Impact of the Covid 19 pandemic on preclinical teaching in medical schools-Lessons learned

Objectives: The authors analyzed the weaknesses and areas of opportunities with the online teaching imposed by the COVID19 lockdown, and the new measures adopted to control the online examinations for medical students.   Method: In addition to personalized question sets we had location mapping and Open Broadcaster Software (OBS) for monitoring students during the exams as well as disabling the back-button during examination. Results: The academic year was successfully completed on time. There was no change in the exams format or scope, yet the results were similar in terms of grade distribution, average and standard deviation as well as the validity and reliability scores. The students’ perception of online teaching was evaluated through a survey. It revealed the importance and added value of online teaching but also exposed the gaps related to lecturers’ preparedness and need for training. Conclusion: The online experience was a valuable lesson for us, as we discovered not only the weaknesses or areas to improve, but also new ways and opportunities that can be explored to enhance the learning experience. Our plan is to introduce online teaching gradually to all modules and align it with students’ readiness through direct implications of students; however, every center should develop its own long-term plan to address its own problems and weaknesses

L'apport du scanner 3D en anatomie dentaire : résultats et applications aux calculs d'ancrage et à la mécanique orthodontique

Cette étude est une mise au point sur les valeurs d'ancrage en orthodontie et leurs influences sur les choix thérapeutiques. Un échantillon de 120 sujets a été analysé. L'utilisation du scanner 3D et des logiciels C2000-Cépha et Cépha3DT, nous permet de faire la sélection des dents ensuite, calculer certains paramètres d'anatomie dentaire tels que les volumes radiculaires, ces derniers peuvent servir comme éléments essentiels pour définir l'ancrage en orthodontie. A partir de cette sélection, le logiciel C2000 réalise une reconstruction ; ceci permet la détermination de paramètres indispensables dans l'étude des dents et de leur rôle dans le choix des attitudes thérapeutiques en orthodontie : - les valeurs d'ancrage des dents et des groupes de dents, - la localisation tridimensionnelle des centres de résistance de groupe. Les données anatomiques individuelles et par groupe de dents éclairent d'un jour nouveau certaines options thérapeutiques. Les valeurs guides sont calculées et comparées à celles proposées dans la littérature. Les nouveaux coefficients d'ancrage proposés remettent en cause certaines attitudes thérapeutiques en orthodontie, et cela nous induit à une attitude thérapeutique plus prudente quelquefois. L'utilisation pratique de ces centres de gravité de groupe, trouve une application clinique immédiate dans les calculs de mécanique conventionnelle et dans les calculs des mécaniques s'appuyant sur des ancrages absolus, c.à.d. sur les micros-vis.The present study is an update on anchorage values in orthodontics and their impact on treatment options. The chosen sample included 120 subjects. 3D tomodensitometry using C2000-Cepha and Cepha 3DT software, calculated tooth anatomy parameters such as root volume which can serve as a basis for defining anchorage in orthodontics. According to this selection, the software C2000 achieves a reconstruction; it permits the determination of essential parameters in the survey of teeth and their role in the therapeutic attitude choice in orthodontics: - Anchorage values of a tooth and groups of teeth, - 3D localization of resistance centers groups. The individual anatomical data for each dental and groups of teeth enlighten certain therapeutic options. The reference values were calculated and compared with those available in the literature. They challenge a number of current approaches in orthodontic treatment, and it sometimes misleads us to a more prudent therapeutic attitude. The use of these group gravity centers in practice, find an immediate clinical application in counts of conventional mechanics and in counts of mechanics relying on the absolute anchorages, means the mini-screws

