bluuebunny/crossref_metadata_2025 huggingface dataset:
Fast and Efficient Hantzsch Synthesis Using Acid‐Activated and Cation‐Exchanged Montmorillonite Catalysts under Solvent‐Free Microwave Irradiation Conditions
Authors: Pham Duc Dung , Le Ngoc Thach , Vo‐Thanh Giang
Published: December 2017

An efficient and one‐pot synthesis of dihydropyridine derivatives using acid‐activated and cation‐exchanged montmorillonite catalysts under solvent‐free microwave irradiation conditions was described. The green, non‐corrosive, non‐toxic, and stable in air catalysts could be easily recycled and re‐used without loss of catalytic activity.
An addendum to the problem of numerical computation of the stabilizing solution of periodic game theoretic Riccati differential equation of stochastic control
Authors: Dragan Vasile , Aberkane Samir
Published: December 2017

This note is an addendum to the results reported in Dragan (2014, IMA J. Math. Control Inf.) concerning the numerical computation of the stabilizing solution of periodic game theoretic Riccati differential equation arising in some stochastic control problems. A globally convergent iterative algorithm is proposed for this purpose. The performances of the proposed algorithm are illustrated on some numerical examples.
Recovery-Based Interprofessional Distance Education (RIDE)
Authors: Beebe Lora Humphrey , Roman Marian , Raynor Hollie , Thompson Dixie , Franks Andrea
Published: December 2017

Graduate student attitudes (n = 28) were assessed before and after participation in interprofessional practitioner education (IPE). Twenty-eight graduate students participated (14 mental health nursing, 6 pharmacy, 4 nutrition, 4 exercise physiology); most had at least some health care experience. Posttest scores indicated gains on a majority of constructs measured. These results suggest that online-blended IPE content yields gains in team skills and attitudes. This study adds to a very small body of literature on IPE in graduate programs. More research is needed in examining online versus face-to-face delivery.
Integrating Gerontology and Community Concepts Through Simulation
Authors: DeBrew Jacqueline Kayler , Hensley-Hannah Susan
Published: December 2017

This article describes an innovative simulation experience for nursing students. Faculty from a community health nursing course and a course in gerontology worked together to provide a comprehensive simulation experience that combined low-fidelity and high-fidelity experiences that provided an integrated learning experience and gave faculty with an opportunity to collaborate to improve outcomes. Student and faculty feedback was overwhelmingly positive. Future plans include incorporating a third didactic course, Leadership and Management, and working with other disciplines to demonstrate interprofessional collaboration.
An Intervention to Improve Cultural Competence in Graduate Nursing Education
Authors: Creech Constance , Filter Marilyn , Wehbe-Alamah Hiba , McFarland Marilyn R. , Andrews Margaret , Pryor Gwendolyn
Published: December 2017

Noting the small number of studies on the influence of an entire curriculum on graduate nursing students’ cultural competence, the researchers examined the effect of a curricular intervention using a pretest-posttest design. The study, conducted from 2012 to 2014, focused solely on the Doctor of Nursing Practice program at a midwestern university. Results from a pre- and postintervention faculty curriculum survey indicated that the percentage of courses including a cultural competence objective increased from 65 percent to 81 percent. Results from the pre- and postintervention administration of the Transcultural Self-Efficacy Tool showed a statistically significant improvement in students’ overall score and three subscale scores.
Assessment of Nursing Student Confidence Using the Clinical Skills Self-Efficacy Scale
Authors: Van Horn Elizabeth , Christman Jeanne
Published: December 2017

Student self-efficacy related to clinical skills is important to successful performance in the clinical setting. This pilot study was designed to evaluate the confidence levels of junior and senior nursing students in performing selected nursing skills, using the Clinical Skills Self-Efficacy Scale. A descriptive cross-sectional design was used in which participants completed an online survey. Findings indicate that senior students demonstrated higher self-efficacy than juniors; their experiences and confidence related to performing specific clinical skills varied across groups. Strategies to improve students’ clinical skills learning specific to the laboratory and clinical settings are addressed.
Flipping an Undergraduate Gerontological Nursing Course
Authors: Dabney Beverly Waller , Mitchell Ronald
Published: December 2017

A flipped classroom instructional method was implemented in a gerontological nursing course. Students were surveyed to evaluate their perceptions of the flipped classroom module as well as their satisfaction with it. Open-ended questions were used to explore the students’ best and least favorite aspects of the format. Results indicated that, overall, students were satisfied with and received benefits from the new format; some students experienced frustration in the nonpassive classroom setting. Additional research is needed to determine how to meet the needs of these students and which undergraduate nursing courses are suited for the flipped classroom format.
Utility of Human Papillomavirus Genotyping in the Management of Low-Grade Squamous Intraepithelial Lesions
Authors: Solé-Sedeno Josep M. , Mancebo Gemma , Miralpeix Ester , Lloveras Belen , Bellosillo Beatriz , Alameda Francesc , Carreras Ramon
Published: December 2017

Objective

The aim of the study was to determine the usefulness of human papillomavirus (HPV) partial genotyping test in the triage of newly diagnosed low-grade squamous intraepithelial lesions (LSILs).

