Learning to diagnose accurately through virtual patients: do reflection phases have an added benefit?

BACKGROUND Simulation-based learning with virtual patients is a highly effective method that could potentially be further enhanced by including reflection phases. The effectiveness of reflection phases for learning to diagnose has mainly been demonstrated for problem-centered instruction with text-based cases, not for simulation-based learning. To close this research gap, we conducted a study on learning history-taking using virtual patients. In this study, we examined the added benefit of including reflection phases on learning to diagnose accurately, the associations between knowledge and learning, and the diagnostic process. METHODS A sample of N = 121 medical students completed a three-group experiment with a control group and pre- and posttests. The pretest consisted of a conceptual and strategic knowledge test and virtual patients to be diagnosed. In the learning phase, two intervention groups worked with virtual patients and completed different types of reflection phases, while the control group learned with virtual patients but without reflection phases. The posttest again involved virtual patients. For all virtual patients, diagnostic accuracy was assessed as the primary outcome. Current hypotheses were tracked during reflection phases and in simulation-based learning to measure diagnostic process. RESULTS Regarding the added benefit of reflection phases, an ANCOVA controlling for pretest performance found no difference in diagnostic accuracy at posttest between the three conditions, F(2, 114) = 0.93, p = .398. Concerning knowledge and learning, both pretest conceptual knowledge and strategic knowledge were not associated with learning to diagnose accurately through reflection phases. Learners' diagnostic process improved during simulation-based learning and the reflection phases. CONCLUSIONS Reflection phases did not have an added benefit for learning to diagnose accurately in virtual patients. This finding indicates that reflection phases may not be as effective in simulation-based learning as in problem-centered instruction with text-based cases and can be explained with two contextual differences. First, information processing in simulation-based learning uses the verbal channel and the visual channel, while text-based learning only draws on the verbal channel. Second, in simulation-based learning, serial cue cases are used to gather information step-wise, whereas, in text-based learning, whole cases are used that present all data at once

Block Crossings in Storyline Visualizations

Storyline visualizations help visualize encounters of the characters in a story over time. Each character is represented by an x-monotone curve that goes from left to right. A meeting is represented by having the characters that participate in the meeting run close together for some time. In order to keep the visual complexity low, rather than just minimizing pairwise crossings of curves, we propose to count block crossings, that is, pairs of intersecting bundles of lines. Our main results are as follows. We show that minimizing the number of block crossings is NP-hard, and we develop, for meetings of bounded size, a constant-factor approximation. We also present two fixed-parameter algorithms and, for meetings of size 2, a greedy heuristic that we evaluate experimentally.Comment: Appears in the Proceedings of the 24th International Symposium on Graph Drawing and Network Visualization (GD 2016

Genomic Scans Support Repetitive Continental Colonization Events during the Rapid Radiation of Voles (Rodentia: Microtus): the Utility of AFLPs versus Mitochondrial and Nuclear Sequence Markers

Single locus studies might not resolve phylogenetic relationships and the evolutionary history of taxa. The analysis of multiple markers promises higher resolution, and congruence among loci may indicate that the phylogenies represent the underlying species history. Here, we examine the utility of a genome-wide approach based on amplified fragment length polymorphisms (AFLP) and several DNA sequence markers in resolving phylogenetic signals in the rapidly radiating rodent genus Microtus which produced about 70 vole species within the last 1.2-2 myr. The current Holarctic distribution of Microtus is assumed to have resulted from three independent colonization events out of Asia to North America, Europe, and northern Asia without subsequent colonization, which would have led to deep splits between species from different continents. We investigated this hypothesis of three single colonization events by reconstructing the phylogenetic relationships among species from all three continents based on data from the first exon of the nuclear arginine vasopressin receptor 1a gene (EXON1), an adjacent noncoding region and the mitochondrial cytochrome b gene. The phylogenetic patterns obtained from these sequence markers are contrasted to genome-wide data on more than 1800 amplified fragment length polymorphisms (AFLP) analyzed for the same samples. Our results show that the single sequence markers partially resolve the phylogenetic relationships within Microtus, but with some incongruence mostly between EXON1 and the other loci. However, deeper nodes of the radiation are only weakly supported and neither the combination of the markers nor additional nuclear sequences improved the resolution significantly. AFLPs provided much stronger support for major continent-specific clades, and show also that reciprocal monophyly of American and European voles is incomplete. Our results demonstrate that Microtus voles colonized the American and European continents each repeatedly in several independent events on similar colonization routes during their radiation. More generally, this study supports the suitability of AFLPs as an alternative to sequence markers to resolve the evolutionary history of rapidly radiating tax

