Search

Medisinstudiet i Norge er i dag regnet som et svært omfattende og krevende studie å gjennomføre. Dagens studieløp er lagt opp med mye fokus på egenlæring, hvor man jobber med teoretiske kasuser for å trene på pasientbehandling. Læringsformer som problembasert læring og klinisk trening er svært utbredt ved norske studiesteder, og det er opp til diskusjon om dette er læringsformer studentene opplever å få et utbytte av og som gjør dem til gode leger. Begrensning av ressurser til praktisk undervisning bidrar også til usikkerhet blant nyutdannede leger som føler de ikke har opparbeidet seg den nødvendige kompetansen som behøves i arbeidslivet. Oppstartsbedriften Zimmer Digital forsøker å bidra til kunnskap og ferdigheter ved å utvikle et digitalt læringsspill som skal bidra til studentenes læring. Bruken av slike seriøse spill i medisinutdanningen har enda ikke blitt en veletablert praksis i Norden, og det er både muligheter og skepsis knyttet til hvor effektive de kan være i å bedre læring. Gjennom både kvalitative og kvantitative undersøkelser og analyse, ønsker vi med denne oppgaven å besvare problemstillingen: “Hva skal til for at utviklingen av et digitalt læringsspill kan bidra til medisinstudentenes læring, og imøtekomme deres behov for å kunne utvikle ferdighetene sine innen pasientbehandling?”. Studien resulterte i flere funn. Blant annet kom det fram at det vil være vanskelig å utvikle læringsspill som dekker alle behov studentene har for å lære. Samtidig kan slike spill, dersom riktig funksjonalitet er på plass og spillet oppleves som brukervennlig, kunne bidra til dybdelæring i noen tilfeller. For at slike læringsspill skal ha et pedagogisk grunnlag og dermed kunne benyttes i undervisningssammenheng, er det viktig at spillene er utviklet med pedagogiske teorier og perspektiver som grunnlag. Det er derfor relevant at et slikt spill som Zimmer Digital utvikler forankrer innholdet i klinisk praksis, slik at det er muligheter for å implementere det i undervisningen og gi en større bredde i måtene å lære på. Education in medicine in Norway today is regarded as a very comprehensive and difficult study to complete. Teaching is focused on self-learning, where the students work on theoretical cases to practice their skills with regards to patient care. Different forms of learning such as problem based learning and clinical practice are quite common among Norwegian universities, and it is up to discussion whether these forms of learning actually give the students the competence they need to become good doctors. Limitations of resources to practical lessons also contributes to create an insecurity among the newly educated doctors who feel that they do not have the necessary competence needed at work. The startup Zimmer Digital is trying to address this need for knowledge by creating a digital serious game to help with the students learning. The usage of these types of games in the medicinal study is not yet a well established practice, with both possibilities and limitations in regards to how effective they actually are at bettering learning. Through both qualitative and quantitative surveys and analysis, we seek with this study to answer this problem: “What is required to make the development of a digital serious game help contribute to the medicine students learning, and accommodate their needs to develop their skills in regards to patient care?”. Our study resulted in several finds. Among others, it was discovered that it can be difficult to create serious games that covers all needs students have for learning. However, these types of games can, with correct functionality and user friendliness, contribute to deep learning. For these games to have an educational basis and thereby be used in a teaching context, it is important that the games are created with educational theories and perspectives as a basis. It is therefore relevant that a game such as the one Zimmer Digital develops, has educational theories as their basis to make it possible for the usage of the game in a learning environment and giving a larger width in the ways of learning.

