A Revised Measure of Acceptance of the Theory of Evolution: Introducing the MATE 2.0.

Hundreds of articles have explored the extent to which individuals accept evolution, and the Measure of Acceptance of the Theory of Evolution (MATE) is the most often used survey. However, research indicates the MATE has limitations, and it has not been updated since its creation more than 20 years ago. In this study, we revised the MATE using information from cognitive interviews with 62 students that revealed response process errors with the original instrument. We found that students answered items on the MATE based on constructs other than their acceptance of evolution, which led to answer choices that did not fully align with their actual acceptance. Students answered items based on their understanding of evolution and the nature of science and different definitions of evolution. We revised items on the MATE, conducted 29 cognitive interviews on the revised version, and administered it to 2881 students in 22 classes. We provide response process validity evidence for the new measure through cognitive interviews with students, structural validity through a Rasch dimensionality analysis, and concurrent validity evidence through correlations with other measures of evolution acceptance. Researchers can now measure student evolution acceptance using this new version of the survey, which we have called the MATE 2.0.

The evaluation of e-learning resources as an adjunct to otolaryngology teaching: a pilot study.

BACKGROUND: The concept of e-Learning has been rapidly accepted as an important component of medical education and is especially adept at teaching clinical skills. However, their impact on learning, particularly in Otolaryngology Head and Neck Surgery (OHNS) medical school curriculum, has yet to be adequately explored. The aim of this pilot study is to develop interactive e-Learning resources and evaluate their impact in enhancing OHNS teaching in medical school. METHODS: This pilot study is a randomized controlled trial assessing the effectiveness of e-Learning resources in enhancing the current traditional lecture and tutorial-based teaching of OHNS in medical school. Nineteen final-year medical students from the University of Sydney were recruited for this study, who were randomly allocated into intervention group with additional e-Learning resources (Group A) and control group (Group B). Student knowledge was assessed through objective structured clinical examinations (OSCE) with use of standardized forms for objective scoring. Assessors were blinded to student randomization status. A post-study questionnaire was distributed to assess student feedback on the e-Learning resources. RESULTS: Eight students were allocated to Group A and 11 students to Group B. Group A performed significantly better than Group B in the overall examination scores (78.50 ± 13.88 v. 55.82 ± 8.23; P = < 0.01). With the minimum pass mark of 65%, the majority of students in Group A was able to pass the OSCE assessments, while the majority of students in Group B failed (87.50% v. 9.10%; P = 0.01). The post-test questionnaire on the e-Learning resources showed very favorable feedback from the students' perspective. CONCLUSION: Results from our pilot study suggests that the use of interactive online e-Learning resources can be a valuable adjunct in supplementing OHNS teaching in medical school, as they are readily accessible and allow flexible on-demand learning. Future studies involving large numbers of medical students are needed to validate these results.

Fibrosing mediastinitis mimicking postpartum heart failure.

Fibrosing mediastinitis, also known as sclerosing mediastinitis and mediastinal fibrosis, is an uncommon disease characterized by the proliferation of a dense fibrous tissue in the mediastinum. This article describes a patient who presented to the ED with atypical signs and symptoms that initially seemed like heart failure but were eventually diagnosed as fibrosing mediastinitis.

Parathyroid hormone, a crucial mediator of pathologic cardiac remodeling in aldosteronism.

Aldosteronism, or chronic elevation in plasma aldosterone (ALDO) (inappropriate for dietary Na(+) intake), is accompanied by an adverse structural remodeling of the heart and vasculature. Herein, we bring forward a new perspective in which parathyroid hormone (PTH) is identified as a crucial mediator of pathologic cardiac remodeling in aldosteronism. Secondary hyperparathyroidism (SHPT) appears because of the marked urinary and fecal losses of Ca(2+) and Mg(2+) that accompany aldosteronism which creates ionized hypocalcemia and hypomagnesemia, providing major stimuli to the parathyroids' enhanced secretion of PTH. Invoked to restore extracellular Ca(2+) and Mg(2+) homeostasis, elevations in plasma PTH lead to paradoxical intracellular Ca(2+) overloading of diverse tissues. In the case of cardiomyocytes, the excessive intracellular Ca(2+) accumulation involves both cytosolic free and mitochondrial domains with a consequent induction of oxidative stress by these organelles and lost ATP synthesis. The ensuing opening of their inner membrane permeability transition pore (mPTP) accounts for the osmotic swelling and structural degeneration of mitochondria followed by programed cell necrosis. Tissue repair, invoked to preserve the structural integrity of myocardium accounts for a replacement fibrosis, or scarring, which is found scattered throughout the right and left heart; it represents a morphologic footprint of earlier necrosis. Multiple lines of evidence are reviewed that substantiate the PTH-mediated paradigm and the mitochondriocentric signal-transducer-effector pathway to cardiomyocyte necrosis.

Management of pleural injuries during retroperitoneal surgical procedures.

PURPOSE: The necessity of a postoperative chest tube for the treatment of pneumothorax after a radical nephrectomy is controversial. MATERIALS AND METHODS: A five-year retrospective study was performed on 91 patients, having undergone a radical nephrectomy. We examined the existence and length of a pleural rent, presence of a postoperative thoracostomy tube, postoperative pneumothorax, postoperative pneumonia, postoperative atelectasis, pain scores, hemoglobin saturation, and length of hospital stay with univariate and multivariate analysis. RESULTS: Incidence of a pleural rent occurred in 29 (36%) of open radical nephrectomy cases; 4 of the 29 cases had a postoperative thoracostomy tube. There was no significant difference in hemoglobin saturation levels between cases that had no pleural rent, a pleural rent without a thoracostomy tube, and a pleural rent with a postoperative thoracostomy tube. A pleural rent without a postoperative chest tube had significantly lower rates of pain score, atelectasis, pneumonia, pleural effusion, and length of hospital stay compared to individuals with a postoperative chest tube. Patients with a chest tube had a significantly higher incidence of pain, atelectasis, pneumonia, effusion, and length of hospital stay. CONCLUSION: Iatrogenic pleural rents treated without a postoperative chest tube show a significant decrease in postoperative complications of pneumonia and atelectasis, pain score and length of hospital stay. These patients show no significant increases in postoperative complications; therefore, it appears that postoperative chest tube placement after a pleural injury occurs is of no advantage.