Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting

Background: Students’ perceptions of the educational environment are an important construct in assessing and enhancing the quality of medical training programs. Reliable and valid measurement, however, can be problematic – especially as instruments developed and tested in one culture are translated for use in another. Materials and method: This study sought to explore the psychometric properties of the Postgraduate Hospital Educational Environment Measure (PHEEM) for use in an Iranian hospital training setting. We translated the instrument into Persian and ensured its content validity by back translation and expert review prior to administering it to 127 residents of Urmia University of Medical Science. Results: Overall internal consistency of the translated measure was good (a=0.94). Principal components analysis revealed five factors accounting for 52.8% of the variance. Conclusion: The Persian version of the PHEEM appears to be a reliable and potentially valid instrument for use in Iranian medical schools and may find favor in evaluating the educational environments of residency programs nationwide

Antibiotic resistance pattern and distribution of psla gene among biofilm producing pseudomonas aeruginosa isolated from waste water of a burn center

Background: Pseudomonas aeruginosa is considered as a major cause of hospital-acquired infections due to its high antibacterial resistance. Biofilm formation is a well-known pathogenic mechanism in P. aeruginosa infections, since sessile bacteria are protected in an extracellular matrix of exopolysaccharide. The expression of polysaccharide synthesis locus (pslA gene) can be important for biofilm formation by P. aeruginosa. Objectives: The purpose of this research was to evaluate the antibiotic resistance pattern and distribution of the pslA gene among biofilm-producing P. aeruginosa isolates obtained from waste water of Burn Centre in Guilan, Iran. Materials and Methods: Fifty isolates of P. aeruginosa were obtained from waste water of a burn center. The P. aeruginosa isolates were identified using standard bacteriological procedures. Drug susceptibility test was performed by disk diffusion method for all the isolates against nine antimicrobial agents. Biofilm formation was measured by microtiter plate assay. Polymerase chain reaction (PCR) was used to identify the presence of the pslA gene among the isolates. Results: Biofilm formation was observed in 70 of the P. aeruginosa isolates. The potential formation of biofilm was significantly associated with resistance to gentamicin, imipenem, tobramycin and piperacillin. In addition, the pslA gene only existed in biofilm-producing isolates with a frequency of 42.9 (n = 15).Conclusions: The findings of the present study well demonstrated that the P. aeruginosa biofilm-producing isolates were more resistant to the tested antibiotics. Furthermore, because of wide distribution, it seems that the pslA gene is associated with biofilm formation. � 2015, Ahvaz Jundishapur University of Medical Sciences

Open education and critical pedagogy

This paper argues for a revaluation of the potential of open education to support more critical forms of pedagogy. Section I examines contemporary discourses around open education, offering a commentary on the perception of openness as both a disruptive force in education, and a potential solution to contemporary challenges. Section II examines the implications of the lack of consensus around what it means to be open, focusing on the example of commercial and proprietary claims to openness commonly known as ‘openwashing’. Section III uses Raymond’s influential essay on open source software ‘The Cathedral and the Bazaar’ as a framework for thinking through these issues, and about alternative power structures in open education. In Section IV an explicit link is drawn between more equal or democratic power structures and the possibility for developing pedagogies which are critical and reflexive, providing examples which show how certain interpretations of openness can raise opportunities to support critical approaches to pedagogy

Metabolomics in systems medicine: an overview of methods and applications

Patient-derived metabolomics offers valuable insights into the metabolic phenotype underlying diseases with a strong metabolic component. Thus, these data sets will be pivotal to the implementation of personalized medicine strategies in health and disease. However, to take full advantage of such data sets, they must be integrated with other omics within a coherent pathophysiological framework to enable improved diagnostics, to identify therapeutic interventions, and to accurately stratify patients. Herein, we provide an overview of the state-of-the-art data analysis and modeling approaches applicable to metabolomics data and of their potential for systems medicine

Reliability of real�time ultrasound imaging for the assessment of trunk stabilizer muscles: A systematic review of the literature

Rehabilitative ultrasound (US) imaging is one of the popular methods for investigating muscle morphologic characteristics and dimensions in recent years. The reliability of this method has been investigated in different studies. As studies have been performed with different designs and quality, reported values of rehabilitative US have a wide range. The objective of this study was to systematically review the literature conducted on the reliability of rehabilitative US imaging for the assessment of deep abdominal and lumbar trunk muscle dimensions. The PubMed/MEDLINE, Scopus, Google Scholar, Science Direct, Embase, Physiotherapy Evidence, Ovid, and CINAHL databases were searched to identify original research articles conducted on the reliability of rehabilitative US imaging published from June 2007 to August 2017. The articles were qualitatively assessed; reliability data were extracted; and the methodological quality was evaluated by 2 independent reviewers. Of the 26 included studies, 16 were considered of high methodological quality. Except for 2 studies, all high�quality studies reported intraclass correlation coefficients (ICCs) for intra�rater reliability of 0.70 or greater. Also, ICCs reported for inter�rater reliability in high�quality studies were generally greater than 0.70. Among low�quality studies, reported ICCs ranged from 0.26 to 0.99 and 0.68 to 0.97 for intra� and inter�rater reliability, respectively. Also, the reported standard error of measurement and minimal detectable change for rehabilitative US were generally in an acceptable range. Generally, the results of the reviewed studies indicate that rehabilitative US imaging has good levels of both inter� and intra�rater reliability. © 2018 by the American Institute of Ultrasound in Medicine

Seminal plasma as a source of prostate cancer peptide biomarker candidates for detection of indolent and advanced disease