This study sought to investigate and evaluate a modified axial translaminar screw fixation for treating odontoid fractures. We performed a retrospective study at Wenzhou Medical University Affiliated Second Hospital between March 2016 and June 2018. We retrospectively collected and analyzed the medical records of 23 cases with odontoid fractures. All patients were identified as type II odontoid fractures without neurological deficiency and serious diseases following the classification of Anderson. The average age, gender ratio, and body mass index (BMI) were 54.3 ± 11.1 years, 12 men to 11 women, and 22.6 ± 2.4 kg/m

Two organic hybrid manganese selenoarsenates, [Mn(en)

Objective Helicobacter pyloriinfection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-basedH. pyloriinfection control and management to reduce the related disease burden. Methods Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. Results Experts discussed and modified the original 23 statements on family-basedH. pyloriinfection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1)H. pyloriinfection and transmission among family members, (2) prevention and management ofH. pyloriinfection in children and elderly people within households, and (3) strategies for prevention and management ofH. pyloriinfection for family members. In addition to the ‘test-and-treat’ and ‘screen-and-treat’ strategies, this consensus also introduced a novel third ‘family-basedH. pyloriinfection control and management’ strategy to prevent its intrafamilial transmission and development of related diseases. Conclusion H. pyloriis transmissible from person to person, and among family members. A family-basedH. pyloriprevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

Many patients show poor outcomes following endovascular reperfusion therapy (ERT), and poor cortical venous outflow is a risk factor for these poor outcomes. We investigated the association between the outflow of the internal jugular vein (IJV) and baseline cortical venous outflow and the outcomes after ERT. We retrospectively enrolled 78 patients diagnosed with an acute anterior circulation stroke and successful ERT. Poor IJV outflow on the affected side was defined as stenosis ≥50% or occlusion of ipsilateral IJV, and poor outflow of bilateral IJVs was defined as stenosis ≥50% or occlusion of both IJVs. Poor cortical venous outflow was defined as a cortical vein opacification score (COVES) of 0 on admission. Multivariate analysis showed that poor outflow of IJV on the affected side was an independent predictor for hemorrhagic transformation. The poor outflow of bilateral IJVs was an independent risk factor for poor clinical outcomes. These patients also had numerical trends of a higher incidence of symptomatic intracranial hemorrhage, midline shift >10 mm, and in-hospital mortality; however, statistical significance was not observed. Additionally, poor IJV outflow was an independent determinant of poor cortical venous outflow. For acute large vessel occlusion patients, poor IJV outflow is associated with poor baseline cortical venous outflow and outcomes after successful ERT.

By changing the coordination anions (OAc

A novel fluorescent probe SHK for Zn

BACKGROUND Thyroid-stimulating hormone (TSH), which is regulated by the negative feedback of triiodothyronine (T3) and thyroxine (T4), is affected by cortisol (a stress hormone) and cytokines during allostasis. Thus, we assessed changes in TSH levels under stress and its potential as a stress marker in patients lacking T3 or T4 feedback after thyroid surgery. MATERIAL AND METHODS Three stress questionnaires (Korean version of the Daily Stress Inventory, Social Readjustment Rating Scale, and Stress Overload Scale-Short [SOSS]), an open-ended questionnaire (OQ), and thyroid function tests were administered twice to 106 patients enrolled from January 2019 to October 2020. RESULTS In a multiple generalized linear mixed-effect model (GLMM) involving 106 patients, the T3 and free T4 levels, OQ, body weight, extent of thyroidectomy, and preoperative TSH levels were significantly correlated with log-transformed TSH (lnTSH). The modified SOSS (category) based on recent stressors on OQ interview was significantly associated with lnTSH. In the GLMM with modified SOSS (category), the lnTSH increased by 2.3 and 0.56 in the unconscious high- and high-risk groups, respectively, compared to that in the low-risk group (P0.05). The calculated power of this study was 0.92 based on alpha=0.05. CONCLUSIONS TSH had a significant relationship with stress and the extent of thyroidectomy. An OQ supported the SOSS to help detect unrecognized stressors. TSH has potential utility as a stress marker combined with the modified SOSS (category) with sufficient power. However, questionnaires on social environments and research on coping strategies for stress are necessary for future studies.

