Impact of a Tutored Theoretical-Practical Training to Develop Undergraduate Students’ Skills for the Detection of Caries Lesions: Study Protocol for a Multicenter Controlled Randomized Study

Background: Tutored laboratorial activities could be a manner of improving the competency development of students. However, its impact over conventional theoretical classes has not yet been tested. Additionally, different university contexts could influence this issue and should be explored. Objective: To assess the impact of a tutored theoretical-practical training for teaching undergraduate students to detect caries lesions as compared with theoretical teaching activities. The impact of these teaching/learning activities will be assessed in terms of efficacy, cost/benefit, retention of knowledge/acquired competences, and student acceptability. Methods: Sixteen centers (7 centers from Brazil and 9 centers from other countries throughout the world) are involved in the inclusion of subjects for this protocol. A randomized controlled study with parallel groups will be conducted. One group (control) will be exposed to a 60- to 90-minute conventional theoretical class and the other group (test) will be exposed to the same theoretical class and also a 90-minute laboratory class, including exercises and discussions based on the evaluation of a pool of images and extracted teeth. The mentioned outcomes will be evaluated immediately after the teaching activities and also in medium- and long-term analyses. To compare the long-term outcomes, students who enrolled in the university before the participating students will be interviewed for data collection and these data will be used as a control and compared with the trained group. This stage will be a nonrandomized phase of this study, nested in the main study. Appropriate statistical analysis will be performed according to the aims of this study. Variables related to the centers will also be analyzed and used to model adjustment as possible sources of variability among results. Results: This ongoing study is funded by a Brazilian national funding agency (CNPq- 400736/2014-4). We expect that the tutored theoretical-practical training will improve the undergraduate students’ performance in the detection of caries lesions and subsequent treatment decisions, mainly in terms of long-term retention of knowledge. Our hypothesis is that tutored theoretical-practical training is a more cost-effective option for teaching undergraduate students to detect caries lesions. Conclusions: If our hypothesis is confirmed, the use of laboratory training in conjunction with theoretical classes could be used as an educational strategy in Cariology to improve the development of undergraduate students’ skills in the detection of caries lesions and clinical decision-making

Vanishing wildlife corridors and options for restoration: a case study from Tanzania

Conserving wildlife corridors is increasingly important for maintaining ecological and genetic connectivity in times of unprecedented habitat fragmentation. Documenting connectivity loss, assessing root causes, and exploring restoration options are therefore priority conservation goals. A 2009 nationwide assessment in Tanzania documented 31 major remaining corridors, the majority of which were described as threatened. The corridor between the Udzungwa Mountains and the Selous Game Reserve in south-central Tanzania, a major link between western and southern wildlife communities, especially for the African elephant Loxodonta africana, provides an illuminating case study. A preliminary assessment in 2005 found that connectivity was barely persisting via two remaining routes. Here we present assessments of these two corridors conducted from 2007-2010, using a combination of dung surveys, habitat mapping and questionnaires. We found that both corridor routes have become closed over the last five years. Increased farming and livestock keeping, associated with both local immigration and population growth, were the main reasons for corridor blockage. However, continued attempts by elephants to cross by both routes suggest that connectivity can be restored. This entails a process of harmonizing differing land owners and uses towards a common goal. We provide recommendations for restoring lost connectivity and discuss the prospects for preventing further loss of corridors across the country

Prognostic stratification of adult primary glioblastoma multiforme patients based on their tumor gene amplification profiles

Several classification systems have been proposed to address genomic heterogeneity of glioblastoma multiforme, but they either showed limited prognostic value and/or are difficult to implement in routine diagnostics. Here we propose a prognostic stratification model for these primary tumors based on tumor gene amplification profiles, that might be easily implemented in routine diagnostics, and potentially improve the patients management. Gene amplification profiles were prospectively evaluated in 80 primary glioblastoma multiforme tumors using singlenucleotide polymorphism arrays and the results obtained validated in publicly available data from 267/347 cases. Gene amplification was detected in 45% of pati

