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Aim: Extended reality (XR) provides technologies that can create engaging and interactive learning resources easily updatable in line with the learning needs. This systematic review aimed to investigate the academic performance (AP), level satisfaction (LS), and acceptability (Ac) of XRs in university education students of medicine and health sciences. Method: The Preferred Reporting Items for Systematic Reviews statement was applied. Results: Nineteen experimental studies were included, which examined AP, 15 LS and 4 AC. No study was found that applies the Metaverse, 15 considered virtual reality (VR), 3 Augmented Reality (AR), 1 Mixed Reality (MR). Ten studies showed a statistically significant increase in AP in students who adopted XRs compared to traditional teaching methodologies. Six 5 studies showed a significant increase in LS after VR use. Two studies reported a high percentage of significant acceptability of XR use. Conclusion: The review provides that Metaverse results still need to be implemented; VR was a valid tool to support the improvement of AP and LS of students; VR turns out to be more widespread than other XRs. There are several discrepancies in the studies that confirm the need to promote the understanding of VR simulation’s effects on the acquisition of skills.

A Gly40Ser amino acid substitution in the glucagon receptor gene has been associated with non-insulin-dependent diabetes mellitus (NIDDM), but the questions raised about its physiological implications have not been resolved. The aim of this study was to determine the frequency of the Gly40Ser mutation in different regions of Sardinia and to investigate the physiological implications of the mutation in glucose and insulin homeostasis. We studied a population of 691 subjects, selected on the basis of their Sardinian origin. Only heterozygous subjects were found, 21 of 574 (3.6 %) in NIDDM patients and 5 of 117 in non-diabetic subjects (4.2 %). In northern Sardinia 3.4 % of the NIDDM patients were carriers of the Gly40Ser substitution, 1.4 % in central Sardinia, while 7.6 % carried the substitution in the Southern part. No significant differences were found between hypertensive and normotensive subjects with respect to the presence of Gly40Ser. Ten subjects with Gly40Ser were carefully matched for diabetic state, BMI, age, sex, and geographical origin with 10 patients with Gly40, and a glucagon infusion test was performed using 1, 3, 9 and 27 ng glucagon kg–1· min–1for 30 min. Blood for determination of glucose, glucagon, and insulin concentrations was drawn at 15-min intervals from the Controlateral arm. Plasma glucagon increased dose-dependently during the infusion with no significant difference between the two groups. Carriers of Gly40Ser had a significantly lower (p< 0.02) increase in plasma glucose concentration in response to glucagon infusion compared to Gly40 homozygous subjects at all times, while the plasma insulin increase was not significantly different at any time. In conclusion, our results indicate that the Gly40Ser variation is not associated with NIDDM in the Sardinian population, and that its frequency varies in different parts of Sardinia. Moreover in vivoGly40Ser plays a physiological role in the glucose homeostasis under glucagon control both in NIDDM and non-diabetic subjects. This latter result suggests that this amino acid substitution in the glucagon receptor may lead to a decreased blood glucose concentration because of the reduced stimulation of liver glucose output via the glucagon receptor. [Diabetologia (1997) 40: 89–94]A Gly40Ser amino acid substitution in the glucagon receptor gene has been associated with non-insulin-dependent diabetes mellitus (NIDDM), but the questions raised about its physiological implications have not been resolved. The aim of this study was to determine the frequency of the Gly40Ser mutation in different regions of Sardinia and to investigate the physiological implications of the mutation in glucose and insulin homeostasis. We studied a population of 691 subjects, selected on the basis of their Sardinian origin. Only heterozygous subjects were found, 21 of 574 (3.6 %) in NIDDM patients and 5 of 117 in non-diabetic subjects (4.2 %). In northern Sardinia 3.4 % of the NIDDM patients were carriers of the Gly40Ser substitution, 1.4 % in central Sardinia, while 7.6 % carried the substitution in the Southern part. No significant differences were found between hypertensive and normotensive subjects with respect to the presence of Gly40Ser. Ten subjects with Gly40Ser were carefully matched for diabetic state, BMI, age, sex, and geographical origin with 10 patients with Gly40, and a glucagon infusion test was performed using 1, 3, 9 and 27 ng glucagon kg–1· min–1for 30 min. Blood for determination of glucose, glucagon, and insulin concentrations was drawn at 15-min intervals from the Controlateral arm. Plasma glucagon increased dose-dependently during the infusion with no significant difference between the two groups. Carriers of Gly40Ser had a significantly lower (p< 0.02) increase in plasma glucose concentration in response to glucagon infusion compared to Gly40 homozygous subjects at all times, while the plasma insulin increase was not significantly different at any time. In conclusion, our results indicate that the Gly40Ser variation is not associated with NIDDM in the Sardinian population, and that its frequency varies in different parts of Sardinia. Moreover in vivoGly40Ser plays a physiological role in the glucose homeostasis under glucagon control both in NIDDM and non-diabetic subjects. This latter result suggests that this amino acid substitution in the glucagon receptor may lead to a decreased blood glucose concentration because of the reduced stimulation of liver glucose output via the glucagon receptor. [Diabetologia (1997) 40: 89–94]

BackgroundTherapeutic non-adherence is a major problem in patients with chronic kidney disease. This is the major cause of rejection in renal transplant patients.PurposeThe aim of this work was to evaluate the therapeutic adherence in renal transplant patients and to identify the causes of poor adherence.Material and methodsThis was a prospective study carried out on patients hospitalised in the renal transplant unit over a period of 4 months: from 1 April to 31 July 2016. All patients hospitalised during this period are included in the study. The test used to assess therapeutic adherence was Morisky’s test. Questioning was conducted for each patient to who were asked to fill inclinical information sheet. Data analysis was done by SPSS.ResultsWe studied 33 renal transplant patients. The average age of these patients was 43-years-old with extremes ranging from 20 to 59 years old. The number of male patients was 22 (66.6%) and the number of female patients was 11 (33.3%). Twenty-one patients had secondary level of education (63,3%), seven patients had primary level of education (21.2%) and four patients had university level of education (12%). Only one patient was illiterate (3.03%). Twenty patients had a minimal therapeutic adherence problem, which represents 60.6%. Twelve patients had good compliance (36.4%) and one had poor compliance (3.03%). Several reasons for non-compliance were raised. Forgetting medication represents 15.2%. The important number of drugs leads to therapeutic non-compliance and accounts for 18.2%. The ineffectiveness of the treatment represents a reason for non-compliance and represents 3.03%. The occurrence of adverse events represents 9.09%. The feeling of embarrassment and shyness when taking medication in front of others accounts for 25.7%.ConclusionSeveral causes are responsible for non-compliance such as forgetfulness, the multitude of drugs, ineffectiveness, the occurrence of adverse effects and the feeling of shyness when taking medication in front of others. A lot of these barriers are preventable just by better communication between the patient, his doctor and the care system. Therapeutic education is important in improving therapeutic adherance.References and/or AcknowledgementsM. Belrhiti, L. Benamar S. Hacib, A. Abouzoubair. Observance thôôérapeutique aprôôéès transplantation rôôéèénale:expôôéèéérience du service de nôôéèéééphrologie du CHU Ibn-Sina de Rabat. 2017.No conflict of interest

The in vitro ATP-dependent phosphorylation of histones catalyzed by bovine histone kinase is severely impaired by Escherichia coli cellular extracts. This effect is not due to a phosphoprotein phosphatase, or an ATPase, or a protease activity present in bacterial preparations. It seems rather attributable to a protein kinase inhibitor.