Teaching Medical Humanities in Medical Schools with Open Education Resources

In this chapter we will explore various ways in which open education resources might be utilised in the teaching of medical humanities in medical schools. Open education resources are generic open access materials in a particular field, which can be used by educators and students alike to support teaching and learning. They might be particularly useful when an institution lacks staff with specific expertise to teach essential but ‘minority’ subjects. The open and generic nature of these resources almost always means that they can be used flexibly to suit the teaching and learning contexts in which they are used. However, that same generic character means that they will be rarely directed towards specific learning outcomes, and therefore educators might struggle to fit them into teaching programmes, or have to alter their own learning outcomes and curricula in order to fit the resources available.Here, we outline and reflect upon different ways we have used open access medical humanities materials developed by the ALCMAEON project to support teaching in UK medical programmes the medical schools at the University of Bristol and University of St Andrews respectively. We begin by discussing the difficulties often encountered in teaching medical humanities in the crowded medical curriculum, before outlining what open education resources are and how they can help, with particular reference to the ALCMAEON project. We then outline and reflect on three different ways in which the ALCMAEON resources have been used to support teaching and learning with medical humanities, and consider the wider lessons we can draw from that experience about the use and development of open education resources to support learning and teaching of ‘minority’ subjects in medical curricula.<br/

Multivariate side-band subtraction using probabilistic event weights

A common situation in experimental physics is to have a signal which can not be separated from a non-interfering background through the use of any cut. In this paper, we describe a procedure for determining, on an event-by-event basis, a quality factor ($Q$-factor) that a given event originated from the signal distribution. This procedure generalizes the "side-band" subtraction method to higher dimensions without requiring the data to be divided into bins. The $Q$-factors can then be used as event weights in subsequent analysis procedures, allowing one to more directly access the true spectrum of the signal.Comment: 17 pages, 9 figure

Data analysis techniques, differential cross sections, and spin density matrix elements for the reaction gamma p -\u3e phi p

High-statistics measurements of differential cross sections and spin density matrix elements for the reaction gamma p -\u3e phi p have been made using the CLAS detector at Jefferson Lab. We cover center-of-mass energies (v s) from 1.97 to 2.84 GeV, with an extensive coverage in the phi production angle. The high statistics of the data sample made it necessary to carefully account for the interplay between the f natural lineshape and effects of the detector resolution, that are found to be comparable in magnitude. We study both the charged-(phi -\u3e K+ K-) and neutral( phi -\u3e(KsKL0)-K-0) K (K) over bar decay modes of the phi Further, for the charged mode, we differentiate between the cases where the final K-track is directly detected or its momentum reconstructed as the total missing momentum in the event. The two charged-mode topologies and the neutral-mode have different resolutions and are calibrated against each other. Extensive usage is made of kinematic fitting to improve the reconstructed f mass resolution. Our final results are reported in 10- and mostly 30-MeV-wide root s bins for the charged-and the neutral-modes, respectively. Possible effects from K+Lambda* channels with pK (K) over bar final states are discussed. These present results constitute the most precise and extensive phi photoproduction measurements to date and in conjunction with the omega photoproduction results recently published by CLAS, will greatly improve our understanding of low energy vector meson photoproduction

New WHO Violence Prevention Information System, an interactive knowledge platform of scientific findings on violence.

Scientific information on violence can be difficult to compile and understand. It is scattered across websites, databases, technical reports and academic journals, and rarely addresses all types of violence. In response, in October 2017 WHO released the Violence Prevention Information System or Violence Info, an online interactive collection of scientific information about the prevalence, consequences, risk factors and preventability of all forms of interpersonal violence. It covers homicide, child maltreatment, youth violence, intimate partner violence, elder abuse and sexual violence

AB0462 BEHCET'S DISEASE: CLINICAL FEATURES AND OFF-LABEL BIOLOGIC TREATMENT STRATEGIES

Background:The treatment of Behçet's disease (BD) is still mainly based on the evidence derived from case reports, case series, retrospective analyses, and few clinical trials suggesting the safety and potential efficacy of off-label use of biologic agents in refractory cases.1Objectives:To describe clinical manifestations and their management, with particular focus on treatment indications, outcomes and safety of biologic therapy, in a cohort of patients with BD.Methods:Patients with a diagnosis of BD who visited our outpatient clinic until December 2019 were included in the study. Clinical data were recorded since diagnosis until the latest follow-up visit, analyzing clinical features, flares and therapeutic strategies adopted.Results:A total of 95 patients were included in the study with a medium follow-up of 108.54 ± 169.59 months. 20 of them (21. 05%) were treated with biologic agents. Patients treated with biologic therapy compared to those on conventional non-biologic therapies had a higher proportion of musculoskeletal (80% vs 46.67%, p = 0.008), neurological (30% vs 10.67%, p = 0.031), intestinal involvement (40% vs 12%, p = 0.004), and they were treated with a higher dose of glucocorticoids at diagnosis (16.84 mg ±14.01 vs 8.89 mg ± 11.76, p = 0.012). The most frequent indications for biologic step-up therapy were musculoskeletal involvement (40%), eye involvement (25%), neurological involvement (15%) and intestinal involvement (10%). Most patients initiated a biologic treatment within the first year of follow-up. TNF-inhibitor (TNFi) were more frequently prescribed (95%) and one patient was treated with 8 therapeutic cycles of Rituximab (500 mg/weekly for 4 infusions to be repeated after at least 6 months) because of recurrent pancytopenia. All patients experienced non-biologic therapy before starting a TNFi. The preferred first-line TNFi was infliximab (50%), followed by adalimumab (40%) and etanercept (5%). As second line treatment were also prescribed certolizumab (10%) and golimumab (5%). 10 patients switched to a second line treatment because of inefficacy of the first biologic agent, mainly because of refractory arthritis, intestinal and mucocutaneous involvement. One patient switched from infliximab to certolizumab during pregnancy with subsequent worsening of arthritis.85% of patients treated with biologic agents reached a clinical remission by the time of the latest follow up visit without any safety or tolerability issues.Conclusion:A relevant proportion of patients in our BD cohort were treated with biologic therapy, because of severe or refractory manifestations. The most frequent indications were musculoskeletal, neurological or intestinal involvement. Biologic agents were a generally effective and safe therapeutic approach.References:[1]F. Alibaz-Oner, M. H. Sawalha, H. Direskeneli. Management of Behçet disease, Curr. Opin. Rheumatol, 2018Table 1.General characteristics and disease involvement at diagnosisBiologic therapyNo biologic therapyp value20 (21.05%)75 (78.95%)General characteristicsMediaSDMediaSDAge at disease onset(years ± SD)34.5± 10.4938.64± 13.18p = 0.1976Diagnostic delay(months ± SD)45.28± 67.4828.09± 48.42p = 0.1996Glucocorticoids at diagnosis (mg prednisone ± SD)16.84± 14.018.89± 11.76p = 0.0115Glucocorticoids at latest follow up visit (mg prednisone ± SD)6.38± 7.763.83± 4.81p = 0.0707N%N%F / M12 / 860 / 4054 / 4172 / 28p = 0.3030Disease involvement at diagnosisOral ulcers2010075100Genital ulcers11553749,33p = 0.6540Cutaneous lesions15755066,67p = 0.4787Eye involvement6302736p = 0.6184Musculoskeletal involvement16803546,67p = 0.0082Neurological involvement630810,67p = 0.0311Intestinal involvement840912p = 0.0039Thrombosis2101824p = 0.1747Disclosure of Interests:None declare

