9 CB-839 +/- A 14.2 ng/dL). These results suggest that commercial formulation of glyphosate is a potent endocrine disruptor in vivo, causing disturbances in the reproductive development of rats when the exposure was performed during the puberty period.”
“Parkinson’s disease (PD) is the second most common neurodegenerative disorder affecting millions of people. Both environmental and genetic factors play important roles in its causation and development. Genetic analysis has shown that over 100 genes are correlated with the etiology and pathology of PD. However, accessing genetic information in a consistent and fruitful way is not

an easy task. The Mutation Database for Parkinson’s Disease (MDPD) is designed to fulfill the need for information

integration so that users Alvocidib cell line can easily retrieve, inspect and enhance their knowledge on PD. The database contains 2391 entries on 202 genes extracted from 576 publications and manually examined by biomedical researchers. Each genetic substitution and the resulting impact are clearly labelled and linked to its primary reference. Every reported gene has a summary page that provides information on the variation impact, mutation type, the studied population, mutation position and reference collection. In addition, MDPD provides a unique functionality for users to compare the differences on the type of mutations among ethnic groups. As such, we hope that MDPD will

serve as a valuable tool to bridge the gap between genetic analysis and clinical practice. MDPD is publicly accessible at http://datam.i2r.a-star.edu.sg/mdpd/.”
“Objective: According to experimental findings, oxycodone (OX) could have some advantages over morphine (MO) in clinical models of visceral pain. It was IPI145 hypothesized that OX could have some advantages over MO in terms of efficacy and dose escalation in pancreatic cancer pain.\n\nMethods: Sixty patients with pancreatic cancer with a pain intensity rating of 4/10 who required opioids were included in the study. Patients were randomized to receive 30 mg/d of sustained release oral MO or sustained release oral OX (20 mg/d). Opioid doses were increased according to the clinical needs. Daily doses of opioids, pain and symptom intensity were recorded at admission (T0) and at weekly intervals for the subsequent 4 weeks (T1, T2, T3, and T4), with an extension at 8 weeks (T8). Opioid escalation index (OEI) as percentage (OEI %) and in mg (OEI mg) was calculated.\n\nResults: Nineteen and 20 patients in groups OX and MO, respectively, were followed for the entire period of study (T4). No differences between groups were found in age (P = 0.400), Karnofsky (P = 0.667), or escalation indexes at T4 and T8 (OEImg, P = 0.945 and OEI %, P = 0.295). No statistical differences in pain and symptoms intensity between the groups were observed.

In total, 163 and 56 species of demersal fishes were collected in the Kuroshio water and Yellow-Sea cold water, respectively.

Densities of shallow-water fishes decreased in both waters, and there was a marked decline in the Kuroshio water from 1996 to 2007. Species richness and evenness of demersal fish assemblage also decreased in the Kuroshio water. These changes are considered to have resulted from the high fishing intensity in the coastal and offshore areas of the seas.”
“The transition from stable to progressive disease is unpredictable in patients with biochemical evidence of medullary thyroid carcinoma (MTC). Calcitonin and carcinoembryonic antigen (CEA) doubling times are currently the most reliable markers for progression, selleck chemical GDC-0973 ic50 but for accurate determination, serial measurements, which need time, are required. We compared F-18-FDG PET and F-18-dihydroxyphenylanaline (F-18-DOPA) PET with biochemical parameters and survival to assess whether these imaging modalities could be of value in detecting progressive disease. Methods: We evaluated the outcome of F-18-FDG PET or F-18-DOPA PET with calcitonin and CEA doubling times in 47 MTC patients. A subgroup of patients was included in the whole metabolic burden (WBMTB) analysis, with determination of standardized uptake values and number of lesions. WBMTB of F-18-DOPA PET

and F-18-FDG PET was compared with biochemical parameters. Furthermore, survival was compared with F-18-DOPA PET or F-18-FDG PET positivity. Results: Doubling times were available for 38 of 40 patients undergoing F-18-FDG PET. There was a significant correlation with F-18-FDG PET positivity. Doubling times were less than 24 mo in 77% (n = 10/13) of F-18-FDG PET-positive patients, whereas 88% (n = 22/25) of F-18-FDG PET-negative patients had doubling times greater than 24 mo (P < 0.001). Between doubling times and F-18-DOPA PET positivity, no significant correlation existed. F-18-DOPA PET detected significantly

