Sustained impact of a short small group course with systematic feedback in addition to regular clinical clerkship activities on musculoskeletal examination skills-a controlled study.

BACKGROUND The discrepancy between the extensive impact of musculoskeletal complaints and the common deficiencies in musculoskeletal examination skills lead to increased emphasis on structured teaching and assessment. However, studies of single interventions are scarce and little is known about the time-dependent effect of assisted learning in addition to a standard curriculum. We therefore evaluated the immediate and long-term impact of a small group course on musculoskeletal examination skills. METHODS All 48 Year 4 medical students of a 6 year curriculum, attending their 8 week clerkship of internal medicine at one University department in Berne, participated in this controlled study. Twenty-seven students were assigned to the intervention of a 6×1 h practical course (4-7 students, interactive hands-on examination of real patients; systematic, detailed feedback to each student by teacher, peers and patients). Twenty-one students took part in the regular clerkship activities only and served as controls. In all students clinical skills (CS, 9 items) were assessed in an Objective Structured Clinical Examination (OSCE) station, including specific musculoskeletal examination skills (MSES, 7 items) and interpersonal skills (IPS, 2 items). Two raters assessed the skills on a 4-point Likert scale at the beginning (T0), the end (T1) and 4-12 months after (T2) the clerkship. Statistical analyses included Friedman test, Wilcoxon rank sum test and Mann-Whitney U test. RESULTS At T0 there were no significant differences between the intervention and control group. At T1 and T2 the control group showed no significant changes of CS, MSES and IPS compared to T0. In contrast, the intervention group significantly improved CS, MSES and IPS at T1 (p < 0.001). This enhancement was sustained for CS and MSES (p < 0.05), but not for IPS at T2. CONCLUSIONS Year 4 medical students were incapable of improving their musculoskeletal examination skills during regular clinical clerkship activities. However, an additional small group, interactive clinical skills course with feedback from various sources, improved these essential examination skills immediately after the teaching and several months later. We conclude that supplementary specific teaching activities are needed. Even a single, short-lasting targeted module can have a long lasting effect and is worth the additional effort.

MASCG: Multi-Atlas Segmentation Constrained Graph method for accurate segmentation of hip CT images

This paper addresses the issue of fully automatic segmentation of a hip CT image with the goal to preserve the joint structure for clinical applications in hip disease diagnosis and treatment. For this purpose, we propose a Multi-Atlas Segmentation Constrained Graph (MASCG) method. The MASCG method uses multi-atlas based mesh fusion results to initialize a bone sheetness based multi-label graph cut for an accurate hip CT segmentation which has the inherent advantage of automatic separation of the pelvic region from the bilateral proximal femoral regions. We then introduce a graph cut constrained graph search algorithm to further improve the segmentation accuracy around the bilateral hip joint regions. Taking manual segmentation as the ground truth, we evaluated the present approach on 30 hip CT images (60 hips) with a 15-fold cross validation. When the present approach was compared to manual segmentation, an average surface distance error of 0.30 mm, 0.29 mm, and 0.30 mm was found for the pelvis, the left proximal femur, and the right proximal femur, respectively. A further look at the bilateral hip joint regions demonstrated an average surface distance error of 0.16 mm, 0.21 mm and 0.20 mm for the acetabulum, the left femoral head, and the right femoral head, respectively.

Apatite as an indicator of fluid salinity: An experimental study of chlorine and fluorine partitioning in subducted sediments