Interlaminar fracture studies in Portugal: Past, present and future

This paper reviews the state-of-the-art in interlaminar fracture testing of composite materials, with particular emphasis on the work performed in Portugal over the last 15 years. Early work, carried out within the ESIS Polymer and Composite Technical Committee, was concerned with improving test methods on unidirectional [0degrees](n) specimens. The focus was on the mode I double cantilever beam (DCB) test and on mode II end-notched flexure (ENE) and end loaded split (ELS) tests. In spite of some remaining controversy on mode II testing, the main issue nowadays is fracture toughness measurement on multidirectional specimens. Remaining difficulties are discussed in the light of the most recent work. Guidelines for ongoing and future research are also presented.FCT - POCTI/EME/38731/2001, FEDER EU fun

C-reactive protein and later preeclampsia: systematic review and meta-analysis taking into account the weight status

OBJECTIVES: This study aims to determine whether high C-reactive protein (CRP) concentration during pregnancy is associated with later preeclampsia and whether weight status (BMI) is a potential modifier of the relation between CRP and preeclampsia. METHODS: Twenty-three studies were included in a systematic literature review and a subset of 18 in a meta-analysis. Weighted mean difference (WMD) [with their 95% confidence intervals (CI)] of CRP in preeclampsia and control groups was the estimator. A quality assessment was carried out using a scale specifically developed for this study. Meta-regression with estimates for study characteristics and inter-arm differences and sensitivity and subgroup analysis was employed. Statistical heterogeneity was investigated using I(2) statistic. RESULTS: The pooled estimated CRP between 727 women, who developed preeclampsia and 3538 controls was 2.30 mg/l (95% CI: 1.27-3.34). The heterogeneity among studies was high (I(2) = 92.8). The WMD was found to be lower in studies comprising preeclampsia and control groups with similar BMI [WMD = 0.85 (95% CI: 0.10-1.61); I(2) = 25.3%] compared with studies among which BMI was significantly elevated in the preeclampsia group [2.01 (95% CI: 1.23-2.78); I(2) = 0.0%], which may explain the high heterogeneity of pooled data. Meta-regression results confirmed that difference in BMI between groups modifies the association of CRP and preeclampsia. High quality studies represented 30%. CONCLUSION: The pooled WMD suggest that women with higher levels of CRP may have an increased risk of developing preeclampsia. This association seems to be modified by confounders, such as BMI. Further studies of high methodological quality are needed

The Effect Of Leptin Concentrations And Other Maternal Characteristics On Gestational Weight Gain Is Different According To Pre-gestational Bmi: Results From A Prospective Cohort

Objective: To evaluate the effect of leptin and other selected variables on gestational weight gain (GWG) according to pre-gestational body mass index (BMI). Design: Prospective cohort. Setting: Public Health Center, Rio de Janeiro, Brazil. Sample: Two hundred and twenty-eight pregnant women. Methods: Women were followed at the 5–13, 20–26 and 30–36th gestational weeks. The effects of independent variables on GWG in normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25.0–29.9 kg/m2) and obese (BMI ≥ 30.0 kg/m2) women were assessed using longitudinal linear mixed-effects models. Main outcome measure: Maternal body weight (kg) throughout pregnancy. Results: Leptin concentrations were associated with GWG in normal weight (β = 0.048, P < 0.001) and overweight (β = 0.023, P = 0.048) women, but not in obese ones (β = 0.011, P = 0.308). Additionally, the number of hours slept per night decreased the effect of leptin on GWG in OW women (β = −0.013, P = 0.002). The effect of other maternal characteristics on GWG was different depending on the BMI category. Conclusions: Leptin concentrations were positively associated with GWG in normal weight and overweight women, but not in obese ones. Maternal height was associated with GWG in all BMI categories, but other variables such as sleep duration, QUICKI values, HDL-c, smoking habit and marital status presented differential effects according to BMI. We encourage further studies to investigate the association between leptin and gestational weight gain, taking into account the pre-pregnancy weight and sleep duration, in order to compare and confirm our results. Tweetable abstract: Leptin is associated with weight gain in normal weight and overweight pregnant women, but not in obese ones. © 2015 Royal College of Obstetricians and Gynaecologists123111804181