What guides student learning in the clinical years: A mixed methods study exploring study behaviours prior to the UK Medical Licensing Assessment (UKMLA).

PURPOSE: Student study behaviours that prioritise the UKMLA content map over the local curriculum are a significant risk for UK medical education. To mitigate this, we describe a student-centred faculty process to improve local curriculum guidance based on an evaluation of student study behaviours, concerns and needs. Responses informed the build of an online curriculum map. METHODS: A mixed methods approach was adopted, including an online anonymous survey exploring student study behaviours and preferences for curricular guidance. This was followed by student-led focus groups to explore emergent themes further. Qualitative data underwent reflexive thematic analysis. RESULTS: 121 students responded to the survey, of which 12 consented to participate in two student-led focus groups. Five key themes emerged, including motivation for learning, student use of the intended curriculum, student experience of the enacted curriculum, the hidden curriculum, and expectations of an online curriculum map. CONCLUSIONS: A participatory framework enabled shared aims and responsive outcomes for curricular development in the run up to the UKMLA. Student responses led to clarification of guidance, reorganisation of learning resources and optimal design of an online curriculum map which linked all content in a visible, UKMLA aligned framework, accessible to all students and teachers.

Lessons from a Multilaboratorial Task Force for Diagnosis of a Fatal Toxoplasmosis Outbreak in Captive Primates in Brazil.

Toxoplasmosis is an important zoonotic disease caused by the parasite Toxoplasma gondii and is especially fatal for neotropical primates. In Brazil, the Ministry of Health is responsible for national epizootic surveillance, but some diseases are still neglected. Here, we present an integrated investigation of an outbreak that occurred during the first year of the COVID-19 pandemic among eleven neotropical primates housed at a primatology center in Brazil. After presenting non-specific clinical signs, all animals died within four days. A wide range of pathogens were evaluated, and we successfully identified T. gondii as the causative agent within four days after necropsies. The liver was the most affected organ, presenting hemorrhage and hepatocellular necrosis. Tachyzoites and bradyzoite cysts were observed in histological examinations and immunohistochemistry in different organs; in addition, parasitic DNA was detected through PCR in blood samples from all specimens evaluated. A high prevalence of Escherichia coli was also observed, indicating sepsis. This case highlights some of the obstacles faced by the current Brazilian surveillance system. A diagnosis was obtained through the integrated action of researchers since investigation for toxoplasmosis is currently absent in national guidelines. An interdisciplinary investigation could be a possible model for future epizootic investigations in animals.

Multi-Sensing Techniques with Ultrasound for Musculoskeletal Assessment: A Review.

The study of muscle contractions generated by the muscle-tendon unit (MTU) plays a critical role in medical diagnoses, monitoring, rehabilitation, and functional assessments, including the potential for movement prediction modeling used for prosthetic control. Over the last decade, the use of combined traditional techniques to quantify information about the muscle condition that is correlated to neuromuscular electrical activation and the generation of muscle force and vibration has grown. The purpose of this review is to guide the reader to relevant works in different applications of ultrasound imaging in combination with other techniques for the characterization of biological signals. Several research groups have been using multi-sensing systems to carry out specific studies in the health area. We can divide these studies into two categories: human-machine interface (HMI), in which sensors are used to capture critical information to control computerized prostheses and/or robotic actuators, and physiological study, where sensors are used to investigate a hypothesis and/or a clinical diagnosis. In addition, the relevance, challenges, and expectations for future work are discussed.

FPGA Implementation and Evaluation of an Approximate Hilbert Transform-Based Envelope Detector for Ultrasound Imaging Using the DSP Builder Development Tool.

In this paper, we present the FPGA implementation of an approximate Hilbert Transform-based envelope detector to compute the magnitude of the received ultrasound echo signals in real-time using a Model-based design flow. The proposed architecture exploits the negative odd-symmetry and interleaved zero-valued coefficients of a Hilbert Transform-based FIR filter to reduce hardware resource requirements and complexity. The hardware design is modeled using the DSP Builder development tool allowing the automatic generation of HDL algorithms directly from the Matlab/Simulink environment. The generated VHDL code was synthesized for an Intel Stratix IV FPGA and validated on a Terasic DE4-230 board. The accuracy and performance of the envelope detector are analyzed with real ultrasound phantom data for different filter orders, coefficient length and two filter design methods: Equiripple and Least-Squares. The normalized residual sum of squares (NRSS) and the normalized root mean square error (NRMSE) cost functions are used for comparison with the reference absolute value of the Matlab Hilbert function. The results demonstrate that the proposed method yields similar results to conventional envelope detection methods, while being simpler to implement and requiring lower computational cost.

Controversies in Reduction Mammoplasty: Being A "Clean" Operation, Does It Mandate Antibiotic Prophylaxis?

BACKGROUND: Considered a clean operation, breast surgery has surgical site infection (SSI) rates ranging from 4% to 18%, higher than the reference value for clean surgery (<3.4%). The aim of this study was to measure the incidence of SSI in patients undergoing reduction mammoplasty with and without antibiotic prophylaxis, comparing the results and defining the value of antibiotic prophylaxis. METHODS: The study was randomized, double-blinded, and interventional. Two groups were formed randomly, with 75 patients in each. Group 1 received prophylactic antibiotic (cefazolin 2 g 30 min before surgery with repetition at 1 g every 3 h during surgery), and Group 2 (control) did not have antibiotic prophylaxis. Patients were followed until the 30th post-operative day for identification of SSI. RESULTS: There were 13 cases of SSI, 3 in Group 1 (4.1%) and 10 in Group 2 (13.9%) (p = 0.039). Their secretion cultures were positive for Staphylococcus aureus. There were more cases of SSI in patients having greater resections (n = 9), but the difference was not significant (p = 0.051). CONCLUSION: Infection was significantly more common in the group that did not receive prophylaxis.

Analysis of mechanical strength to fixing the femoral neck fracture in synthetic bone type Asnis.

OBJECTIVE: To analyze the results of biomechanical assays of fixation of Pauwels type III femoral neck fracture in synthetic bone, using 7.5mm cannulated screws in inverted triangle formation, in relation to the control group. METHODS: TEN SYNTHETIC BONES WERE USED, FROM A DOMESTIC BRAND, DIVIDED INTO TWO GROUPS: test and control. In the test group, a 70° tilt osteotomy of the femoral neck was fixated using three cannulated screws in inverted triangle formation. The resistance of this fixation and its rotational deviation were analyzed at 5mm displacement (phase 1) and 10mm displacement (phase 2). The control group was tested in its integrity until the fracture of the femoral neck occurred. The Mann-Whitney test was used for group analysis and comparison. RESULTS: The values in the test group in phase 1, in samples 1-5, showed a mean of 579N and SD =77N. Rotational deviations showed a mean of 3.33°, SD = 2.63°. In phase 2, the mean was 696N and SD =106N. The values of the maximum load in the control group had a mean of 1329N and SD=177N. CONCLUSION: The analysis of mechanical strength between the groups determined a statistically significant lower value in the test group. Level of Evidence III, Control Case.