more lesions (75%, 56/75) than did F-18-FDG PET (47%, 35/75) in the 21 patients included in WBMTB analysis (P = 0.009). Calcitonin and CEA levels correlated significantly MK5108 price with WBMTB on F-18-DOPA PET, but doubling times did not. F-18-FDG PET positivity was a more important indicator for poor survival in patients for whom both scans were obtained. Conclusion: F-18-FDG PET is superior in detecting patients with biochemical progressive disease and identifying patients with poor survival. Although F-18-DOPA PET has less prognostic value, it can more accurately assess the extent of the disease in patients with residual MTC. Hence, both scans are informative about tumor localization and behavior. On the basis of these results, we designed a clinical flow diagram for general practice in detecting recurrent MTC.

(C) 2011 American Institute of Physics. [doi:10.1063/1.3565049]“
“Aims: While complex symptom scales are important research tools, simpler, preferably single item scales may be more useful for routine clinical practise in the evaluation of patients with overactive bladder syndrome (OAB). This study aimed to compare multiple single-item scales at baseline and after treatment with patient-reported

overall rating of treatment efficacy. Methods: In a pre-planned secondary analysis of a previously reported observational study, 4,450 patients were evaluated at baseline and after 12 weeks open-label treatment with solifenacin. Apart from episode counting for selleck classical OAB symptoms, the following single-item rating scales were applied: Indevus Urgency Severity Scale, Urgency Perception Scale, a Visual Analog Scale (VAS), quality of life question of the IPSS, and general health and bladder problem questions of the King’s Health Questionnaire (KHQ). Results: At baseline OAB symptoms correlated at best moderately with each (r = 0.285-0.508) other or with any of the rating scales (r = 0.060-0.399). Pair-wise correlations between treatment-associated symptom

or scale improvements tended to be tighter (r = 0.225-0.588). When compared to patient-reported efficacy, the VAS (r = 0.487) and the bladder problem question of the KHQ (r = 0.452) showed the tightest correlation, whereas all symptom and rating scale improvements exhibited poor correlation with patient-reported tolerability (r <= 0.283). Conclusions: The VAS and the bladder problem question of the KHQ show the greatest this website promise as single-item scales to assess problem intensity in OAB patients. Neurourol. Urodynam.

30: 510-514, 2011. (C) 2011 Wiley-Liss, Inc.”
“BACKGROUND: Ovarian tumors during pregnancy are rare. There is sparse clinical evidence about the safety of chemotherapy in this situation.\n\nCASE: A 34-year-old woman was diagnosed by ultrasonography at 15 1/2 weeks of pregnancy with a Krukenberg tumor. She was treated with surgical removal and 10 courses of the combination of 5-fluorouracil, folinic acid, and irinotecan every 2 weeks KU-57788 concentration until the 36th week of her pregnancy. The neonate was born without complications, and at age 4 months, showed normal development and no teratogenic effects.\n\nCONCLUSION: In this case, irinotecan started at the second trimester and was safely used at full adjuvant dose. (Obstet Gynecol 2009;114:451-2)”
“Bird M-L, Hill KD, Fell JW. A randomized controlled study investigating static and dynamic balance in older adults after training with Pilates. Arch Phys Med Rehabil 2012;93:43-9.\n\nObjective: To evaluate effects of a Pilates intervention on balance and function in community-dwelling older (aged > 60y) adults.\n\nDesign: Randomized crossover study design lasting 16 weeks.\n\nSetting: University exercise clinic.

Thus, check details strain MN08-A0264(T) represents a novel species, for which the name Cryptosporangium mongoliense sp. nov. is proposed. The type strain is MN08-A0264(T) (=NBRC 105887(T) =VTCC D9-27(T)).”
“Background: Behavioral and psychological symptoms of dementia (BPSD) are common and are core symptoms of the condition. They cause considerable distress to the person with dementia and their

carers and predict early institutionalization and death. Historically, these symptoms have been managed with anxiolytic and antipsychotic medication. Although potentially effective, such medication has been used too widely and is associated with serious adverse side-effects and increased mortality. Consequently, there is a need to evaluate non-pharmacological therapies for behavioral and psychological symptoms in this population. One such therapy is physical activity, which has widespread health benefits. The aim of this review is to summarize the current findings of the efficacy of physical activity on BPSD.\n\nMethod: Published articles were identified using electronic and manual searches. Rather than systematically aggregating data, this review adopted a rapid critical interpretive approach to synthesize the literature.\n\nResults: Exercise appears to be beneficial in reducing some BPSD, especially depressed mood, agitation, and