In order to constrain the salinity of subduction zone fluids, piston-cylinder experiments have been conducted to investigate the partitioning behaviour of Cl and F in subducted sediments. These experiments were performed at H2O-undersaturated conditions with a synthetic pelite starting composition containing 800 ppm Cl, over a pressure and temperature range of 2.5–4.5 GPa and 630–900 °C. Repetitive experiments were conducted with 1900 ppm Cl + 1000 ppm F, and 2100 ppm Cl. Apatite represents the most Cl-abundant mineral phase, with Cl concentration varying in the range 0.1–2.82 wt%. Affinity for Cl decreases over the following sequence: aqueous fluid > apatite ⩾ melt > other hydrous minerals (phengite, biotite and amphibole). It was found that addition of F to the Cl-bearing starting composition significantly lowers the Cl partition coefficients between apatite and melt (DClAp–melt) and apatite and aqueous fluid (DClAp–aq). Cl–OH exchange coefficients between apatite and melt (KdCl–OHAp–melt) and apatite and aqueous fluid (KdCl–OHAp–aq) were subsequently calculated. KdCl–OHAp–melt was found to vary from 1 to 58, showing an increase with temperature and a decrease with pressure and displaying a regular decrease with increasing H2O content in melt. Mole fractions of Cl and OH in melt were calculated based on an ideal mixing model for H2O, OH, O, Cl and F. The Cl contents of other hydrous minerals (phengite, biotite and amphibole) fall between 200 and 800 ppm, with resultant Cl partition coefficients from 0.02 to 0.49, appearing independent of the bulk Cl and F content. Preliminary data from this study show that the partitioning behaviour of F is strongly in favour of apatite relative to melt and phengite, with DFAp–melt = 15–51. Apatites from representative eclogite facies metasediments were examined and found to have low Cl contents close to ∼100 ppm. Calculations using our experimentally determined KdCl–OHAp–aq of 0.004 at 2.5 GPa, 630 °C indicate a low salinity character (0.5–2 wt% NaCleq) for the fluid formed during dehydration of subducted oceanic sediment at ∼80 km depth.

PSHARE: Stata module to compute and graph percentile shares

-pshare- computes and graphs percentile shares from individual level data. Percentile shares are often used in inequality research to study the distribution of income or wealth. They are defined as differences between Lorenz ordinates of the outcome variable. Technically, the observations are sorted in increasing order of the outcome variable and the specified percentiles are computed from the running sum of the outcomes. Percentile shares are then computed as differences between percentiles, divided by total outcome. pshare requires moremata to be installed on the system; see ssc describe moremata.

The relevance of sport-related behaviour patterns in the family for the sport participation of youth in Switzerland

Despite various efforts to promote sport participation among youth, social inequalities still exist. An explanation for these social inequalities could be traced back to transgenerational transmission of sport-related values and behaviour patterns in a family (Baur, 1989). Therefore, children’s socialisation to sport is strongly influenced by the parents’ sport-related values and sport behaviour (Burrmann, 2005). However, findings of previous studies are inconsistent, and the daily sport-related behaviour patterns of families have often not been taken into account. The paper deals with the question, to what extent sport participation of youth is influenced by factors such as the importance of sport, the self-evidence of regular sport activity, mutual support, shared sport activities, sport-related health-awareness and communication about sport in the family. In order to pursue this research question, socialisation theories were used as theoretical framework (Hurrelmann, 2006). Based on this approach, a quantitative online survey where 4’039 adolescents and young adults from the ages of 15 to 30 (n = 4’039, M = 21.48, SD = 4.64) answered questions according their sport participation and the sport-related patterns of their families. Furthermore, a qualitative study that included guideline-based interviews with adolescents and young adults (n = 13) were undertaken. Content analysis was used to analyse the interviews. Initial findings of the multiple regression analysis reveal that the most important predictors of sport participation of youth are communication about sport (β = .18, p < .001), mutual support (β = .13, p < .001), regular sport activity (β = .10, p < .01) and the importance of sport in the family (β = .10, p < .01). By means of content analysis, more in-depth information could be identified. The promotion of sport through sport-related behaviour patterns in the family appears to be a successful strategy to develop a durable sport commitment in youth. References Baur, J. (1989). Körper- und Bewegungskarrieren [Body and exercise careers]. Schorndorf: Hofmann. Burrmann, U. (2005). Zur Vermittlung und intergenerationalen "Vererbung" von Sport(vereins)engagements in der Herkunftsfamilie [On placing and "inheriting" intergenerational sport(club) commitment in the family of origin]. Sport und Gesellschaft, 2, 125–154. Hurrelmann, K. (2006). Einführung in die Sozialisationstheorie [Introduction to socialisation theory] (9th ed.). Studium Paedagogik. Weinheim: Beltz.

