Electrophysiological Characterization of Cerebellar Responses during Exploration and Grooming Behaviors in a Rat Model of Parkinsonism.

Parkinson's disease is currently a global public health challenge due to the rapid growth of aging populations. To understand its pathophysiology is necessary to study the functional correlation between the basal ganglia (BG) and the cerebellum, which are involved in motor control. Herein, we explored multiunit electrical activity (MUA) in the cerebellum of rats with induced Parkinsonism as a result of lesions following bilateral placement of electrodes and passing of current in the ventrolateral striatum (VLS). In one control group, the electrodes descended without electrical current, and another group was left intact in VLS. MUA was recorded in Sim B and Crus II lobes, and in the dentate nucleus (DN) during the execution of exploration behaviors (horizontal and vertical) and grooming. The lesioned and sham groups showed a decrease in MUA amplitude in the Crus II lobe compared to the intact group in all recorded behaviors. However, Sim B and DN did not express differences. Both electrical and physical insults to the VLS induced Parkinsonism, which results in less MUA in Crus II during the execution of motor behaviors. Thus, this type of Parkinsonism is associated with a decrease in the amplitude of Crus II.

How curricular changes influence medical students' perceptions of basic science: A pilot study.

THEORY: The perceived value of study material may have implications on learning and long-term retention. This study compares the perceived value of basic science of medical students from schools with a traditional "2+2" curriculum and the USMLE Step 1 placed before core clerkships to those from medical schools that have undergone curricular revisions, resulting in shortened pre-clerkship curricula and administration of the USMLE Step 1 after core clerkships. HYPOTHESIS: We hypothesize that differences in curricula, particularly duration of pre-clerkship curriculum and timing of the USMLE Step 1, affect medical students' perceived value of basic science. METHODS: A twenty item anonymous questionnaire using a 5-point Likert scale was developed to assess medical students' perceptions of basic science. The questionnaire was distributed to third-year medical students across four medical schools. Generalized linear models and p-values were calculated comparing the perceived value and use of basic science between medical schools with the USMLE Step 1 before clerkships and 2-years of basic science (BC) and medical schools with the USMLE Step 1 after core clerkships and 1.5-years of basic science (AC). RESULTS: The questionnaire was distributed to 695 eligible students and completed by 287 students. Students at BC schools tended to view basic science as more essential for clinical practice than students at AC schools across both outcomes (rating independence of basic science and clinical practice, AC school mean = 2.97, BC school mean = 2.73, p = 0.0017; rating importance of basic science to clinical practice, AC school mean = 3.30, BC schools mean = 3.50, p = 0.0135). CONCLUSIONS: Our study suggests that students who have a longer basic science curriculum tend to value basic science greater than students with a shorter basic science curriculum. The timing of the USMLE Step 1 may also influence this relationship. Curricular decisions, such as reductions in pre-clerkship curricula and administration of the USMLE Step 1 after clerkships, may impact medical students' perceptions of the value of basic science to clinical practice. This can have implications on their future engagement with basic science and should be considered when modifying curriculum.

Institutional differences in USMLE Step 1 and 2 CK performance: Cross-sectional study of 89 US allopathic medical schools.

INTRODUCTION: The United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) are important for trainee medical knowledge assessment and licensure, medical school program assessment, and residency program applicant screening. Little is known about how USMLE performance varies between institutions. This observational study attempts to identify institutions with above-predicted USMLE performance, which may indicate educational programs successful at promoting students' medical knowledge. METHODS: Self-reported institution-level data was tabulated from publicly available US News and World Report and Association of American Medical Colleges publications for 131 US allopathic medical schools from 2012-2014. Bivariate and multiple linear regression were performed. The primary outcome was institutional mean USMLE Step 1 and Step 2 CK scores outside a 95% prediction interval (≥2 standard deviations above or below predicted) based on multiple regression accounting for students' prior academic performance. RESULTS: Eighty-nine US medical schools (54 public, 35 private) reported complete USMLE scores over the three-year study period, representing over 39,000 examinees. Institutional mean grade point average (GPA) and Medical College Admission Test score (MCAT) achieved an adjusted R2 of 72% for Step 1 (standardized ßMCAT 0.7, ßGPA 0.2) and 41% for Step 2 CK (standardized ßMCAT 0.5, ßGPA 0.3) in multiple regression. Using this regression model, 5 institutions were identified with above-predicted institutional USMLE performance, while 3 institutions had below-predicted performance. CONCLUSIONS: This exploratory study identified several US allopathic medical schools with significant above- or below-predicted USMLE performance. Although limited by self-reported data, the findings raise questions about inter-institutional USMLE performance parity, and thus, educational parity. Additional work is needed to determine the etiology and robustness of the observed performance differences.

Institutional therapeutic alliance and its relationship with outcomes in a psychiatric day hospital program.

The article shows the results of a longitudinal study aimed to explore the institutional therapeutic alliance (ITA) that is the alliance formed by a patient and all the therapeutic staff. Fifty five patients who have psychiatric disorders in partial hospitalization were evaluated at admission (global functional level, social support, symptomatic condition, and treatment expectancies), at discharge, and after 3 months. ITA was assessed after 1 week of treatment and at discharge, from patient's and staff's perspectives. Preliminary findings suggest that the ITA represents a specific phenomenon different from the classical therapeutic alliance (patienttherapist), which would be particularly relevant for the treatment of patients who are severely disturbed.

