Effects of Organ System Courses of the First Two Years of Medical School on the Performance of the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 2-Cognitive Evaluation.

OBJECTIVES: The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) Level 2-Cognitive Evaluation (CE) is a board examination that medical students usually take in the third or fourth year of medical school. A few researchers have investigated the prediction of COMLEX Level 2-CE scores based on the performance in third-year clerkships. However, given how close the clerkships are to the board exam, this type of prediction is too late for students to have adequate time to get assistance to prepare for COMLEX Level 2-CE. We aimed to investigate the predictive value of each organ system course during the first two years in predicting COMLEX Level 2-CE performance. Our findings will help students at risk focus on important basic and clinical sciences much earlier before preparing for COMLEX Level 2-CE. METHODS: Academic data from students enrolled at Rocky Vista University College of Osteopathic Medicine from 2011 to 2017 were retrieved. Data included the Medical College Admission Test (MCAT) scores, course grades in the first two years of medical school, COMLEX Level 1 scores, and COMLEX Level 2-CE scores. Pearson correlation coefficients, a multiple linear regression model, and a backward stepwise regression model were generated for analysis. RESULTS: The highest correlation with COMLEX Level 2-CE scores was the COMLEX Level 1 score, followed by the performances in the third-semester Cardiovascular System II (CV II) and Renal System II (REN II) courses. Multiple linear regression and backward stepwise regression predictive models found that scores on third-semester CV II and Principles of Clinical Medicine III (PCM III) were the most significant predictors of performance on Level 2-CE. Both models explained 46% of the variance in COMLEX Level 2-CE scores. CONCLUSIONS: Performances in third-semester courses are the most important predictors of COMLEX Level 2-CE scores.

Early prediction of the risk of scoring lower than 500 on the COMLEX 1.

BACKGROUND: The Comprehensive Osteopathic Medical Licensing Examination of the United States Level 1 (COMLEX 1) is important for medical students to be able to graduate. There is a glaring need to identify students who are at a significant risk of performing poorly on COMLEX 1 as early as possible so that extra assistance can be provided to those students. Our goal is to produce a reliable predictive model to identify students who are at risk of scoring lower than 500 on COMLEX 1 at the earliest possible time. METHODS: Academic data from medical students who matriculated at Rocky Vista University College of Osteopathic Medicine between 2011 and 2017 were obtained. Odds ratios were used to assess the predictors for scoring lower than 500 on COMLEX 1. Correlation with COMLEX 1 scores was assessed with Pearson correlation coefficient. The predictive models were developed by multiple logistic regression, backward logistic regression, and logistic regression with average scores in courses in the first three semesters, and were based on performances on the Medical College Admissions Test (MCAT) before admission, as well as students' performances in preclinical courses during the first three semesters. The models were generated in about 82% of the student performance data and were then validated in the remaining 18% of the data. RESULTS: Odds ratios showed that MCAT scores and final grades in each course in the first three semesters were significant in predicting a score lower than 500 on COMLEX 1. Performances in third-semester courses including Renal System II, Cardiovascular System II, and Respiratory System II were most important in prediction. The three predictive models had sensitivities of 65.8 -71%, and specificities of 83.2 - 88.2% in predicting a score lower than 500 on COMLEX 1. CONCLUSIONS: Lower MCAT scores and lower grades in the first three semesters of medical school predict scoring lower than 500 on COMLEX 1. Students who are identified at risk by our models will have a 65.8 -71% chance of actually scoring lower than 500 on COMLEX 1. Those students will have enough time to receive assistance before taking COMLEX 1.

Subjective Well-Being In Later Life: 20 years after the Butterworths monograph series on individual and population aging.

This article discusses developments in theory and research on happiness two decades after publication of Psychological Well-Being in Later Life (Butterworths, 1991) by Albert Kozma, Michael Stones, and Kevin McNeil. Major empirical advances include new knowledge about contributions to happiness resulting from genetically related effects and personality. Personality traits have stronger relationships with happiness than was apparent 20 years ago and contribute to covariance between happiness and some of its predictors. Evolving emphases in research include the ways in which genetically related effects influence how people shape, and react to, their environment.

Bioavailability, intracellular mobilization of nickel, and HIF-1α activation in human lung epithelial cells exposed to metallic nickel and nickel oxide nanoparticles.

Micron-sized particles of poorly soluble nickel compounds, but not metallic nickel, are established human and rodent carcinogens. In contrast, little is known about the toxic effects of a growing number of Ni-containing materials in the nano-sized range. Here, we performed physicochemical characterization of NiO and metallic Ni nanoparticles and examined their metal ion bioavailability and toxicological properties in human lung epithelial cells. Cellular uptake of metallic Ni and NiO nanoparticles, but not metallic Ni microparticles, was associated with the release of Ni(II) ions after 24-48 h as determined by Newport Green fluorescence. Similar to soluble NiCl2, NiO nanoparticles induced stabilization and nuclear translocation of hypoxia-inducible factor 1α (HIF-1α) transcription factor followed by upregulation of its target NRDG1 (Cap43). In contrast to no response to metallic Ni microparticles, nickel nanoparticles caused a rapid and prolonged activation of the HIF-1α pathway that was stronger than that induced by soluble Ni(II). Soluble NiCl2 and NiO nanoparticles were equally toxic to H460 human lung epithelial cells and primary human bronchial epithelial cells; metallic Ni nanoparticles showed lower toxicity and Ni microparticles were nontoxic. Cytotoxicity induced by all forms of Ni occurred concomitant with activation of an apoptotic response, as determined by dose- and time-dependent cleavage of caspases and poly (ADP-ribose) polymerase. Our results show that metallic Ni nanoparticles, in contrast to micron-sized Ni particles, activate a toxicity pathway characteristic of carcinogenic Ni compounds. Moderate cytotoxicity and sustained activation of the HIF-1α pathway by metallic Ni nanoparticles could promote cell transformation and tumor progression.