PBL and critical thinking disposition in Chinese medical students – A randomized cross-sectional study

 The purpose of this study was to explore the relationship of problem-based learning (PBL) and the development of critical thinking disposition (CT) and academic achievement in Chinese medical students using a cross-sectional randomized design. Medical students from China Medical University (CMU) were randomized to PBL or non-PBL teaching at the commencement of the study. After five years of study, CT was scored by a Chinese version of the California Critical Thinking Disposition Inventory (CCTDI-CV). The score achieved on a Computer Case Simulation (CCS) test evaluated academic performance. Total CT score was higher in PBL students (n=170) than non-PBL students (n=83) (304.7±36.8 vs. 279.2±39.4, p < 0.01). Subscale CT-scores were significant in favor of PBL in six of the seven subscales (truth seeking, open-mindedness, analyticity, systematicity, inquisitiveness, maturity). There was no significant difference in terms of gender on the total CT score, though minor differences were seen in subscales favoring female PBL students. PBL students had higher CCS scores than non-PBL students, but not significantly (112.8±20.6 vs. 107.3±16.5; p=0.11). There was no significant correlation between CCS scores and CCTDI-CV results. Male students scored slightly higher on the CCS test compared to female students (male 113.4±18.9 vs. female 109.7±19.7), but the difference was not significant. This study concludes that in Chinese medical students, PBL teaching was related to a higher disposition of critical thinking, but not to improved academic skills

Analysis of infection related factors and clinical characteristics after percutaneous vertebral augmentation procedures

Objective Based on the clinical study of patients infected after percutaneous vertebral augmentation procedures (PVAP), the infection related factors and clinical characteristics were analyzed to provide basis for early prevention and diagnosis. Methods A retrospective study was conducted to analyze the diagnosis and treatment process and prognosis of 5 patients with infection after PVAP in Shanghai Ninth Peaple's Hospital from December 2017 to November 2023. Results There were 3 males and 2 females, aged 68-81 years, with an average age of 74.8 years. The time from operation to infection was 5-24 months. All patients presented with low back pain, the visual analogue scale (VAS) score was 7-8. All patients had imited thoracolumbar movement, local tenderness and percussion pain. Four patients had nerve symptoms such as decreased muscle strength in both lower limbs to varying degrees, 2 of which accompanied by defecation disorder. In laboratory tests, white blood cell (WBC) count was (4.0-7.3）×109/L, C-reactive protein (CRP) was 1.51-66.00 mg/dL, erythrocyte sedimentation rate (ESR) was 2-94 mm/1 h, and procalcitonin (PCT) was 0.10-0.40 ng/mL. X-ray, CT and MRI indicated the manifestations of infection, etiology and pathology confirmed 4 cases of Mycobacterium tuberculosis, of which 1 case was complicated with Acinetobacter baumannii, and the other case was diagnosed with Staphylococcus epidermidis. At the last follow-up, 2 patients died of complications, 3 patients were relieved of low back pain after surgery combined with drug treatment, body temperature was normal and inflammatory indicators were within the normal reference value range, and imaging examination showed no signs of infection. Conclusion Adequate preoperative assessment， symptomatic treatment of complications, and standard operation during the operation can reduce the incidence of infection after PVAP. If infection occurs, early diagnosis and systematic treatment can obtain good results

Inactivation of a Novel FGF23 Regulator, FAM20C, Leads to Hypophosphatemic Rickets in Mice