Purpose Laparoscopic radical nephroureterectomy (LNU) has gradually become the new standard treatment for localized upper tract urothelial cancer (UTUC). With more blunt dissection and tactile sensation, hand-assisted LNU might shorten the operative time compared with the pure laparoscopic approach. However, whether the use of the hand-assisted or the pure laparoscopic approach has an effect on oncological outcomes remains unclear. Methods We retrospectively identified 629 patients with non-metastatic UTUC who underwent hand-assisted (n = 515) or pure LNU (n = 114) at 9 hospitals in Taiwan between 2004 and 2019. Overall survival, cancer-specific survival, recurrence-free survival, and bladder recurrence-free survival were compared between these two groups using inverse-probability of treatment weighting (IPTW) derived from the propensity scores for baseline covariate adjustment. Results The median follow-up period was 32.9 and 28.7 months in the hand-assisted and the pure groups, respectively. IPTW-adjusted Cox proportional hazards models showed that the laparoscopic approach (pure vs. hand-assisted) was not significantly associated with all-cause mortality (HR 0.79, 95% CI 0.49-1.24, p = 0.304), cancer-specific mortality (HR 0.88, 95% CI 0.51-1.51, p = 0.634), or extra-vesical recurrence (HR 0.65, 95% CI 0.41-1.04, p = 0.071). However, the pure laparoscopic approach was significantly associated with lower intra-vescial recurrence (HR 0.64, 95% CI 0.43-0.96, p = 0.029) for patients who underwent LNU. Kaplan-Meier curves also revealed that the pure laparoscopic approach was associated with better bladder recurrence-free survival compared with the hand-assisted laparoscopic approach in both the original cohort and the IPTW-adjusted cohort (log-rank p = 0.042 and 0.027, respectively). Conclusions The performance of hand-assisted or pure LNU does not significantly affect the all-cause mortality, cancer-specific mortality, or extra-vesical recurrence for patients with non-metastatic UTUC. However, the hand-assisted laparoscopic approach could increase the risk of intra-vesical recurrence for patients who undergo LNU.

Two Dy4 complexes, namely, [Dy4(L1)4(NO3)2(μ3-OH)2]·2C2H5OH·3H2O (1) and [Dy4(L2)4(NO3)2(μ3-OH)2]·3C2H5OH·8H2O (2), were successfully designed and synthesized under solvothermal conditions. X-ray d...

The ecotype population of goats (Capra hircus) was created by long‐term artificial selection and natural adaptation. Mile red‐bone goat is an indigenous breed with visible red bones, and its special bone structure has received extensive attention. This study aimed to identify genetic variants and candidate genes associated with specific bone phenotypes using next‐generation sequencing technology (NGS). The results revealed that 31,828,206 single nucleotide polymorphisms (SNPs) were obtained from 72 goats (20 Mile red‐bone goats and 52 common goats) by NGS. A total of 100 candidate genes were identified on the basis top 1% window interaction from nucleotide diversity (π), π ratio (π A/π B), and pairwise fixation index (F ST). Exactly 77 known signaling pathways were enriched. Specifically, three coding genes (NMNAT2, LOC102172983, and PNLIP) were annotated in the vitamin metabolism signaling pathways, and NCF2 was annotated to the osteoclast (OC) differentiation pathway. Furthermore, 5862 reliable copy number variations (CNVs) were obtained, and 14 and 24 genes were annotated with the top 1‰ CNV based on F ST (>0.490) and V ST (>0.527), respectively. Several pathways related to bone development and metabolism of exogenous substances in vivo, including calcium signaling pathway, OC differentiation, and glycerophospholipid metabolism, were annotated. Specifically, six genes from 19 candidate CNVs, which were obtained by interaction of the top 1‰ CNVs with F ST and V ST, were annotated to mucin‐type O‐glycan biosynthesis and metabolic pathways. Briefly, the results implied that pseudopurpurin and specific genetic variants work together to contribute to the red‐bone color and specific bone structure of Mile red‐bone goat. This study is helpful to understanding the genetic basis of the unique bone phenotype of Mile red‐bone goats., Mile red‐bone goat is an indigenous breed with visible red bones and special bone structure has received extensive attention. The aim of this study was to identify genetic variants and candidate genes associated with specific bone phenotypes using next‐generation sequence technology (NGS). This study is helpful to understanding the genetic basis of unique bone phenotype of Mile red‐bone goats.

