Student perceptions of syndicate learning: tutor‐less group work within an undergraduate dental curriculum

This paper describes the implementation of syndicate learning (tutor‐less group working) to teach the basic principles and skills of removable partial denture design within an undergraduate dental curriculum at the University of Glasgow. Student perceptions of syndicate group learning were collected through using questionnaires with Likert scales and through focus group interviews. The majority of students expressed positive views of syndicate learning that focused on the following themes: the added value of the group in terms of learning and in terms of social cohesion; the sense of responsibility to peers that led them to work harder; the autonomy of tutor‐less groups that led them to improve their ability to justify their work; and the effectiveness of the syndicate groups in comparison with other learning methods. On the basis of these findings along with reports from students that learning about group roles enhanced their preparation for future work, we argue that syndicate learning can offer some valuable benefits to the undergraduate dental curriculum.     

基于Ridit和RSR法的临床手术科室风险系数及其风险等级评价

目的探寻构建临床手术科室风险系数并客观评价其风险等级的方法。方法结合Ridit法与RSR法,对临床手术科室风险系数进行分档评级。结果手术科室风险系数(Ki)=各科室平均Ridit值+三四级手术占比+复杂病人占用床日比。后期通过运用RSR法和最佳分档准则,将Ki值分为3档,即临床手术科室风险分为3个等级:第一级为低风险科室,第二级为一般风险科室,第三级为高风险科室。结论利用临床手术科室风险系数Ki值反映各科承担的手术风险,能相对客观公正地表现临床医生的工作量和工作强度,有利于优化医院内部运营绩效考核与分配等工作。     

Correlation between the extent of smoking,salivary protein profiles,and dental caries in young adult smokers

Context.Proteins in the saliva are one of the defense mechanism factors that can protect the oral cavity from disease. However, smoking might affect the properties of saliva.AimTo determine the differences in salivary protein profiles and total concentrations in smokers and non-smokers and their correlation with dental caries severity as indicated by the Decayed, Missing, Filled-Teeth (DMF-T) scores.Methods and materialThis cross-sectional study included 25 smokers and 25 non-smokers. The DMF-T scores were recorded. The total salivary protein was measured by the Bradford method, and the profile proteins were determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE).ResultsThe average of salivary protein concentration in smokers was lower than that in non-smokers (551.486 µg/mL versus 765.361 µg/mL), but the difference was not statistically significant (P > 0.05). Further correlation analyses showed a negative correlation between the concentration of proteins based on the extent of smoking. A weak negative correlation was found between protein concentration and DMF-T scores (r = −0.239). Dominant salivary protein bands of 11.6 kDa and 54.5 kDa were found in smokers and 27 kDa, 60 kDa, and 94.5 kDa were found in non-smokers.ConclusionDifferent protein bands appeared in smokers and non-smokers. There was a weak correlation between protein concentration, DMF-T scores, and the extent of smoking.     

Nutritional intervention during maxillomandibular fixation of jaw fractures prevents weight loss and improves quality of life

Maxillomandibular fixation (MMF) for the management of jaw fractures leads to compromised nutritional intake and consequent weight loss and poor quality of life (QoL). The present study aimed to evaluate the effectiveness of a home-based dietary plan to prevent weight loss, and its effect on the QoL of patients who underwent four weeks of MMF for the treatment of maxillofacial fractures. A total of 50 patients were randomised into nutritional intervention (Group1) and non-intervention groups (Group 2). Patients in Group1 were counselled by a dietitian and given a diet plan. Patients in Group 2 were advised to take a liquid diet of their own choice in the form of shakes, juices, and milk, along with protein supplements. Patients in Group1 lost significantly less weight than those in Group 2 (p=0.001) at week four of follow up. Group1 patients had significantly better oral health-related QoL in the ‘physical pain’ domain during the two weeks of MMF, and in the ‘physical discomfort’ and ‘psychological disability’ domains two weeks after the release of MMF. They had significantly better nutrition-related QoL in all the domains during the two weeks of MMF and, except for the ‘physical’ domain, also during the two weeks after its release. Individual home-based diet plans effectively helped the patients maintain their weight and improved QoL.     

Influence of unfused cranial bones on magnetoencephalography signals in human infants

ObjectiveTo clarify the effects of unfused cranial bones on magnetoencephalography (MEG) signals during early development.MethodsIn a simulation study, we compared the MEG signals over a spherical head model with a circular hole mimicking the anterior fontanel to those over the same head model without the fontanel for different head and fontanel sizes with varying skull thickness and conductivity.ResultsThe fontanel had small effects according to three indices. The sum of differences in signal over a sensor array due to a fontanel, for example, was < 6% of the sum without the fontanel. However, the fontanel effects were extensive for dipole sources deep in the brain or outside the fontanel for larger fontanels. The effects were comparable in magnitude for tangential and radial sources. Skull thickness significantly increased the effect, while skull conductivity had minor effects.ConclusionMEG signal is weakly affected by a fontanel. However, the effects can be extensive and significant for radial sources, thicker skull and large fontanels. The fontanel effects can be intuitively explained by the concept of secondary sources at the fontanel wall.SignificanceThe minor influence of unfused cranial bones simplifies MEG analysis, but it should be considered for quantitative analysis.     

