An exploratory study on the teaching of evidence-based decision making

Background: There is no clear guideline on how to teach students evidence-based decision making (EBDM), so this study aimed to assess the impact of an educational intervention on students’ EBDM skills. Methods: This was an explorative mixed-method study of 12 undergraduate occupational therapy students and their teacher. The teaching was aimed at increasing self-efficacy and cognitive skills in EBDM. Semi-structured interviews were conducted to gather the students’ perceived learning benefits. Before and after the intervention, a self-efficacy questionnaire, a critical thinking test, and scored generic cognitive skills in an argument were used as measures of learning achievements. Content analysis was applied to analyze the interview data. To analyze the quantitative data, the Wilcoxon signed rank test was applied. Results: Following the five teaching sessions, the participants’ experienced (a) an understanding of the value and challenges in individually tailored EBDM, (b) the ability to sort and select information, (c) being more cautious in reasoning and reaching conclusions, and (d) better interaction with clients. These categories were supported by significant increases in measures of self-efficacy and cognitive skills used in EBDM. Active, guided education and working with real clients were reported as powerful stimuli for learning. Conclusion: Critical thinking exercises used in authentic health professional evidence-based decisions are promising methods for promoting EBDM

Anti-Müllerian hormone and androgens: regulation of receptors during sex differentiation and gonadal development

This chapter gives an outline of sex determination, sex differentiation, and gonadal development in mammalian species. In most studies described herein, rats and mice were used. During embryonal development in mammals, sex differentiation is preceded by a bipotential stage. Indifferent gonads are formed that can develop into eilher testes or ovaries. The anlagen of the male and female intemal genitalia, which are both present in embryos of either chromosomal sex, are called the wolffian and the mullerian ducts, respectively

Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease.

Department of Pulmonology, University of Limburg, Maastricht, the Netherlands. Resting energy expenditure (REE) is often elevated in patients with chronic obstructive pulmonary disease (COPD), but no data are available regarding total energy expenditure in free living conditions. We compared total daily energy expenditure (TDE) in eight COPD patients (FEV1 36 +/- 13%) admitted to a pulmonary rehabilitation center and eight independently living healthy subjects, matched for sex, age, and body mass index (BMI). TDE was measured over a 2-wk interval using doubly labeled water in combination with measurement of REE and body composition. The COPD patients had a significantly higher TDE than the healthy subjects (2,499 +/- 320 kcal/d and 2,107 +/- 88 kcal/d, respectively, p < 0.01). The nonresting component of TDE (TDE-REE: physical activity and diet-induced thermogenesis [DIT]) was significantly higher in the COPD patients than in the healthy subjects, resulting in a ratio between TDE and REE of 1.7 +/- 0.2 and 1.4 +/- 0.1, respectively (p < 0.01). The results indicate that COPD patients exhibit an increased TDE in comparison with healthy subjects. The difference could by attributed to an increase in the nonresting component of TDE, since REE was comparable between the groups. Publication Types: Clinical Trial Controlled Clinical Tria

Ketamine treatment upon memory retrieval reduces fear memory in marmoset monkeys

Emotionally arousing experiences are retained very well as seen in posttraumatic stress disorder (PTSD). Various lines of evidence indicate that reactivation of these memories renders them labile which offers a potential time-window for intervention. We tested in non-human primates whether ketamine, administered during fear memory reactivation, affected passive (inhibitory) avoidance learning. For the consolidation of contextual emotional memory, the unescapable foot-shock paradigm in a passive avoidance task with two compartments (dark vs illuminated) was used. After entering the dark compartment, marmoset monkeys received four random foot-shocks (1 mA, 4 s) within 15-min. This stressful exposure increased the saliva cortisol and heart rate and impaired REM-sleep (p  <0.05). One week later the monkeys were re-exposed to the stressful situation for the reconsolidation of the fearful experience. During the re-exposure the monkeys were treated with ketamine (0.5 mg/kg) or saline. In week 3, the monkeys were placed in the experimental setting to test their memory for the fearful experience. In contrast to the vehicle-treated monkeys, who avoided the dark compartment, the ketamine-treated monkeys entered the dark compartment that was previously associated with the fearful experience (p < 0.05). Post-mortem analysis of the hippocampus showed that ketamine-treated animals exhibited less doublecortin positive neurons and BrdU-labeled cells in the dentate gyrus. This study reveals that a single low dose of ketamine, administered upon fear retrieval in monkeys, reduce contextual fear memory and attenuate neurogenesis in the hippocampus. These are important findings for considering ketamine as a potential candidate to target traumatic memories in PTSD

DNA repair mechanisms and gametogenesis

In mammals, there is a complex and intriguing relationship between DNA repair and gametogenesis. DNA repair mechanisms are involved not only in the repair of different types of DNA damage in developing germline cells, but also take part in the meiotic recombination process. Furthermore, the DNA repair mechanisms should tolerate mutations occurring during gametogenesis, to a limited extent. In the present review, several gametogenic aspects of DNA mismatch repair, homologous recombination repair and postreplication repair are discussed. In addition, the role of DNA damage-induced cell cycle checkpoint control is considered briefly. It appears that many genes encoding proteins that take part in DNA repair mechanisms show enhanced or specialized expression during mammalian gametogenesis, and several gene knockout mouse models show male or female infertility. On the basis of such knowledge and models, future experiments may provide more information about the precise relationship between DNA repair, chromatin dynamics, and genomic stability versus instability during gametogenesis

Regulation of gene expression in Sertoli cells by follicle-stimulating hormone (FSH): Cloning and characterization of LRPR1, a primary response gene encoding a leucine-rich protein

Searching for hormone-regulated genes in testicular Sertoli cells, we cloned and sequenced a cDNA of 3108 base pairs, named LRPR1 (signifying leucine-rich primary response gene 1). This cDNA sequence has an open reading frame of 2238 base pairs encoding a leucine-rich protein of 746 amino acid residues with a relative molecular mass of 85.6 kDa. As much as 16% of the amino acid residues is leucine. Database analysis revealed significant similarity of LRPR1 to the human brain cDNA sequence EST00443, but not to any other sequences present in databases. The expression of LRPR1 mRNA in Sertoli cells is strongly and rapidly up-regulated by follicle-stimulating hormone (FSH). The level of LRPR1 mRNA was very low in Sertoli cells isolated from 21-day-old rats and cultured for 3 days in the absence of FSH, but LRPR1 mRNA expression was markedly increased within 2 h after addition of FSH to these cultures. A maximal response was reached within 4 h. Dibutyryl-cyclic AMP [(Bu)2cAMP] and forskolin had similar effects compared to FSH, indicating that cAMP acts as a second messenger in the regulation of LRPR1 expression. The up-regulation of LRPR1 mRNA expression by FSH was also observed in the presence of the protein synthesis inhibitor cycloheximide, indicating that FSH regulates LRPR1 mRNA expression through a direct mechanism which does not require de novo protein synthesis. Thus, LRPR1 represents a primary response gene in FSH action on Sertoli cells. The presently available data indicate that LRPR1 mRNA expression is regulated specifically by FSH, since several other hormones and growth factors did not affect LRPR1 mRNA expression in the cultured Sertoli cells. LRPR1 mRNA expression is relatively high in testis, ovary and spleen. A much lower mRNA level was found in brain and lung, and no expression was detected in liver, kidney, heart, muscle, pituitary gland, prostate, epididymis and seminal vesicle. The basal level of testicular LRPR1 expression in intact 21-day-old rats was markedly increased within several hours after a single i.p. injection of FSH, indicating that in vivo LRPR1 mRNA expression may appear to be a useful parameter to evaluate testicular FSH action