Guidelines: The dos, don'ts and don't knows of remediation in medical education.

INTRODUCTION: Two developing forces have achieved prominence in medical education: the advent of competency-based assessments and a growing commitment to expand access to medicine for a broader range of learners with a wider array of preparation. Remediation is intended to support all learners to achieve sufficient competence. Therefore, it is timely to provide practical guidelines for remediation in medical education that clarify best practices, practices to avoid, and areas requiring further research, in order to guide work with both individual struggling learners and development of training program policies. METHODS: Collectively, we generated an initial list of Do's, Don'ts, and Don't Knows for remediation in medical education, which was then iteratively refined through discussions and additional evidence-gathering. The final guidelines were then graded for the strength of the evidence by consensus. RESULTS: We present 26 guidelines: two groupings of Do's (systems-level interventions and recommendations for individual learners), along with short lists of Don'ts and Don't Knows, and our interpretation of the strength of current evidence for each guideline. CONCLUSIONS: Remediation is a high-stakes, highly complex process involving learners, faculty, systems, and societal factors. Our synthesis resulted in a list of guidelines that summarize the current state of educational theory and empirical evidence that can improve remediation processes at individual and institutional levels. Important unanswered questions remain; ongoing research can further improve remediation practices to ensure the appropriate support for learners, institutions, and society

Phytogrowth-Inhibitory lactones derivatives of Glaucolide B

The sesquiterpene lactone glaucolide B (1), isolated from Vernonia fruticulosa (Asteraceae), was transformed into six lactones (2-7). The structures of the products were elucidated by spectroscopic analysis. A series of solutions of compounds 1-7, at 200 μᴍ, were tested on the germination and on the root and shoot growth of the dicotyledons Physalis ixocarpa and Trifolium alexandrinum and of the monocotyledons Lolium multiflorum and Amaranthus hypochondriacus. Lactone 5 exhibited clear selectivity towards dicotyledonous species at 200 μᴍ, with an average inhibition of 90% on the germination of P. ixocarpa. Lactones 1, 3 and 4 had a greater effect on root length of monocotyledonous species, inhibiting around 70% at 200 μᴍ in L. multiflorum. It seems that the diol function is required in lactones 4-6 to increase the activity, the polarity in the molecule might be required to reach its target

Bioactivity of Ionic Liquids Based on Valproate in SH-SY5Y Human Neuroblastoma Cell Line

This work received financial support from the PT national funds (FCT-MCTES, Fundação para a Ciência e Tecnologia and Ministério da Ciência, Tecnologia e Ensino Superior) through the project UIDB/50006/2020 | UIDP/50006/2020. A.F.M.S. and Ž.P. also acknowledge FCT-MCTES for the PhD grant (SFRH/BD/132551/2017) and Norma Transitória DL 57/2016 program contract, respectivelyThe search for alternative and effective therapies to fight cancer is one of the main goals of the pharmaceutical industry. Recently, ionic liquids (ILs) have emerged as potential therapeutic agents with antitumor properties. The goal of this study was to synthesize and evaluate the bioactivity of different ILs coupled with the active pharmaceutical ingredient (API) valproate (VPA) as an antitumor agent. The toxicity of the prepared ionic liquids was evaluated by the MTT cell metabolic assay in human neuroblastoma SH-SY5Y and human primary Gingival Fibroblast (GF) cell lines, in which they showed inhibitory effects during the study period. In addition, low cytotoxicity against GF cell lines was observed, suggesting that these compounds are not toxic to human cell lines. [C2OHDMiM][VPA] demonstrated an outstanding antitumor activity against SH-SY5Y and lower activity against the non-neoplastic GF line. The herein assessed compounds played an important role in the modulation of the signaling pathways involved in the cellular behavior. This work also highlights the potential of these ILs-API as possible antitumor agentspublishersversionpublishe

Measuring skin temperature before, during and after exercise: a comparison of thermocouples and infrared thermography

Measuring skin temperature (TSK) provides important information about the complex thermal control system and could be interesting when carrying out studies about thermoregulation. The most common method to record TSK involves thermocouples at specific locations; however, the use of infrared thermal imaging (IRT) has increased. The two methods use different physical processes to measure TSK, and each has advantages and disadvantages. Therefore, the objective of this study was to compare the mean skin temperature (MTSK) measurements using thermocouples and IRT in three different situations: pre-exercise, exercise and post-exercise. Analysis of the residual scores in Bland-Altman plots showed poor agreement between the MTSK obtained using thermocouples and those using IRT. The averaged error was -0.75 °C during pre-exercise, 1.22 °C during exercise and -1.16 °C during post-exercise, and the reliability between the methods was low in the pre- (ICC = 0.75 [0.12 to 0.93]), during (ICC = 0.49 [-0.80 to 0.85]) and post-exercise (ICC = 0.35 [-1.22 to 0.81] conditions. Thus, there is poor correlation between the values of MTSK measured by thermocouples and IRT pre-exercise, exercise and post-exercise, and low reliability between the two forms of measurement