Envelhecimento populacional: realidade atual e desafios

The aim was to reflect on active aging and the influence of internal and external factors that contribute and even influence the aging process and how Brazil is preparing to face the new reality in relation to significant age group changes and, therefore, change in the general scope. This is a reflective study, with a search in electronic databases that point to population aging. It was evident that there is a great concern in what is discerned about the aging process, without making the necessary decisions so that the health of the individual in the aging process is taken care of as a whole and not partially.Objetivou-se refletir sobre o envelhecimento ativo e a influência de fatores internos e externos que contribuem e até influenciam no processo de envelhecimento e como o Brasil, está se preparando para enfrentar a nova realidade em relação a mudanças significativas de faixa etária e sendo assim, mudança no âmbito geral. Trata-se de estudo de reflexão, com busca nas bases de dados eletrônicas que apontam para o envelhecimento populacional. Evidenciou-se que há uma grande preocupação no que discerne sobre o processo de envelhecer, sem a tomada de decisões necessárias para que a saúde do indivíduo em processo de envelhecimento seja cuidado como um todo e não parcialmente

Estudo das ondas de pressão formadas na admissão de um motor de combustão interna com a presença de um ressonador

Numerical analysis has become a tool of great importance in the search for solutions of increasingly complex engineering problems. This is due both to the technological advancement with respect to the computers’ processing power, and to the techniques used to discretize and solve equations that would be impossible to solve manually and even numerically a few years ago. However, it is neither possible nor advisable to abandon the experimental part, since it is through the experimental results that the numerical results are validated so that from there the computational side can gain more representativeness and credibility. Based on this, this work compares the results obtained through numerical simulation with experimental data of pressure waves in the admission of an internal combustion engine, with the presence of a resonator. These data were found by Hanriot, 2001 and will be used as boundary conditions in the AVL FIRE software and also as a comparison of the numerical model used. AVL FIRE uses the Finite Volume Method, which was better described in the paper. Firstly, a review was done on internal combustion engines, ranging from basic engine operation to some of the equations representative of it. Then there was a brief explanation of Helmholtz's resonator so that, finally, one can approach the numerical and experimental methods used. Numerically, the analysis of pressure waves made in this work generates difficulties to be simulated, because the problem of the compressibility of the fluid in addition to the low values of the speed of the flow can lead to difficulties of convergence of the problem. Fortunately, the numerical methods developed are already capable of solving such problems, but it is still necessary to continue advancing more and more towards discovering new methods or perfecting existing methods, so that solutions are increasingly accurate and methods spend each time less processing time.Trabalho de Conclusão de Curso (Graduação)A análise numérica tem se tornado uma ferramenta de grande importância na busca de soluções de problemas de engenharia cada vez mais complexos. Isto se deve tanto ao avanço tecnológico, no que diz respeito à capacidade de processamento dos computadores, quanto às técnicas utilizadas para discretizar e resolver equações que seriam impossíveis de serem resolvidas manualmente e até mesmo numericamente alguns anos atrás. Contudo, não é possível, nem recomendável, abandonar a parte experimental, pois é através dos resultados experimentais que os resultados numéricos são validados para que, a partir daí o lado computacional possa ganhar mais representatividade e credibilidade. Com base nisto, o presente trabalho compara os resultados encontrados através de simulação numérica com dados experimentais de ondas de pressão na admissão de um motor de combustão interna, com a presença de um ressonador. Estes dados foram encontrados por Hanriot, 2001 e serão usados como condições de contorno no software AVL FIRE e também como forma de comparação do modelo numérico utilizado. O AVL FIRE utiliza o Método dos Volumes Finitos, o qual foi melhor descrito no trabalho. Primeiramente, foi feita uma revisão sobre motores de combustão interna, abordando desde o funcionamento básico do motor até algumas das equações representativas dele. Em seguida, houve uma breve explicação sobre o ressonador de Helmholtz para que, enfim, se possa abordar os métodos numéricos e experimentais utilizados. Numericamente, a análise de ondas de pressão feitas neste trabalho gera dificuldades para serem simuladas, pois o problema da compressibilidade do fluido juntamente com os baixos valores de velocidade do escoamento pode levar a dificuldades de convergência do problema. Felizmente, os métodos numéricos desenvolvidos já são capazes de resolver tais problemas, mas ainda é preciso continuar avançando cada vez mais rumo à descoberta de novos métodos ou aperfeiçoamento dos já existentes, para que as soluções sejam cada vez mais precisas e que os métodos gastem cada vez menos tempo de processamento

