Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of ...evidence of the effects that problem-based learning during medical school had on physician competencies after graduation.
We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed.
Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate).
Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.
Currently, there are no reliable RBC invasion assays to guide the discovery of vaccines against Plasmodium vivax, the most prevalent malaria parasite in Asia and South America. Here we describe a ...protocol for an ex vivo P vivax invasion assay that can be easily deployed in laboratories located in endemic countries. The assay is based on mixing enriched cord blood reticulocytes with matured, trypsin-treated P vivax schizonts concentrated from clinical isolates. The reliability of this assay was demonstrated using a large panel of P vivax isolates freshly collected from patients in Thailand.
The aim of the current study was to analyse the effects of posterior cruciate ligament (PCL) deficiency on forces of the posterolateral corner structure and on tibiofemoral (TF) and patellofemoral ...(PF) contact force under dynamic-loading conditions.
A subject-specific knee model was validated using a passive flexion experiment, electromyography data, muscle activation, and previous experimental studies. The simulation was performed on the musculoskeletal models with and without PCL deficiency using a novel force-dependent kinematics method under gait- and squat-loading conditions, followed by probabilistic analysis for material uncertain to be considered.
Comparison of predicted passive flexion, posterior drawer kinematics and muscle activation with experimental measurements showed good agreement. Forces of the posterolateral corner structure, and TF and PF contact forces increased with PCL deficiency under gait- and squat-loading conditions. The rate of increase in PF contact force was the greatest during the squat-loading condition. The TF contact forces increased on both medial and lateral compartments during gait-loading conditions. However, during the squat-loading condition, the medial TF contact force tended to increase, while the lateral TF contact forces decreased. The posterolateral corner structure, which showed the greatest increase in force with deficiency of PCL under both gait- and squat-loading conditions, was the popliteus tendon (PT).
PCL deficiency is a factor affecting the variability of force on the PT in dynamic-loading conditions, and it could lead to degeneration of the PF joint.Cite this article: K-T. Kang, Y-G. Koh, M. Jung, J-H. Nam, J. Son, Y.H. Lee, S-J. Kim, S-H. Kim. The effects of posterior cruciate ligament deficiency on posterolateral corner structures under gait- and squat-loading conditions: A computational knee model. Bone Joint Res 2017;6:31-42. DOI: 10.1302/2046-3758.61.BJR-2016-0184.R1.
New therapeutic targets for noncognitive reductions in energy intake, absorption, or storage are crucial given the worldwide epidemic of obesity. The gut microbial community (microbiota) is essential ...for processing dietary polysaccharides. We found that conventionalization of adult germ-free (GF) C57BL/6 mice with a normal microbiota harvested from the distal intestine (cecum) of conventionally raised animals produces a 60% increase in body fat content and insulin resistance within 14 days despite reduced food intake. Studies of GF and conventionalized mice revealed that the microbiota promotes absorption of monosaccharides from the gut lumen, with resulting induction of de novo hepatic lipogenesis. Fasting-induced adipocyte factor (Fiaf), a member of the angiopoietin-like family of proteins, is selectively suppressed in the intestinal epithelium of normal mice by conventionalization. Analysis of GF and conventionalized, normal and Fiaf knockout mice established that Fiaf is a circulating lipoprotein lipase inhibitor and that its suppression is essential for the microbiota-induced deposition of triglycerides in adipocytes. Studies of Rag1-/- animals indicate that these host responses do not require mature lymphocytes. Our findings suggest that the gut microbiota is an important environmental factor that affects energy harvest from the diet and energy storage in the host.
We conducted a study to determine the prevalence of Trichomonas vaginalis (TV), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) in men with urethritis, attending an urban sexual health ...clinic, in order to inform screening and treatment policies. Men attending an urban sexual health clinic between June 2011 and January 2012 were evaluated. Urine samples were collected from men with urethritis and tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and TV using transcription-mediated amplification and for MG and UU using polymerase chain reaction. Eighty-three samples were analysed. The prevalence of CT was 33.7% (28/83), GC was 16.8% (14/83), TV was 3.6% (3/83), MG was 12.0% (10/83) and UU was 4.8% (4/83). Fifteen men had recurrent urethritis. Of these, three were found to have had TV, five to have had MG and none to have had UU, at initial presentation. Given the prevalence of MG in this study, there is an urgent need for further larger studies looking at optimal treatment regimens and screening strategies in urethritis.
