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Rakhmawati HSN, Wungu CDK, Purwanto B, Andarianto A. Exercise under hypoxia on glucose tolerance in type 2 diabetes mellitus risk individuals: A systematic review and meta-analysis. Tzu Chi Med J 2024; 36:212-222. [PMID: 38645791 PMCID: PMC11025589 DOI: 10.4103/tcmj.tcmj_144_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/04/2023] [Accepted: 11/06/2023] [Indexed: 04/23/2024] Open
Abstract
Objectives To analyze the impact of exercise under hypoxic exposure versus normoxic exposure on blood glucose level, insulin level, and insulin sensitivity in people at risk of Type 2 diabetes mellitus (T2DM). Materials and Methods We systematically performed electronic searching on PubMed, Web of Science, ProQuest, and Scopus. Primary studies that met the inclusion criteria were analyzed using Revman 5.4.1. Results Nine randomized controlled trials were included in this meta-analysis. We found that physical exercise under hypoxic exposure had no significant effect on improving blood glucose levels, insulin levels, and insulin sensitivity in the elderly and sedentary people compared to normoxic condition. However, physical exercise during hypoxic exposure had a significant effect on lowering blood glucose levels in overweight/obese individuals (pooled Standardized Mean Difference = 0.29; 95% confidence interval = 0.01-0.57; P = 0.04). Conclusions Exercising under hypoxic exposure can be an alternative strategy for reducing blood glucose levels in overweight/obese people. Nevertheless, in other populations at risk of T2DM, exercising in hypoxic conditions gives similar results to normoxic conditions.
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Affiliation(s)
| | - Citrawati Dyah Kencono Wungu
- Division of Biochemistry, Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bambang Purwanto
- Division of Physiology, Department of Medical Physiology and Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Andre Andarianto
- Sport Health Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Fang YW, Chen SF, Wang ML, Wang MH. Effects of traditional Chinese medicine-assisted intervention on improving postpartum lactation: A systematic review and meta-analysis. Heliyon 2024; 10:e27154. [PMID: 38524574 PMCID: PMC10957381 DOI: 10.1016/j.heliyon.2024.e27154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Importance Breast milk is the safest food for infants and has many psychological and physical benefits for infants and mothers. However, problems encountered during the breastfeeding process can reduce postpartum women's willingness to breastfeed. Lactation and engorgement may be improved through Traditional Chinese Medicine auxiliary therapy. However, the overall efficacy of various Traditional Chinese Medicine auxiliary therapies and the relevant meridians and acupuncture points for treating breast milk deficiency remain unclear. Objective To investigate Traditional Chinese Medicine auxiliary therapy's effectiveness and acupoints for postpartum women who experience problems during the breastfeeding process. Methods Data were sourced from Embase, Web of Science, CINAHL, Cochrane, CNKI, PubMed, and the Airiti Library Central Register of Controlled Trials and Clinical Trials from the database inception to October 2022. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Main outcome measures The primary outcomes were overall efficiency, prolactin level, milk volume, and breast engorgement in postpartum women with lactation deficiency after-assisted therapies and the correlation between meridian points and milk secretion. Results A total of 1,516 studies were initially identified, and 357 articles were assessed. In the final analysis, 20 studies were included, covering various Traditional Chinese Medicine therapies (acupuncture, acupressure, scrapping, moxibustion cupping, etc.) to stimulate relative acupoints without any acupoint stimulation. The overall efficiency (odds ratio [OR] = 14.17, 95% confidence interval [CI] = 6.49 to 30.92), prolactin level (standardized mean difference [SMD] = 0.36, 95% CI = 0.074 to 0.64), improvement of milk volume (SMD = 0.94, 95% CI = 0.59 to 1.29), reduction of engorgement level (OR= 18, 95% CI = 8.34 to 38.82) demonstrated that Traditional Chinese Medicine therapies can effectively improve lactation and breast fullness, thereby helping patients with breast milk deficiency. The most common acupuncture points used to treat agalactia were classified as the Stomach Meridian, Small Intestine Meridian, and Conception Vessel, with the common acupoints CV17: Danzhong, ST18: Rugen, SI1: Shaoze, ST36: Zusanli, and ST16: Yingchuang. Conclusion Adjuvant Traditional Chinese Medicine therapy can improve lactation and breast engorgement, thereby increasing the willingness to breastfeed. Clinical Finding: 1. The best time for Traditional Chinese Medicine acupoint intervention for breast deficiency treatment is within 24 h 2. The most effective acupuncture points for improving milk deficiency and bloating pain are ST18: Rugen, ST16: Yingchuang, ST36: Zusanli, SI1: Shaoze, CV17: Danzhong. 3. Traditional Chinese Medicine is non-invasive and effective techniques such as scraping, cupping, acupressure and ear peas. 4. Traditional Chinese Medicine can be combined with other different acupuncture points according to the different constitutions of post-partum women. Breast acupressure, ear acupuncture, scrapping, cupping, and moxibustion are noninvasive treatments that can effectively help patients during lactation, and their clinical practice should be considered and widely promoted.
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Affiliation(s)
- Yu-Wen Fang
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Shu-Fen Chen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ming-Ling Wang
- Researcher, School of Nursing, International Ph. D. Program in Gerontology and Long-term Care, Taipei Medical University, Taipei, Taiwan
| | - Mei-Hua Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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3
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Ivander G, Anggono Y. a comparison of intra-articular hyaluronic acid and platelet-rich plasma for knee osteoarthritis: a systematic review. Orthop Rev (Pavia) 2024; 16:94236. [PMID: 38435440 PMCID: PMC10908594 DOI: 10.52965/001c.94236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Knee osteoarthritis (KOA), the most common chronic degenerative condition in an older population, accounts for many disabilities around the world. One of the most popular treatments is intra-articular injection of hyaluronic acid (HA) and platelet-rich plasma (PRP). Objective Prior studies have found that both HA and PRP had a therapeutic effect on KOA. This study aims to perform a systematic review regarding whether PRP is superior to HA for KOA. Method We conducted a comprehensive literature search using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for prospective randomized control trials (pRCTs) in three international databases PubMed, Google Scholar, and ScienceDirect from 2019-2022. Two researchers independently searched the reviews, extracted, and cross-checked the data. The disparity when choosing the literature was resolved by discussion. The modified Jadad was scale used to assess the quality of the included studies. Cochrane risk of bias 2 tool (RoB-2) was used for determininzg risk of bias. Results Twenty three studies were eligible for inclusion. Four pRCT with the highest Jadad score were selected as best evidence. Risk of bias assesment concluded two studies having a low risk of bias, one is high risk of bias, and the other possesses some concerns.. Three studies found no difference in patient-reported outcomes between PRP and HA group and one study concluded that PRP is more effective than HA in treating KOA. Conclusion Intra-articular injections of PRP and HA are effective interventions for KOA. However, there is not enough evidence of PRP superiority over HA.
