Timing of Case-Based Discussions and Educational Outcomes for Dental Students.

The aim of this study was to determine if the timing of a case-based discussion affected dental students' assessment scores. The study specifically investigated whether the timing of a 60-minute case-based discussion before or after a 90-minute lecture affected students' performance on a quiz on topics in pediatric dentistry. In addition, students' preferences for the timing of the case discussion and confidence in the material with different timings were assessed in a survey. In a crossover design, all 52 second-year students in fall 2016 at one U.S. dental school participated in a case-based discussion either before or after lectures on stainless steel crowns and pulp therapy, compared to a control unit on space maintenance with no case-based discussion. The students took quizzes and responded to questionnaires a week after the lectures. A total of 45 (87%) of the 52 students consented to have their scores used. The results showed that the students performed better on the quiz when participating in a case-based discussion after the lecture compared to the discussion before the lecture (after mean=6.1±0.8 vs. before mean=5.5±1.3). The students' control quiz mean following a lecture with no associated case discussion was 6.3±0.8. Students also expressed more confidence when the case was held after the lecture (12.7 vs. 11.6, p=0.02) and preferred the case after (p=0.01). This study found that higher quiz and confidence scores resulted when a case discussion was held after (vs. before) a lecture. When dental educators consider adding a case discussion to a lecture format as a method of increasing students' active learning, these results suggest that having the case discussion after the lecture may be more effective for learners new to the material.

A novel mouse model that develops spontaneous arthritis and is predisposed towards atherosclerosis.

OBJECTIVES: Patients with rheumatoid arthritis (RA) have a reduced life expectancy due to increased cardiovascular disease. The lack of a suitable animal model resembling both RA and atherosclerosis has hindered studies demonstrating a direct link between systemic inflammation in RA and the development of atherosclerosis. Our objective was to overcome this barrier by generating an animal model (K/BxA(g7)) that spontaneously develops both RA-like disease and atherosclerosis. METHODS: Arthritis severity was evaluated using clinical indices and immunohistochemical staining of ankle joint specimens. Aortic atherosclerosis was delineated via Sudan IV staining and immunohistochemical analysis. Serum cholesterol and lipoprotein levels were measured using enzymatic assays. Serum levels of cytokines, chemokines and adipokines were determined by Luminex assays. RESULTS: K/BxA(g7) mice developed a destructive arthropathy followed by prominent aortic atherosclerosis. These animals also displayed dyslipidaemia, characterised by reduced serum levels of total cholesterol and high-density lipoprotein, and increased low-density lipoprotein (LDL)/vLDL compared with control mice. Further, there were higher levels of circulating inflammatory mediators, such as interleukin-6, sRANKL and CCL5 in atherosclerotic K/BxA(g7) mice compared with controls. Treatment with etanercept reduced arthritis and atherosclerosis development in K/BxA(g7) mice. CONCLUSIONS: K/BxA(g7) mice recapitulate the same sequence of events occurring in patients with RA, namely an erosive, inflammatory arthritis followed by atherosclerosis. These data suggest that the K/BxA(g7) mouse is a novel system for investigating the interplay between systemic inflammation occurring in RA and the development of atherosclerosis.