An integrated plastic microfluidic device was designed and fabricated for bacterial detection and identification. The device, made from poly(cyclic olefin) with integrated graphite ink electrodes and ...photopatterned gel domains, accomplishes DNA amplification, microfluidic valving, sample injection, on-column labeling, and separation. Polymerase chain reaction (PCR) is conducted in a channel reactor containing a volume as small as 29 nL; thermal cycling utilizes screen-printed graphite ink resistors. In situ gel polymerization was employed to form local microfluidic valves that minimize convective flow of the PCR mixture into other regions. After PCR, amplicons (products) are electrokinetically injected through the gel valve, followed by on-chip electrophoretic separation. An intercalating dye is admixed to label the amplicons; they are detected using laser-induced fluorescence. Two model bacteria, Escherichia coli O157 and Salmonella typhimurium, were chosen to demonstrate bacterial detection and identification based on amplification of several of their unique DNA sequences. The limit of detection is about six copies of target DNA.
Posterior condylar offset (PCO) and posterior tibial slope (PTS) are critical factors in total knee arthroplasty (TKA). A computational simulation was performed to evaluate the biomechanical effect ...of PCO and PTS on cruciate retaining TKA.
We generated a subject-specific computational model followed by the development of ± 1 mm, ± 2 mm and ± 3 mm PCO models in the posterior direction, and -3°, 0°, 3° and 6° PTS models with each of the PCO models. Using a validated finite element (FE) model, we investigated the influence of the changes in PCO and PTS on the contact stress in the patellar button and the forces on the posterior cruciate ligament (PCL), patellar tendon and quadriceps muscles under the deep knee-bend loading conditions.
Contact stress on the patellar button increased and decreased as PCO translated to the anterior and posterior directions, respectively. In addition, contact stress on the patellar button decreased as PTS increased. These trends were consistent in the FE models with altered PCO. Higher quadriceps muscle and patellar tendon force are required as PCO translated in the anterior direction with an equivalent flexion angle. However, as PTS increased, quadriceps muscle and patellar tendon force reduced in each PCO condition. The forces exerted on the PCL increased as PCO translated to the posterior direction and decreased as PTS increased.
The change in PCO alternatively provided positive and negative biomechanical effects, but it led to a reduction in a negative biomechanical effect as PTS increased.
: K-T. Kang, Y-G. Koh, J. Son, O-R. Kwon, J-S. Lee, S. K. Kwon. A computational simulation study to determine the biomechanical influence of posterior condylar offset and tibial slope in cruciate retaining total knee arthroplasty.
2018;7:69-78. DOI: 10.1302/2046-3758.71.BJR-2017-0143.R1.
COVID-19 and Extended Reality (XR) Kwok, Andrei O. J.; Koh, Sharon G. M.
Current issues in tourism,
07/2021, Letnik:
24, Številka:
14
Journal Article
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Rapid advancement in immersive technology and the global response to the COVID-19 pandemic will catalyze Extended Reality in tourism. This research letter draws from Schumpeter's innovation theory to ...examine how the evolving market-driven factors arising from the magnitude of change in the tourism industry will accelerate innovation through creative accumulation and creative destruction for tourism enterprises leading to sustainable competitive advantage. Insights from this research letter contribute to how Extended Reality will reshape tourism and provide implications for tourism stakeholders.
This paper is concerned with the hydroelastic response of pontoon-type, very large floating structures (VLFS) with a flexible line connection. For the hydroelastic analysis, the water is modeled as ...an ideal fluid and its motion is assumed to be irrotational so that a velocity potential exists. The VLFS is modeled by a plate according to the Mindlin plate theory. In order to decouple the fluid–structure interaction problem, the modal expansion method is adopted for the hydroelastic analysis that is carried out in the frequency domain. The boundary element method is used to solve the Laplace equation together with the fluid boundary conditions for the velocity potential, whereas the finite element method is adopted for solving the deflection of the floating plate. This study examines the effects of the location and the rotational stiffness of such a flexible line connection on the hydroelastic response. Hinge and semi-rigid line connections are found to be effective in reducing hydroelastic response of the VLFS as well as the stress resultants, depending on the wavelength. The effects of wave angle, water depth and plate's aspect ratio on the hydroelastic response of the VLFS are also investigated.
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