Nonpoint-source pollution from agricultural activities is currently the leading cause of degradation of waterways in the United States. Applying best management practices to flood-irrigated mountain meadows may improve agricultural runoff and return flow water quality. Prior research has focused on fertilizer use for increased hay yields, while few studies have investigated the environmental implications of this practice. We examined the effects of fertilizer application timing on overland flow water quality from an irrigated mountain meadow near Gunnison, Colorado. Application of 40 kg phosphorus (P) and 19 kg nitrogen (N) ha(-1) using monoammonium phosphate (11-52-0, N-P-K) fertilizer to plots in the fall significantly reduced concentrations of reactive P and ammonium N in irrigation overland flow compared with early or late spring fertilization. Reactive P loading was 9 to almost 16 times greater when fertilizer was applied in the early or late spring, respectively, compared with in the fall. Ammonium N followed a similar trend with early spring loading more than 18 times greater and late spring loading more than 34 times greater than loads from fall-fertilized plots. Losses of 45% of the applied P and more than 17% of the N were measured in runoff when fertilizer was applied in the late spring. These results, coupled with those from previous studies, suggest that mountain meadow hay producers should apply fertilizer in the fall, especially P-based fertilizers, to improve hay yields, avoid economic losses from loss of applied fertilizers, and reduce the potential for impacts to water quality.

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Misplacement of an inferior vena caval (IVC) filter is an infrequent event. We describe a patient who underwent IVC filter placement after lower extremity trauma. Fourteen years later, the presence of microscopic hematuria prompted evaluation. Computed tomography urography revealed an IVC filter within the right renal vein. Ureteroscopy revealed penetration of a filter tine into the collecting system. The patient is being followed conservatively.

Fertilizer-free buffer strip establishment has proved to be effective in attenuating nitrates which are mobile in shallow water-tables feeding watercourses of conservation potential. This paper demonstrates their effectiveness on reclaimed alluvial marshland soils.

Biochemistry is implemented in undergraduate medical school from the very beginning of the curriculum. Achieving a high level of competence in this area strongly influences academic success throughout the entire program. Due to the evaporating nature of this subject, medical students struggle to retain biochemistry concepts across the two years of their preclinical courses, especially while preparing for their board examinations. Therefore, the curriculum should be designed strategically to effectively implement the ever-growing field of biochemistry and metabolic pathways across the preclinical years of medical education. We propose a broadened integration of biochemistry by providing clinically correlated metabolic concepts which spiral across multiple domains, thus deepening and solidifying students’ understanding of pathology and etiology. This approach may help medical students retain their subject expertise and understand the complex material in the clinical context to minimize rote memorization. We hope to encourage medical educators, course directors, and curriculum administrators to utilize these tips to augment their biochemistry instruction in medical education.