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Affiliation(s)
- Gian Ivander
- Orthopedic Universitas Katolik Widya Mandala Surabaya
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Liu T, Liu M, Sha Z, Wu C, Zhao Z, Yuan J, Feng D, Nie M, Jiang R. Chinese Neurosurgical Randomized Controlled Trials: Dynamics in Trial Implementation and Completion. Neurosurgery 2024; 94:497-507. [PMID: 37796000 DOI: 10.1227/neu.0000000000002702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/03/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The focus on evidence-based neurosurgery has led to a considerable amount of neurosurgical evidence based on randomized controlled trials (RCTs) being published. Nevertheless, there has been no systematic appraisal of China's contribution to RCTs. Information about the changes in characteristics of Chinese neurosurgical RCTs before and during the COVID-19 pandemic is limited. This study aims to perform a detailed examination and comprehensive analysis of the characteristics of Chinese neurosurgical RCTs and to examine the differences before and during the COVID-19 pandemic. METHODS We conducted a comprehensive database search including PubMed, Web of Science, Embase, and Cochrane Library up to March 2023, with a criterion of inclusion based on an impact factor above 0. We subsequently examined the design and quality parameters of the included RCTs and assessed the differences before and during the COVID-19 pandemic (based on follow-up ending before or after January 2020). Moreover, we investigated potential factors that may affect the quality and developmental trends of neurosurgical RCTs in China. RESULTS The main focus of the 91 neurosurgical RCTs was vascular disease (47.3%) and trauma (18.7%). Over half of the trials used Consolidated Standards of Reporting Trial diagrams (69.2%), and the majority compared nonsurgical treatments (63.7%). Larger trials tended to have better quality scores, but those with significant efficacy were less likely to have power calculations. Over time, there was an increase in the use of Consolidated Standards of Reporting Trial diagrams and well-specified outcomes. The COVID-19 pandemic may have hindered the completion of neurosurgical RCTs in China, but it has had little impact on the design and quality so far. CONCLUSION Chinese neurosurgeons have made significant progress in advancing neurosurgical RCTs despite challenges. However, shortcomings in sample size and power calculation need attention. Improving the rigor, rationality, and completeness of neurosurgical RCT design is crucial.
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Affiliation(s)
- Tao Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Mingqi Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Zhuang Sha
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Chenrui Wu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Zhihao Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Jiangyuan Yuan
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Dongyi Feng
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Meng Nie
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
| | - Rongcai Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin , China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin , China
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Zhang S, Zhu D, Wang X, Liu T, Wang L, Fan X, Gong H. Effects of six teaching strategies on medical students: protocol for a systematic review and network meta-analysis. BMJ Open 2024; 14:e079716. [PMID: 38296281 PMCID: PMC10828868 DOI: 10.1136/bmjopen-2023-079716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Mounting evidence has suggested that novel teaching strategies have a positive impact on the quality and efficiency of medical education. However, the comprehensive evidence about the superiority among various strategies is not clear. To address this issue, we aim to conduct a systematic review and network meta-analysis (NMA) to evaluate the effects of six main strategies on medical education, including case-based learning, problem-based learning, team-based learning, flipped classrooms, simulation-based education and bridge-in, objective, preassessment, participatory learning, postassessment and summary. METHODS AND ANALYSIS A systematic search will be conducted in PubMed, Embase, Web of Science and the Cochrane Library, covering studies published from database inception to November 2023. Randomised controlled trials which evaluated the different teaching methods and meet the eligibility criteria will be included. The effectiveness of medical students' learning, which is evaluated by theoretical test score, experimental or practical test score, will be analysed as the primary outcomes. Besides, the secondary outcomes consist of learning satisfaction of students and formative evaluation score. The study selection and data extraction will be independently performed by two authors. The risk of bias in each study will be assessed using V.2 of the Cochrane risk-of-bias tool for randomised controlled trials. To compare the effects of six teaching strategies, pairwise meta-analysis and NMA will be performed using Rev Man, STATA and R software. Statistical analyses including homogeneity tests, sensitivity analysis, consistency tests, subgroup analysis, Egger's test and publication bias will also be completed. ETHICS AND DISSEMINATION No formal research ethics approval is required because this study is a meta-analysis based on published studies. The results will be disseminated to a peer-reviewed journal for publication. PROTOCOL REGISTRATION NUMBER CRD42023456050.
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Affiliation(s)
- Shuailong Zhang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
- Battalion 2022 of the Cadet Brigade, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Dongmei Zhu
- Department of Hospital Infection Control, Chongqing Health Center for Women and Children, Chongqing 401147, China
- Department of Hospital Infection Control, Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Xiaqing Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Hong Gong
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
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Khandelwal S, Dhande R, Sood A, Parihar P, Mishra GV. Role of Multidetector Computed Tomography Urography in the Evaluation of Obstructive Uropathy: A Review. Cureus 2023; 15:e48038. [PMID: 38034148 PMCID: PMC10688237 DOI: 10.7759/cureus.48038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Obstructive uropathy, a prevalent clinical problem, can irreparably harm the kidneys if not treated promptly. As a result, accurate diagnosis is necessary for prompt management. This study examines the utility of multidetector computed tomography (MDCT) urography in identifying obstructive uropathy. PubMed, Google, Embase, Medline, and other electronic databases were used to search the English-language literature. The search phrases were obstructive urinary infections or urinary bladder or kidneys or MDCT. The authors' expertise and experience in the subject area aided in archiving pertinent publications. Even though the dilated upper tract of the ureters can be seen, ultrasonography (USG) has limitations because it cannot show the middle portion of the ureters, even if they are dilated mostly due to bowel gas artifacts. The USG does not emphasize the functioning of the renal tract. To evaluate obstructive uropathy, MDCT urography plays a very important role. For speedy, effective therapy, it provides a quick diagnosis of the source of obstruction.
