestibular rehabilitation may serve as treatment options for dizziness, but data on their efficacy in older patients is lacking.

Magnetohydrodynamic (MHD) accelerator is proposed as a next generation propulsion system. It can be used to increase the performance of a propulsion system. The objective of this study is to investigate the performance of MHD accelerator using non-equilibrium air plasma as working gas. In this study, the fundamental performance of MHD accelerator such as flow performance and electrical performance is evaluated at different levels of applied magnetic field using 1-D numerical simulation. The numerical simulation is developed based on a set of differential equations with MHD approximation. To solve this set of differential equations the MacCormack scheme is used. A specified channel designed and developed at NASA Marshall Space Flight Centre is used in the numerical simulation. The composition of the simulated air plasma consists of seven species, namely, N2, N, O2, O, NO, NO+, and e−. The performance of the non-equilibrium MHD accelerator is also compared with the equilibrium MHD accelerator.

Large bone defects caused by fracture, non-union and bone tumor excision has been a major clinical problem. Autogenous bone grafting and Ilizarov method are commonly performed to treat them. However, bone grafting has limitation in volume of available bone, and Ilizarov method requires long periods of time to treat. Accordingly, there is need for stem cell therapy for bone repair and/or regeneration. Mesenchymal stem cells (MSCs) hold the ability to differentiate into osteoblasts and are available from a wide variety of sources. The route of "intramembranous ossification (direct bone formation)" by transplantation of undifferentiated MSCs has been tested but it did not demonstrate the success initially envisaged. Recently another approach has been examined being the transplantation of "MSCs pre-differentiated in vitro into cartilage-forming chondrocytes" into bone defect, in brief, representing the route of "endochondral ossification (indirect bone formation)". It's a paradigm shift of Stem Cell Therapy for bone regeneration. We have already reported on the healing of large femur defects in rats by transplantation of "MSCs pre-differentiated in vitro into cartilage-forming chondrocytes". We named the cells as Mesenchymal Stem Cell-Derived Chondrocytes (MSC-DCs). The success of reconstruction of a massive 15-mm femur defect (approximately 50% of the rat femur shaft length) provides a sound foundation for potential clinical application of this technique. We believe our results may offer a new avenue of reconstruction of large bone defect, especially in view of the their high reproducibility and the excellent biomechanical strength of repaired femora.

In mouse atrium, M₂ and M₃ muscarinic receptors (M₂R and M₃R) are involved in biphasic (negative and positive) inotropic actions of muscarinic agonists, and the positive inotropic action is reduced by indomethacin. The aim of our study was to determine the localization of M₂R, M₃R and cyclo-oxygenase (COX) in mouse atrium and to characterize muscarinic receptor-mediated positive inotropy. M₂R immunoreactivity was found only on atrial myocardium, but M₃R immunoreactivity was localized on both the myocardium and endocardial endothelium. COX-1 and COX-2 immunoreactivities were identified in both myocardial and endocardial endothelium. In electrically stimulated left atria, carbachol caused M₂R-mediated negative inotropy followed by M₃R-mediated positive inotropy. Removal of atrial endothelium reduced the positive inotropy without affecting the negative inotropy, suggesting that stimulation of endothelial M₃R mediates the positive inotropy. N-[2-(cyclohexyloxy)-4-nitrophenyl]-methanesulfonamide (NS398, COX-2 inhibitor) decreased the carbachol-induced positive inotropy; however, 5-(4-chlorophenyl)-1-(4-methoxyphenyl)-3-trifluoromethylpyrazole (SC560, COX-1 inhibitor), 1-[[4,5-bis(4-methoxyphenyl)-2-thiazolyl]carbonyl]-4-methylpiperazine (FR122047, COX-1 inhibitor) and L-nitroarginine methylester did not affect the inotropic response. M₃R activation caused positive chronotropy in spontaneously beating right atria when M₂R-mediated negative chronotropy was suppressed and rate of contraction was low

Ferulic acid (4-hydroxy-3-methoxycinnamic acid; FA) is a plant constituent and is contained in several medicinal plants for clinical use. In this paper, we investigated the effects of FA on the proliferation of neural stem/progenitor cells (NSC/NPCs) in vitro and in vivo. FA significantly increased the proliferation of NSC/NPCs cultured from the telencephalon of embryonic day-14 rats, and increased the number and size of secondary formed neurospheres. An in vitro differentiation assay showed that FA did not affect the percentage of either neuron-specific class III beta-tubulin (Tuj-1)-positive cells or glial fibrillary acidic protein (GFAP)-positive cells in the total cell population. Oral administration of FA increased the number of newly generated cells in the dentate gyrus (DG) of the hippocampus of corticosterone (CORT)-treated mice, indicating that FA enhances the proliferation of adult NSC/NPCs in vivo. We also found that oral administration of FA increased cAMP response element binding protein (CREB) phosphorylation and brain-derived neurotrophic factor (BDNF) mRNA level in the hippocampus of CORT-treated mice, and ameliorated the stress-induced depression-like behavior of mice. These novel pharmacological effects of FA may be useful for the treatment of mood disorders such as depression.