Materials and Methods

We analyzed 143 patients with LSIL diagnosed de novo. Lesions were classified as positive for HPV 16 or HPV 18, positive for HPV but not HPV 16 or HPV 18 (HPVno16no18) or no HPV detected (HPVneg). Patients were followed for a period of 2 years or until the lesion progressed. We calculated absolute and relative risks for progression and regression according to the HPV result.

Results

The mean (SD) age was 33.8 (11.1) years. A total of 19.6% were positive for HPV 16, 4.9% for HPV 18, and 63.6% for HPVno16no18. The absolute risk of HPV 16 for progression to cervical intraepithelial neoplasia grade 2 or more (CIN 2+) was 32.1%, 14.3% for HPV 18, and 5.8% for HPVno16no18. None of the HPVneg cases evolved to CIN 2+. The presence of HPV 16 conferred a 7.4 (95% CI = 2.7–20.3) times greater risk of developing CIN 2+ than its absence. The absolute risks for HPV 16, HPV 18, HPVno16no18, and HPVneg for regression were 53.6%, 57.1%, 75.4%, and 87.5%, respectively. Relative risks for regression were 0.7 (95% CI = 0.5–0.9) for HPV 16 and 1.3 (95% CI = 1.1–1.5) for HPVneg.

Conclusions

The HPV 16 LSILs are more likely to progress to CIN 2+, so tight control and immediate colposcopy are crucial, whereas when HPV 16 is not present, follow-up could be less strict. Low-grade squamous intraepithelial lesions in which high-risk HPV is not detected do not progress to CIN 2+, so its control should be different from other LSIL, and conservative management could be an acceptable strategy.
Photodynamic Therapy for Vulvar Lichen Sclerosus—A Systematic Review
Authors: Prodromidou Anastasia , Chatziioannou Eftychia , Daskalakis Georgios , Stergios Kostantinos , Pergialiotis Vasilios
Published: December 2017

Objective

Lichen sclerosus (LS) is a disease affecting mostly genital and perianal areas. Photodynamic therapy (PDT) has gained interest during the past years. The present study accumulates current evidence on the efficacy of PDT in the management of vulvar LS.

Methods

We used Medline (1966–2017), Scopus (2004–2017), ClinicalTrials.gov (2008–2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999–2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers.

Results

Eleven studies were finally included in our systematic review, which recruited 337 women. The existing evidence supports that PDT results in significant relief of symptoms related to LS, hence remains confusing in evaluating the progress in the clinical appearance of the lesion. No major adverse effects were reported during therapy and during the posttreatment period. Pathologic findings seem to be conflicting, as current data do not unanimously support a beneficial histological effect.

Conclusions

According to the findings of our study, PDT seems to be promising in the treatment of patients with vulvar LS. Nonetheless, current knowledge is extremely limited, and further observational studies with large patient series are needed in the field to elucidate the efficacy of PDT.
Job Mismatch and On‐the‐job Search Behavior Among University Graduates in Malaysia
Authors: Zakariya Zainizam
Published: December 2017

This paper examines the incidence and the effects of job mismatch on workers' job search behavior while working in Malaysia. Using the 2007 Graduate Tracer Study (GTS‐07) dataset, approximately 32 percent of workers were deemed mismatched and 52 percent were actively looking for another job. Using a logit model, the risk of being engaged in on‐the‐job search activity was higher among the mismatched workers and the magnitude of the effects was greater for the severely mismatched than for the moderately mismatched workers. This suggests that the mismatched workers are heterogeneous. This might be due to different traits of workers or there may be unobserved heterogeneity that varies from one mismatched to another mismatched worker.
Access Inequalities in the Artistic Labour Market in the UK: A Critical Discourse Analysis of Precariousness, Entrepreneurialism and Voluntarism
Authors: Samdanis Marios , Lee Soo Hee
Published: December 2017

This paper investigates the roles played by social enterprise and social activism in mitigating access inequalities in the artistic labour market in the UK. Our analysis focuses on underpaid internships as a primary form of access inequalities. By employing critical discourse analysis, this study contrasts the discourses of entrepreneurialism and voluntarism advocated by the government and social enterprises, with the counter‐discourse of precarity advanced by social activists. The central argument is that precarity is not simply an innate characteristic of artistic labour, but is also a social construct and discourse which is directly linked to social class and the experience of less privileged creative workers.
Abacavir usage patterns and hypersensitivity reactions in the EuroSIDA cohort
Authors: Roen A , Laut K , Pelchen‐Matthews A , Borodulina E , Caldeira L , Clarke A , Clotet B , d'Arminio Monforte A , Fätkenheuer G , Gatell Artigas JM , Karpov I , Kuznetsova A , Kyselyova G , Mozer‐Lisewska I , Mulcahy F , Ragone L , Scherrer A , Uzdaviniene V , Vandekerckhove L , Vannappagari V , Ostergaard L , Mocroft A ,   on behalf of the EuroSIDA study
Published: December 2017

Objectives

Five to eight per cent of HIV‐positive individuals initiating abacavir (ABC) experience potentially fatal hypersensitivity reactions (HSRs). We sought to describe the proportion of individuals initiating ABC and to describe the incidence and factors associated with HSR among those prescribed ABC.