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Affiliation(s)
- Shreya Khandelwal
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anshul Sood
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratapsingh Parihar
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Liu Z, Ren Z, Fang L, Liao Y, Ren D, Yu Y, Qin Y, Wu J, Rong P. From the West to the East: an evidence-based educational reform for modern medical students in traditional Chinese medicine learning. Front Med (Lausanne) 2023; 10:1223614. [PMID: 37766919 PMCID: PMC10520962 DOI: 10.3389/fmed.2023.1223614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Generally, Traditional Chinese Medicine (TCM) courses are now given to modern medicine students without proper course scheduling, resulting in poor teaching results. Methods To analyze the main factors affecting TCM learning, we surveyed the medical students and TCM teachers from Xiangya School of Medicine of Central South University via online questionnaires. The questionnaire comprised two parts, the students' part included the basic information, the subjective cognition in TCM, the attitude toward TCM course arrangements, and the attitude toward curriculum content and the design of TCM. The teachers' part included the basic information, the attitudes and opinions on TCM course arrangements, and suggestions and views on TCM teaching reform. The related data were collected from 187 medical students divided into two groups, namely, clinical medical students and non-clinical medical students. Results We found a more positive attitude toward TCM [including "Scientific nature of TCM" (P = 0.03) and "Necessity for modern medicine students to learn TCM" (P = 0.037)] in clinical medical students compared with non-clinical medical students, clinical and non-clinical medical students tended to find TCM courses difficult, and the students prefer clinical training to be better than theoretical teaching, while the teachers believe that lecture-based education should have a more significant proportion. Discussion Hence, to optimize the current TCM teaching, we conducted education reform, including differentiated teaching, hybrid teaching, and selective teaching.
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Affiliation(s)
- Zhenrui Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhixuan Ren
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Linhan Fang
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuxuan Liao
- The Third Xiangya Hospital, Central South University, Changsha, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- National Cancer Center, National Clinical Center of Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dan Ren
- Department of Traditional Chinese Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yao Yu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yixuan Qin
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianzhen Wu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Pengfei Rong
- Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China
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Chetry D, Singh J, Chhetri A, Katiyar VK, Singh DS. Effect of yoga on intra-ocular pressure in patients with glaucoma: A systematic review and meta-analysis. Indian J Ophthalmol 2023; 71:1757-1765. [PMID: 37203026 PMCID: PMC10391478 DOI: 10.4103/ijo.ijo_2054_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Glaucoma is the second leading cause of blindness in the world, with an estimated 57.5 million people suffering from glaucoma globally. Treatment of glaucoma focuses on lowering intra-ocular pressure to prevent progression of visual field defects, which is the only proven method for treating this disease. Yoga practices are believed to lower intra-ocular pressure in the eyes and prevent further damage in patients with glaucoma. Therefore, this systematic review was planned to explore the available scientific studies on yoga and intra-ocular pressure in glaucoma patients. PubMed, Cochrane Library, and Google Scholar were the basis for the investigation of the literature. The Jadad Scale was used to assess the quality of included clinical trials, and the JBI Critical Appraisal Checklist was used to assess the quality of included case studies. Based on the quality assessment and eligibility, six studies on yoga and intra-ocular pressure in glaucoma patients carried out between 2007 and 2021 were included in the final review. The results showed a reduction in intra-ocular pressure in patients with glaucoma through Jyoti-trataka (gazing steadily on a point or candle flame) and some other slow yogic breathing techniques, whereas studies on inversion Asanas (yoga postures) showed a rapid increase in intra-ocular pressure soon after starting. The three high-quality RCTs included in the meta-analysis showed a greater improvement in intra-ocular pressure in the yoga groups in both eyes than in the control groups; however, there were some limitations related to a small sample size, study quality, a long-term follow-up period, and variations in the yoga practices. Therefore, further studies with larger sample sizes and long-term follow-up are needed to overcome the limitations for a better understanding.
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Affiliation(s)
- Dipak Chetry
- Department of Yoga, University of Patanjali, Haridwar, Uttarakhand, India
| | - Jayvindra Singh
- Department of Yoga, University of Patanjali, Haridwar, Uttarakhand, India
| | - Archana Chhetri
- Department of Yoga, Uttarakhand Sanskrit University, Haridwar, Uttarakhand, India
| | | | - Daya Shankar Singh
- Department of Shalakya Tantra (ENT), Patanjali Bhartiya Ayurvigyan Evam Anusandhan Sansthan, Haridwar, Uttarakhand, India
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Maatouk M, Kbir GH, Mabrouk A, Rezgui B, Dhaou AB, Daldoul S, Sayari S, Haouet K, Moussa MB. Can ventral TAPP achieve favorable outcomes in minimally invasive ventral hernia repair? A systematic review and meta-analysis. Hernia 2022:10.1007/s10029-022-02709-4. [PMID: 36378412 DOI: 10.1007/s10029-022-02709-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The concept of the transabdominal preperitoneal (TAPP) was transferred from the inguinal hernia repair to be adopted in minimally invasive ventral hernia repair (VHR) and since then it has been gaining popularity. However, there are minimal data supporting the ventral TAPP (vTAPP) technique which may lead to reticence in the adoption of this approach. The aim of this meta-analysis was to evaluate the outcomes of patients who received minimally invasive vTAPP for VHR. STUDY DESIGN A systematic search was performed of PubMed, Science Direct, Google Scholar and Cochrane Library until July 2022. We selected studies that compared the vTAPP technique with any of other minimally invasive techniques. A meta-analysis was done for the outcomes of perioperative characteristics and postoperative parameters. RESULTS A total of 9 studies (1429 patients) were identified. vTAPP was associated with considerable benefit when compared to IPOM. vTAPP was less painful (MD = - 1.01; 95% CI [- 1.39, - 0.64], p < 0.00001), of reduced average cost (MD = - 457.10; 95% CI [- 457.27, - 456.92], p < 0.00001) and decreased SSI (OR = 0.29; 95% [0.09, 0.96], p = 0.04). On the other hand, the vTAPP approach consumed less operative time (MD: - 31.01, 95% CI [- 33.50, - 28.51]), p < 0.00001) and shorter hospital stay than the e-TEP approach. CONCLUSION vTAPP appears to be safe and effective procedure for VHR, superior or similar to other minimally invasive techniques for perioperative characteristics and short-term outcomes.