Time required to stabilize thermographic images at rest

Thermography for scientific research and practical purposes requires a series of procedures to obtain images that should be standardized; one of the most important is the time required for acclimatization in the controlled environment. Thus, the objective of this study was to identify the appropriate acclimatization time in rest to reach a thermal balance on young people skin. Forty-four subjects participated in the study, 18 men (22.3 ± 3.1 years) and 26 women (21.7 ± 2.5 years). Thermographic images were collected using a thermal imager (Fluke ®), totaling 44 images over a period of 20 minutes. The skin temperature (TSK) was measured at the point of examination which included the 0 minute, 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20. The body regions of interest (ROI) analyzed included the hands, forearms, arms, thighs, legs, chest and abdomen. We used the Friedman test with post hoc Dunn?s in order to establish the time at rest required to obtain a TSK balance and the Mann-Whitney test was used to compare age, BMI, body fat percentage and temperature variations between men and women, considering always a significance level of pmenor que0.05. Results showed that women had significantly higher temperature variations than men (pmenor que0.01) along the time. In men, only the body region of the abdomen obtained a significant variance (pmenor que0.05) on the analyzed period, both in the anterior and posterior part. In women, the anterior abdomen and thighs, and the posterior part of the hands, forearms and abdomen showed significant differences (pmenor que0.05). Based on our results, it can be concluded that the time in rest condition required reaching a TSK balance in young men and women is variable, but for whole body analysis it is recommended at least 10 minutes for both sexes

Robust Control of Maintenance-Phase Anesthesia

In biomedical systems, feedback control can be applied whenever adequate sensors, actuators, and sufficiently accurate mathematical models are available. The key issue is the capacity of the control algorithm to tackle the large levels of uncertainty, both structured and unstructured, associated with patient dynamics. In the particular case of intravenous anesthesia considered here, manipulated variables are drug infusion rates, administered by syringe pumps, and the measured signal outputs are the levels of hypnosis or depth of anesthesia (DoA) and of neuromuscular blockade (NMB). Figure 1 provides an example of a loop closed for the control of NMB

Assessment on the Achievable Throughput of Multi-band ITU-T G.652.D Fiber Transmission Systems

Fiber-optic multi-band transmission (MBT) aims at exploiting the low-loss spectral windows of single-mode fibers (SMFs) for data transport, expanding by ∼11× the available bandwidth of C-band line systems and by ∼5× C+L-band line systems'. MBT offers a high potential for cost-efficient throughput upgrades of optical networks, even in absence of available dark-fibers, as it utilizes more efficiently the existing infrastructures. This represents the main advantage compared to approaches such as multi-mode/-core fibers or spatial division multiplexing. Furthermore, the industrial trend is clear: the first commercial C+L-band systems are entering the market and research has moved toward the neighboring S-band. This article discusses the potential and challenges of MBT covering the ITU-T optical bands O → L. MBT performance is assessed by addressing the generalized SNR (GSNR) including both the linear and non-linear fiber propagation effects. Non-linear fiber propagation is taken into account by computing the generated non-linear interference by using the generalized Gaussian-noise (GGN) model, which takes into account the interaction of non-linear fiber propagation with stimulated Raman scattering (SRS), and in general considers wavelength-dependent fiber parameters. For linear effects, we hypothesize typical components' figures and discussion on components' limitations, such as transceivers,' amplifiers' and filters' are not part of this work. We focus on assessing the transmission throughput that is realistic to achieve by using feasible multi-band components without specific optimizations and implementation discussion. So, results are meant to address the potential throughput scaling by turning-on excess fiber transmission bands. As transmission fiber, we focus exclusively on the ITU-T G.652.D, since it is the most widely deployed fiber type worldwide and the mostly suitable to multi-band transmission, thanks to its ultra-wide low-loss single-mode high-dispersion spectral region. Similar analyses could be carried out for other single-mode fiber types. We estimate a total single-fiber throughput of 450 Tb/s over a distance of 50 km and 220 Tb/s over regional distances of 600 km: ∼ 10 × and 8× more than C-band transmission respectively and ∼ 2.5× more than full C+L

