Introduction
Identification and assessment of Evidence‐based dentistry (EBD) outcomes have been elusive. Our objective was to describe EBD skill acquisition during the second (D2) year of ...pre‐doctoral dental education and student competency at the end of the year.
Methods
The first and fourth (final) curricular‐required EBD Exercises (ie, application of the first 4 steps of the 5‐Step evidence‐based practice process applied to a real or hypothetical situation) completed by D2 students (n = 151) during 2014‐2015 and 2015‐2016 were evaluated to measure skill acquisition through use of a novel rubric with measures of performance from novice to expert. Exercises were evaluated on the performance for each step, identification of manuscript details and reflective commentary on manuscript components. Changes in performance were evaluated using the chi‐square test for trend and the Wilcoxon signed‐rank test.
Results
Seventy‐eight per cent of students scored competent or higher on the Ask step at the beginning of the D2 year; scores improved with 58% scoring proficient or expert on the fourth Exercise (P < .001). Most students were advanced beginners or higher in the Acquire, Appraise and Apply steps at the beginning of the D2 year, with minimal growth observed during the year. Identification of manuscript details improved between the first and fourth Exercises (P = .015); however, depth of commentary skills did not change.
Discussion
Unlike previous investigations evaluating EBD knowledge or behaviour in a testing situation, we evaluated skill acquisition using applied Exercises.
Conclusion
Consistent with their clinical and scientific maturity, D2 students minimally performed as advanced beginners at the end of their D2 year.
Genome-wide association (GWA) studies have identified multiple loci at which common variants modestly but reproducibly influence risk of type 2 diabetes (T2D). Established associations to common and ...rare variants explain only a small proportion of the heritability of T2D. As previously published analyses had limited power to identify variants with modest effects, we carried out meta-analysis of three T2D GWA scans comprising 10,128 individuals of European descent and ∼2.2 million SNPs (directly genotyped and imputed), followed by replication testing in an independent sample with an effective sample size of up to 53,975. We detected at least six previously unknown loci with robust evidence for association, including the JAZF1 (P = 5.0 × 10−14), CDC123-CAMK1D (P = 1.2 × 10−10), TSPAN8-LGR5 (P = 1.1 × 10−9), THADA (P = 1.1 × 10−9), ADAMTS9 (P = 1.2 × 10−8) and NOTCH2 (P = 4.1 × 10−8) gene regions. Our results illustrate the value of large discovery and follow-up samples for gaining further insights into the inherited basis of T2D.
Summary
A number of variables may influence the outcome of complete denture therapy. The objective of this study was to verify possible correlations between previous experience with dentures, patient ...expectation and the number of post‐delivery adjustments with patient satisfaction after treatment. One hundred patients (mean age 61·9 ± 10·3) rated their previous experiences with complete dentures and their expectations before and satisfaction after treatment on a visual analogue scale (VAS) using scores from 0 (worst results) to 10 (best results). The number of post‐delivery adjustments and other patient‐related clinical variables was also noted. Patient expectation scores were higher than previous experience scores and satisfaction after treatment scores. Positive and weak correlations were found between previous chewing experiences with complete dentures, with regard to chewing expectations and comfort of use. Phonetics and comfort of use in previous experiences presented a positive correlation with expectations for chewing, aesthetics, phonetics and comfort of use. Groups of patients with different levels of education presented significant differences in expectation scores regarding comfort of use as well. A negative and weak correlation was found between phonetics satisfaction and the number of post‐delivery adjustments. Patients' expectations for the therapy were higher than their satisfaction after treatment. Previous experiences with complete dentures could slightly influence patients' expectations and satisfaction, whereas lower scores for previous experience with complete dentures caused lower scores for both expectation and satisfaction. Patients' educational levels and the number of post‐delivery adjustments influenced negatively the expectations about comfort of use and patient satisfaction, respectively.
We carried out a genome-wide association study of schizophrenia (479 cases, 2,937 controls) and tested loci with P < 10−5 in up to 16,726 additional subjects. Of 12 loci followed up, 3 had strong ...independent support (P < 5 × 10−4), and the overall pattern of replication was unlikely to occur by chance (P = 9 × 10−8). Meta-analysis provided strongest evidence for association around ZNF804A (P = 1.61 × 10−7) and this strengthened when the affected phenotype included bipolar disorder (P = 9.96 × 10−9).
An approach on defining competency in evidence‐based dentistry Marshall, T. A.; Straub‐Morarend, C. L.; Guzman‐Armstrong, S. ...
European journal of dental education,
February 2018, 2018-Feb, 2018-02-00, 20180201, Letnik:
22, Številka:
1
Journal Article
Recenzirano
Introduction
Assessment of evidence‐based dentistry (EBD) knowledge and behaviour is hampered by lack of explicit competency criteria. This void impedes instructional design and assessment of student ...growth during the educational process.
