Clinical Neuroscience in Practice: An Experiential Learning Course for Undergraduates Offered by Neurosurgeons and Neuroscientists.

Many pre-health students pursue extracurricular shadowing opportunities to gain clinical experience. The Virginia Tech School of Neuroscience introduced a formal course that provides a clinical experience superior to that received by many medical students. This course is composed of weekly 75-minute seminars that cover diseases affecting the nervous system, their diagnosis and treatment, complemented by weekly half-day intensive clinical experiences with unprecedented access to a team of neurosurgeons (in hospital operating rooms, Intensive Care Units, emergency room, angiographic suites, and wards). In the operating rooms, students routinely "scrub-in" for complex surgeries. On hospital rounds, students experience direct patient care and receive in-depth exposure to modern nervous system imaging. Students participate in two 24-hour "on-call" experiences with team providers. After call, students participate in cognitive and psychological studies to assess physiological and psychological effects of call-related sleep deprivation. Students prepare weekly essays on challenging socioeconomic and ethical questions, exploring subjects such as the cost of medicine and inequalities in access to health care. Towards the end of the course, students meet with the admission dean of the Virginia Tech Carilion medical school; they prepare a personal statement for medical school/graduate school applications, and attend a half-day block of mock medical school/graduate school interviews delivered by experienced clinicians. In lieu of a final exam, each student presents to the entire neurosurgery department, an in-depth clinical analysis of a case in which they participated. We provide details on implementation, challenges and outcomes based on experiences from three semesters with a total enrollment of approximately 60 students.

Cumulus removal and addition of follicular fluid possibly improves pregnancy rates with in vitro fertilization for male factor.

This study evaluated the use of in vitro fertilization (IVF) for patients with subnormal semen parameters without the use of micromanipulation. All patients were characterized as having male factor as follows: normal morphology (NM) < or = 10% according to strict criteria [15] and motile density (MD) < or = 10 x 10(6)/mL. Strict morphology was divided into three groups: group I (n = 72), < or = 2% group II (n = 24), 3-5%; and group III (n = 29), 6-10%. Modification of standard IVF techniques included manual cumulus removal (CR) from oocytes, pooling up to ten oocytes together in 1 mL of media, and supplementing media with 20% human follicular fluid (FF). Rates of fertilization and pregnancy were compared. The overall fertilization rate (FR) was 57.7% and the pregnancy rate (PR) per retrieval cycle was 14.8%. There was no significant improvement in the fertilization or PRs when IVF was modified using CR and FF, although the FR was higher in group I for patients who received the modified procedures. In patients with < or = 5 x 10(6) sperm/mL, there were no pregnancies in five cycles and four transfers following the conventional method, but two sets of twins with the modified protocols in seven cycles. Clinical pregnancies were achieved with male factor without the need for micromanipulation. The most severe cases were automatically assigned to modified IVF techniques, e.g., CR with or without FF. Prospective randomized studies are needed to determine if modified procedures are superior to conventional therapy.

Perceptual asymmetries in the somatosensory system: a dichhaptic experiment and critical review of the literature from 1929 to 1986.

Dichhaptic matching of 3-D nonsense shapes was used to assess sex-specific differences in haptics. In an initial object exploration/description phase, strategy was manipulated with instructions to encode each object using either a visual image (which was drawn) or verbal description (tape recorded). These drawings or tape recordings were subsequently used on their own to identify each object. Attempts were made to maintain similarity between the verbal and spatial procedures, to avoid methodological biasing of hand superiorities (e.g., the same number of alternatives and the same presentation times were used). Differences in hand superiority did not, however, result. To obtain a broader perspective, a critical review table was compiled of the entire somatosensory asymmetry literature. Clear patterns emerged for all types of task when results potentially stemming from methodological biases and those based on only certain levels of samples were excluded. Somatosensory perceptual asymmetries are not robust, although hand superiorities are in the predicted direction when they do occur; nevertheless, we find little support for sex-specific asymmetries in these studies. Dichhaptic presentations lack the efficacy of other somatosensory (as well as tachistoscopic) tasks overall, possibly because of the time scale necessary for free haptic exploration.