Parkstein7091

Predicted maturity offset and ages at PHV with the original and modified equations increase with CA at prediction, have reduced variation, and have major limitations with early and late maturing boys and girls.

Predicted maturity offset and ages at PHV with the original and modified equations increase with CA at prediction, have reduced variation, and have major limitations with early and late maturing boys and girls.

Although patient decision aids (PtDAs) have been shown to improve shared decision-making, integration into clinical care pathways remains limited. This study investigated, among other outcomes, the uptake of the PtDA by professionals and the uptake as perceived by patients.

We performed a process evaluation among four breast cancer care teams that had been exposed to a multifaceted implementation strategy. Data were gathered by auditing patient files using a standardised data extraction sheet and conducting telephone interviews with patients using a structured interview guide. We analysed the data by using descriptive statistics.

We found that the implementation strategies, including advice on how and when to present the PtDA to the patient, were followed for 14% of the included patients (N=84); 92% of the patients reported to have received a login code for the web-based PtDA, while 67% logged in and used the PtDA at home. An important factor influencing the use was the clinician promoting it when delivering the PtDA (OR 9.95 95% CI 3.03-37.72).

The implementation strategies were followed in 14% of the patients, and a high delivery of the PtDA was achieved. Redesigning the care pathway and providing personal instruction on using PtDAs seem crucial.

The implementation strategies were followed in 14% of the patients, and a high delivery of the PtDA was achieved. S63845 Redesigning the care pathway and providing personal instruction on using PtDAs seem crucial.Steroids are secreted by the gonads and adrenal glands into the blood to modulate neurophysiology and behaviour. In addition, the brain can metabolise circulating steroids and synthesise steroids de novo. Songbirds show high levels of neurosteroid synthesis. In the present study, we developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the measurement of 10 steroids in whole blood, plasma and microdissected brain tissue (1-2 mg) of song sparrows. Our assay is highly accurate, precise, specific and sensitive. Moreover, the liquid-liquid extraction is fast, simple and effective. We quantified steroids in the blood and brain of wild male song sparrows in both breeding and non-breeding seasons. As expected, systemic androgen levels were higher in the breeding season than in the non-breeding season. Brain androgens were detectable only in the breeding season; androstenedione and 5α-dihydrotestosterone levels were up to 20-fold higher in specific brain regions than in blood. Oestrogens were not detectable in blood in both seasons. Oestrone and 17β-oestradiol were detectable in brain in the breeding season only (up to 1.4 ng g-1 combined). Progesterone levels in several regions were higher in the non-breeding season than the breeding season, despite the lack of seasonal changes in systemic progesterone. Corticosterone levels in the blood were higher in the breeding season than in the non-breeding season but showed few seasonal differences in the brain. In general, the steroid levels presented here are lower than those in previous reports using immunoassays, because of the higher specificity of mass spectrometry. We conclude that (i) brain steroid levels can differ greatly from circulating steroid levels and (ii) brain steroid levels show region-specific seasonal patterns that are not a simple reflection of circulating steroid levels. This approach using ultrasensitive LC-MS/MS is broadly applicable to other species and allows steroid profiling in microdissected brain regions.

Neurology is often perceived as a difficult discipline by medical students, yet it is an essential part of medical training. While the most common disorders of the nervous system can be observed in the outpatient setting, positive neurological signs are more likely to be found in neurology wards. We aimed to compare the impact of a neurology outpatient versus inpatient rotation setting on the grades obtained by medical students as a proxy measure of the learning outcomes.

We compared the results obtained by fourth year medical students in practical (OSCE) and multiple choice question (MCQ) exams in neurology, between students whose main (total of 24h contact) teaching allocation was either the outpatient or inpatient setting, controlling for students' gender, teacher, academic year and student' previous achievement (measured by their scores on practical evaluation).

A total of 1127 students were included, of whom 644 (57.14%) were allocated mainly to the neurology ward and 483 (42.86%) to the outpatient clinic. Students assigned to the ward obtained significantly higher grades in the OSCE and MCQ exams than those placed in the outpatient clinic. Teaching setting was an independent predictor of both classifications after adjustment.

The teaching setting had a significant impact on the learning outcomes. This may be due to a higher likelihood of observing abnormal neurological signs or to more student-centered teaching on the ward. These results highlight the importance of a balanced distribution of students by different clinical settings.

The teaching setting had a significant impact on the learning outcomes. This may be due to a higher likelihood of observing abnormal neurological signs or to more student-centered teaching on the ward. These results highlight the importance of a balanced distribution of students by different clinical settings.Direct ethanol fuel cells (DEFCs) are regarded as an attractive power source with high energy density, bio-renewability, and convenient storage and transportation. However, the anodic reaction of DEFCs, that is, the ethanol oxidation reaction (EOR), suffers from poor efficiency due to the low selectivity to CO2 (C1 pathway) and high selectivity to CH3 COOH (C2 pathway). In this study, the selective EOR to CO2 can be achieved at the Rh-SnO2 interface in SnO2 -Rh nanosheets (NSs). The optimized catalyst of 0.2SnO2 -Rh NSs/C exhibits excellent alkaline EOR performance with a mass activity of 213.2 mA mgRh-1 and a Faraday efficiency of 72.8% for the C1 pathway, which are 1.7 and 1.9 times higher than those of Rh NSs/C. Mechanism studies indicate that the strong synergy at the Rh-SnO2 interface significantly promotes the breaking of CC bond of C2 H5 OH to form CO2 , and facilitates oxidation of the poisonous intermediates (* CO and * CH3 ) to suppress the deactivation of the catalyst. This work not only provides a highly selective, active, and stable catalyst for the EOR, but also promotes fundamental research for the design of efficient catalysts via interface modification.