The Bradyrhizobium japonicum phoB gene is required for phosphate-limited growth but not for symbiotic nitrogen fixation

We identified by cloning and DNA sequence analysis the phosphate regulatory gene phoB of Bradyrhizobium japonicum. The deduced gene product displayed pronounced similarity to the PhoB protein of Sinorhizobium meliloti (71.4% identical amino acids), Escherichia coli (50.2%) and other bacterial species. Insertion of a kanamycin resistance cassette into phoB led to impaired growth of the B. japonicum mutant in media containing approximately 25 μM phosphate or less. A standard plant infection test using wild-type and phoB-defective B. japonicum strains showed that the phoB mutation had no effect on the symbiotic properties of B. japonicum with its soybean host plan

Non-destructive Three-dimensional Imaging of Artificially Degraded CdS Paints by Pump-probe Microscopy

Cadmium sulfide (CdS) pigments have degraded in several well-known paintings, but the mechanisms of degradation have yet to be fully understood. Traditional non-destructive analysis techniques primarily focus on macroscopic degradation, whereas microscopic information is typically obtained with invasive techniques that require sample removal. Here, we demonstrate the use of pump-probe microscopy to nondestructively visualize the three-dimensional structure and degradation progress of CdS pigments in oil paints. CdS pigments, reproduced following historical synthesis methods, were artificially aged by exposure to high relative humidity (RH) and ultraviolet (UV) light. Pump-probe microscopy was applied to track the degradation progress in single grains, and volumetric imaging revealed early CdS degradation of small particles and on the surface of large particles. This indicates that the particle dimension influences the extent and evolution of degradation of historical CdS. In addition, the pump-probe signal decrease in degraded CdS is observable before visible changes to the eye, demonstrating that pump-probe microscopy is a promising tool to detect early-stage degradation in artworks. The observed degradation by pump-probe microscopy occurred through the conversion from CdS into CdSO4.xH2O, verified by both FTIR (Fourier-transform infrared) and XPS (X-ray photoelectron spectroscopy) experiment

Time-of-flight imaging of invisibility cloaks

As invisibility cloaking has recently become experimental reality, it is interesting to explore ways to reveal remaining imperfections. In essence, the idea of most invisibility cloaks is to recover the optical path lengths without an object (to be made invisible) by a suitable arrangement around that object. Optical path length is proportional to the time of flight of a light ray or to the optical phase accumulated by a light wave. Thus, time-of-flight images provide a direct and intuitive tool for probing imperfections. Indeed, recent phase-sensitive experiments on the carpet cloak have already made early steps in this direction. In the macroscopic world, time-of-flight images could be measured directly by light detection and ranging (LIDAR). Here, we show calculated time-of-flight images of the conformal Gaussian carpet cloak, the conformal grating cloak, the cylindrical free-space cloak, and of the invisible sphere. All results are obtained by using a ray-velocity equation of motion derived from Fermat's principle.Comment: 11 pages, 6 figures, journal pape

Chaos and localization in the wavefunctions of complex atoms NdI, PmI and SmI

Wavefunctions of complex lanthanide atoms NdI, PmI and SmI, obtained via multi-configuration Dirac-Fock method, are analyzed for density of states in terms of partial densities, strength functions ($F_k(E)$), number of principal components ($\xi_2(E)$) and occupancies (\lan n_\alpha \ran^E) of single particle orbits using embedded Gaussian orthogonal ensemble of one plus two-body random matrix ensembles [EGOE(1+2)]. It is seen that density of states are in general multi-modal, $F_k(E)$'s exhibit variations as function of the basis states energy and $\xi_2(E)$'s show structures arising from localized states. The sources of these departures from EGOE(1+2) are investigated by examining the partial densities, correlations between $F_k(E)$, $\xi_2(E)$ and \lan n_\alpha \ran^E and also by studying the structure of the Hamiltonian matrices. These studies point out the operation of EGOE(1+2) but at the same time suggest that weak admixing between well separated configurations should be incorporated into EGOE(1+2) for more quantitative description of chaos and localization in NdI, PmI and SmI.Comment: There are 9 figure