Methods

We calculated the proportion of EuroSIDA individuals receiving ABC‐based combination antiretroviral therapy (cART) among those receiving cART after 1 January 2009. Poisson regression was used to identify demographic, and current clinical and laboratory factors associated with ABC utilization and discontinuation.

Results

Between 2009 and 2016, of 10 076 individuals receiving cART, 3472 (34%) had ever received ABC‐based cART. Temporal trends of ABC utilization were also heterogeneous, with 28% using ABC in 2009, dropping to 26% in 2010 and increasing to 31% in 2016, and varied across regions and over time. Poisson models showed lower ABC utilization in older individuals, and in those with higher CD4 cell counts, higher cART lines, and prior AIDS. Higher ABC utilization was associated with higher HIV RNA and poor renal function, and was more common in Central‐East and Eastern Europe and lowest during 2014. During 779 person‐years of follow‐up (PYFU) in 2139 individuals starting ABC after 1 January 2009, 113 discontinued ABC within 6 weeks of initiation for any reason [incidence rate (IR) 14.5 (95% confidence interval (CI) 12.1, 17.5) per 100 PYFU], 13 because of reported HSR [IR 0.3 (95% CI 0.1, 1.0) per 100 PYFU] and 35 because of reported HSR/any toxicity [IR 4.5 (95% CI 3.2, 6.3) per 100 PYFU]. There were no factors significantly associated with ABC discontinuation because of reported HSR/any toxicity.

Conclusions

ABC remains commonly used across Europe and the incidence of discontinuation because of reported HSR was low in our study population.
Telephone Follow‐Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial
Authors: Biese Kevin J. , Busby‐Whitehead Jan , Cai Jianwen , Stearns Sally C. , Roberts Ellen , Mihas Paul , Emmett Doug , Zhou Qingning , Farmer Franklin , Kizer John S.
Published: December 2017

Background/Objectives

Telephone calls after discharge from the emergency department (ED) are increasingly used to reduce 30‐day rates of return or readmission, but their effectiveness is not established. The objective was to determine whether a scripted telephone intervention by registered nurses from a hospital‐based call center would decrease 30‐day rates of return to the ED or hospital or of death.

Design

Randomized, controlled trial from 2013 to 2016.

Setting

Large, academic medical center in the southeast United States.

Participants

Individuals aged 65 and older discharged from the ED were enrolled and randomized into intervention and control groups (N = 2,000).

Intervention

Intervention included a telephone call from a nurse using a scripted questionnaire to identify obstacles to elements of successful care transitions: medication acquisition, postdischarge instructions, and obtaining physician follow‐up. Control subjects received a satisfaction survey only.

Measurements

Primary outcome was return to the ED, hospitalization, or death within 30 days of discharge from the ED.

Results

Rate of return to the ED or hospital or death within 30 days was 15.5% (95% confidence interval (CI) = 13.2–17.8%) in the intervention group and 15.2% (95% CI = 12.9–17.5%) in the control group (P = .86). Death was uncommon (intervention group, 0; control group, 5 (0.51%), 95% CI = 0.06–0.96%); 12.2% of intervention subjects (95% CI = 10.1–14.3%) and 12.5% of control subjects (95% CI = 10.4–14.6%) returned to the ED, and 9% of intervention subjects (95% CI = 7.2–10.8%) and 7.4% of control subjects (95% CI = 5.8–9.0%) were hospitalized within 30 days.

Conclusion

A scripted telephone call from a trained nurse to an older adult after discharge from the ED did not reduce ED or hospital return rates or death within 30 days. Clinicaltrials.gov identifier: NCT01893931z.
Intestinal failure‐associated liver disease: Risks and regression
Authors: Stueck Ashley E.
Published: December 2017

See Article on Page 174
The lifetime costs of overweight and obesity in childhood and adolescence: a systematic review
Authors: Hamilton D. , Dee A. , Perry I. J.
Published: December 2017

Background

Research into lifetime costs of obesity in childhood is growing. This review synthesizes that knowledge.

Methodology

A computerized search of the international literature since 2000 was conducted. Mean total lifetime healthcare and productivity costs were estimated and inflated to 2014 Irish euros.

Results

This resulted in 13 published articles. The methodology used in these studies varied widely, and only one study estimated both healthcare and productivity costs. Cognizant of this heterogeneity, the mean total lifetime cost of a child or adolescent with obesity was €149,206 (range, €129,410 to €178,933) for a boy and €148,196 (range, €136,576 to €173,842) for a girl. This was divided into an average of €16,229 (range, €6,580 to €35,810) in healthcare costs and €132,977 (range, €122,830 to €143,123) in productivity losses for boys and €19,636 (range, €8,016 to €45,283) and €128,560, respectively, for girls. Income penalty accounted for the greater part of productivity costs, amounting to €97,118 (range, €86,971 to €107,264) per male adolescent with obesity and €126,108 per female adolescent.