葡萄糖转运蛋白1和波形蛋白在肺癌胸水中的应用价值

目的:采用免疫细胞化学技术测定葡萄糖转运蛋白1(GLUT1)及波形蛋白(VM)在癌细胞中的定位表达,探讨GLUT1和VM在肺癌胸水中的应用价值。方法:以肺癌患者为研究对象,以肺癌性胸水为检测基础,收集胸水沉淀细胞,制成石蜡切块,采用免疫组化技术-链霉菌抗生物素-过氧化物霉法检测30例肺癌胸水和20例良性胸水中GLUT1和VM蛋白表达,统计单个及联合应用价值。结果:30例肺癌胸水中,GLUT1表达阳性的有25例(86.7%),良性胸水中间皮细胞VM表达阳性的有18例(90.0%),两种不同性质的胸水GLUT1和VM的阳性率表达均有差异(P<0.05),GLUT1和VM在肺癌胸水中表达呈负相关(P<0.05),两者联合诊断灵敏度为90%。结论:应用免疫组化方法检测肺癌胸水中GLUT1和VM蛋白表达,可提高肺癌早期诊断的灵敏度。     

护士决策分级护理工作流程的研究

[目的]制订护士决策分级护理的工作流程。[方法]应用Delphi法对19名护理专家和15名医疗专家进行护士决策分级护理工作流程的2轮专家咨询。[结果]护士决策分级护理分为准备、评估、决策、调整4个步骤;决策护士通过判断病人病情严重程度及生活自理能力,依据分级标准独立做出级别诊断,并下达在分级护理护嘱单上;某些特定情况护士无法决策护理级别时,与医生进行病情讨论后共同决议。[结论]制订并规范护士决策分级护理的工作流程,体现工作步骤关系并提供操作标准,使护理工作处于最佳运行状态,以提高护理质量。     

Inference for Clinical Trials with Some Protocol Amendments

ABSTRACT

The use of adaptive methods in clinical development has become very popular in recent years due to its flexibility in modifying trial procedures and/or statistical procedures of on-going clinical trials. Modifications to trial procedures are usually documented by protocol amendments. However, the actual patient population after protocol amendments could deviate from the originally targeted patient population. In addition, protocol amendments made based on accrued data of the on-going trial may distort the sampling distribution of the statistic designed for the case of no protocol change. In this article, we model the population deviations due to protocol amendments using some covariates and study how to develop a valid statistical inference procedure. An example concerning an asthma trial is presented for illustration.     

Survival of pre-viable preterm infants in the United States: A systematic review and meta-analysis

The objective of this paper is to review observational studies that addressed the survival of pre-viable gestations in the United States. We searched PubMed, Ovid, CINAHL, and Web of Knowledge for studies reporting survival of infants born at <24 gestational weeks and/or <500 g in the United States and published between January 2003 and January 2013. The full texts of 70 articles were examined and a total of 15 studies qualified and were selected. We analyzed fixed-effect and random-effects models for eight studies on survival to discharge. Pooled survival to discharge in the random-effects model was 45.9% (95% CI: 41.1–51.7) and 39.7% in the fixed-effect model (95% CI: 38.8–40.7). Studies differed by pre-viable survival measures and epochs (1985–2009). Protective factors included antenatal corticosteroids, neonatal resuscitation, and intensive care. The current survival threshold for pre-viable infants warrants reconsideration of the limits of viability. Protective factors that enhance survival should be considered in the management of these infants.     

The Effect of Premature Loss of Deciduous Teeth a Biomktric Study in 14- and 10-Year-Olds

Abstract

Objective. To compare two methods used to examine the cement interface homogeneity of adhesively luted glass fiber posts (GFPs). Material and methods. GFPs were divided into four groups (n = 5 in each) and inserted into artificial root canals under standardized conditions: Group I = RelyX Unicem, application with application aid; Group II = RelyX Unicem; Group III = Panavia F 2.0; and Group IV = Variolink II. Posts in Groups II–IV were cemented without using an appliance. All specimens were sectioned at three levels (cervical, middle and apical) perpendicularly to the post's long axis and examined and photographed (n = 60) using scanning electron microscopy (SEM). Cement interface inhomogeneities were (A) measured by means of SEM software and (B) estimated using a graphics program with SEM images being divided into 72 equal circle segments to calculate a percentage value of inhomogeneities of the 360° circumference. Results. Median values of inhomogeneities (A/B; %) within the cement interface for the cervical, middle and apical levels of analysis, respectively were 1.4/2.1, 2.2/4.2 and 1.9/2.1 for Group I; 21.0/20.1, 24.8/23.6 and 27.0/24.3 for Group II; 1.5/1.7, 5.5/6.3 and 19.4/20.8 for Group III; and 18.1/16.7, 16.1/15.3 and 27.2/25.7 for Group IV. The two methods correlated very well (0.994), with a value of one indicating a 100% correlation. Conclusion. Both evaluation methods were found to be equally appropriate for quantifying the cement interface homogeneity of SEM cross-sections of adhesively luted GFPs.