A superb alkali-resistant single-molecule-magnet (SMM) material with the molecular formula [Dy2Ni4(L)8(CH3COO)4(NO3)2] (1) (HL = 8-hydroxyquinoline) has been structurally and magnetically characterized. Single-crystal X-ray diffraction revealed that 1 possesses a hexanuclear [DyIII2NiII4] cluster, which is built by two triangular [DyIIINiII2] cores double-bridged through two CH3COO- ions. Interestingly, 1 can keep its original structure in dilute acid and common basic solutions (e.g., triethylamine and NaOH). More importantly, 1 is still stable after treatment with a 20 M NaOH aqueous solution for 1 month at room temperature. Magnetic measurements uncovered that 1 is an SMM under zero applied field with Ueff = 7.43 K. To the best of our knowledge, 1 is the first example of a 3d-4f SMM with such extreme alkali resistance. This work will broaden the vision of preparing SMM materials with excellent chemical stability.

Although various lanthanide clusters with different shapes and connections have been synthesised, more rules are still needed to guide their further serial expansion and directed structural modific...

The application of scaffolding materials is believed to hold enormous potential for tissue regeneration. Despite the widespread application and rapid advance of several tissue-engineered scaffolds such as natural and synthetic polymer-based scaffolds, they have limited repair capacity due to the difficulties in overcoming the immunogenicity, simulating in-vivo microenvironment, and performing mechanical or biochemical properties similar to native organs/tissues. Fortunately, the emergence of decellularized extracellular matrix (dECM) scaffolds provides an attractive way to overcome these hurdles, which mimic an optimal non-immune environment with native three-dimensional structures and various bioactive components. The consequent cell-seeded construct based on dECM scaffolds, especially stem cell-recellularized construct, is considered an ideal choice for regenerating functional organs/tissues. Herein, we review recent developments in dECM scaffolds and put forward perspectives accordingly, with particular focus on the concept and fabrication of decellularized scaffolds, as well as the application of decellularized scaffolds and their combinations with stem cells (recellularized scaffolds) in tissue engineering, including skin, bone, nerve, heart, along with lung, liver and kidney., Graphical abstract Image 1, Highlight • dECM scaffolds for tissue regeneration are primarily introduced according to the development and fabrication of decellularized scaffolds, as well as the application of dECM scaffolds and their constructs combined with stem cells in various tissue engineering. • Limitations, challenges, and perspectives of dECM for accelerating development of tissue regeneration are discussed, respectively.

An open-atmosphere, unconfined setup comprising a novel multiple inverse-diffusion flame (m-IDF) burner modified with extended precursor tubes is employed to synthesize graphene on substrates. Growth conditions of mono-, bi-, and few-layer graphene (MLG, BLG, and FLG, respectively) are investigated, with systematic variation of parameters such as substrate temperature, methane-to-hydrogen volume flow rate ratio ( J CH 4 : J H 2 ), growth duration, post-flame flow profiles, substrate material, precursor species (e.g., CH4, C2H2, C2H4), and in-situ post-growth hydrogen annealing. Graphene growth on copper is observed for a wide range of temperatures from 850 °C to 1000 °C, with high-quality BLG created at a substrate temperature of 1000 °C with J CH 4 : J H 2 of 1:100 for 5 min growth duration. A sequential in-situ post-growth hydrogen annealing treatment, where the hydrocarbon precursor flow is terminated but the hydrogen m-IDFs are maintained, is found to be effective for etching adlayers of graphene. As such, BLG is reduced to MLG by increasing the post-growth hydrogen annealing duration at 1000 °C to 10 min. In-situ gas-phase Raman measurements characterize the evolution of the gas-phase precursor species in the synthesis flow field. CH2 is determined to be the main gas-phase carbon species needed near the substrate to form graphene in our flame synthesis system.