Conclusions

Healthcare costs and income penalty appear greater in girls while costs because of workdays lost seem greater in boys. There is proportionality between body mass index and costs. Productivity costs are greater than healthcare costs.
The “Stressful” Life of Cell Adhesion Molecules: On the Mechanosensitivity of Integrin Adhesome
Authors: Shams Hengameh , Hoffman Brenton D. , Mofrad Mohammad R. K.
Published: December 2017

Cells have evolved into complex sensory machines that communicate with their microenvironment via mechanochemical signaling. Extracellular mechanical cues trigger complex biochemical pathways in the cell, which regulate various cellular processes. Integrin-mediated focal adhesions (FAs) are large multiprotein complexes, also known as the integrin adhesome, that link the extracellular matrix (ECM) to the actin cytoskeleton, and are part of powerful intracellular machinery orchestrating mechanotransduction pathways. As forces are transmitted across FAs, individual proteins undergo structural and functional changes that involve a conversion of chemical to mechanical energy. The local composition of early adhesions likely defines the regional stress levels and determines the type of newly recruited proteins, which in turn modify the local stress distribution. Various approaches have been used for detecting and exploring molecular mechanisms through which FAs are spatiotemporally regulated, however, many aspects are yet to be understood. Current knowledge on the molecular mechanisms of mechanosensitivity in adhesion proteins is discussed herein along with important questions yet to be addressed, are discussed.
Diagnostic spectrum and 2-year outcome in a cohort of patients with very early arthritis
Authors: Norli Ellen Sauar , Brinkmann Gina Hetland , Kvien Tore Kristian , Bjørneboe Olav , Haugen Anne Julsrud , Nygaard Halvor , Thunem Cathrine , Lie Elisabeth , Mjaavatten Maria Dahl
Published: December 2017

Objectives

To describe the diagnostic spectrum, arthritis persistency and clinical outcomes after 2 years in patients with inflammatory arthritis (IA) of less than 16 weeks’ duration.

Methods

Data from the Norwegian Very Early Arthritis Clinic, a 2-year longitudinal observational study of adults with IA of ≤16 weeks’ duration, were used. Exclusion criteria were arthritis due to crystal deposits, trauma, osteoarthritis and septic arthritis. In all patients who had any follow-up information (population A), clinical diagnoses and persistency of arthritis were described. For patients with 2-year follow-up (population B), we also studied other clinical outcomes (disease activity, pain, fatigue, functional disability and health-related quality of life).

Results

In population A (n=1017) median (25th–75th percentile) duration of joint swelling was 35.0 (13.0–66.5) days, mean (SD) age 45.7 (14.8) years, 55.2% were females and 17.8% anticitrullinated protein antibodies positive. The most common final diagnoses were undifferentiated arthritis (UA) (41.7%), rheumatoid arthritis (RA) (24.1%) and reactive arthritis (18.1%). After 2 years, the arthritis had resolved in 59% of the patients. The remaining 41.0% had persistent disease defined by disease modifying antirheumatic drug (DMARD) use (32.1%) or persistent joint swelling without DMARD use (8.9%). In population B (n=669), all clinical outcomes improved significantly (P<0.001). Baseline joint pain and fatigue were similar across diagnoses.

Conclusions

Among 1017 patients with IA of ≤16 weeks’ duration, UA was the most common diagnosis after 2 years, and less than one-fourth were diagnosed with RA. Arthritis resolved without DMARDs in the majority of the patients. All clinical parameters improved significantly over a 2-year course.
An initiation into teaching for graduate students.
Authors: Van Liew H D
Published: December 2017

The Physiology Department at State University of New York at Buffalo offers a one-credit course that is intended to improve communication skills and to foster a problem-solving approach to the teaching/learning process. In the course, students practice lecturing, prepare examination questions, and participate in discussions of various teaching problems.
A problem-solving approach to teaching electrochemical driving force to undergraduates.
Authors: Nolan W F
Published: December 2017

The diversity of students in the typical undergraduate general physiology course demands consideration of several important education objectives: the instructor seeks to provide students with a sound understanding of basic physiological concepts, sharpen their analytical skills, and demonstrate how universal physicochemical laws determine function within living systems. These objectives converge in a problem-solving approach to electrochemical driving force and ion flux across biological membranes.
Membrane potential simulation program for IBM-PC-compatible equipment for physiology and biology students.
Authors: Barry P H
Published: December 2017