Background:Extensive prostate specific antigen screening for prostate cancer generates a high number of unnecessary biopsies and over-treatment due to insufficient differentiation between indolent and aggressive tumours. We hypothesized that seminal plasma is a robust source of novel prostate cancer (PCa) biomarkers with the potential to improve primary diagnosis of and to distinguish advanced from indolent disease. <br>Methodology/Principal Findings: In an open-label case/control study 125 patients (70 PCa, 21 benign prostate hyperplasia, 25 chronic prostatitis, 9 healthy controls) were enrolled in 3 centres. Biomarker panels a) for PCa diagnosis (comparison of PCa patients versus benign controls) and b) for advanced disease (comparison of patients with post surgery Gleason score <7 versus Gleason score >>7) were sought. Independent cohorts were used for proteomic biomarker discovery and testing the performance of the identified biomarker profiles. Seminal plasma was profiled using capillary electrophoresis mass spectrometry. Pre-analytical stability and analytical precision of the proteome analysis were determined. Support vector machine learning was used for classification. Stepwise application of two biomarker signatures with 21 and 5 biomarkers provided 83% sensitivity and 67% specificity for PCa detection in a test set of samples. A panel of 11 biomarkers for advanced disease discriminated between patients with Gleason score 7 and organ-confined (<pT3a) or advanced (≥pT3a) disease with 80% sensitivity and 82% specificity in a preliminary validation setting. Seminal profiles showed excellent pre-analytical stability. Eight biomarkers were identified as fragments of N-acetyllactosaminide beta-1,3-N-acetylglucosaminyltransferase​,prostatic acid phosphatase, stabilin-2, GTPase IMAP family member 6, semenogelin-1 and -2. Restricted sample size was the major limitation of the study.</br> <br>Conclusions/Significance: Seminal plasma represents a robust source of potential peptide makers for primary PCa diagnosis. Our findings warrant further prospective validation to confirm the diagnostic potential of identified seminal biomarker candidates.</br&gt

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. We examined the actions taken between 2010 and early 2016 – by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organizations, philanthropic institutions and transnational industries – to help decrease the prevalence of obesity and diet-related noncommunicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organizations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors we investigated appears variable and generally less robust. We suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from noncommunicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030

Gamma-Irradiation Reduces the Allogenicity of Donor Corneas

Purpose. To evaluate the utility and allogenicity of gamma-irradiated corneal allografts. Methods. Corneal buttons were harvested from C57BL/6 mice and decellularized with gamma irradiation. Cell viability was assessed using TUNEL and viability/cytotoxicity assays. Orthotopic penetrating keratoplasty was performed using irradiated or nonirradiated (freshly excised) C57BL/6 donor grafts and BALB/c or C57BL/6 recipients. Graft opacity was assessed over an 8-week period and graft survival was evaluated using Kaplan-Meier survival curves. Mixed-lymphocyte reactions and delayed-type hypersensitivity assays were performed to evaluate T-cell alloreactivity. Real-time PCR was used to investigate the corneal expression of potentially pathogenic T-helper 1, 2, and 17 cell-associated cytokines. Results. Corneal cells were devitalized by gamma irradiation as evidenced by widespread cellular apoptosis and plasma membrane disruption. Nonirradiated allograft and isograft rates of survival were superior to irradiated allograft and isograft rates of survival (P < 0.001). Mixed lymphocyte reactions demonstrated that T-cells from irradiated allograft recipients did not exhibit a secondary alloimmune response (P < 0.001). Delayed-type hypersensitivity assays demonstrated that irradiated allografts did not elicit an alloreactive delayed-type hypersensitivity response in graft recipients (P ≤ 0.01). The corneal expression of T-helper 1, 2, and 17 cell-associated cytokines was significantly lower in failed irradiated allografts than rejected nonirradiated allografts (P ≤ 0.001). Conclusions. Gamma-irradiated corneas failed to remain optically clear following murine penetrating keratoplasty; however, gamma irradiation reduced the allogenicity of these corneas, potentially supporting their use in procedures such as anterior lamellar keratoplasty or keratoprosthesis implantation

The dosimetric effects of limited elective nodal irradiation in volumetric modulated arc therapy treatment planning for locally advanced non-small cell lung cancer

Objective—Contemporary radiotherapy guidelines for locally advanced non-small cell lung carcinoma (LA-NSCLC) recommend omitting elective nodal irradiation, despite the fact that evidence supporting this came primarily from older reports assessing comprehensive nodal coverage using 3D conformal techniques. Herein, we evaluated the dosimetric implications of the addition of limited elective nodal irradiation (LENI) to standard involved field irradiation (IFI) using volumetric modulated arc therapy (VMAT) planning. Method—Target volumes and organs-at-risk (OARs) were delineated on CT simulation images of 20 patients with LA-NSCLC. Two VMAT plans (IFI and LENI) were generated for each patient. Involved sites were treated to 60 Gy in 30 fractions for both IFI and LENI plans. Adjacent uninvolved nodal regions, considered high risk based on the primary tumor site and extent of nodal involvement, were treated to 51 Gy in 30 fractions in LENI plans using a simultaneous integrated boost approach. Results—All planning objectives for PTVs and OARs were achieved for both IFI and LENI plans. LENI resulted in significantly higher esophagus Dmean (15.3 vs. 22.5 Gy, p \u3c 0.01), spinal cord Dmax (34.9 vs. 42.4 Gy, p = 0.02) and lung Dmean (13.5 vs. 15.9 Gy, p = 0.02), V20 (23.0 vs. 27.9%, p = 0.03), and V5 (52.6 vs. 59.4%, p = 0.02). No differences were observed in heart parameters. On average, only 32.2% of the high-risk nodal volume received an incidental dose of 51 Gy when untargeted in IFI plans. Conclusion—The addition of LENI to VMAT plans for LA-NSCLC is feasible, with only modestly increased doses to OARs and marginal expected increase in associated toxicity