wandering, and may also improve night-time sleep. Evidence of the efficacy of exercise on improving other symptoms such as anxiety, apathy, and repetitive Proteasome inhibition assay behaviors is currently weak or lacking.\n\nConclusion: The beneficial effect of exercise type, its duration, and

frequency is unclear although some studies suggest that walking for at least 30 minutes, several times a week, may enhance outcome. The methodological shortcomings of current work in this area are substantial. The research and clinical implications of current findings are buy XMU-MP-1 discussed.”
“Comparative study of the genetic characteristics among three Acidithiobacillus caldus strains isolated from different typical environments in China was performed using a combination of molecular methods, namely sequencing analysis of PCR-amplified 16S rRNA genes and 16S-23S rRNA gene intergenic spacers (ITS), repetitive element PCR (rep-PCR), arbitrarily primed PCR (AP-PCR) fingerprinting and random amplified polymorphic DNA (RAPD). Both of the 16S rRNA gene and 16S-23S rRNA gene intergenic spacers sequences of the three strains exhibited small variations, with 99.9-100%, 99.7-100% identity respectively. In contrast, according to the analysis of bacterial diversity based on rep-PCR and AP-PCR fingerprinting, they produced highly discriminatory banding patterns, and the similarity values between them varied from 61.97% to 71.64%. RAPD analysis showed that banding profiles of their genomic DNA exhibited obvious differences from each other with 53.44-75% similarity.

(C) 2011 Elsevier Ltd. All rights reserved.”
“Natural reward and drugs of abuse converge on the mesolimbic pathway and activate common mechanism of neural plasticity in the nucleus accumbens. Chronic exposure to opiates induces plasticity in dopaminergic neurons of the ventral tegmental area (VTA), which regulates morphine reward tolerance. Here, we test the hypotheses that mating-induced

release of endogenous opioids in the VTA causes morphological changes R788 cost of VTA dopamine cells in male rats, which in-turn regulate the long-term expression of experience-induced reinforcement of sexual behavior. First, sexual experience decreased VTA dopamine soma size 1 and 7 days, but not 30 days after the last mating session. This effect was blocked with naloxone before each mating session; thus, VTA dopamine cell plasticity was dependent on action of endogenous

opioids. In turn, VTA plasticity was associated with altered opiate reward, as sexually experienced males did not form conditioned place preference for 0.5 mg/kg morphine. Next, it was determined whether endogenous opioid action mediates sexual reward and memory in male rats treated with naloxone buy S63845 during mating experience, either systemically or intra-VTA. Naloxone did not prevent the initial experience-induced facilitation of sexual behavior over repeated mating sessions, or conditioned place preference for mating. However, naloxone treatment attenuated the longer-term expression of experience-induced facilitation of sexual behavior and neural activation in mesolimbic areas induced by mating-associated conditioned cues. Together, these data demonstrate that endogenous opioids during mating induce neural plasticity in find more VTA dopamine neurons that appear critical for morphine reward and long-term memory for natural reward behavior.”
“Mitogen-activated protein kinase (MPK) cascades are highly conserved signaling pathways that respond to environmental cues. Arabidopsis MPK4 has been identified as a stress-responsive protein kinase. Here we demonstrate that Brassica napus MPK4 (BnMPK4) is activated by hydrogen peroxide (H2O2) and phytohormone abscisic acid (ABA). Transient expression of a constitutively active

BnMPK4 causes H2O2 production and cell death in Nicotiana benthamiana leaves. However, little is known about how H2O2 contributes to the regulation of MPK4 kinase function. Biochemical analysis revealed that recombinant BnMPK4 autophosphorylates on both threonine and tyrosine residues in the activation loop. In the presence of H2O2, phosphorylation of BnMPK4 caused protein aggregation in vitro. The aggregation of BnMPK4 could be reversed to the monomeric form by reducing reagents. Point-mutation of cysteine codons indicated that cysteine 232 is involved in protein aggregation. Our results suggest that BnMPK4 is involved in reactive oxygen species (ROS) signaling and metabolism, and its aggregation may be modulated by redox. (C) 2014 Elsevier B.V. All rights reserved.