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Design of Flute Music Remote Teaching System Based on Multi-Pass Scheduling Optimization. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:1126785. [PMID: 36211020 PMCID: PMC9536956 DOI: 10.1155/2022/1126785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022]
Abstract
With the gradual development of the Internet industry, every aspect of people's life has been affected by the Internet, playing increasingly irreplaceable functions in people's entertainment, office, and other aspects. Judging from the current development situation, the old Internet digital teaching system has many problems, such as low artificial intelligence, weak information processing ability, and lack of effective learning ability. This paper designs the flute music remote teaching system, which can realize remote music teaching and provide help in providing real-time music teaching. The music learning system includes the user's access records, the user's operation and the completion of the test data, the discussion and communication of online participation, the user's interests, specialties and operation methods, learning progress and scoring, and so on. In addition, it explores and explains all the key steps required by the current distance education model and invents a sample of the distance education model. On this basis, Internet algorithm programs will be used for all key processing functions of the system. The use of Internet algorithm programs is interactive and automated, which greatly enhances the role of the education system. This article first discusses the unique teaching and automated teaching mode of the system, which lays the cornerstone for further reforms in this field in the future.
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Kalsoom S, Zamir A, Rehman AU, Ashraf W, Imran I, Saeed H, Majeed A, Alqahtani F, Rasool MF. Clinical pharmacokinetics of nadolol: A systematic review. J Clin Pharm Ther 2022; 47:1506-1516. [PMID: 36040016 DOI: 10.1111/jcpt.13764] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/02/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Nadolol is a non-selective beta-adrenergic antagonist that is used for the treatment of hypertension and angina. The primary route for its administration is oral. It is given once daily as it has a longer half-life (t½). The purpose of conducting this systematic review is to provide a comprehensive view of all the available pharmacokinetic (PK) data on nadolol in humans. This review aimed to systematically collate and analyze publish data on the clinical PK of nadolol in humans and this can be beneficial for the clinicians in dosage adjustments. METHODS Two electronic databases PubMed and Google Scholar were used for conducting a systematic literature search. All the relevant articles containing PK data of nadolol in humans were retrieved. A total of 1275 articles were searched from both databases and after applying eligibility criteria finally, 22 articles were included for conducting the systematic review. RESULTS AND DISCUSSION The area under the plasma concentration curve (AUC) and maximum plasma concentration (Cmax ) of nadolol increased in a dose-dependent manner. The t½ of nadolol was increased to double (18.2-68.6 h) in the patients with chronic kidney disease while the serum t½ became shorter (3.2-4.3 h) when administered to the children. The bioavailability of nadolol was greatly reduced by the coadministration of green tea. Nadolol can be effectively removed by hemodialysis. It undergoes enterohepatic circulation thus activated charcoal decreased its bioavailability. WHAT IS NEW AND CONCLUSION Since, there is no previous report of a systematic review on the PK of nadolol, the current review encompasses all the relevant published articles on nadolol in humans. The analysis and understanding of PK parameters (AUC, Cmax , and t½) of nadolol may be helpful in the development and evaluation of PK models.
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Affiliation(s)
- Samia Kalsoom
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Ammara Zamir
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Anees Ur Rehman
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Waseem Ashraf
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, Allama Iqbal Campus, University of the Punjab, Lahore, Pakistan
| | - Abdul Majeed
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
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Jannah N, Fitrisia D, Fitriani SS, Safira RY. Nursing students’ attitude towards problem-based learning in the classroom. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The Effects of Sequencing Strategies in Teaching Methods on Nursing Students’ Knowledge Acquisition and Knowledge Retention. Healthcare (Basel) 2022; 10:healthcare10030430. [PMID: 35326908 PMCID: PMC8950601 DOI: 10.3390/healthcare10030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023] Open
Abstract
Background: No existing research has determined which teaching sequence strategy is the best for nursing students. Purpose: To find out which sequence is most effective in knowledge acquisition and knowledge retention and to further verify knowledge acquisition between problem-based learning (PBL) and lecture-based learning (LBL). Methods: This was a quasi-experimental design with a comparison of two nursing student groups selected from students in their final program year who were invited to participate. Generalized estimating equation was used to compare Group I (LBL-PBL-clinical practicum) and Group II (PBL-LBL-clinical practicum) by using knowledge acquisition and knowledge retention as outcome variables. Findings: Fifty-six senior students joined this study. Group I was significantly better than Group II on both knowledge acquisition (β = 7.05, p = 0.04) and knowledge retention (β = 9.40, p = 0.03). Discussion: The sequence of LBL-PBL-clinical practicum or policy of allowing practicum and courses in the same semester might be the best strategy to enhance knowledge retention.
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A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation. J Pers Med 2022; 12:jpm12020298. [PMID: 35207786 PMCID: PMC8876986 DOI: 10.3390/jpm12020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
The superiority of second-generation cryoballoon (2G-CB) ablation versus contact force-sensing radiofrequency (CF-RF) ablation in patients with paroxysmal atrial fibrillation (AF) was assessed in this systematic review and meta-analysis. Freedom from atrial tachyarrhythmias (ATAs) (OR = 0.89; 95% confidence interval [CI] = 0.68 to 1.17; p = 0.41), freedom from AF (OR = 0.93; 95% CI = 0.65 to 1.35; p = 0.72), and acute pulmonary vein isolation (PVI) (OR = 1.17; 95% CI = 0.54 to 2.53; p = 0.70) between 2G-CB ablation and CF-RF ablation were not different. The procedure time for the 2G-CB ablation was shorter (MD = −18.78 min; 95% CI = −27.72 to −9.85 min; p < 0.01), while the fluoroscopy time was similar (MD = 2.66 min; 95% CI = −0.52 to 5.83 min; p = 0.10). In the 2G-CB ablation group, phrenic nerve paralysis was more common (OR = 5.74; 95% CI = 1.80 to 18.31; p = < 0.01). Regarding freedom from ATAs, freedom from AF, and acute PVI, these findings imply that 2G-CB ablation is not superior to CF-RF ablation in paroxysmal AF. Although faster than CF-RF ablation, 2G-CB ablation has a greater risk of phrenic nerve paralysis.
