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Bone defects are a global public health problem. However, the available methods for inducing bone regeneration are limited. The application of traditional Chinese herbs for bone regeneration has gained popularity in recent years. β-ecdysterone is a plant sterol similar to estrogen, that promotes protein synthesis in cells; however, its function in bone regeneration remains unclear. In this study, we investigated the function of β-ecdysterone on osteoblast differentiation and bone regeneration in vitro and in vivo. MC3T3-E1 cells were used to test the function of β-ecdysterone on osteoblast differentiation and bone regeneration in vitro. The results of the Cell Counting Kit-8 assay suggested that the proliferation of MC3T3-E1 cells was promoted by β-ecdysterone. Furthermore, β-ecdysterone influenced the expression of osteogenesis-related genes, and the bone regeneration capacity of MC3T3-E1 cells was detected by polymerase chain reaction, the alkaline phosphatase (ALP) test, and the alizarin red test. β-ecdysterone could upregulate the expression of osteoblastic-related genes, and promoted ALP activity and the formation of calcium nodules. We also determined that β-ecdysterone increased the mRNA and protein levels of components of the BMP-2/Smad/Runx2/Osterix pathway. DNA sequencing further confirmed these target effects. β-ecdysterone promoted bone formation by enhancing gene expression of the BMP-2/Smad/Runx2/Osterix signaling pathway and by enrichment biological processes. For in vivo experiments, a femoral condyle defect model was constructed by drilling a bone defect measuring 3 mm in diameter and 4 mm in depth in the femoral condyle of 8-week-old Sprague Dawley male rats. This model was used to further assess the bone regenerative functions of β-ecdysterone. The results of micro-computed tomography showed that β-ecdysterone could accelerate bone regeneration, exhibiting higher bone volume, bone surface, and bone mineral density at each observation time point. Immunohistochemistry confirmed that the β-ecdysterone also increased the expression of collagen, osteocalcin, and bone morphogenetic protein-2 in the experiment group at 4 and 8 weeks. In conclusion, β-ecdysterone is a new bone regeneration regulator that can stimulate MC3T3-E1 cell proliferation and induce bone regeneration through the BMP-2/Smad/Runx2/Osterix pathway. This newly discovered function of β-ecdysterone has revealed a new direction of osteogenic differentiation and has provided novel therapeutic strategies for treating bone defects.

Scoring of performance can be based on different modes of observation, which can include live and videotaped observations. Although live observations have been the traditional format of measuring examinee performance in education and in healthcare, videotaped observations provide educators and testing agencies the promise of unbiased and standardized evaluations, offering practical solutions to limitations of real-time scoring. This study proposes a measurement model taking into account different modes of observation, using an extension of the hierarchical rater model based on signal detection theory (HRM-SDT). A hierarchical rater model is motivated by the nested structure of scores assigned by raters – scores assigned by raters become indicators of performance quality, which in turn become indicators of examinee ability. This study extends the hierarchical structure of the scoring process to include modes of observation, which serves as an intermediary level between the latent categorical indicator of performance quality and examinee ability, forming a three-level HRM-SDT. Analyses based on real-world data showed differences in the quality of scores from live observations and videotaped recordings. Compared to the traditional HRM-SDT, the overall model fit improved when including modes of observation. Simulations using different sample sizes and conditions provide implications for uses of this model. [ABSTRACT FROM AUTHOR]

Background: The relationship between learning modalities and nursing students' sleep quality during the coronavirus disease (COVID-19) pandemic is unknown. Purpose: This study examined the relationships between remote learning and the sleep quality of nursing students during the COVID-19 pandemic. Methods: Using a cross-sectional descriptive design, 890 nursing students were surveyed online to identify sleeping habits and learning modalities. Results: There were no significant correlations between remote learning hours, self-reported sleep hours, and sleep quality. The asynchronous-only group reported better sleep quality than the in-person and online hybrid group after controlling for health conditions and grade point average. Students who reported that remote learning had impacted their sleep had poorer sleep quality. Conclusions: This study provides insight into how different learning modalities impact nursing students' sleep quality during the pandemic. [ABSTRACT FROM AUTHOR]

Summary Statement: We conducted a systematic review to assess if any condition before- or after simulation-based training of teamwork competencies for healthcare professionals affects learning or transfer of skills to the clinical environment.We searched CINAHL, Medline, and Embase for studies published between January 1, 2011, and July 10, 2023. We screened 13,149 abstracts and 335 full texts, of which 5 studies were included. We included primary studies with and without a comparator published in English. We assessed risk of bias using the ROBINS-I tool before narrative synthesis. All studies were observational and reported heterogeneous conditions such as posters, coaching, and leadership support initiatives. Very low certainty evidence suggested that implementing conditions in the clinical environment such as coaching, wider communication of learning objectives, or leadership initiatives could be considered to facilitate the transfer of skill to the clinical environment. Funding: Society for Simulation in Healthcare. Prospero registration: CRD42022320721., Competing Interests: Conflicts of interest: J.W., K.K., E.E.B., K.X., J.K., and R.F. have no relevant conflict of interest to disclose; AB is a member of the European Resuscitation Council ALS Science and Education Committee and a medical specialist for Laerdal Medical Copenhagen; S.N.G.F. disclosed consultancy work for Edenbridge Health for teamwork and safety culture. No devices or medical products are involved. S.N.G.F. is the cofounder and member of the steering committee of the Emergency Manuals Implementation Collaborative (EMIC) and Stanford Anesthesia Cognitive Aid Program (SACAP); J.P. is an associate editor for the International Journal of Healthcare Simulation and received royalties from Oxford and Springer for books on simulation and surgical education; K.G.L. is a member of the International Liaison Committee on Resuscitation Task Force on Education, Implementation, and Teams and a member of the ERC Science and Education Committee on ALS., (Copyright © 2024 Society for Simulation in Healthcare.)