Effects of Intervention and Team Culture on Operating Room Traffic.

PURPOSE: How changes in the surgical team's culture can potentially reduce operating room (OR) traffic. INTRODUCTION: Excessive OR traffic during surgical procedures can present a risk to the patient's safety and recovery. Data suggest that limiting the number of OR personnel during the intraoperative period can reduce excessive OR traffic. However, it is unclear whether the surgeon's verbal intervention can also successfully reduce intraoperative OR traffic. This study compares traffic rates in hip and knee arthroplasty cases against traffic rates during nonarthroplasty cases to examine the effects of verbal interventions implemented by the surgeon to reduce intraoperative traffic. METHOD: The study consisted of 16 orthopedic surgeons in a noninterventional group and 1 orthopedic surgeon in the interventional group. The surgeon in the interventional group implemented verbal protocols to OR staff to limit excessive intraoperative traffic. Operating room traffic was monitored for 3 consecutive months (January-March 2015) with the use of infrared automated door counters that tracked door openings when someone entered or left the OR. RESULTS: A total of 50 hip and knee arthroplasties cases and 157 nonarthroplasty cases were tracked during the study period. A total of 134 hours and 4482 movements were collected for the hip and knee arthroplasty cases. A total of 498 hours and 22 902 movements were collected for the nonarthroplasty cases. Comparing the 2 groups, the interventional group averaged 33 movements per hour while the noninterventional group averaged 46 movements per hour (P < .001). CONCLUSIONS: These results suggest that operative room traffic can be reduced through simple verbal protocols established by the surgical team.

La actividad física, el entrenamiento continuo e intervalo: una solución para la salud / The physical actvity, continuous and interval training: A solution for the health

Resumen El propósito de este documento fue reportar los beneficios de la actividad física, entrenamiento intervalo y entrenamiento continuo moderado en adultos sedentarios y físicamente activos. La actividad física involucra cualquier movimiento corporal que produce un aumento en el gasto energético en el metabolismo, mientras que el entrenamiento intervalo y entrenamiento continuo moderado puede ser utilizado para controlar el programa de cargas de entrenamiento (intensidad, volumen y pausa). Los beneficios que se han reportado cuando se realiza actividad física son: el incremento o mantenimiento de la condición física muscular, funciones cognitivas, cardiorespiratoria, equilibrio, peso corporal, control de la obesidad; todos ellos disminuyen los riesgos de enfermedades cardiovasculares, enfernedades crónicorrespiratorias, diabetes, presión alterial alta, sindrome metabolico, cáncer de colon, depresión y todas las causas de mortalidad. En contraste, la falta de actividad fisica ha ha sido identificada como factor de riesgo y está asociada a diversas enfemedades no transmisibles a nivel mundial. En este documento puntualizamos dos tipos de entrenamiento que han tenido aplicaciones para la salud en adultos. Este trabajo podría ayudar a promover la salud calidad de vida de la población adulta y eliminar el sedentarismo mediante la prescripción de la actividad física para la salud.

Abstract The purpose of this paper was report the benefit of the physical activity, interval training and moderate continuous training in sedentary and physically active adults. The physycal activity involve whatever bodily movement that produce a increased in the metabolic energetic expenditure. While that the interval training and moderate continuous training can be used for the training load schedule (intensity, volume and rest). While that the interval training and moderate continuous training can be used for the load training charge (intensity, volume and rest). The benefit that have been reported is the increasing or maintaining muscle fitness, cognitive and cardio- respiratory function, balance, body weight, obesity control, all reduce the risk of cardiovascular disease, cáncer, chronic respiratory diseases, diabetes, high blood pressure, metabolic syndrome, colon cancer, depression, and all causes of mortality. In contrast, the lack of physycal activity had been identified as risk factor and associated with various non comunicable diseases worldwide. In this paper, we point two types of training that had aplications for health in adults. This document could help to promote health, quality of live of the adult population and eliminate the physical inactivity by prescripcion of physical activity for the health.

Sexual behavior and locomotion induced by sexual cues in male rats following lesion of Lobules VIa and VII of the cerebellar vermis.

The cerebellum is an important contributor to the neural basis of sexual behavior, but the specific cerebellar regions underlying different aspects of reproduction are still unknown. Here, we used experimental lesions of Lobules VIa and VII of the vermis to investigate their specific role, both in locomotion stimulated by sexual cues and the execution of sexual behavior. Sexually experienced male rats and receptive females were used, and experimental males received an electrolytic lesion of either lobule. Before and after the lesion, males were tested for sexual behavior, and for locomotion on a horizontal or ascending bar to reach an estrous female. The lesion of Lobule VIa produced impairments in intromission-related behaviors during copulation, and produced slippery footsteps that increased the time to cross the bars with a stronger effect on the ascending bar. The lesion of Lobule VII produced a dramatic arrest of respiration that precluded further behavioral tests. These results suggested that Lobule VIa is involved in the integration of sensory inputs coming from in-copula penile stimulation, implying the existence of a penis-cerebellum neural pathway for a proprioception-like process involved in the proper spatial orientation of the erected penis. Walking on bars showed an alteration of the stepping cycle that suggests the role of Lobule VIa in the fine tuning of locomotion spinal reflexes. The lesion of Lobule VII suggested its role in the physiology of respiration, a topic that deserves further research.