The development of self-regulated learning during the pre-clinical stage of medical school: a comparison between a lecture-based and a problem based curriculum

Society expects physicians to always improve their competencies and to be up to date with developments in their field. Therefore, an important aim of medical schools is to educate future medical doctors to become self-regulated, lifelong learners. However, it is unclear if medical students become better self-regulated learners during the pre-clinical stage of medical school, and whether students develop self-regulated learning skills differently, dependent on the educational approach of their medical school. In a cross-sectional design, we investigated the development of 384 medical students’ self-regulated learning skills with the use of the Self-Regulation of Learning Self-Report Scale. Next, we compared this development in students who enrolled in two distinct medical curricula: a problem-based curriculum and a lectured-based curriculum. Analysis showed that more skills decreased than increased during the pre-clinical stage of medical school, and that the difference between the curricula was mainly caused by a decrease in the skill evaluation in the lecture-based curriculum. These findings seem to suggest that, irrespective of the curriculum, self-regulated learning skills do not develop during medical school

Laser printing of silver-based micro-wires in ZrO2 substrate for smart implant applications

Smart implants are endowed with functions of sensing, actuating and control to solve problems that may arise during their use. The assembly of these functions along the implant surface is still a challenge. However, with the advent of 3D printing, it is possible to print on implants’ surface, communication channels or micro-antennas or even sensoric/actuating areas. Hence, a positive impact on the long-term performance of the implants (including hip, dental and knee) may be expected with the proposed approach. Despite titanium and Ti6Al4V titanium alloy are the standard choice for implants fabrication, 3Y-TZP (tetragonal 3% mol yttria-stabilized zirconia) has emerged as a ceramic material suitable to overcome titanium alloy problems, due to its numerous advantages. In this sense, this work is concerned with the ability of printing silver-based communication system in zirconia substrates by using laser technology. For this purpose, micro-cavities were created on ZrO2 substrate, where the silver powder was placed and sintered into them. Through the laser approach, silver-based wires with great quality and low resistivity values were achieved. The flexural strength results showed that the mechanical resistance of zirconia disks was affected by laser micro-wire printing, which decreased as the laser passage was performed. Based on the results, it is believed that the proposed approach seems to be effective for the manufacturing of implants with intrinsic capacities, useful for smart implant applications.This work has been supported by FCT (Fundação para a Ciência e Tecnologia - Portugal) in the scope of the projects UID/EEA/04436/ 2019 and NORTE-01-0145-FEDER-000018-HAMaBICo and Add.Additive_Manufacturing to Portuguese Industry_POCI-01-0247- FEDER-024533. Thank the CNPq (205791/2014-0) and CAPES for the financial support

Metric versus observable operator representation, higher spin models

We elaborate further on the metric representation that is obtained by transferring the time-dependence from a Hermitian Hamiltonian to the metric operator in a related non-Hermitian system. We provide further insight into the procedure on how to employ the time-dependent Dyson relation and the quasi-Hermiticity relation to solve time-dependent Hermitian Hamiltonian systems. By solving both equations separately we argue here that it is in general easier to solve the former. We solve the mutually related time-dependent Schrödinger equation for a Hermitian and non-Hermitian spin 1/2, 1 and 3/2 model with time-independent and time-dependent metric, respectively. In all models the overdetermined coupled system of equations for the Dyson map can be decoupled algebraic manipulations and reduces to simple linear differential equations and an equation that can be converted into the non-linear Ermakov-Pinney equation

'Immunising' physicians against availability bias in diagnostic reasoning: A randomised controlled experiment