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Cheng X, Chan LK, Cai H, Zhou D, Yang X. Adaptions and perceptions on histology and embryology teaching practice in China during the Covid-19 pandemic. TRANSLATIONAL RESEARCH IN ANATOMY 2021; 24:100115. [PMID: 38620760 PMCID: PMC7890343 DOI: 10.1016/j.tria.2021.100115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 12/23/2022] Open
Abstract
Backgroud Under the circumstance of school closures caused by the coronavirus outbreak, medical schools in China began implementing online teaching, including histology and embryology (HE) beginning in the middle of February 2020. The changes in HE education in responding to the pandemic in China needs to be determined, for further adaption of online teaching delivery or blended learning. Methods A nationwide survey of the major medical colleges was conducted via WeChat. Results In total, 83 medical schools (one respondent per school) were invited to survey, 78 medical schools responded which represented most medical schools across all the provinces in mainland China, as well as Hong Kong and Macao. The results revealed that 77% (n = 60) and 58% (n = 45) of the responding schools had conducted HE theoretical and practical online teaching, respectively, prior to the pandemic; however, 27% (n = 21) of the medical schools had temporally suspended practical sessions at the time the survey was completed. During the pandemic, 73% (n = 57) and 29% (n = 23) of the medical schools delivered HE theoretical and practical sessions by synchronous live broadcasting, respectively; 65% (n = 51) of the medical schools increased virtual microscopy using during practical sessions. During the pandemic, 54% (n = 42) of the medical schools implemented teaching activities promoting active learning; meanwhile, online assessment was implemented in 84% (n = 66) of the responding medical schools. With regard to the satisfaction with the effectiveness of online teaching during the pandemic, 64% (n = 50) of the medical schools gave positive answers and considered that it was a good opportunity to develop novel and diversified teaching methods. Despite various difficulties such as work overload and unstable online teaching environments, most medical schools are willing to continue or increase theoretical online teaching after the pandemic. Conclusions Medical institutes in China were the earliest of closing campuses and having complete online teaching experience during the pandemic. This paper presents overall HE teaching situation extracted from the survey, to assist other medical schools optimizing the transitions to quality online teaching within a short time, and to serve as reference for schools that demand essential knowledge in online teaching methods, infrastructure construction, and platform integrations.
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Affiliation(s)
- Xin Cheng
- Department of Histology and Embryology, Medical College, Jinan University, Guangzhou, China
| | - Lap Ki Chan
- Macau University of Science and Technology, Macao SAR, China
| | - Hongmei Cai
- Department of Histology and Embryology, Medical College, Jinan University, Guangzhou, China
| | - Deshan Zhou
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Xuesong Yang
- Department of Histology and Embryology, Medical College, Jinan University, Guangzhou, China
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Waranugraha Y, Rizal A, Firdaus AJ, Sihotang FA, Akbar AR, Lestari DD, Firdaus M, Nurudinulloh AI. The superiority of high-power short-duration radiofrequency catheter ablation strategy for atrial fibrillation treatment: A systematic review and meta-analysis study. J Arrhythm 2021; 37:975-989. [PMID: 34386124 PMCID: PMC8339091 DOI: 10.1002/joa3.12590] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Radiofrequency catheter ablation (RFCA) using the high-power short duration (HPSD) results in better ablation lesion formation in the swine model. This systematic review and meta-analysis purposed to investigate the safety and efficacy profile between HPSD and low-power long-duration (LPLD) ablation strategies to treat atrial fibrillation (AF) patients. METHODS We completed the literature review after identifying the relevant articles comparing HPSD and LPLD ablation methods for AF recorded in ClinicalTrials.com, CENTRAL, PubMed, and ScienceDirect until February 2021. The overall effects were calculated using pooled risk ratio (RR) and mean difference (MD) for categorical and continuous data, respectively. We also estimated the 95% confidence interval (CI). RESULTS The HPSD strategy took shorter procedure time (MD = -33.75 min; 95% CI = -44.54 to -22.97; P < .01), fluoroscopy time (MD = -5.73 min; 95% CI = -8.77 to -2.70; P < .001), and ablation time (MD = -17.71; 95% CI = -21.02 to -14.41) than LPLD strategy. The HPSD RFCA was correlated with lower risk of esophageal thermal injury (RR = 0.75; 95% CI = 0.59 to 0.94; P = .02). The HPSD method resulted in higher first-pass pulmonary vein isolation (PVI) (RR = 1.36; 95% CI = 1.13 to 1.64; P < .01), lower PV reconnection (RR = 0.47; 95% CI = 0.34 to 0.64; P < .01), and lower recurrent AF (RR = 0.72; 95% CI = 0.54 to 0.96; P = .02) than LPLD strategy. CONCLUSION HPSD RFCA was superior to the conventional LPLD RFCA in terms of safety and efficacy in treating AF patients.
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Affiliation(s)
- Yoga Waranugraha
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Ardian Rizal
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Achmad J. Firdaus
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Fransiska A. Sihotang
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Akita R. Akbar
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Defyna D. Lestari
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Muhammad Firdaus
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
| | - Akhmad I. Nurudinulloh
- Department of Cardiology and Vascular MedicineFaculty of MedicineUniversitas Brawijaya, Dr. Saiful Anwar General HospitalMalangIndonesia
- Brawijaya Cardiovascular Research CenterUniversitas BrawijayaMalangIndonesia
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Pavlek LR, Rivera BK, Smith CV, Randle J, Hanlon C, Small K, Bell EF, Rysavy MA, Conroy S, Backes CH. Eligibility Criteria and Representativeness of Randomized Clinical Trials That Include Infants Born Extremely Premature: A Systematic Review. J Pediatr 2021; 235:63-74.e12. [PMID: 33894262 PMCID: PMC9348995 DOI: 10.1016/j.jpeds.2021.04.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/23/2021] [Accepted: 04/15/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the eligibility criteria and trial characteristics among contemporary (2010-2019) randomized clinical trials (RCTs) that included infants born extremely preterm (<28 weeks of gestation) and to evaluate whether eligibility criteria result in underrepresentation of high-risk subgroups (eg, infants born at <24 weeks of gestation). STUDY DESIGN PubMed and Scopus were searched January 1, 2010, to December 31, 2019, with no language restrictions. RCTs with mean or median gestational ages at birth of <28 weeks of gestation were included. The study followed the PRISMA guidelines; outcomes were registered prospectively. Data extraction was performed independently by multiple observers. Study quality was evaluated using a modified Jadad scale. RESULTS Among RCTs (n = 201), 32 552 infants were included. Study participant characteristics, interventions, and outcomes were highly variable. A total of 1603 eligibility criteria were identified; rationales were provided for 18.8% (n = 301) of criteria. Fifty-five RCTs (27.4%) included infants <24 weeks of gestation; 454 (1.4%) infants were identified as <24 weeks of gestation. CONCLUSIONS The present study identifies sources of variability across RCTs that included infants born extremely preterm and reinforces the critical need for consistent and transparent policies governing eligibility criteria.