The influence of Fe2O3 doping on the pore structure and mechanical strength of TiO2-containing alumina obtained by freeze-casting

This work investigated TiO/FeO doped alumina prepared by the freeze-casting technique and using camphene as the solvent. Dendritic pores were formed in the TiO doped alumina, a structure conferred by the frozen camphene. Contrary to this trend, further FeO doping of TiO-containing alumina resulted in the formation of non-dendritic structures. This behavior was attributed to the higher density of α-FeO (5.24 g cm) when compared to α-AlO (3.95 g cm) and anatase TiO (3.89 g cm), which reduced critical solidification front velocity, thus forming material with different pore shape. FeO doping also improved the densification of TiO-alumina and inhibited the formation of cracks, reflected by superior mechanical strength with best results ∼150% higher for 10% FeO loaded samples as compared to TiO-alumina samples

Effect of titania addition on the properties of freeze-cast alumina samples

This work investigated the behavior of TiO2-containing α-Al2O3 samples prepared by the freeze-casting technique. Camphene and liquid nitrogen were used as the solvent and cooling fluid, respectively. Camphene resulted in the formation of dendritic pores, in the direction of the freeze-casting cold front during sample preparation. The formation of β-Al2TiO5 phase occurred at 1300°C, and became more evident as the sintering temperatures reached 1500°C. The TiO2 loading did not affect the sample porosity at a given temperature, but it was detrimental in the case of mechanical properties under certain conditions. For instance, the flexural strength slightly improved with increasing the TiO2 loading and sintering temperature from 1100 to 1300°C. This effect was attributed to the occurrence of a more effective sintering of alumina. However, as the heat treatment temperature was raised from 1300 to 1500°C, the flexural strength did not increase as a function of the TiO2 loading, even though the densification occurred with loss of porosity. The loss of mechanical strength was found to be associated with the formation of microcracks which stemmed from the formation of β-Al2TiO5 phase for TiO2 loadings in excess of 4wt% at these high sintering temperatures

The timing of the deglaciation in the Atlantic Iberian mountains:Insights from the stratigraphic analysis of a lake sequence in Serra da Estrela (Portugal)

Understanding the environmental response to the last glacial termination in regions located in transitional climate zones such as the Atlantic Iberian mountains is crucial to estimate potential changes in regions affected by current glacial melting. We present an 8.5 m-long, solid last deglaciation and Holocene chronostratigraphic record including detailed sediment analysis from Lake Peixão, a pro-glacial lake in the Serra da Estrela (Central Portugal). The age–depth model relies on a Bayesian approach that includes 16 AMS 14C dates and 210Pb–137CS measurements, robustly dating the lake formation at 14.7 ± 0.32 cal. ka BP. This chronological reconstruction shows an average sedimentation rate of ca. 0.07 cm yr−1 (15 yr cm−1), enabling proxy analyses at decadal timescales. The sediment sequence is composed of five lithological units: (U1) coarse and unsorted fluvioglacial lacustrine deposits; (U2) massive fluvioglacial lacustrine deposits (863–790 cm below surface [bsf]; 14.7 ± 0.32–13.8 ± 0.12 cal. ka BP); (U3) water current fluvioglacial lacustrine deposits (790–766 cm bsf; 13.8 ± 0.12–12.9 ± 0.29 cal. ka BP); (U4) laminated/banded lacustrine deposits characterized by terrigenous deposits from ice-covered lake periods and episodic events of ice and snow melting (766–752 cm bsf; 12.9 ± 0.29–11.7 ± 0.15 cal. ka BP); and (U5) massive muddy lacustrine deposits (752–0 cm bsf; 11.7 ± 0.15 cal. ka BP–present). The occurrence of U2 to U4 deposits defines the transition from glacial cold (U1) to net warm postglacial conditions (U5). These climate transitions are marked by changes in sediments and the presence of very low sedimentation rate periods, possibly related to the Intra-Allerød Cold Period and the coldest phase of the Younger Dryas. Our results support the previously proposed timing of the retreat of the Serra da Estrela glaciers ca. 13.8 ± 0.12 cal. ka BP. The robust chronology of Lake Peixão highlights the potential of Iberian pro-glacial lakes for dating deglaciation processes and will lead to unprecedented decadal-to-centennial timescale palaeoclimate reconstructions in this region since the last glacial–interglacial transition