The red WGP boards showed a high break strength and modulus of elasticity with a moderate percentage strain value, whereas the white STAT inhibitor WGP boards had a high flexibility and biodegradability. After burial in soil for 30 days, the red and white WGP boards degraded by about 50 and 80%, respectively. Microstructure studies indicated that

the use of binders and other functional agents resulted in a compact fracture surface of the WGP biocomposite boards. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 119: 2834-2846, 2011″
“In this study, sodium gluconate was applied as a novel carbon source for the fuel ethanol production using an engineered Escherichia coli strain KO11 in batch fermentations. Ethanol and acetic acid were produced as two major products as well as small amount of lactic acid during the fermentation. Compared to the conventional carbon source glucose, the bioconversion of sodium gluconate possessed two distinct advantages: faster utilization rate of sodium gluconate (1.66 g/L per h) compared to glucose (0.996 g/L per h) and no requirement for pH control during fermentation. Selleckchem CP868596 A general inhibition model including both substrate and products inhibitory effects was

proposed, which adequately simulated batch fermentation kinetics at various concentrations of sodium gluconate. All of the products showed inhibitory effects on cell growth. The order of the inhibitory strength of all products and substrate was for the first time clarified in this study. Acetic acid was the most inhibitory product mitigating the cell growth, followed by ethanol and lactic acid. Sodium gluconate stimulated cell growth when its concentration was below 16 g/L, while it inhibited the cell growth when the concentration was above this concentration. It completely inhibited the AZD4547 ic50 cell growth when the concentration was 325 g/L. The high value of both the coefficient of determination (R (2)) and the adjusted R (2) verified the good fit of the model.

This paper provides key insights into further engineering these strains to improve ethanol production.”
“Introduction: Endermology is a mechanical massage therapy that enables fat mobilization and body contouring. The authors’ aim was to assess the effect of endermology on indurations and panniculitis/lipoatrophy associated with subcutaneous administration of glatiramer acetate in patients with multiple sclerosis (MS).\n\nMethods: This was a multicenter pilot experience carried out in patients with MS treated with glatiramer acetate who showed indurations and/or panniculitis/lipoatrophy at the injection site. Patients underwent endermology and glatiramer acetate treatment according to clinical practice.

Gene Therapy (2011) 18, 213-219; doi:10.1038/gt.2010.161; published online 16 December 2010″
“Intrinsic properties and rotation-evoked responses of trochlear motoneurons were investigated in the turtle using an in vitro preparation consisting of the brain stem with attached temporal bones that retain functional semicircular canals. Motoneurons were divided into two classes based on intrinsic properties. The first class exhibited

higher impedance ( 123.0 +/- 11.0 M Omega), wider spikes ( 0.99 +/- 0.05 ms), a single spike afterhyperpolarization ( AHP), little or no spike frequency adaptation ( SFA), and anomalous rectification, characterized by an initial “sag” in membrane potential in response to hyperpolarizing current injection. The second class exhibited lower impedance ( 21.8 +/- 2.5 M Omega), narrower spikes ( 0.74 +/- 0.03 ms), a double AHP, substantial this website SFA, and little or no rectification. Vestibular responses were evoked by horizontal sinusoidal rotation ( 1/12-1/3 Hz; peak velocity: 30-100 degrees/ s). Spiking in higher-impedance cells was recruited earlier

in the response and exhibited a more limited dynamic range relative to that of lower impedance cells. Spiking evoked by injecting depolarizing current during rotation was blocked during contraversive motion and was consistent with a shunting inhibition. No morphological features were identified in neurobiotin-filled cells that correlated with the two physiological classes. Recovered motoneurons were multipolar but exhibited a less-complex dendritic morphology than ocular motoneurons of similarly SBE-β-CD sized mammals. The two physiologically defined cell classes have homologues in other vertebrates, suggesting that intrinsic membrane properties play an important role in oculomotor processing.”
“The area under a receiver operating characteristic (ROC) Curve (AUC) is a commonly used index for summarizing the ability of a continuous TPCA-1 chemical structure diagnostic test to discriminate between healthy and diseased subjects. If all subjects have their true disease status

verified, one can directly estimate the AUC nonparametrically using the Wilcoxon statistic. In some studies, verification of the true disease status is performed only for a subset of subjects. possibly depending on the result of the diagnostic test and other characteristics of the subjects. Because estimators of the AUC based only on verified subjects are typically biased, it is common to estimate the AUC from a bias-corrected ROC curve. The variance of the estimator. however, does not have a closed-form expression and thus resampling techniques are used to obtain an estimate. In this paper. we develop a new method for directly estimating the AUC in the setting of verification bias based on U-statistics and inverse probability weighting (IPW). Closed-form expressions for the estimator and its variance are derived.