MEMPOT is an interactive graphic simulation program, written in Turbo C for IBM-PC-compatible equipment and designed to teach students in the physiological and biological sciences about the measurement and ion dependence of cell membrane potentials. Different external salt solution values can be chosen and an intracellular electrode can be moved on the screen to impale one of a group of cells and measure resting or action potential responses. A simulated voltage-to-frequency audio signal emulates normal experimental audio monitoring of the electrode potential, and a window displays a simulated oscilloscope trace (together with "electrical noise") of the resting or action potential response. The average value of each set of successful impalements is determined for each solution. Once measurements have been made over a suitable range of different solutions, the data can be reentered and plotted graphically on the screen and an interactive approach can be used to determine relative sodium-to-potassium permeabilities at rest or at the action-potential peak. A randomization routine varies permeability ratios within a small range between runs.
Design of a problem-based undergraduate course in pharmacology: implications for the teaching of physiology.
Authors: Rangachari P K
Published: December 2017

University learning can be either teacher centered or student centered. Problem-based self-directed learning in the context of small groups provides students with an opportunity to take greater responsibility for their own learning. In problem-based learning, process and content are inextricably linked, with the three cardinal elements being the students, the tutors, and the problems. The design of such an undergraduate course in pharmacology is described, and the implications for teaching physiology are discussed.
A prolegomenon to the study of graduate research training.
Authors: Refinetti R
Published: December 2017

Academic physiologists are both teachers and researchers. As a teacher the physiologist has two main tasks, to teach courses and to supervise graduate student research. It is argued that these two tasks involve different pedagogic strategies and therefore should not be confounded with one another. The physiologist who acts as a teacher in a situation of research advising will be an inappropriate advisor and will provide the student with inappropriate research training. When performing the task of graduate advisor, the physiologist should maintain a liberal attitude that fosters the graduate student's research education.
"Murder mystery" for student practice of pulmonary physiology calculations.
Authors: Maron M B , Bosso F J
Published: December 2017

We have developed an exercise designed to give students practice calculating arterial O2 content, O2 delivery, physiological dead space, dead space and alveolar ventilation, and alveolar partial pressure of O2 and CO2. The exercise is in the form of a "murder mystery" in which students are required to make these calculations to identify the murderer.
Behavior as a window on physiology: a simple apparatus for recording caterpillar feeding.
Authors: Bowdan E
Published: December 2017

Regulation of feeding is a fundamental element of homeostasis. This is reflected in the similarity of control mechanisms in a wide range of animals, including insects and humans. A close examination of feeding behavior can illuminate the physiological processes driving regulation. A simple, inexpensive method for recording fine details of feeding by caterpillars is described. Possible experiments, interpretation of the data, and the relationship of observations to the underlying physiology, are outlined.
Simple, inexpensive suction electrode system for the student physiology laboratory.
Authors: Easton D M
Published: December 2017

A versatile, inexpensive, easily constructed suction electrode system is described that can be used for routine exercises by the student on, or for demonstrations of, the electrophysiology of frog sciatic nerve and gastrocnemius and sartorius muscles. A disposable plastic syringe and a disposable pipette with Ag-AgCl wire comprise the suction electrode. Six readily manipulable electrodes are installed in the walls of the Plexiglas preparation bath, and an arbitrary number of additional "free" electrodes can be placed where desired. An optional small chamber, formed from a disposable plastic culture dish and Gootch rubber tubing, provides for "barrier" recording within the larger chamber. Interpretations are given of the electrical responses of nerve and muscle in terms of longitudinal currents along the preparation within the suction electrode tubes.
A computer simulation for learning about the physiological response to exercise.
Authors: Coleman I P , Dewhurst D G , Meehan A S , Williams A D
Published: December 2017

An interactive computer program written for IBM-compatible microcomputers, which simulates the physiological response to graded exercise in healthy individuals, is described. The program presents high-resolution graphic data (heart rate, pulmonary ventilation, oxygen consumption, and blood lactate concentration) in a form comparable to that of a chart recorder display. Data are derived from an empirical model that allows users to select certain parameters of the subject they wish to investigate, including sex, age, height, weight, and level of training. Measurements may be taken directly from the monitor screen by use of the cross-hair cursor facility provided. The program has been positively evaluated in use by undergraduate students and shown to be an effective teaching aid. The potential use of the software in light of these findings is discussed.
Investigative approach to frog gastrocnemius laboratory: potential impact on animal use in teaching laboratories.
Authors: Welsford I G , Flamm A E , Barr J , Fenton B , Wright J R , Kellerman L R
Published: December 2017

With growing concern over the use of animal experimentation in the teaching of physiology, many biology departments are reassessing the use of animal experiments in the teaching lab. However, it may be just as important to assess how animal experimentation is used in the undergraduate teaching laboratory rather than simply assessing if animal experimentation should be used at all. In our study, sophomore-level life science students enrolled in a core organismal biology course undertook a laboratory exercise designed to elucidate properties of muscles and neuromuscular communication following two protocols: 1) a standard demonstrational model wherein students were told to undertake the exercise as a means to understand physiological processes that they had been exposed to previously in lecture or 2) an investigative model wherein the use of the gastrocnemius preparation was a logical next step in an ongoing investigation, the content of which was driven by student-generated hypotheses. We have observed a significant decrease in a number of the negative comments concerning the use of animals in experimentation (25.6 vs. 3.6%) since the implementation of the investigative approach to the laboratory, suggesting that curricular approaches to the use of animals in the teaching laboratory may have an impact on student attitudes concerning animal experimentation.
Directed case study method for teaching human anatomy and physiology.
Authors: Cliff W H , Wright A W
Published: December 2017