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Affiliation(s)
- Leeann R. Pavlek
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital,Department of Pediatrics and The Ohio State University Wexner Medical Center, Columbus, OH
| | - Brian K. Rivera
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital
| | - Charles V. Smith
- Center for Integrated Brain Research, Seattle Children’s Research Institute, Seattle, WA
| | - Joanie Randle
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Cory Hanlon
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Kristi Small
- Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH
| | - Edward F. Bell
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Matthew A. Rysavy
- Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA
| | - Sara Conroy
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University,Biostatistics Resource at Nationwide Children’s Hospital
| | - Carl H. Backes
- Center for Perinatal Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital,Department of Pediatrics and The Ohio State University Wexner Medical Center, Columbus, OH,Ohio Perinatal Research Network at Nationwide Children’s Hospital, Columbus, OH,Obstetrics and Gynecology, The Ohio State University Wexner Medical Center,The Heart Center, Nationwide Children’s Hospital, Columbus, OH
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Allahabadi S, Feeley SE, Lansdown DA, Pandya NK, Feeley BT. Influential Articles on Pediatric and Adolescent Anterior Cruciate Ligament Injuries: A Bibliometric Analysis. Orthop J Sports Med 2021; 9:23259671211010772. [PMID: 34164558 PMCID: PMC8191091 DOI: 10.1177/23259671211010772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/09/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The understanding of pediatric anterior cruciate ligament (ACL) injuries and optimal treatment has evolved significantly. Influential articles have been previously evaluated using article citations to determine impact. PURPOSE To identify and characterize the 50 most cited and recent influential articles relating to pediatric and adolescent ACL injuries, to examine trends in publication characteristics, and to evaluate correlations of study citations with quality of evidence. STUDY DESIGN Cross-sectional study. METHODS The top 50 most cited articles on pediatric and adolescent ACL injuries were gathered using the Web of Science and Scopus online databases by averaging the number of citations from each database. Articles from recent years were also aggregated and sorted by citation density (citations/year). Publication and study characteristics were recorded. Level of evidence and methodologic quality were assessed where applicable using the modified Coleman Methodology Score (mCMS), modified Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS). Spearman correlation was used to evaluate the association between citation data and level of evidence or methodologic quality scorings. RESULTS The top 50 cited papers had a mean of 117.5 ± 58.8 citations (range, 58.5-288.5 citations), with a mean citation density of 9.4 ± 5.4 citations per year (range, 2.9-25.8 citations/year); 80% were published in 2000 or later, and 6% were considered basic science. Articles were mainly level 4 evidence (27/42; 64.3%), and none was level 1. There were moderate, significant associations between publication year and level of evidence (r S = -0.45; P = .0030) and citation density and publication year (r S = 0.59; P < .001). Mean methodologic quality scores were as follows: mCMS, 53 ± 7.2 (range, 39-68); modified Jadad scale, 3.2 ± 1.1 (range, 2-6); and MINORS, 11.2 ± 3.2 (range, 6-20). There was a significant, strong correlation between rank of mean citations and modified Jadad scale (r S = 0.76; P < .0001), suggesting poorer score associated with more mean citations. CONCLUSION Influential articles on pediatric and adolescent ACL injuries were relatively recent, with a low proportion of basic science-type articles. Most of the studies had a lower evidence level and poor methodologic quality scores. Higher methodologic quality did not correlate positively with citation data.
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Affiliation(s)
- Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA
| | - Sonali E. Feeley
- Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA
| | - Drew A. Lansdown
- Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA
| | - Nirav K. Pandya
- Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA
| | - Brian T. Feeley
- Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA
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Bi S, Liu R, Li J, Gu J. The effectiveness of problem-based learning in gynecology and obstetrics education in China: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e24660. [PMID: 33655930 PMCID: PMC7939176 DOI: 10.1097/md.0000000000024660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/08/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A meta-analysis was conducted to assess the effectiveness of problem-based learning (PBL) in gynecology and obstetrics education in China. METHODS English and Chinese databases were systematically searched for eligible studies that compared the effects of PBL and traditional teaching methods measuring theoretical knowledge, student satisfaction, clinical operations, and clinical practice scores in gynecology and obstetrics education in China. The authors restricted included studies to randomized controlled trials and performed a meta-analysis. Standardized mean difference (SMD) and risk ratio with 95% confidence interval (CI) were estimated. RESULTS A total of 38 randomized controlled trials with 3005 participants were included. Compared with traditional teaching group, the PBL group significantly increased theoretical knowledge scores (SMD: 3.17, 95% CI: 2.28, 4.07), student satisfaction (risk ratio: 1.29, 95% CI: 1.16, 1.43), clinical operations (SMD: 1.15, 95% CI: 0.93, 1.37) and clinical practice (SMD: 2.17, 95% CI: 3.63, 2.71). CONCLUSION The current research shows that PBL in gynecology and obstetrics education in China is more effective than the traditional teaching in enhancing theoretical knowledge, student satisfaction, clinical operations, and clinical practice scores. However, more delicate-designed studies on this topic are needed in the future to validate these results.
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Affiliation(s)
- Siwei Bi
- Department of Burn and Plastic Surgery, West China Hospital
| | - Ruiqi Liu
- Department of Burn and Plastic Surgery, West China Hospital
| | | | - Jun Gu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
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Surgical site infection in mesh repair for ventral hernia in contaminated field: A systematic review and meta-analysis. Ann Med Surg (Lond) 2021; 63:102173. [PMID: 33680450 PMCID: PMC7907974 DOI: 10.1016/j.amsu.2021.02.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/14/2023] Open
Abstract
Background Given the risk of surgical site infection (SSI), the use of mesh in contaminated ventral hernia repair (VHR) is not standardized and still a clinical dilemma. This meta-analysis aimed to assess whether mesh use increased the risk of SSI in patients following VHR in contaminated field. Methods We performed a systematic review of published literature. Studies comparing the mesh repair and anatomic repair, the use of mesh in different Center for Disease Control and Prevention (CDC) wound classes and mesh repair with synthetic mesh or other type of meshes to treat complicated and contaminated VHR were considered for analysis. The main outcome was SSI incidence. Results Six studies compared mesh and suture repairs. No significant difference in SSI incidence was observed between patients with complicated VHR in the mesh and suture repair groups.Five studies analyzed mesh repair in patients by field contamination level. There was no significant difference between the use of mesh in clean-contaminated, contaminated and dirty field versus clean wound class. Moreover, there was no significant difference between the use of mesh in clean-contaminated and contaminated cases.Four studies compared mesh repair technique with synthetic mesh or other type of meshes were included. The incidence of SSI was significantly lower in the synthetic mesh group. Conclusions The use of mesh repair in the management of complicated VHR compared to suture repair is not associated with an increased incidence of SSI even in potentially contaminated fields.