4% (6/39). MR-predicted IPH was significantly higher prevalence in high-grade stenosis group (p=0.010). Relative risk between carotid MPRAGE-positive signal and ipsilateral high-signal intensity on DWI in arteries with carotid artery

plaques was 6.8 (p=0.010). Conclusion : Carotid MPRAGE-positive signal in patients was associated with an increased risk of territorial acute infarction as detected objectively by brain DWI. The relative risk of stroke was increased in high-grade stenosis categories.”
“Effects of chicken selleck screening library collagen hydrolysate (CCH) on atherogenesis in apolipoprotein E-deficient C57BL/6.KOR-ApoE(shI) mice were investigated in this paper. The mice were fed on either a normal CE-2 diet (control group) or a diet containing 10% CCH (CCH group) for 12 wk. Compared with that of the control, the amount of total plasma cholesterol, total hepatic cholesterol and hepatic triglycerides in the CCH group was reduced by 14.4, 24.7 and 42.8%, respectively. Histological analysis results showed that the abundance of diffuse ERK inhibitor datasheet hepatic lipid droplets and fat vacuoles was decreased in the CCH group. Meanwhile, the concentration of proinflammatory

cytokines in the CCH group plasma, including interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), and tumor necrosis factor-a (TNF-alpha), was downregulated by 43.4, 17.9 and 24.1%, respectively. The present results suggested that CCH treatment might help prevent atherosclerosis through not only its lipid-lowering effects but also inhibiting expression of inflammatory cytokines.”
“Background The role of ambulance clinicians in providing psychosocial care in major incidents and emergencies is recognised

in recent Department of Health guidance. The study described in this paper identified NHS professional first responders’ needs for education about survivors’ psychosocial responses, training in psychosocial AG-881 nmr skills, and continuing support.\n\nMethod Ambulance staff participated in an online Delphi questionnaire, comprising 74 items (Round 1) on 7-point Likert scales. Second-round and third-round participants each received feedback based on the previous round, and responded to modified versions of the original items and to new items for clarification.\n\nResults One hundred and two participants took part in Round 1; 47 statements (64%) achieved consensus. In Round 2, 72 people from Round 1 participated; 15 out of 39 statements (38%) achieved consensus. In Round 3, 49 people from Round 2 participated; 15 out of 27 statements (59%) achieved consensus. Overall, there was consensus in the following areas: ‘psychosocial needs of patients’ (consensus in 34/37 items); ‘possible sources of stress in your work’ (8/9); ‘impacts of distress in your work’ (7/10); ‘meeting your own emotional needs’ (4/5); ‘support within your organisation’ (2/5); ‘needs for training in psychosocial skills for patients’ (15/15); ‘my needs for psychosocial training and support’ (5/6).

The possible reason was the presence of clinical pharmacists in more numbers in the private hospitals as compared to the public sector hospitals. It is therefore required that the role of pharmacist should be

increased in the hospitals.”
“The straight chain n-alkanes and their mixture, which can be used as phase change materials (PCM) for thermal energy storage, have attracted much attention in recent years. We employ the molecular dynamics (MD) simulation to investigate their thermophysical properties, including self diffusion and melting of n-octadecane with crystal and amorphous structures. Our results show that, although the initial and melted structures of n-octadecane with crystal and amorphous are different, the melting behaviors of n-octadecane judged by the self diffusion behavior are consistent. selleck chemicals llc The MD Galunisertib simulation indicates that both the crystal and amorphous structures are effective for the property investigation of n-octadecane and the simulated conclusion can be used as reference for modeling the alkanes-based PCM system.”
“A 9-year-old male Yellow-headed Amazon (Amazona oratrix) with a history of anorexia and vomiting died of a liver tumor.