A mastery of human anatomy and physiology requires a familiarity with a vast number of details about the human body. A directed method of case analysis is described that helps students deepen and solidify their understanding of anatomical and physiological facts, concepts, and principles. The successful case had four distinctive features as follows: clear learning objectives, a concise and informative scenario, straightforward and didactic questions, and an emphasis on information readily available to the student. A directed case study is presented, and its salient features are described. A procedure for integrating case analyses into an undergraduate anatomy and physiology course is outlined. Student response to this type of case study suggests that this method improves the ease of learning, the depth of learning, and an appreciation of the relevance of and a curiosity about anatomy and physiology. The addition of case analyses to a two-semester integrated course in anatomy and physiology was also associated with an improvement in exam performance. The regular use of directed case analysis is a valuable addition to the traditional methods of lecture, textbook reading, and laboratory for the teaching of human anatomy and physiology.
A spinal circuitry simulator as a teaching tool for neuromuscular physiology.
Authors: Maw S , Frank J , Greig G
Published: December 2017

Many concepts in neuromuscular physiology can be difficult for instructors to teach and for students to understand. The behaviors of various components in neuromuscular systems do not always interact in obvious ways, and the function of hundreds of components can be very different from the function of just one or two "representatives." In this paper, a simulator is presented that can model both small and large spinal circuitry systems thus allowing students to explore the dynamic functional implications of the static circuitry diagrams that are common in many neuroscience textbooks. The simulator brings to life many concepts in neuromuscular physiology and permits students to explore such concepts without extensive supervision. The benefits and drawbacks of using this kind of simulator in the classroom are discussed, based on initial field tests with undergraduate and graduate students as well as input from the literature. It was found that such a simulation can be very useful as a teaching tool if it is used properly with the right audience.
Professional development: a guide to the educator's portfolio.
Authors: Carroll R G
Published: December 2017

The educator's portfolio provides a mechanism for identifying and evaluating faculty teaching activities. The educator's portfolio has separate areas for educational research, teaching encounters, and educational service. This article describes the components of a traditional educator's portfolio and relates them to the basic scientist's curriculum vitae. The article concludes with suggestions for implementing use of the educator's portfolio at the departmental and institutional level.
Construction of a model demonstrating neural pathways and reflex arcs.
Authors: Chan V , Pisegna J M , Rosian R L , DiCarlo S E
Published: December 2017

Employment opportunities in the future will require higher skills and an understanding of mathematics and science. As a result of the growing number of careers that require solid science and mathematics training, the methods of science education are undergoing major reform. To adequately equip students for technologically advanced positions, new teaching methods must be developed that prepare tomorrow's workforce for the challenges of the 21st century. One such method is the use of models. By actively building and manipulating concrete models that represent scientific concepts, students are involved in the most basic level of Piaget's learning scheme: the sensorimotor stage. Models are useful in reaching all students at the foundational levels of learning, and further learning experiences are rapidly moved through higher learning levels. This success ensures greater comprehension and understanding compared with the traditional methods of rote memorization. We developed an exercise for the construction of an inexpensive, easy-to-build model demonstrating neural pathways and reflex arcs. Our exercise also includes many supplemental teaching tools. The exercise is designed to fulfill the need of sound physiological teaching materials for high school students.
It's time for a change in the way we educate physiology PhD candidates.
Authors: Tallitsch R B
Published: December 2017

Graduate students in physiology programs today are faced with a job market that is significantly different from that which many of us faced 25, 10, or even 5 years ago. As a result, physiology educators need to change the content and style of their programs to prepare graduates for their futures. Programs must continue to prepare graduates for research postdoctoral positions, but they also should prepare them for employment at smaller institutions that have higher teaching demands and that encourage, but do not require, research. Changes are suggested in the way PhD candidates are taught and in the way professors mentor students seeking employment at smaller institutions.
Students' misconceptions about perceived physiological responses.
Authors: Michael J A
Published: December 2017

Students' misconceptions about scientific phenomena can arise from at least two possible sources, the students' personal experience with those phenomena and things learned in the classroom. Misconceptions have been studied in a variety of science disciplines, but little attention has been given to the faulty models that students have for physiological processes. In this study 393 undergraduates in three different research universities were asked to predict the changes in heart rate and strength of cardiac contraction and breathing frequency and depth of breathing (physiological parameters that can be directly and personally perceived) under conditions that result in predicted that heart rate would increase but that the strength of contraction would decrease or stay unchanged. Approximately one-half of the students predicted that breathing frequency would increase but depth of breathing would decrease (also erroneous). Explanations for these erroneous predictions were elicited, and the reasons offered revealed significant misconceptions about cardiac and respiratory mechanics. The persistence of such misconceptions was demonstrated in a small group of first-year medical students. A general approach to detecting and remediating misconceptions is discussed.
Assessing prebaccalaureate human physiology courses.
Authors: McCleary V L
Published: December 2017

