Student Perspectives on the Undergraduate Medical Student Research Experience at a Single United States Allopathic Institution.

Introduction The purpose of this study was to identify student-reported institutional facilitators and barriers to successful research experiences at a single United States allopathic institution. Residency applications have increasingly become more competitive, and with the United States Medical Licensing Examination (USMLE) Step 1 exam's transition to pass/fail, factors such as research experience and outcomes may become more important to increase residency application competitiveness. This study sought to explore factors that impact successful research experiences leading to tangible outcomes for medical students at our medical school, the Joe R. & Teresa Lozano Long School of Medicine. Methods  A cross-sectional survey was developed and administered via REDCap to 853 students in May 2022. Survey question domains included demographics, past and present research participation, perceived barriers/facilitators to research, tangible outcomes (e.g., publications and posters), and overall satisfaction with research comparing subjectively "best" and "worst" experiences. The Institutional Review Board (IRB) deemed this project as non-regulated research.  Results We had a 24% (n = 204/853) response rate. The responses were distributed equally among the four classes. A big portion of the participants (71%, n = 59/83) identified a tangible outcome as the most important measure of success. Regarding facilitators, students identified having a mentor (89%, n = 165/184) and departmental connections (85%, n = 156/184) as the most important when looking for a project. Barriers included SMART goals (Specific, Measurable, Achievable, Relevant, and Time-Bound) lacking in 31% (n = 24/75) of worst projects, followed by a clear timeline in 29% (n = 22/76) and hours of commitment in 27% (n = 21/78). The best projects were more likely to have resulted in a publication (61% (27/44) vs. 32% (14/44)) or have a poster (64% (28/44) vs. 36% (16/44)). Conclusions Medical students are interested in participating in research, with important facilitators including mentorship and departmental connections. Modifiable variables include lack of clear timelines, well-defined roles and responsibilities, and time commitments. This information may be useful for faculty who mentor medical students or medical schools interested in designing medical student research programs.

Retrospective analysis of the effects of hypocalcemia in severely injured trauma patients.

BACKGROUND: It has been suggested that the Lethal Triad be modified to include hypocalcemia, coined as the Lethal Diamond. Hypocalcemia in trauma has been attributed to multiple mechanisms, but new evidence suggests that traumatic injury may result in the development of hypoCa independent of blood transfusion. We hypothesize that hypocalcemia is associated with increased blood product requirements and mortality. METHODS: A retrospective study of 1,981 severely injured adult trauma patients from 2016 to 2019. Ionized calcium (iCa) levels were obtained on arrival and subjects were categorized by a threshold iCa level of 1.00 mmol/L and compared. Univariable and multivariable logistic regression analysis was performed. RESULTS: The hypocalcemia (iCa <1.00 mmol/L) group had increased rate of overall (p = 0.001), 4-hr (p = 0.007), and 24-hr (p = 0.003) mortality. There was no difference in prehospital transfusion volume between groups (p = 0.25). Hypocalcemia was associated with increased blood product requirements at 4 h (p <0.001), 24 h (p <0.001), and overall hospital length of stay (p <0.001). Logistic regression analysis showed increased odds of 4-hour mortality (OR 0.077 [95 % CI 0.011, 0.523], p = 0.009) and 24-hour mortality (OR 0.121 [95 % CI 0.019, 0.758], p = 0.024) for every mmol/L increase in iCa. CONCLUSIONS: This study shows the association of hypoCa and traumatic injury. Severe hypoCa was associated with increased odds of early and overall mortality and increased blood product requirements. These results support the need for future prospective trials assessing the role of hypocalcemia in trauma.

A comparison of the effect of a variety of thermal and vibratory modalities on skin temperature and blood flow in healthy volunteers.

BACKGROUND: Circulation plays an essential role in tissue healing. Moist heat and warm water immersion have been shown to increase skin circulation; however, these heating modalities can cause burns. Recent research has shown that passive vibration can also increase circulation but without the risk of burns. MATERIAL/METHODS: The aim of this study is to compare the effects of short-duration vibration, moist heat, and a combination of the two on skin blood flow (SBF) and skin temperature (ST). Ten (10) subjects, 5 female and 5 male, aged 20-30 years of age, received two interventions a day for 3 consecutive days: Intervention 1--Active vibration only (vibration exercise), Intervention 2--passive vibration only, Intervention 3--moist heat only, Intervention 4--passive vibration combined with moist heat, Intervention 5--a commercial massaging heating pad, and Intervention 6--no intervention, resting in supine only (control). SBF and ST were measured using a laser Doppler imager during the 10 minute intervention and then throughout the nine minute recovery period. RESULTS: The mean skin blood flow following a ten-minute intervention of the combination of passive vibration and moist heat was significantly different from the control, active vibration, and the commercial massaging heating pad. Skin temperature following the ten-minute interventions of moist heat alone and passive vibration alone were both significantly different from the commercial massaging heating pad and active vibration interventions. CONCLUSIONS: The combination of passive vibration and moist heat produced the greatest increase in skin blood flow and the second highest increase in skin blood flow nine minutes post application.