The tumor consisted of neoplastic cells with hepatocellular and cholangiocellular differentiations and their intermingled areas. Neoplastic hepatocytes showed islands or trabecular growth with vacuolated eosinophilic cytoplasm. Cells showing biliary differentiation formed ducts or tubules lined by cytokeratin AE1/AE3-positive epithelia, accompanied by desmoplasia consisting of myofibroblasts reacting to alpha-smooth muscle actin and desmin. The tumor was diagnosed as a combined hepatocellular-cholangiocarcinoma, which is very rare in the avian.”
“Objective To evaluate whether the addition of cilostazol to dual antiplatelet therapy (DAT, aspirin plus clopidogrel) can attenuate clopidogrel on-treatment platelet reactivity (OPR) in patients with the CYP2C19 loss-of-function (LOF) allele.\n\nMethods In the CILON-T randomised trial, patients were randomly assigned to either DAT or triple antiplatelet therapy (TAT,

DAT plus cilostazol). Genotyping of cytochrome P450 CYP2C19 *2, *3 and *17 was performed and OPR was SB525334 in vitro measured using the VerifyNow P2Y12 assay. Carriers were those with at least one CYP2C19 LOF allele.\n\nResults 474 patients were enrolled; 236 received DAT, 238 TAT. Mean OPR was significantly lower in the TAT compared with the DAT group (207 +/- 5 vs 236 +/- 5, p<0.001, P2Y12 reaction units, PRU). When grouped according to the presence of the CYP2C19 LOF allele, mean OPR was significantly lower in the TAT compared with the DAT group in only carriers of the LOF allele and not non-carriers (213 +/- 6 vs 256 +/- 7 PRU, p<0.001 in carriers, 196 +/- 9 vs 211 +/- 8 PRU, p=0.242 in non-carriers for TAT vs DAT, respectively). The proportion of patients with high OPR was highest in carriers receiving DAT (60.

The differences in adsorption performances between these dyes have been related to the molecular structure of the dyes and the surface chemistry of bagasse. (C) 2012 Elsevier B.V. All rights reserved.”
“The

aim of this investigation was to find a proper harvesting period and establishing fern number, which effects the spear yield, bioactive compounds and antioxidant activities of Asparagus officinalis L. Spears were harvested at 2, 4, and 6 weeks after sprouting. Control for comparison was used without harvest. Spears and total yield increased with prolonged spear harvest period. In harvest of 6 weeks selleck chemicals llc long optimum spear yield was the highest and fern numbers were 5 similar to 8. Bioactive compounds (polyphenols, flavonoids, flavanols, tannins and ascorbic acid) and the levels of antioxidant activities by ferric-reducing/antioxidant power (FRAP) and cupric reducing antioxidant capacity (CUPRAC) assays in asparagus ethanol Selleckchem YM155 extracts significantly differed in the investigated samples and were the highest at 6 weeks harvest period (P smaller than 0.05). The first and the second segments from the tip significantly increased with the increase of catalase (CAT). It was interesting to investigate in vitro

how human serum albumin (HSA) interacts with polyphenols extracted from investigated vegetables. Therefore the functional properties of asparagus were studied by the interaction of polyphenol ethanol extracts with HSA, using 3D- FL. In conclusion, antioxidant status (bioactive compounds, binding and antioxidant activities) improved with the harvesting period and the first segment from spear tip. Appropriate harvesting is effective for higher asparagus yield and its bioactivity.”
“OBJECTIVE: To report changes in pediatric clerkship nighttime clinical structures before and after implementation of the 2011 Accreditation Council for Graduate Medical Education (ACGME) resident duty hour standards. METHODS: As part of the 2011 Council on Medical Student Education in Pediatrics (COMSEP) member GDC-0068 annual survey, we surveyed leaders of pediatric undergraduate

medical education on their medical school’s current nighttime clinical structure, changes in nighttime structure between 2010 and 2011, and their school’s student duty hour standards. RESULTS: Fifty-six percent (n = 83) of Liaison Committee for Medical Education (LCME)-accredited medical schools responded to the survey. Of received responses, 98% of pediatric clerkships have some form of nighttime clinical experience; 49% of clerkships have medical students stay late, 24% of clerkships utilize night shifts, and 16% use a traditional call structure. Forty-five percent of clerkships report changing their nighttime clinical experience after implementation of the 2011 ACGME duty hour standards; 46% of clerkships that changed had previously used traditional call. Seventy-six percent of clerkships report having medical student duty hour standards at their medical school.