Two surveys were conducted between 1994 and 1996. The purpose of the initial survey was to obtain demographic information about prebaccaulareate human physiology courses. Of the 117 responding physiology departments, 50% offered human physiology at the prebaccalaureate level to 14,185 students during the 1994-1995 academic year. The mean was 245 students per year (+/- 30 SE). Class size was limited by 44% of the respondents. Prebaccaluareate human physiology was offered as a separate course from anatomy by 93% of the departments. Sixty-one percent scheduled the course once a year. The purpose of the second survey was to determine how physiology departments evaluated prebaccalaureate physiology courses and faculty. All responding departments utilized student feedback; 38% of the departments included physiology chair review, 38% peer review, and 9% allied health faculty review. Twenty-eight percent of allied health programs evaluated the course. Results indicated that, whereas a significant number of undergraduate students are enrolled in prebaccaluareate physiology courses annually, those courses appear to lack formal, consistent formative evaluation.
Educational card games for understanding gastrointestinal physiology.
Authors: Odenweller C M , Hsu C T , DiCarlo S E
Published: December 2017

In the last few years, there has been an emphasis on the development of creative educational materials that supplement the traditional lecture format. The new materials should engage students in interactive learning and enhance critical thinking, small group discussion, and problem-solving skills. To help students understand and apply basic science concepts in a challenging, interactive format, we developed two card games. Although the principles of the games can be adapted to many scientific disciplines, these specific games provide a unique opportunity to integrate, analyze, and interpret basic concepts of gastrointestinal (GI) physiology. Go GI and GI Rummy were developed to assist students in the understanding of GI physiology and were designed to function as a tool for learning lecture material. Both games were evaluated by medical, graduate, and high school students. Student evaluation of the educational material showed that the games were successful in promoting the learning of GI physiology and engaging students in the discussion of GI concepts. Through this new approach, the students' level of understanding and ability to apply and synthesize materials were enhanced.
Pulmonary circulation demonstration using an isolated rat lung model.
Authors: Resta T C , Eichinger L M , Russ R D , Walker B R
Published: December 2017

We have developed a pulmonary circulation laboratory exercise that effectively illustrates basic concepts typically taught in a graduate physiology curriculum. The demonstration uses an isolated, perfused rat lung model to delineate the mechanisms by which pulmonary vascular resistance can be altered either passively or in an active manner by contraction or relaxation of vascular smooth muscle. The exercise further offers an opportunity to closely observe an experimental preparation commonly used to study the pulmonary circulation and allows students the opportunity to interpret the resulting physiological data. Student evaluations indicate that the demonstration was received with enthusiasm and provides an effective teaching tool for reinforcing concepts in pulmonary vascular physiology.
It's a long way to multimedia: an account of 18 years of pursuing a new media project in physiology.
Authors: Wiemer W
Published: December 2017

A teaching-oriented multimedia database authoring system, MILES ( Multimediales Informations- und Lehrsystem), has been in development since 1980 in our department. The hardware consists of a network of personal computers connected to digital and, until recently, audio/video storage devices. The system provides a database capable of handling all kinds of multimedia data and computer programs. User-friendly software provides input, editing, retrieval, and communication; the authoring system allows these components to be organized into structures of complex menus, combined with free database access. More than 12,000 components have been stored, including approximately 3,500 pictures. The paper reports on an extensive field test, in which the system has been applied as a common source for all kinds of materials used in teaching physiology to students of medicine. ResuIts show that the "new media" are powerful instruments for improving teaching and learning. However, they should not be expected to provide the sole basis for education. Their application still faces many problems regarding concepts, efficiency, and acceptance by students and staff.
TEACHING PEER REVIEW AND THE PROCESS OF SCIENTIFIC WRITING
Authors: Guilford William H.
Published: December 2017

Many undergraduate and graduate students understand neither the process of scientific writing nor the significance of peer review. In response, some instructors have created writing assignments that teach or mimic parts of the scientific publishing process. However, none fully reproduced peer review and revision of papers together with the writing and publishing process from research to final, accepted draft. In addition, most have been instituted at the graduate rather than undergraduate level. We present a detailed method for teaching undergraduate students the full scientific publishing process, including anonymous peer review, during the process of writing a “term paper.” The result is a review article in the format for submission to a major scientific journal. This method has been implemented in the course Cell and Molecular Biology for Engineers at the University of Virginia. Use of this method resulted in improved grades, much higher quality in the final manuscript, greater objectivity in grading, and improved understanding of the importance of peer review.
SUBMITTING ILLUMINATIONS FOR REVIEW
Authors: Rodenbaugh David W. , Collins Heidi L. , Dicarlo Stephen E.
Published: December 2017