Schiff base ligands with multiple chelating coordination sites are usually able to quickly capture lanthanide metal ions to form complexes, and it is difficult to twist and construct helical chains. In this work, we used 2-hydroxy-1-naphthaldehyde, propylenediamine, and Ln(NO3)3·6H2O to react at 80 °C in solvothermal to obtain chains [Ln = Dy (1); Ln = Gd (2)] with a helical structure. It is worth noting that 2-hydroxy-1-naphthaldehyde and propylenediamine undergo an in situ reaction under one-pot conditions to form ligand 1,1′-((1E,1′E)-(propane-1,3-diylbis(azaneylylidene))bis(methaneylylidene))bis(naphthalen-2-ol) (H2L). The ligand (L)2− bridges the two metal center Ln(III) ions with a monodentate, causing it to twist into an “S” shape and further form a helical chain. In addition, the independent unit of the helical chain is a single core, and its metal center is in the O9 coordination environment provided by the ligand and the end group coordination NO3− ions. What’s more noteworthy is that chain 1 exhibits single-molecule magnet (SMM) behavior, and its SMM performance is significantly improved under the DC field induction condition of 600 Oe. By Debye model fitting, the effective energy barrier of 1 is 17.8 K, and the relaxation time is 2.4 × 10–6 s. The magnetocaloric effect test of chain 2 is further carried out. When ΔH = 7 T and T = 2 K, its − ΔSm reaches the maximum value of 16.19 J K−1 kg−1.

Objective To evaluate the efficacy of a novel decellularized porcine bone xenograft, produced by supercritical carbon dioxide extraction technology, on alveolar socket healing after tooth extraction compared to a commercially available deproteinized bovine bone (Bio‐Oss®). Materials and methods Nine dogs (about 18 months old and weighing between 20 kg and 30 kg) underwent extractions of lower second to fourth premolars, bilaterally. The dogs were randomly selected and allocated to the following groups: Group 1: control unfilled socket; Group 2: socket filled with decellularized porcine bone xenograft (ABCcolla®) and covered by a commercially available porcine collagen membrane (Bio‐Gide®); Group 3: socket filled with Bio‐Oss® and covered by Bio‐Gide® membrane. One dogs from each group was sacrificed at 4‐, 12‐, and 24‐week to evaluate the socket healing after tooth extraction. The mandible bone blocks were processed without decalcification and specimens were embedded in methyl methacrylate and subjected to histopathology analyses to evaluate the bone regeneration in the extraction sockets. Results At 24‐week after socket healing, ABCcolla® treated defects demonstrated significantly higher histopathology score in new bone formation and bone bridging, but significantly lower score in fluorescent labeling than those of the Bio‐Oss®. In the microphotographic examination, decellularized porcine bone xenograft showed similar characteristics of new bone formation to that of Bio‐Oss®. However, there was significantly less remnant implant materials in the decellularized porcine bone xenograft compared to the Bio‐Oss® group at 24‐week. Thus, the decellularized porcine bone graft seems to have promising bone regeneration properties similar to that of Bio‐Oss® with less remnant grafted material in a canine tooth extraction socket model. Conclusions Within the limits of the study, we concluded that ABCcolla® treated defects demonstrated significantly more new bone formation and better bone bridging, but less amount of fluorescent labeling than those of the Bio‐Oss® group. However, clinical studies in humans are recommended to confirm these findings.

Most published newborn growth references are based on conventional monitoring data that usually included both low- and high-risk pregnancies. We sought to develop a set of neonatal growth standards constructed from only a large sample of low-risk pregnancies. A total of 24,375 naturally conceived singleton live births with gestational ages of 24–42 weeks were collected in 69 hospitals in thirteen Chinese cities between 2015 and 2018. Unhealthy infants or those with high-risk mother were excluded. Smoothed percentile curves of six anthropometric indicators were established using the Generalized Additive Model for Location, Scale and Shape. The 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile references for birth weight, length, head circumference, weight/length, body mass index, and ponderal index were calculated for neonates with gestational ages of 24–42 weeks. This set of neonatal growth standards with six anthropometric indicators can provide more tools for growth and nutrition assessment and body proportionality in neonatal clinical practice. These standards might also help to show the differences between growth curves based on low-risk and mixed low- and high-risk pregnancies.