Building the View Graph of a Category by Exploiting Image Realism

We propose a weakly supervised method to arrange images of a given category based on the relative pose between the camera and the object in the scene. Relative poses are points on a sphere centered at the object in a given canonical pose, which we call object viewpoints. Our method builds a graph on this sphere by assigning images with similar viewpoint to the same node and by connecting nodes if they are related by a small rotation. The key idea is to exploit a large unlabeled dataset to validate the likelihood of dominant 3D planes of the object geometry. A number of 3D plane hypotheses are evaluated by applying small 3D rotations to each hypothesis and by measuring how well the deformed images match other images in the dataset. Correct hypotheses will result in deformed images that correspond to plausible views of the object, and thus will likely match well other images in the same category. The identified 3D planes are then used to compute affinities between images related by a change of viewpoint. We then use the affinities to build a view graph via a greedy method and the maximum spanning tree.

LOGITCPRPLOT: Stata module to graph component-plus-residual plot for logistic regression

logitcprplot can be used after logistic regression for graphing a component-plus-residual plot (a.k.a. partial residual plot) for a given predictor, including a lowess, local polynomial, restricted cubic spline, fractional polynomial, penalized spline, regression spline, running line, or adaptive variable span running line smooth

CPRPLOT2: Stata module to graph component-plus-residual plots for transformed regressors

cprplot2 is a variation of official Stata's cprplot and is used for graphing component-plus-residual plots (a.k.a. partial residual plots). Additional features (compared to cprplot): (1) cprplot2 can handle variables that enter the model repeatedly via different transformations (for example, polynomials). (2) cprplot2 can display component-plus-residual plots using the original units for transformed variables in the model. (3) A wrapper is provided to quickly display several component-plus-residual plots in a single image.

Potential Future Coral Habitats Around Japan Depend Strongly on Anthropogenic CO2 Emissions

Using the results from the NCAR CSM1.4-coupled global carbon cycle– climate model under the Intergovernmental Panel on Climate Change (IPCC) emission scenarios SRES A2 and B1, we estimated the effects of both global warming and ocean acidification on the future habitats of corals in the seas around Japan during this century. As shown by Yara et al. (Biogeosciences 9:4955–4968,2012), under the high-CO₂-emission scenario (SRES A2), coral habitats will be sandwiched and narrowed between the northern region, where the saturation state of the carbonate mineral aragonite (Ωarag) decreases, and the southern region, where coral bleaching occurs. We found that under the low-emission scenario SRES B1, the coral habitats will also shrink in the northern region by the reduced Ωarag but to a lesser extent than under SRES A2, and in contrast to SRES A2, no bleaching will occur in the southern region. Therefore, coral habitats in the southern region are expected to be largely unaffected by ocean acidification or surface warming under the low-emission scenario. Our results show that potential future coral habitats depend strongly on CO₂ emissions and emphasize the importance of reducing CO₂ emissions to prevent negative impacts on coral habitats.

Epileptic networks are strongly connected with and without the effects of interictal discharges

OBJECTIVE Epilepsy is increasingly considered as the dysfunction of a pathologic neuronal network (epileptic network) rather than a single focal source. We aimed to assess the interactions between the regions that comprise the epileptic network and to investigate their dependence on the occurrence of interictal epileptiform discharges (IEDs). METHODS We analyzed resting state simultaneous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) recordings in 10 patients with drug-resistant focal epilepsy with multifocal IED-related blood oxygen level-dependent (BOLD) responses and a maximum t-value in the IED field. We computed functional connectivity (FC) maps of the epileptic network using two types of seed: (1) a 10-mm diameter sphere centered in the global maximum of IED-related BOLD map, and (2) the independent component with highest correlation to the IED-related BOLD map, named epileptic component. For both approaches, we compared FC maps before and after regressing out the effect of IEDs in terms of maximum and mean t-values and percentage of map overlap. RESULTS Maximum and mean FC maps t-values were significantly lower after regressing out IEDs at the group level (p < 0.01). Overlap extent was 85% ± 12% and 87% ± 12% when the seed was the 10-mm diameter sphere and the epileptic component, respectively. SIGNIFICANCE Regions involved in a specific epileptic network show coherent BOLD fluctuations independent of scalp EEG IEDs. FC topography and strength is largely preserved by removing the IED effect. This could represent a signature of a sustained pathologic network with contribution from epileptic activity invisible to the scalp EEG.