The effect of e-learning on the quality of orthodontic appliances

Purpose: The effect of e-learning on practical skills in medicine has not yet been thoroughly investigated. Today’s multimedia learning environment and access to e-books provide students with more knowledge than ever before. The aim of this study is to evaluate the effect of online demonstrations concerning the quality of orthodontic appliances manufactured by undergraduate dental students. Materials and methods: The study design was a parallel-group randomized clinical trial. Fifty-four participants were randomly assigned to one of the three groups: 1) conventional lectures, 2) conventional lectures plus written online material, and 3) access to resources of groups one and two plus access to online video material. Three orthodontic appliances (Schwarz Plate, U-Bow Activator, and Fränkel Regulator) were manufactured during the course and scored by two independent raters blinded to the participants. A 15-point scale index was used to evaluate the outcome quality of the appliances. Results: In general, no significant differences were found between the groups. Concerning the appliances, the Schwarz Plate obtained the highest scores, whereas the Fränkel Regulator had the lowest scores; however, these results were independent of the groups. Females showed better outcome scores than males in groups two and three, but the difference was insignificant. Age of the participants also had no significant effect. Conclusion: The offer that students could use additional time and course-independent e-learning resources did not increase the outcome quality of the orthodontic appliances. The advantages of e-learning observed in the theoretical fields of medicine were not achieved in the educational procedures for manual skills. Factors other than e-learning may have a higher impact on manual skills, and this should be investigated in further studies

Authenticity and the 'Authentic City'

In this paper, I argue that the benefits that smart cities purport to provide cohere poorly with a number of our shared phenomenological intuitions about the relationships(s) between authentic experience and technologised society. While many of these intuitions are, strictly speaking, pseudo-problems, they deserve our attention. These issues will only grow more pressing as our ‘dumb cities’, already so opaque to experience, give way to hyper-technologised ‘smart cities’. However, it is possible to design our way out of these pseudo-problems. Assuming we accept my argument that the distinction between authenticity and the device paradigm is premised upon a certain kind of category error, there is no categorical or definitional reason why it is not possible for urbanised, technologised spaces to feel authentic, whether by virtue of their aesthetic properties, or because they facilitate ‘authentic’ behaviour. Indeed, I argue that ‘inauthenticity’ is an aesthetic rather than an ontological category (much like ‘ugliness’, or ‘boring-ness’), with feelings of inauthenticity serving as evidence of a basic failure of design. Redressing these failures of design requires that we adopt a novel approach to the design and use of technical objects. Consequently, in the concluding analysis of the chapter I outline how the feeling of authenticity can be invoked in the smart city and, consequently, how these failures of design can be avoided.<br/

The trauma patient in hemorrhagic shock: How is the C-priority addressed between emergency and ICU admission?

BACKGROUND: Trauma is the leading cause of death in young people with an injury related mortality rate of 47.6/100,000 in European high income countries. Early deaths often result from rapidly evolving and deteriorating secondary complications e.g. shock, hypoxia or uncontrolled hemorrhage. The present study assessed how well ABC priorities (A: Airway, B: Breathing/Ventilation and C: Circulation with hemorrhage control) with focus on the C-priority including coagulation management are addressed during early trauma care and to what extent these priorities have been controlled for prior to ICU admission among patients arriving to the ER in states of moderate or severe hemorrhagic shock. METHODS: A retrospective analysis of data documented in the TraumaRegister of the ‘Deutsche Gesellschaft für Unfallchirurgie’ (TR-DGU®()) was conducted. Relevant clinical and laboratory parameters reflecting status and basic physiology of severely injured patients (ISS ≥ 25) in either moderate or severe shock according to base excess levels (BE -2 to -6 or BE < -6) as surrogate for shock and hemorrhage combined with coagulopathy (Quick’s value <70%) were analyzed upon ER arrival and ICU admission. RESULTS: A total of 517 datasets was eligible for analysis. Upon ICU admission shock was reversed to BE > -2 in 36.4% and in 26.4% according to the subgroups. Two of three patients with initially moderate shock and three out of four patients with severe shock upon ER arrival were still in shock upon ICU admission. All patients suffered from coagulation dysfunction upon ER arrival (Quick’s value ≤ 70%). Upon ICU admission 3 out of 4 patients in both groups still had a disturbed coagulation function. The number of patients with significant thrombocytopenia had increased 5-6 fold between ER and ICU admission. CONCLUSION: The C-priority including coagulation management was not adequately addressed during primary survey and initial resuscitation between ER and ICU admission, in this cohort of severely injured patients

Positive Changes in Safety Perception Among Blacks with HIV and Comorbidities: Assessment of Social Determinants of Health During COVID‑19