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Waranugraha Y, Rizal A, Setiawan D, Aziz IJ. Additional complex fractionated atrial electrogram ablation does not improve the outcomes of non-paroxysmal atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials. Indian Heart J 2020; 73:63-73. [PMID: 33714411 PMCID: PMC7961253 DOI: 10.1016/j.ihj.2020.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/04/2020] [Accepted: 11/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background Non-paroxysmal atrial fibrillation (AF) has a complex pathophysiological process. The standard catheter ablation approach is pulmonary vein isolation (PVI). The additional value of complex fractionated electrogram (CFAE) ablation is still unclear. We aimed to investigate the additional value of CFAE ablation for non-paroxysmal AF. Methods We performed a systematic review and meta-analysis of randomized controlled studies up to May 2020. Articles comparing pulmonary vein isolation (PVI) plus CFAE ablation and PVI alone for AF were obtained from the electronic scientific databases. The pooled mean difference (MD) and pooled risk ratio (RR) were assessed. Results A total of 8 randomized controlled trials (RCTs) including 1034 patients were involved. Following a single catheter ablation procedure, the presence of any atrial tachyarrhythmia (ATA) with or without the use of antiarrhythmic drugs (AADs) between both groups were not significantly different (RR = 1.1; 95% confidence interval [CI] = 0.97–1.24; p = 0.13). Similar results were also obtained for the presence of any ATA without the use of AADs (RR = 1.08; 95% CI = 0.96–1.22; p = 0.2). The additional CFAE ablation took longer procedure times (MD = 46.95 min; 95% CI = 38.27–55.63; p = < 0.01) and fluoroscopy times (MD = 11.69 min; 95% CI = 8.54–14.83; p = < 0.01). Conclusion Additional CFAE ablation failed to improve the outcomes of non-paroxysmal AF patients. It also requires a longer duration of procedure times and fluoroscopy times.
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Affiliation(s)
- Yoga Waranugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Brawijaya Cardiovascular Research Center, Malang, Indonesia.
| | - Ardian Rizal
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Brawijaya Cardiovascular Research Center, Malang, Indonesia
| | - Dion Setiawan
- Brawijaya Cardiovascular Research Center, Malang, Indonesia
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Hung W, Dolmans DHJM, van Merriënboer JJG. A review to identify key perspectives in PBL meta-analyses and reviews: trends, gaps and future research directions. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2019; 24:943-957. [PMID: 31768786 DOI: 10.1007/s10459-019-09945-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 11/14/2019] [Indexed: 06/10/2023]
Abstract
In the past 50 years, the original McMaster PBL model has been implemented, experimented, revised, and modified, and is still evolving. Yet, the development of PBL is not a series of success stories, but rather a journey of experiments, failures and lessons learned. In this paper, we analyzed the meta-analyses and systematic reviews on PBL from 1992 to present as they provide a focused lens on the PBL research in the past 5 decades. We identified three major waves in the PBL research development, analyzed their impact on PBL research and practice, and offered suggestions of research gaps and future directions for the field. The first wave of PBL research (polarization: 1990-mid 2000) focused on answering the question "Does PBL work?" and the outcomes. The results were conflicting. The researchers took polarizing positions and debated over the merits of PBL throughout this wave. However, the contradictory results and the debates in fact pushed the researchers to look harder for new directions to solve the puzzle. These efforts resulted in the second wave (from outcomes to process: mid 2000-mid 2010) that focused on the question "How does PBL work?" The second wave of PBL research targeted at investigating the effects of implementation constituents, such as assessment formats or single versus curriculum wide implementations. The third wave (specialization: mid 2010 and onward) of PBL research focused on "How does PBL work in different specific contexts?" These research widened our perspectives by expanding our understanding of how PBL manifests itself in different contexts. Given the diversification of PBL and more hybrid PBL models, we suggest "Why does PBL with particular implementation characteristics for specific outcomes work or not work in the condition where it is implemented?" to be the question to answer in the next wave of PBL research.
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Affiliation(s)
- Woei Hung
- Instructional Design and Technology Program, Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, USA.
| | - Diana H J M Dolmans
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jeroen J G van Merriënboer
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Bernard RM, Borokhovski E, Schmid RF, Waddington DI, Pickup DI. Twenty-first century adaptive teaching and individualized learning operationalized as specific blends of student-centered instructional events: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2019; 15:e1017. [PMID: 37131463 PMCID: PMC8356521 DOI: 10.1002/cl2.1017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Robert M. Bernard
- Centre for the Study of Learning and PerformanceConcordia UniversityMontrealCanada
| | | | - Richard F. Schmid
- Department of Education (Educational Technology), Centre for the Study of Learning and PerformanceConcordia UniversityMontrealCanada
| | - David I. Waddington
- Department of Education (Educational Studies), Centre for the Study of Learning and PerformanceConcordia UniversityMontrealCanada
| | - David I. Pickup
- Centre for the Study of Learning and PerformanceMontrealCanada
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Lin WT, Lin SY, Chou FH, Wu LM, Lee BO. The longitudinal learning outcomes of using different teaching sequences in a nursing administration project. J Nurs Manag 2019; 27:1304-1313. [PMID: 31144363 DOI: 10.1111/jonm.12812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/24/2019] [Accepted: 05/27/2019] [Indexed: 12/01/2022]
Abstract
AIM To examine the effects of using different teaching sequences on knowledge acquisition, knowledge retention, self-directed learning and teamwork in a nursing administration project. BACKGROUND Compared to other professional courses, nursing administration is relatively difficult, and it is important for nursing administration students to spend long hours working in hospitals. As such, better teaching strategies utilizing proper sequencing may yield better learning outcomes for students. METHODS A longitudinal quasi-experimental design was used. A total of 129 students were assigned to two groups with which different teaching sequences were used. The investigated learning outcomes were knowledge acquisition, knowledge retention, self-directed learning and teamwork. Generalized estimating equations were used to measure the learning outcomes. RESULTS There was no significant difference between the two teaching sequences in terms of learning effects. One teaching strategy, problem-based learning (PBL), yielded effective student learning outcomes. CONCLUSION PBL increased the students' self-directed learning and teamwork. This strategy can be applied to side-by-side co-teaching and post-graduate year training programmes. IMPLICATIONS FOR NURSING MANAGEMENT The results from this study may help hospitals retain nurses and find potential nursing leaders. Instructors and nurse managers should discuss learning goals with students in advance to enhance the students' learning outcomes.