Physical, chemical, and mineralogical characteristics of a reservoir sediment delta (Lake Powell, U.S.A.) and implications for water quality during low water level.

Lake Powell is a large reservoir in Utah and Arizona that has experienced large changes in water level during a recent drought. As a first step in assessing the connection between hydrologic and chemical changes at Lake Powell, we characterized the particle size and solid-phase bulk concentrations for 31 elements and 25 minerals in sediment from the inflow region and some shoreline locations by using laser diffractometry, X-ray fluorescence, elemental analysis, and X-ray diffraction Our results are consistent with previous results that show a negative correlation between particle size and concentrations of most elements and most minerals other than quartz and some feldspars. In our samples, however, solid-phase iron, rather than particle size or organic carbon, is the best predictor variable for the solid-phase concentrations of elements and minerals. Sediment characteristics vary on a scale of tens of kilometers, with fine sediment that is enriched in trace elementsnearer to the dam. These trends allow formulation of an algorithm for determining a water-level threshold below which sediment resuspension may alter water chemistry in a generic reservoir with a long and narrow sediment delta.

Frequency in usage of FCAT-approved anatomical terms by North American anatomists.

It has been 10 years since the Federative Committee on Anatomical Terminology (FCAT) published Terminologia Anatomica (TA), the current authority on anatomical nomenclature. There exists a perceived lack of unity among anatomists to adopt many FCAT recommended anatomical terms in TA. An e-mail survey was sent to members of the American Association of Anatomists (AAA) to determine the frequency of FCAT term usage by North American anatomists. The survey consisted of 29 questions, including 25 different sets of synonymic names for selected gross anatomical structures or related terms. Overall results indicate that the FCAT preferred term had the highest frequency of usage in only 44.0% of the survey questions. As frequency of use of FCAT terms decreased, the corresponding frequency of use of non-FCAT terms increased. Some questions showed almost complete compliance with the FCAT preferred terms (highest = 98.4% usage) to almost complete disregard for the FCAT terms (lowest = 0.8% usage). A slight association (P = 0.06) may exist between FCAT familiarity and concern for usage of synonymic terms. The more familiar anatomists were with the FCAT, the more concerned they were with anatomic synonyms.

Stable transfection of an estrogen receptor beta cDNA isoform into MDA-MB-231 breast cancer cells.

We previously reported stable transfection of estrogen receptor alpha (ERalpha) into the ER-negative MDA-MB-231 cells (S30) as a tool to examine the mechanism of action of estrogen and antiestrogens [J. Natl. Cancer Inst. 84 (1992) 580]. To examine the mechanism of ERbeta action directly, we have similarly created ERbeta stable transfectants in MDA-MB-231 cells. MDA-MB-231 cells were stably transfected with ERbeta cDNA and clones were screened by estrogen response element (ERE)-luciferase assay and ERbeta mRNA expression was quantified by real-time RT-PCR. Three stable MDA-MB-231/ERbeta clones were compared with S30 cells with respect to their growth properties, ability to activate ERE- and activating protein-1 (AP-1) luciferase reporter constructs, and the ability to activate the endogenous ER-regulated transforming growth factor alpha (TGFalpha) gene. ERbeta6 and ERbeta27 clones express 300-400-fold and the ERbeta41 clone express 1600-fold higher ERbeta mRNA levels compared with untransfected MDA-MB-231 cells. Unlike S30 cells, 17beta-estradiol (E2) does not inhibit ERbeta41 cell growth. ERE-luciferase activity is induced six-fold by E2 whereas neither 4-hydroxytamoxifen (4-OHT) nor ICI 182, 780 activated an AP-1-luciferase reporter. TGFalpha mRNA is induced in response to E2, but not in response to 4-OHT. MDA-MB-231/ERbeta clones exhibit distinct characteristics from S30 cells including growth properties and the ability to induce TGFalpha gene expression. Furthermore, ERbeta, at least in the context of the MDA-MB-231 cellular milieu, does not enhance AP-1 activity in the presence of antiestrogens. In summary, the availability of both ERalpha and ERbeta stable breast cancer cell lines now allows us to compare and contrast the long-term consequences of individual signal transduction pathways.