‘Difficult Conversations with Patients’—A Modified Group Objective Structured Clinical Experience for Medical Students

This study presents a modified Group Objective Structured Clinical Experience (GOSCE) focused on difficult conversations, in which, due to limited time and financial resources, only some students could actively participate in scenarios. We aimed to evaluate the intervention, including differences between them and observers. The intervention was organized for sixth-year medical students at a Polish medical university. The study protocol assumed a pre-post analysis of students’ attitudes and self-efficacy of communication skills and their opinions about the intervention. Complete questionnaire pairs were returned by 126 students. The pre-post analysis revealed a significant improvement in their self-efficacy levels of almost all skills as well as their affective attitudes and belief in outcomes of communication learning. The improvement was significant among both the active participants and observers. It also showed a decrease in the motivation score, significant only in females. Regardless of their roles, students had positive opinions about the course and its particular aspects. The modified GOSCE may be an enjoyable and effective learning experience for students, especially in the light of limited resources. However, changes in their motivation score suggest the necessity to increase the importance of communication learning in the curriculum

Współczesne terapie niealkoholowej stłuszczeniowej choroby wątroby

Non-alcoholic fatty liver disease (NAFLD) is an increasing problem in the modern world due toincreased morbidity and due to its clinical consequences. It is a chronic liver disease definedas the accumulation of triglycerides in the form of fatty drops in the hepatocyte cytoplasm. Thepathogenesis of the disease has not been fully elucidated. The theory of two strokes assumes that obesity or type 2 diabetes causes liver damage as a result of the for mation of reactiveoxygen species and proinflammatory cytokines. Because the main risk factors include obesity,including abdominal obesity, metabolic syndrome and type 2 diabetes, the primary treatmentwill be lifestyle modification. The Mediterranean diet is one of the healthiest diet models, itreduces mortality due to chronic diseases, the risk of death from cardiovascular causes andmetabolic syndrome. Some studies suggest the use of a low carbo hydrate diet. In addition,the relationship between the consumption of fr uctose and NAFLD has been demonstrated.A positive effect of the combination of physical activity and s upplementation with vitamin E800 mg/day for the reduction of liver enzymes in the blood and the reduction of liver steatosisin ultrasound was showed. It is also suggested to use antioxidants in the treatment of, amongothers flavonoids, which belong to natural antioxidants, are found in vegetables, fruits and otherparts of plants — the most commonly used is silymarin — milk thistle extract. The omega 3acids also have a positive effect. As insulin resistance and ex cess body weight is the mostcommon cause of NAFLD, the drug recommended for treatment is metformin - the drug inhibitsthe progression of NAFLD. Experimental therapies are also car ried out with the inclusion ofincretin or Niemann-Pick C2.Niealkoholowa stłuszczeniowa choroba wątroby (NAFLD) stanowi coraz większy problem we współczesnym świecie z uwagi na wzrost zachorowalności oraz ze względu na swoje konsekwencje kliniczne. Jest to przewlekła choroba wątroby definiowana jako akumulacja triglicerydów w postaci kropel tłuszczowych w cytoplazmie hepatocytów. Patogeneza choroby nie została do końca wyjaśniona. Teoria dwóch uderzeń zakłada, że otyłość lub cukrzyca typu 2 powodują uszkodzenie wątroby w wyniku powstawania reaktywnych form tlenu oraz prozapalnych cytokin. Ponieważ do głównych czynników ryzyka należą otyłość, w tym otyłość brzuszna, zespół metaboliczny i cukrzyca typu 2  podstawowym leczeniem będzie modyfikacja stylu życia. Dieta śródziemnomorska jest jednym z najzdrowszych modeli żywieniowych, obniża śmiertelność z powodu chorób przewlekłych, ryzyko zgonu z przyczyn sercowo-naczyniowych oraz zespołu metabolicznego. Wyniki niektórych badań sugerują zastosowanie diety niskowęglowodanowej. Dodatkowo wykazano związek pomiędzy spożyciem fruktozy a NAFLD. Wykazano pozytywny wpływ połączenia aktywności fizycznej oraz suplementacji witaminą E w dawce 800 mg/dobę na obniżenie wartości enzymów wątrobowych we krwi oraz na redukcję stłuszczenia wątroby w badaniu ultrasonograficznym. Sugeruje się również zastosowanie antyoksydantów w leczeniu między innymi flawoinoidów, które należą do naturalnych antyoksydantów, występują w warzywach, owocach i innych częściach roślin — najczęściej stosowana jest sylimaryna (wyciąg z ostropestu plamistego). Pozytywny efekt wykazują także kwasy omega 3. Jako że insulinooporność oraz nadmierna masa ciała jest najczęstszą przyczyną NAFLD, lek  rekomendowany w leczeniu to metformina — hamująca progresję NAFLD. Prowadzone są ponadto eksperymentalne terapie z zastowaniem inkretyn lub białka Niemanna-Picka typu C2