As educators, we are continually designing new methods and procedures to enhance learning. During this process, good ideas are frequently generated and tested, but the extent of such activities may not be adequate for a full manuscript. Nonetheless, the ideas may be quite beneficial in improving the teaching and learning of physiology. Illuminations is a column designed to facilitate the sharing of these ideas (illuminations). The format of submissions is quite simple: a succinct description of about one or two double-spaced pages (less title and authorship) of something you have used for the classroom, teaching, lab, conference room, etc. You may include one or two simple figures or references. Submit ideas for inclusion in Illuminations directly to the Associate Editor in charge, Stephen DiCarlo ( sdicarlo@med.wayne.edu ).
Increased calcium uptake by muscle mitochondria of cold-acclimated rats
Authors: Greenway D. C. , Himms-Hagen J.
Published: December 2017

Skeletal muscle mitochondria of cold-acclimated rats have an altered morphology that is related to the occurrence of nonshivering thermogenesis. The transport of calcium by these mitochondria was studied in a search for an alteration in an energy-dissipating mechanism which might be related to the altered morphology and to the altered mode of thermogenesis in the cold-acclimated animal. The rates of calcium uptake, of calcium-stimulated respiration, and of state 4 respiration after calcium uptake were increased in the altered mitochondria. The capacity to accumulate calcium without phosphate was increased, whereas with phosphate all the calcium was removed from the medium and no difference in total uptake was seen. Spontaneous release of calcium was greater but sodium-induced release was unchanged. No effect of cyclic AMP or prostaglandin E1 on release of calcium was seen. The increase in rate of calcium uptake occurred gradually during the first 3-5 wk of acclimation to cold. The results are considered to give some support to the hypothesis that adaptive changes in the mitochondrial calcium transport cycle in skeletal muscle occur during acclimation to cold.
Placental transfer of water and nonelectrolytes during a single circulatory passage
Authors: Bissonnette J. M. , Cronan J. Z. , Richards L. L. , Wickham W. K.
Published: December 2017

A bolus of a 14C-labeled nonelectrolyte and tritiated water was injected into the maternal arterial system supplying the uterine circulation. Blood was sampled immediately on the fetal side of the placenta from the umbilical vein. A placental transfer index (PTI) was calculated from the ratio of the tracers in the fetal blood divided by the ratio of the tracers in the injectate. Placental transfer was measured for 11 nonelectrolytes in anesthetized guinea pigs and 8 nonelectrolytes in unanesthetized sheep. Placental transfer in both species was determined by molecular weight and lipid solubility. The PTI measured for the lipophilic solutes antipyrine and 1,6-hexanediol were less than 1, and those for methanol and ethanol were greater than 1. We conclude that placental transfer for water and small (mol wt less than 200) lipid-soluble nonelectrolytes is limited by diffusion as well as by blood flow.
Distribution of ionic sulfate, lithium, and bromide across the sheep placenta
Authors: Thornburg K. L. , Binder N. D. , Faber J. J.
Published: December 2017

Salts of sulfate, lithium, and bromine were injected or infused intravenously into ewes in the last trimester of gestation. Ewes and fetuses had indwelling catheters; most fetuses were nephrectomized. Concentrations were measured in paired maternal and fetal samples over periods of 4--14 days. Maternal excretion of sulfate was too rapid to permit near equilibration of fetal and maternal plasma concentrations; the results, however, did not support the existence of a large potential difference across the exchange barrier. The concentrations of Li+ (given by continuous infusion) and 82Br- in maternal plasma did not change rapidly. The concentrations of these tracers in fetal plasma rose until they were nearly equal to the maternal plasma concentrations. Steady-state transplacental potentials, calculated by use of the Nernst equation, were 5.2 +/- 2.0 (SEM) mV (n = 26) for Li+ and -2.2 +/- 0.8 (SEM) mV (n = 10) for Br-. Nernst potentials calculated from previously measured maternal and fetal plasma concentrations of Na+, K+, Mg2+, and Cl- were +0.4, +3.6, +0.5, and -1.4 mV. We concluded that, of the total potential difference of about -50 mV (fetus negative) between the fetal lamb and the ewe, only a few mV are dropped across the placental exchange barrier.
Isometric endurance in fast and slow muscles in the cat
Authors: Petrofsky J. S. , Lind A. R.
Published: December 2017

By use of a method of sequential stimulation described previously, the ability to sustain tensions of 3--100% of the initial strength (maximum isometric tension that could be developed in the fresh muscle) to fatigue (endurance) was assessed in the soleus (slow-twitch), medial gastrocnemius (mixed, fast-twitch), and plantaris (mainly fast-twitch) muscles. For all fractions of the initial strength the endurance was longest in soleus and shortest in plantaris. However, although plantaris fatigued at any tension examined, soleus could maintain a tension of up to 30% of its initial strength indefinitely with no sign of fatigue. Part of the difference in endurance between these two muscles could be accounted for in terms of blood flow because arterial occlusion sharply reduced the endurance of soleus but had only a small effect on endurance in plantaris. However, even with an occluded circulation, soleus still had substantially longer endurance than either medial gastrocnemius or plantaris. The origin of fatigue in any of the three muscles examined appeared to be in the muscle; there was no evidence of failure of transmission at the neuromuscular junction.