Effect of drying methods on phenolic compounds and antioxidant activity of Urtica dioica L. leaves

Stinging nettle (Urtica dioica) is a plant well known in traditional medicine for its many beneficial properties, but the lack of standardization regarding the product to offer to consumers limits its diffusion. To this end, drying appears to be a useful technique to offer a low-cost product that can be stored for long time, but the different drying procedures may give rise to end-products of very different quality as nutraceutical and antioxidant compounds. Nettle leaves have been dehydrated employing freeze-drying (FD), oven-drying (OD) or heat pump drying (HPD) and compared with fresh leaves following water extraction to emulate the use by final consumers. Results indicate that the best dehydration technique is HPD, which apparently gives rise to more than a doubling of total phenols and antioxidant activity in the extract compared to the water extract obtained from fresh leaves but a reduction in the level of ascorbic acid of about 39%. In addition, the content of some phenolic compounds is 10 to over a hundred times higher in the extract after HPD than that obtained from fresh samples. This confirms that the dehydration technique should be tuned in relation to the compounds of greatest interest or value

1D numerical and experimental investigations of an ultralean pre-chamber engine

In recent years, lean-burn gasoline Spark-Ignition (SI) engines have been a major subject of investigations. With this solution, in fact, it is possible to simultaneously reduce NOx raw emissions and fuel consumption due to decreased heat losses, higher thermodynamic efficiency, and enhanced knock resistance. However, the real applicability of this technique is strongly limited by the increase in cyclic variation and the occurrence of misfire, which are typical for the combustion of homogeneous lean air/fuel mixtures. The employment of a Pre-Chamber (PC), in which the combustion begins before proceeding in the main combustion chamber, has already shown the capability of significantly extending the lean-burn limit. In this work, the potential of an ultralean PC SI engine for a decisive improvement of the thermal efficiency is presented by means of numerical and experimental analyses. The SI engine is experimentally investigated with and without the employment of the PC with the aim to analyze the real gain of this innovative combustion system. For both configurations, the engine is tested at various speeds, loads, and air-fuel ratios. A commercial gasoline fuel is directly injected into the Main Chamber (MC), while the PC is fed in a passive or active mode. Compressed Natural Gas (CNG) or Hydrogen (H2) is used in the actual case. A 1D model of the engine under study is implemented in a commercial modeling framework and is integrated with “in-house developed” sub-models for the simulation of the combustion and turbulence phenomena occurring in this unconventional engine. The numerical approach proves to reproduce the experimental data with good accuracy, without requiring any case-dependent tuning of the model constants. Both the numerical and experimental results show an improvement of the indicated thermal efficiency of the active PC, compared to the conventional ignition device, especially at high loads and low speeds. The injection of H2 into the PC leads to a significant benefit only with very lean mixtures. With the passive fueling of the PC, the lean-burn limit is less extended, with the consequent lower improvement potential for thermal efficiency

Effects of the ionizing radiation disinfection treatment on historical leather

Microorganisms often cause significant damage on historical objects. The archive or library materials as well as textile or leather artifacts suffer serious attacks that need appropriate care treatments. Several biocide processes have been implemented but often their application does not preserve the material of the good. The objective of this work is the disinfection through ionizing radiation of leather wallpaper from the museum building Palazzo Chigi in Ariccia (Rome, Italy). The controlled sterilization treatments were carried out using X-ray beams to eliminate the microorganisms present on the leather and maintaining unchanged the properties of the constituent material. Some fragments of decorated leather wallpaper, dating back to the 1700s, were irradiated with X-rays up to 5,000 Gy. The amount of microorganisms was evaluated by microbiological analysis before and after X-ray irradiation treatments to identify the dose that inhibits the bacterial load. It will be shown how the results obtained by the application of different chemical-physical techniques (Scanning Electron Microscopy, Fourier Transform Infrared spectroscopy and Light Transmission Analysis) have helped in the evaluation of the impact of the X-rays on leather chemical and physical integrity