Introduction: The use of free open access medicine, particularly open educational resources (OERs), by medical educators and learners continues to increase. As OERs, especially blogs and podcasts, rise in popularity, their ease of dissemination raises concerns about their quality. While critical appraisal of primary research and journal articles is formally taught, no training exists for the assessment of OERs. Thus, the ability of educators and learners to effectively assess the quality of OERs using gestalt alone has been questioned. Our goal is to determine whether gestalt is sufficient for emergency medicine learners (EM) and physicians to consistently rate and reliably recommend OERs to their colleagues. We hypothesized that EM physicians and learners would differ substantively in their assessment of the same resources. Methods: Participants included 31 EM learners and 23 EM attending physicians from Canada and the U.S. A modified Dillman technique was used to administer 4 survey blocks of 10 blog posts per subject between April and August, 2015. Participants were asked whether they would recommend each OER to 1) a learner or 2) an attending physician. The ratings reliability was assessed using single measures intraclass correlations and their correlations amongst the groups were assessed using Spearman’s rho. Family-wise adjustments were made for multiple comparisons using the Bonferroni technique. Results: Learners demonstrated poor reliability when recommending resources for other learners (ICC= 0.21, 95% CI 0.13-0.39) and attending physicians (ICC = 0.16, 95% CI=0.09-0.30). Similarly, attendings had poor reliability when recommending resources for learners (ICC= 0.27, 95% CI 0.18-0.41) and other attendings (ICC=0.22, 95% CI 0.14-0.35). Learners and attendings demonstrated moderate consistency between them when recommending resources for learners (rs=0.494, p<.01) and attendings (rs=0.491, p<.01). Conclusion: Using a gestalt-based rating system is neither reliable nor consistent when recommending OERs to learners and attending physicians. Learners’ gestalt ratings for recommending resources for other learners and attendings were especially unreliable. Our findings suggests the need for structured rating systems to rate OERs.

This paper examines factors affecting the oxidation behavior of Ir thin film electrodes and the stability of bilayer Ir/Ir-Ir-O-Si electrodes on silicon substrates. We first examine the morphology and texture of faceted IrO2 extrusions formed on the Ir films during thermal oxidation, and show that an Ir grain-growth anneal in N2 at 650°C for 5 min prior to the oxidation treatment increases both the areal density of IrO2 extrusions and the IrO2<110> x-ray diffraction intensity while decreasing apparent film roughness. We then examine the stability of bilayer lr(100 nm)/Ir(20 nm) films on polycrystalline silicon and show how fairly mild oxygen anneals of the Ir(20 nm)/Si structures can provide an in-situ formed Ir-O-Si barrier that protects the subsequently deposited Ir(100 nm) layer from silicidation reactions during annealing in N2 ambients at 750°C. Transmission electron microscopy indicates that this in-situ formed barrier at the Ir/Si interface has a two layer structure comprising an IrSix underlayer in contact with the silicon substrate and an SiO2 overlayer directly below the remaining Ir.

In order to estimate genetic variance and heritability of systolic blood pressure (SBP), diastolic blood pressure (DBP), serum cholesterol and triglyceride levels, a total of 235 (79 male and 82 female MZ, 41 male and 33 female DZ) twin pairs, recruited from 12 junior high schools in Taipei city, were studied. Statistically significant genetic variance observed for SBP, DBP, serum cholesterol and triglycerides persisted after adjustment for age and anthropometric characteristics. However, further adjustment for dietary preference, beverage consumption, and other host and environmental factors gave different results: genetic variance of adjusted SBP and DBP was still significant, while significance was found only in males for cholesterol and in neither males nor females for triglycerides. Heritability estimates of unadjusted SBP, DBP, cholesterol and triglycerides were 0.27, 0.45, 0.21 and 0.41, respectively, for males, and 0.15, 0.42, 0.41 and 0.82, respectively, for females. After adjustment for age, anthropometric characteristics, host and environmental factors, the heritability estimates of SBP, DBP and cholesterol were 0.64, 0.72 and 0.50, respectively, for males, and 0.40, 0.60 and 0.37, respectively, for females.

A population-based sample of 73 male and 77 female monozygotic (MZ), and 41 male and 33 female dizygotic (DZ) Chinese adolescent twin pairs were studied to assess effects of gene-environment interactions of systolic blood pressure (SBP), diastolic blood pressure (DBP), serum cholesterol and triglyceride levels. Intrapair concordance in BP levels was found to be significantly associated with the interaction of zygosity and salty foods preference and also with that of zygosity and vegetable preference. A consistently positive and statistically significant association was observed between the intrapair difference in serum cholesterol and the interaction of zygosity and animal organ preference; while intrapair concordance in serum cholesterol was associated with the interaction of zygosity and milk consumption. Intrapair difference in serum triglycerides was associated with the interaction of zygosity and fish preference, and a significant association was also found between the intrapair concordance in serum triglycerides and the interaction of zygosity and sweets preference. These observations suggest that the impact of these environmental agents may be influenced by the genotype.

The monozygotic (MZ) cotwin control method was employed to elucidate possible environmental determinants of systolic blood pressure (SBP), diastolic blood pressure (DBP), serum cholesterol and triglyceride levels. A population-based twin sample of 73 male and 77 females MZ twin pairs was recruited from 12 junior high schools in Taipei city. Intrapair differences in blood pressure were negatively associated with intrapair difference in vegetable preference, attaining significance for DBP in males and SBP in females. Cholesterol was positively associated with milk consumption and preference for sweets, fried foods, meat and fish. A negative association was also observed between choleserol and vegetable preference. These associations for cholesterol were significant in males only. Triglyceride level negatively associated with preferences for sweets and vegetable, attaining significance for vegetables in both males and females and for sweets in males only.