Temperature (latitude) and nutrient (seabird guano) effects on limno-terrestrial Tardigrada (Testechiniscus spitsbergensis and Pilatobius recamieri) body size

Surveys of terrestrial microinvertebrate morphometry, especially spatial patterns of body size at wider geographical scales, including the polar regions, are very scarce. In this study, we focused on Tardigrada, common limno-terrestrial microinvertebrates. Considering Bergmann’s rule, originally formulated for endothermic animals, we tested the hypothesis that body length of limno-terrestrial tardigrades augments with increasing latitude and decreasing temperature. Since some of our sampling areas adjoined seabird colonies, we also explored the effects of nutrients from seabird guano deposits. Individual body length of Testechiniscus spitsbergensis was measured in populations obtained from seven localities distributed along a latitudinal gradient extending from 45^{\circ}N (northern Italy) to 79^{\circ}N (northern Svalbard), and for Pilatobius recamieri from three localities in Svalbard (77^{\circ}N-80^{\circ}N). Considering both latitude and proximity to a seabird colony there were significant effects of locality on the body length of T. spitsbergensis; however, no clear pattern of increasing individual body size with increasing latitude could be detected. Immense differences in body size may be a signal for cryptic species diversity within this genus. No effect of latitude, or proximity to a seabird colony, on the body length of Arctic populations of P. recamieri was documented. Evidently, there is no tendency towards body size increase along the latitudinal gradient in either T. spitsbergensis or P. recamieri. Our study, and recent literature, indicates that larger body size in polar regions reported for several groups of micro-fauna may be a taxon-dependent response, and cannot be taken as a universally applicable rule for limnoterrestrial animals

Synthesis of new 4-butyl-arylpiperazine-3-(1H-indol-3-yl)pyrrolidine-2,5-dione derivatives and evaluation for their 5-HT1A_{1A} and D2_{2} receptor affinity and serotonin transporter inhibition

A series of novel 4-butyl-arylpiperazine-3-(1H-indol-3-yl)pyrrolidine-2,5-dione derivatives were synthesized and evaluated for their 5-HT$_{1A}$/D2 receptor affinity and serotonin reuptake inhibition. The compounds exhibited high affinity for the 5-HT$_{1A}$ receptor, (especially 4d K$_{i}$ = 0.4 nM) which depended on the substitution pattern at the phenylpiperazine moiety. From this series screen, compound 4c emerged with promising mixed receptor profiles for the 5-HT$_{1A}$/D2 receptors and the serotonin transporter (K$_{i}$ = 1.3 nM, 182 nM and 64 nM, respectively).long-chain arylpiperazinesdepression5-HT$_{1A}$ receptor ligandsschizophreniamulti-target ligand

Distance Learning and Assessment During the COVID-19 Pandemic-Perspectives of Polish Medical and Healthcare Students

The abrupt transition from the traditional model of medical education to online learning caused by the COVID-19 pandemic led to unprecedented changes in the education of future healthcare professionals. This study aimed to evaluate the opinions of Polish healthcare students on the changes introduced due to the COVID-19 pandemic and propose recommendations for improvement. Data were collected from June to July 2020 using an online questionnaire. The results demonstrate that students were generally satisfied with the online learning solutions implemented during the pandemic and appreciated their teachers’ efforts. In their opinion, some of the solutions should also be continued after the pandemic. Students noticed positive aspects of online learning: time efficiency, bigger student-friendliness and unlimited attention from teachers, the flexibility of the learning process, better learning conditions for students, and absences due to illness and other random situations. However, they also noticed its disadvantages: problems with the Internet connection and technical aspects, attitudes of teachers, limited interpersonal relations, limited learning of practical skills, health concerns, students’ engagement and distractions at home, and assessment. To conclude, our results indicate some necessary recommendations to improve the quality of further online learning in medical schools during the COVID-19 pandemic