Purpose This study aimed to examine the impact of the COVID-19 lockdown on social determinants of health (SDOH) among Blacks with HIV and a comorbid diagnosis of hypertension or type 2 diabetes mellitus (T2DM). Methods This was a longitudinal survey study. The inclusion criteria were adults ≥ 18 years and the presence of hypertension and/or diabetes, along with a positive HIV diagnosis. This study enrolled patients in the HIV clinics and chain specialty pharmacies in the Dallas-Fort Worth (DFW) area. A survey of ten questions examining SDOH was conducted before, during, and after the lockdown. A proportional odds mixed effects logistic regression model was applied to assess differences between time points. Results A total of 27 participants were included. Respondents felt significantly safer in their living place post-lockdown than in the pre-lockdown period (odds ratio = 6.39, 95% CI [1.08–37.73]). No other statistically significant differences in the responses were found over the study timeframe. However, borderline p values indicated better SDOH status post-lockdown as compared to pre-lockdown. Conclusion Study participants feel safer one year after lockdown compared to pre-lockdown. The CARES Act and the moratorium on rent and mortgage are among the factors that may explain this increase. Future research should include designing and evaluating interventions for social equity enhancement

Probing the N = 32 shell closure below the magic proton number Z = 20: Mass measurements of the exotic isotopes 52,53K

The recently confirmed neutron-shell closure at N = 32 has been investigated for the first time below the magic proton number Z = 20 with mass measurements of the exotic isotopes 52,53K, the latter being the shortest-lived nuclide investigated at the online mass spectrometer ISOLTRAP. The resulting two-neutron separation energies reveal a 3 MeV shell gap at N = 32, slightly lower than for 52Ca, highlighting the doubly-magic nature of this nuclide. Skyrme-Hartree-Fock-Boguliubov and ab initio Gorkov-Green function calculations are challenged by the new measurements but reproduce qualitatively the observed shell effect.Comment: 5 pages, 5 figure

Analysis of the optical properties of the silvery spots on the wings of the Gulf Fritillary, Dione vanillae

The ventral face of the wings of the butterfly Dione vanillae is covered with bright and shiny silvery spots. These areas contain densely packed ground- and coverscales with a bright metallic appearance reflecting more than 50% of light uniformly over the visible range. Our analysis shows that this optically attractive feature is caused by the inner microstructure of the scales located in these areas. Electron microscopy of cross sections through the scales shows that upper and lower lamina, supporting trabeculae, and topping ridges can be approximated by a ‘circus tent’-like geometry. By simulating its optical properties, we show that a moderate disorder of this geometry is important for the uniform reflection of light resulting in the silvery appearance

Junior doctors' experiences with interprofessional collaboration:Wandering the landscape

Context The transition from medical student to junior doctor is challenging. Junior doctors need to become part of the physician community of practice (CoP), while dealing with new responsibilities, tasks and expectations. At the same time, they need to learn how to navigate the frontiers and intersections with the other communities of practice that form the Landscape of Practice (LoP). This study aims to understand how junior doctors experience interprofessional collaboration (IPC) and what elements shape these experiences considering their transition to clinical practice. Methods In this multicentre qualitative study, 13 junior doctors individually drew two rich pictures of IPC experiences, one positive and one negative. A rich picture is a visual representation, a drawing of a particular situation intended to capture the complex and non-verbal elements of an experience. We used semi-structured interviews to deepen the understanding of junior doctors' depicted IPC experiences. We analysed both visual materials and interview transcripts iteratively, for which we adopted an inductive constructivist thematic analysis. Results While transitioning into a doctor, junior doctors become foremost members of the physician CoP and shape their professional identity based on perceived values in their physician community. Interprofessional learning occurs implicitly, without input from the interprofessional team. As a result, junior doctors struggle to bridge the gap between themselves and the interprofessional team, preventing IPC learning from developing into an integrative process. This professional isolation leaves junior doctors wandering the landscape of practice without understanding roles, attitudes and expectations of others. Conclusions Learning IPC needs to become a collective endeavour and an explicit learning goal, based on multisource feedback to take advantage of the expertise already present in the LoP. Furthermore, junior doctors need a safe environment to embrace and reflect on the emotions aroused by interprofessional interactions, under the guidance of experienced facilitators

DATA PROCESSING AND RECORDING USING A VERSATILE MULTI-SENSOR VEHICLE

In this paper we present a versatile multi-sensor vehicle which is used in several research projects. The vehicle is equipped with various sensors in order to cover the needs of different research projects in the area of object detection and tracking, mobile mapping and change detection. We show an example for the capabilities of this vehicle by presenting camera- and LiDAR-based pedestrian detection methods. Besides this specific use case, we provide a more general in-depth description of the vehicle’s hard- and software design and its data-processing capabilities. The vehicle can be used as a sensor carrier for mobile mapping, but it also offers hardware and software components to allow for an adaptable onboard processing. This enables the development and testing of methods related to real-time applications or high-level driver assistance functions. The vehicle’s hardware and software layout result from several years of experience, and our lessons learned can help other researchers set up their own experimental platform