Envelhecimento populacional: realidade atual e desafios

The aim was to reflect on active aging and the influence of internal and external factors that contribute and even influence the aging process and how Brazil is preparing to face the new reality in relation to significant age group changes and, therefore, change in the general scope. This is a reflective study, with a search in electronic databases that point to population aging. It was evident that there is a great concern in what is discerned about the aging process, without making the necessary decisions so that the health of the individual in the aging process is taken care of as a whole and not partially.Objetivou-se refletir sobre o envelhecimento ativo e a influência de fatores internos e externos que contribuem e até influenciam no processo de envelhecimento e como o Brasil, está se preparando para enfrentar a nova realidade em relação a mudanças significativas de faixa etária e sendo assim, mudança no âmbito geral. Trata-se de estudo de reflexão, com busca nas bases de dados eletrônicas que apontam para o envelhecimento populacional. Evidenciou-se que há uma grande preocupação no que discerne sobre o processo de envelhecer, sem a tomada de decisões necessárias para que a saúde do indivíduo em processo de envelhecimento seja cuidado como um todo e não parcialmente

3D figure of epilepsy syndromes

We propose an instructive figure that summarized the classification of epilepsy syndromes according to the 2022 report of the ILAE Task Force on Nosology and Definitions. Our aim is to present, in one figure, different concepts such as the names of epilepsy syndromes, their extreme and classical ages of onset, their epilepsy types (generalized, focal or generalized and focal) but also their membership in groups of epilepsy syndromes as for self-limited or developmental and epileptic encephalopathy. With this figure, we provided an interactive tool, as supplementary data, helping to present this classification and link it to electro-clinical mandatory, alerts and exclusionary criteria of each syndrome, in accordance with the ILAE position papers on syndromes classification and nosology. This report may be used as an illustrative tool for teaching epilepsy syndromes and as a practical and comprehensive aid for the classification of epilepsy individuals' syndromes

Ketogenic diet for super-refractory status epilepticus (SRSE) with NORSE and FIRES: Single tertiary center experience and literature data

Background and purposeKetogenic diet (KD) is an emerging treatment option for super-refractory status epilepticus (SRSE). We evaluated the effectiveness of KD in patients presenting SRSE including NORSE (and its subcategory FIRES).MethodsA retrospective review of the medical records was performed at the Necker Enfants Malades Hospital. All children with SRSE in whom KD was started during the last 10 years were included. A systematic search was carried out for all study designs, including at least one patient of any age with SRSE in whom KD was started. The primary outcome was the responder rate and Kaplan–Meier survival curves were generated for the time-to-KD response. As secondary outcomes, Cox proportional hazard models were created to assess the impact of NORSE-related factors on KD efficacy.ResultsSixteen children received KD for treatment of SRSE, and three had NORSE presentation (one infectious etiology, two FIRES). In medical literature, 1,613 records were initially identified, and 75 were selected for review. We selected 276 patients receiving KD during SRSE. The most common etiology of SRSE was acute symptomatic (21.3%), among these patients, 67.7% presented with NORSE of immune and infectious etiologies. Other etiologies were remote symptomatic (6.8%), progressive symptomatic (6.1%), and SE in defined electroclinical syndromes (14.8%), including two patients with genetic etiology and NORSE presentation. The etiology was unknown in 50.7% of the patients presenting with cryptogenic NORSE, of which 102 presented with FIRES. Overall, most patients with NORSE benefit from KD (p < 0.004), but they needed a longer time to achieve RSE resolution after starting KD compared with other non-NORSE SRSE (p = 0.001). The response to KD in the NORSE group with identified etiology compared to the cryptogenic NORSE was significantly higher (p = 0.01), and the time to achieve SE resolution after starting KD was shorter (p = 0.04).ConclusionsThe search for underlying etiology should help to a better-targeted therapy. KD can have good efficacy in NORSE; however, the time to achieve SE resolution seems to be longer in cryptogenic cases. These findings highlight the therapeutic role of KD in NORSE, even though this favorable response needs to be better confirmed in prospective controlled studies