Family with sequence similarity 20,-member C (FAM20C) is highly expressed in the mineralized tissues of mammals. Genetic studies showed that the loss-of-function mutations in FAM20C were associated with human lethal osteosclerotic bone dysplasia (Raine Syndrome), implying an inhibitory role of this molecule in bone formation. However, in vitro gain- and loss-of-function studies suggested that FAM20C promotes the differentiation and mineralization of mouse mesenchymal cells and odontoblasts. Recently, we generated Fam20c conditional knockout (cKO) mice in which Fam20c was globally inactivated (by crossbreeding with Sox2-Cre mice) or inactivated specifically in the mineralized tissues (by crossbreeding with 3.6 kb Col 1a1-Cre mice). Fam20c transgenic mice were also generated and crossbred with Fam20c cKO mice to introduce the transgene in the knockout background. In vitro gain- and loss-of-function were examined by adding recombinant FAM20C to MC3T3-E1 cells and by lentiviral shRNA–mediated knockdown of FAM20C in human and mouse osteogenic cell lines. Surprisingly, both the global and mineralized tissue-specific cKO mice developed hypophosphatemic rickets (but not osteosclerosis), along with a significant downregulation of osteoblast differentiation markers and a dramatic elevation of fibroblast growth factor 23 (FGF23) in the serum and bone. The mice expressing the Fam20c transgene in the wild-type background showed no abnormalities, while the expression of the Fam20c transgene fully rescued the skeletal defects in the cKO mice. Recombinant FAM20C promoted the differentiation and mineralization of MC3T3-E1 cells. Knockdown of FAM20C led to a remarkable downregulation of DMP1, along with a significant upregulation of FGF23 in both human and mouse osteogenic cell lines. These results indicate that FAM20C is a bone formation “promoter” but not an “inhibitor” in mouse osteogenesis. We conclude that FAM20C may regulate osteogenesis through its direct role in facilitating osteoblast differentiation and its systemic regulation of phosphate homeostasis via the mediation of FGF23

Session 2 - Establishment of a VET system with focus on Further Education: presentation of ideas on the motivation and establishment of a Further Education system (FES), especially in universities in Sub-Sahara Africa

Session 2 Establishment of a VET system with focus on Further Education: presentation of ideas on the motivation and establishment of an education system, particularly a Further Education system, especially in universities in Sub-Sahara Africa. While session 1 discusses the basics of VET and Further Education, session 2 deals with how to establish Further Education structures by presenting visions and ideas on their implementation and formation. Different approaches are analysed from a VET perspective to develop them for practical purposes. The focus is specifically on efforts from Sub-Saharan countries

Protective Roles of DMP1 in High Phosphate Homeostasis

PURPOSE: Dmp1 (dentin matrix protein1) null mice (Dmp1(−/−)) display hypophosphatemic rickets with a sharp increase in fibroblast growth factor 23 (FGF23). Disruption of Klotho (the obligatory co-receptor of FGF23) results in hyperphosphatemia with ectopic calcifications formed in blood vessels and kidneys. To determine the role of DMP1 in both a hyperphosphatemic environment and within the ectopic calcifications, we created Dmp1/Klotho compound deficient (Dmp1(−/−)kl/kl) mice. PROCEDURES: A combination of TUNEL, immunohistochemistry, TRAP, von Kossa, micro CT, bone histomorphometry, serum biochemistry and Scanning Electron Microscopy techniques were used to analyze the changes in blood vessels, kidney and bone for wild type control, Dmp1(−/−), Klotho deficient (kl/kl) and Dmp1(−/−)kl/kl animals. FINDINGS: Interestingly, Dmp1(−/−)kl/kl mice show a dramatic improvement of rickets and an identical serum biochemical phenotype to kl/kl mice (extremely high FGF23, hyperphosphatemia and reduced parathyroid hormone (PTH) levels). Unexpectedly, Dmp1(−/−)kl/kl mice presented elevated levels of apoptosis in osteocytes, endothelial and vascular smooth muscle cells in small and large blood vessels, and within the kidney as well as dramatic increase in ectopic calcification in all these tissues, as compared to kl/kl. CONCLUSION: These findings suggest that DMP1 has an anti-apoptotic role in hyperphosphatemia. Discovering this novel protective role of DMP1 may have clinical relevance in protecting the cells from apoptosis in high-phosphate environments as observed in chronic kidney disease (CKD)

A generalization of Cauchy-Khinchin-van Dam inequality

We first give an alternative proof of a theorem originally presented by E. R. van Dam. Then we show a generalization of the van Dam matrix inequality