Inclusion of juvenile stages improves diversity assessment and adds to our understanding of mite ecology – A case study from mires in Norway

Arachnid orders, Mesostigmata, Trombidiformes, and Sarcoptiformes, commonly known as ‘mites’, are abundant in mires, both as adults and as juveniles. However, due to the challenges of identification, the juvenile forms are often excluded from analyses. This is the first study in mires that included all three mite orders identified to the species level, including juvenile instars. We aimed to compare how diversity and the response to ecological variables differed if only the adults (ad) vs. the total number of specimens (ad+juv) are considered. Samples of 20 Sphagnum species (five subgenera) were collected and mites were extracted using Berlese funnels. Overall, nearly 60,000 mites were analyzed; of these Mesostigmata made up 1.87% of the total, Trombidiformes −0.27%, and Sarcoptiformes −97.86%. The study revealed 154 species (33 Mesostigmata, 24 Trombidiformes, and 97 Sarcoptiformes), the highest diversity of mites ever reported from mires. The inclusion of juveniles increased observed species richness by 6%, with 10 species (one Mesostigmata, six Trombidiformes, and three Sarcoptiformes) represented only by juvenile forms. Seventeen species are new to Norway (four Mesostigmata, one Sarcoptiformes, and 12 Trombidiformes, including five undescribed species of Stigmaeidae and Cunaxidae). Four of these were represented in the samples only by juveniles. Including the juveniles explained a greater amount of the variability of Trombidiformes (explanatory variables account for 23.60% for ad, and 73.74% for ad+juv) and Mesostigmata (29.23% − ad, 52.91% − ad+juv), but had less of an impact for Sarcoptiformes (38.48% − ad, 39.26% − ad+juv). Locality, Sphagnum subgenus and species, wetness, and trophic state significantly affected the mite communities and should be taken into consideration when studying mires. Since juvenile stages contribute significantly to mite diversity in mires, they should also be included in mite studies in other habitats.publishedVersio

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world\u27s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (−0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Global maps of soil temperature

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km² resolution for 0–5 and 5–15 cm soil depth. These maps were created by calculating the difference (i.e., offset) between in-situ soil temperature measurements, based on time series from over 1200 1-km² pixels (summarized from 8500 unique temperature sensors) across all the world’s major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in-situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Global maps of soil temperature.

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km2 resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km2 pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications

Phoenicopteriella mirabilis Fain 1970

<i>Phoenicopteriella mirabilis</i> Fain, 1970 <p>(Fig. 8)</p> <p> <i>Phoenicopteriella mirabilis</i> Fain, 1970: 323, figs. 25–27. Holotype in RBINS, examined.</p> <p> Type host: <i>Phoenicopterus ruber</i> Linnaeus (Phoenicopteriformes: Phoenicopteridae) from North Africa.</p> <p> <b>Diagnosis.</b> Palp tarsus with 2 setae (dorsal seta Sa-type, seta situated apically mushroom-like), solenidion absent; palp tibia without setae, solenidion present. Hypostome with 2 pairs of setae (Sa-type). Setae <i>vi</i> situated anterior to level of setae <i>si</i>. Setae <i>vi</i>, <i>se</i>, <i>c2</i> Sa-type, sensillae <i>si</i> Na-type, genital setae Bd-type, other idiosomal setae (including coxal setae) Db-type. Agenital series with 1 pair of setae. Genital series with 3 pairs of setae. Number of leg setae: coxae 1–0–1–1, femora 7–4–3–4.</p> <p> <b>Host and distribution.</b> Phoenicopteriformes (Phoenicopteridae): <i>PhOenicOpterus ruber</i> Linnaeus from North Africa (Fain 1970).</p>Published as part of <i>Skoracki, Maciej, Schmidt, Karl-Heinz, Marciniak, Natalia & Marciniak, Martyna, 2018, A review of mites of the subfamily Speleognathinae (Acariformes: Ereynetidae) parasitizing respiratory tracts of birds in the Afrotropical region, pp. 401-440 in Zootaxa 4403 (3)</i> on page 412, DOI: 10.11646/zootaxa.4403.3.1, <a href="http://zenodo.org/record/1212849">http://zenodo.org/record/1212849</a&gt