Background: Diagnostic errors have often been attributed to biases in physicians' reasoning. Interventions to 'immunise' physicians against bias have focused on improving reasoning processes and have largely failed. Objective: To investigate the effect of increasing physicians' relevant knowledge on their susceptibility to availability bias. Design, settings and participants: Three-phase multicentre randomised experiment with second-year internal medicine residents from eight teaching hospitals in Brazil. Interventions: Immunisation: Physicians diagnosed one of two sets of vignettes (either diseases associated with chronic diarrhoea or with jaundice) and compared/contrasted alternative diagnoses with feedback. Biasing phase (1 week later): Physicians were biased towards either inflammatory bowel disease or viral hepatitis. Diagnostic performance test: All physicians diagnosed three vignettes resembling inflammatory bowel disease, three resembling hepatitis (however, all with different diagnoses). Physicians who increased their knowledge of either chronic diarrhoea or jaundice 1 week earlier were expected to resist the bias attempt. Main outcome measurements: Diagnostic accuracy, measured by test score (range 0-1), computed for subjected-to-bias and not-subjected-to-bias vignettes diagnosed by immunised and not-immunised physicians. Results: Ninety-one residents participated in the experiment. Diagnostic accuracy differed on subjected-to-bias vignettes, with immunised physicians performing better than non-immunised physicians (0.40 vs 0.24; difference in accuracy 0.16 (95% CI 0.05 to 0.27); p=0.004), but not on not-subjected-to-bias vignettes (0.36 vs 0.41; difference -0.05 (95% CI -0.17 to 0.08); p=0.45). Bias only hampered non-immunised physicians, who performed worse on subjected-to-bias than not-subjected-to-bias vignettes (difference -0.17 (95% CI -0.28 to -0.05); p=0.005); immunised physicians' accuracy did not differ (p=0.56). Conclusions: An intervention directed at increasing knowledge of clinical findings that discriminate between similar-looking diseases decreased physicians' susceptibility to availability bias, reducing diagnostic errors, in a simulated setting. Future research needs to examine the degree to which the intervention benefits other disease clusters and performance in clinical practice. Trial registration number: 68745917.1.1001.0068

Access to infertility consultations: what women tell us about it?

The main objective of the present paper is to evaluate the perception of women concerning the barriers and access to infertility consultations. Socio cultural and economic access to infertility consultations is detached and three municipalities of the northwest of Portugal were chosen as an example of a peripheral country. A quantitative/qualitative study was done with 60 women. Three dimensions were evaluated: geographic and structural and functional access; economic access; and sociocultural access. The main barriers were mainly identified in the last two dimensions. The economic access was the less well evaluated by women being the cost of treatment (medication, and concentration of costs in a short period) difficult to bear. This can justify a greater involvement of the Portuguese Government, by developing policies for the reimbursement of part of the costs. Also, some changes in structural and functional access must be done with special regard to the separation of the infertility consultations from the reproductive medicine section. The setting of the teams, with a follow-up by the same team of health professionals is also needed

Efeitos da quitosana no desenvolvimento in vitro de videiras cv. merlot e no crescimento micelial do fungo elsinoe ampelina.

Objetivou-se, neste trabalho, avaliar o efeito da quitosana no desenvolvimento in vitro de plântulas de videira cv. Merlot e sua atividade antifúngica sobre Elsinoe ampelina. No primeiro experimento, explantes da cultivar Merlot foram transferidos para meio de cultura DSD1, acrescido das concentrações 0; 25; 50,100; 150 e 200 mg L-1 de quitosana. Após 90 dias de cultivo in vitro, as plântulas foram avaliadas quanto ao número de raízes e de folhas, porcentagem de enraizamento e brotação, comprimento de raízes e de parte aérea, massa fresca da planta. No segundo experimento, incorporou-se às concentrações 0, 60, 120, 180, 240 e 300 mg L-1 de quitosana ao meio BDA, onde inoculou-se o fungo. Posteriormente, avaliou-se o crescimento micelial aos 6 e 9 dias de incubação a 25º C no escuro. No primeiro experimento para as variáveis comprimento médio da parte aérea, massa fresca da planta inteira, porcentagem de enraizamento e porcentagem de estacas brotadas houve decréscimo linear em função das concentrações de quitosana. No segundo experimento, houve efeito linear negativo em função das concentrações crescentes de quitosana, sendo que a inibição do crescimento micelial foi de 81,7%, demonstrando o grande potencial do uso de quitosana no controle da antracnose da videira

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio

Observation of a new chi_b state in radiative transitions to Upsilon(1S) and Upsilon(2S) at ATLAS

The chi_b(nP) quarkonium states are produced in proton-proton collisions at the Large Hadron Collider (LHC) at sqrt(s) = 7 TeV and recorded by the ATLAS detector. Using a data sample corresponding to an integrated luminosity of 4.4 fb^-1, these states are reconstructed through their radiative decays to Upsilon(1S,2S) with Upsilon->mu+mu-. In addition to the mass peaks corresponding to the decay modes chi_b(1P,2P)->Upsilon(1S)gamma, a new structure centered at a mass of 10.530+/-0.005 (stat.)+/-0.009 (syst.) GeV is also observed, in both the Upsilon(1S)gamma and Upsilon(2S)gamma decay modes. This is interpreted as the chi_b(3P) system.Comment: 5 pages plus author list (18 pages total), 2 figures, 1 table, corrected author list, matches final version in Physical Review Letter