In this study, a couple of tetradentate Pt(II) enantiomers ((-)

A consensus is lacking on the accuracy of torque value on different types of mechanical torque-limiting devices.The purpose of this systematic review and meta-analysis was to determine the accuracy of unused mechanical torque-limiting devices.Electronic searches were conducted until October 2021 in 6 electronic databases. Relevant articles were manually screened in 5 journals from January 2000 to October 2021. Two reviewers screened titles, abstracts, and full texts and extracted the data independently. A meta-analysis was conducted to evaluate the weighted mean difference in torque value deviation from target torque between spring-style and friction-style devices as a primary outcome. Deviations of output torque value from target value in spring-style or friction-style devices were also analyzed as a secondary outcome.A total of 11 595 articles were identified, and 16 articles were included for final statistical analysis. Meta-analysis of the included articles showed that torque value deviation in the spring-style was significantly lower than in the friction-style devices (-0.99 Ncm, 95% confidence interval [CI]: [-1.89, -0.09], P=.030). Deviations of output torque value from target value was -0.54 Ncm in the spring-style group (CI: [-1.23, 0.15], P=.122) and -0.18 Ncm in the friction-style group (95% CI: [-1.40, 1.04], P=.770). Meta-regression analysis indicated that target value was significantly associated with the mean deviation from target value only in the spring-style group. High heterogeneity was found, suggesting more studies with standardized research design are required.Both spring- and friction-style mechanical torque-limiting devices can produce relatively accurate torque values; however, unused spring-type devices tend to have lower deviation from target torque value than unused friction-type devices.

The metallic central magnetic axes in high-nucleation clusters with complex structural connections tend to be disorganized and cancel each other out. Therefore, high-nucleation clusters cannot easily exhibit single-molecule magnets (SMMs) behaviors. Herein, we select a triple-core building block (Dy

IntroductionChildren with obesity in the absence of traditional cardiometabolic risk factors (CRF) have been described as metabolically healthy obese (MHO). Children with MHO phenotype has a favorable metabolic profile with normal glucose metabolism, lipids, and blood pressure compared to children with metabolically unhealthy obese (MUO) phenotype. This study aimed to compare several parameters related to obesity between these two groups and to examine the predictors associated with the MHO phenotype.MethodsThis study included a cross-sectional baseline data of 193 children with obesity (BMI z-score > +2 SD) aged 8-16 years enrolled in MyBFF@school program, a school-based intervention study conducted between January and December 2014. Metabolic status was defined based on the 2018 consensus-based criteria with MHO children had no CRF (HDL-cholesterol > 1.03 mmol/L, triglycerides ≤ 1.7 mmol/L, systolic and diastolic blood pressure ≤ 90th percentile, and fasting plasma glucose ≤ 5.6 mmol/L). Those that did not meet one or more of the above criteria were classified as children with MUO phenotype.ResultsThe prevalence of MHO was 30.1% (95% CI 23.7 – 37.1) among schoolchildren with obesity and more common in younger and prepubertal children. Compared to MUO, children with MHO phenotype had significantly lower BMI, lower waist circumference, lower uric acid, higher adiponectin, and higher apolipoprotein A-1 levels (p < 0.01). Multivariate logistic regression showed that adiponectin (OR: 1.33, 95% CI 1.05 – 1.68) and apolipoprotein A-1 (OR: 1.02, 95% CI 1.01 – 1.03) were independent predictors for MHO phenotype in this population.ConclusionsMHO phenotype was more common in younger and prepubertal children with obesity. Higher serum levels of adiponectin and apolipoprotein A-1 increased the possibility of schoolchildren with obesity to be classified into MHO phenotype.