Methods
Knowledge and cognitive domains supporting educational objectives in a pre‐doctoral dental programme were identified for each level of the EBD five‐step process. We articulated educational objectives with behavioural expectations for each level of skill acquisition at each step of the EBD process. Outcome evaluation criteria identify students’ progressive level of skill acquisition from novice to expert.
Results
The educational objectives, type of knowledge, and nature of the cognitive process supporting these objectives are presented for each step of the EBD process. For example, educational objectives of the “Ask” step include (i) to construct a question from the patient presentation and knowledge limitations that addresses the clinical problem and (ii) to articulate the Problem, Intervention/Exposure, Comparison, Outcome (PICO) components. Achievement of these objectives requires both factual information regarding the PICO format and the cognitive process of understanding. Educational outcome criteria consistent with a competent clinician include clear articulation of the PICO with identifiable pieces that relate to the clinical situation.
Discussion
Assessment strategies for progression towards EBD competency are limited due to the complexity associated with evaluating EBD knowledge and behaviours. To evaluate performance, the EBD academic community must define competency expectations for entry into unsupervised general dental practice.
Conclusion
This framework offers measurable outcome evaluation criteria to initiate a conversation with academic peers regarding current gaps in EBD assessment.
The potential for rapid evolution in invasive species makes them useful for studying adaptive responses of populations to novel environments. However, phenotypic divergence during invasion is not ...necessarily due to selection, but may be a product of neutral processes resulting from population bottlenecks during colonization and range expansion. We investigated phenotypic adaptation during the establishment and range expansion of the invasive bunchgrass, slender false brome (Brachypodium sylvaticum; Poaceae). Utilizing a novel approach, we made robust comparisons of functional traits using genetic similarity based on unique alleles to determine the genetic probability of contribution from native source regions and integrated these probabilities into our QST–FST comparisons for 12 physiological and anatomical traits associated with drought stress in the introduced range. Our results indicate phenotypic divergence greater than neutral expectations in five traits between native and invasive populations, indicating selective divergence occurred during invasive species establishment. The results indicate that the majority of divergence in B. sylvaticum occurred after introduction to the novel environment, but prior to invasive range expansion. This study provides evidence for adaptive genetic differentiation during the establishment of an invasive species, while also describing a robust method for the detection of selective processes after species introduction to a novel environment.
Effect of extended defects in planar and pixelated CdZnTe detectors Camarda, G.S.; Andreini, K.W.; Bolotnikov, A.E. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
10/2011, Letnik:
652, Številka:
1
Journal Article
Recenzirano
We evaluated a spectroscopy-grade 15×15×7
mm
3 CdZnTe (CZT) crystal with a high μτ-product, >10
−2
cm
2/V, but impaired by microscopic extended defects, such as walls of dislocations, low-angle and ...sub-grain boundaries, and Te inclusions. First, we evaluated a planar detector fabricated from this crystal using a Micro-scale X-ray Detector Mapping (MXDM) technique. Then, we fabricated from the same crystal a pixel detector to study local non-uniformities of the electric field. The measured X-ray response maps confirmed the presence of non-uniformities in the charge transport, and they showed that the global- and local-distortions of the internal E-field correlated to the extended defects and space-charge buildup on the side surfaces.
Poor crystallinity remains a major problem affecting the availability and cost of CdZnTe (CZT) detectors. Point defects are responsible for small gradual charge loss and correlated with the electron ...clouds' drift times, which allows electronic correction of the output signals to achieve high spectral-resolution even with large-volume CZT detectors. In contrast, extended defects causes significant charge losses, which typically are uncorrelated, and, thus, result in much greater fluctuations of the output signals that cannot be corrected. Although extended defects do not affect all the interaction events, their fraction rapidly increases with the crystal's thickness and volume. In this paper, we summarize our recent results from testing CZT material and detectors that emphasize the particular roles of two types of extended defects, and their contributions to the device's overall performance.
CdZnTe crystals were grown by the vertical Bridgman technique using boron oxide for preventing material decomposition. The experiments show that a boron oxide layer completely encapsulates the ...crystal during growth, so that the crystal grows without direct contact with the crucible. The origins of this effect are investigated. In this work it is shown that boron oxide and quartz create a mixing layer at high temperature. This layer explains the reason for the good wetting of the quartz crucible by boron oxide.
Two-inch-diameter CdZnTe crystals doped with indium were grown by the boron oxide encapsulated vertical Bridgman technique. The crystals showed large single crystalline yield and low etch pit ...density. The background impurity content was dominated by boron in concentration lower than 1 ppm. High resistivity was obtained and a procedure for contact preparation was developed. The mobility-lifetime product of the material was determined by both X-ray irradiation and photocurrent spectroscopy. The X-ray detector prepared with this material showed good spectroscopic performance.
PDF