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Affiliation(s)
- Wei-Ting Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Shu-Yuan Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Nursing Department, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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25
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Observational Application Comparing Problem-Based Learning with the Conventional Teaching Method for Clinical Acupuncture Education. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2102304. [PMID: 31011356 PMCID: PMC6442311 DOI: 10.1155/2019/2102304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/12/2019] [Accepted: 03/11/2019] [Indexed: 11/18/2022]
Abstract
Aim Although the problem-based learning (PBL) teaching method was introduced in 1969, its rapid and widespread application in Malaysia started in 1979. This study aimed to evaluate satisfaction with PBL compared to that of conventional learning, using satisfaction surveys and the Rosenberg Self-Esteem scores, of students learning clinical acupuncture at the School of Traditional Chinese Medicine (TCM), Xiamen University Malaysia. Method The participants of this study (N=36) were registered for a bachelor's degree program in TCM in 2016 and enrolled in the Science of Acupuncture and Moxibustion course beginning in September 2018. The students were randomly allocated into two groups: PBL group and conventional group. A self-administered learning satisfaction survey and the Rosenberg Self-Esteem scores were used for data collection. An independent sample t-test was used to compare the results between the two groups. A p-value <0.05 was considered significant. Results The results of the learning satisfaction survey and Rosenberg Self-Esteem scores were significantly better in the PBL group than in the conventional group (p<0.05). Conclusions PBL appears to be more effective for clinical acupuncture education than the conventional teaching method. However, further studies are needed to identify the mechanisms by which PBL excels in clinical acupuncture education, as well as other related TCM fields.
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Sahu PK, Chattu VK, Rewatkar A, Sakhamuri S. Best practices to impart clinical skills during preclinical years of medical curriculum. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:57. [PMID: 31008124 PMCID: PMC6442250 DOI: 10.4103/jehp.jehp_354_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/01/2018] [Indexed: 06/01/2023]
Abstract
Globally, health is regarded as a booming industry with greater stress being laid on high quality, accountability, and transparency. Traditional medical curricula rely primarily on clerkships during the clinical period of study to train clinical skills, while the preclinical period is mainly used to teach the basic sciences. In recent years, the early introduction of clinical skills training has received increased attention. This review aims to identify and summarize teaching approaches of clinical skills for medical students during preclinical years, namely, (1) framing objectives (2) learning activities, and (3) evaluation strategies. Although the clinical tutor's role is to ensure that students receive effective preclinical skills through different modes of learning (lectures, presentations, and problem-based learning), the role of advanced technologies, namely, simulation-based learning platforms and gamification are found to be very successful. To improve the communication skills, there is strong evidence in support of role plays, and similarly, for enhancing observation skills, an introduction of fine arts in clinical skills training was found to be very useful. Medical schools worldwide should give high priority to conduct faculty development programs on various aspects of training and teaching modalities, evaluation strategies, and improving the evaluation of various clinical skills. Students should be provided with sufficient learning opportunities including a well-equipped clinical skills laboratory and individual attention, and constructive feedback should be given to students for building their confidence level during their learning process.
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Affiliation(s)
- Pradeep Kumar Sahu
- Centre for Medical Sciences Education, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Vijay Kumar Chattu
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Aishwarya Rewatkar
- Department of Biochemistry, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Sateesh Sakhamuri
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
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27
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Jia X, Zeng W, Zhang Q. Combined administration of problem- and lecture-based learning teaching models in medical education in China: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e11366. [PMID: 30412058 PMCID: PMC6221680 DOI: 10.1097/md.0000000000011366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim of this meta-analysis is to assess the effectiveness of the combined administration of problem-based learning (PBL) and lecture-based learning (LBL) teaching models in Chinese medical education. MATERIALS AND METHODS We searched the following Chinese electronic databases: China National Knowledge Infrastructure, WanFang Data, China Science Periodical Database, and the Chinese BioMedical Literature Database. We also searched the following English electronic databases: PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Search Engine. We searched for published studies involving the combined administration of PBL+LBL teaching models in Chinese medical education. All randomized controlled trials were included. The focus of the meta-analysis was on the outcomes of knowledge scores, skill scores, medical writing scores, comprehensive ability scores and teaching satisfaction. A subgroup analysis was also performed. RESULTS A total of 23 RCTs were included, with a total sample size of 2589 medical students. The PBL+LBL teaching model significantly increased knowledge scores (95% CI, 2.85-5.78; P < .00001), skill scores (95% CI, 0.51-3.71; P = .01), medical writing scores (95% CI, 1.04-4.04; P = .0009), comprehensive ability scores (95% CI, 2.04-8.71; P = .002) and teaching satisfaction (RR, 1.32; 95% CI, 1.10-1.59; P = .003) compared with the LBL teaching model alone. Additionally, a subgroup analysis showed significant differences in the effect of PBL+LBL on knowledge scores, medical writing scores, and comprehensive ability scores when comparing practical and theoretical courses. Another subgroup analysis that looked at the level of training showed that the PBL+LBL teaching model also significantly improved the knowledge scores of Freshman, Sophomore, Junior, Senior and Masters students. DISCUSSION AND CONCLUSIONS Based on the current evidence, this meta-analysis showed that the PBL+LBL teaching model is an effective way to increase knowledge scores, skill scores, medical writing scores, and comprehensive ability scores and to improve teaching satisfaction.
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Corell A, Regueras LM, Verdú E, Verdú MJ, de Castro JP. Effects of competitive learning tools on medical students: A case study. PLoS One 2018. [PMID: 29518123 PMCID: PMC5843339 DOI: 10.1371/journal.pone.0194096] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective Competitive learning techniques are being successfully used in courses of different disciplines. However, there is still a significant gap in analyzing their effects in medical students competing individually. The authors conducted this study to assess the effectiveness of the use of a competitive learning tool on the academic achievement and satisfaction of medical students. Methods The authors collected data from a Human Immunology course in medical students (n = 285) and conducted a nonrandomized (quasi-experimental) control group pretest-posttest design. They used the Mann-Whitney U-test to measure the strength of the association between two variables and to compare the two student groups. Results The improvement and academic outcomes of the experimental group students were significantly higher than those of the control group students. The students using the competitive learning tool had better academic performance, and they were satisfied with this type of learning. The study, however, had some limitations. The authors did not make a random assignment to the control and experimental groups and the groups were not completely homogenous. Conclusion The use of competitive learning techniques motivates medical students, improves their academic outcomes and may foster the cooperation among students and provide a pleasant classroom environment. The authors are planning further studies with a more complete evaluation of cognitive learning styles or incorporating chronometry as well as team-competition.
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Affiliation(s)
- Alfredo Corell
- School of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Luisa M. Regueras
- Higher Technical School of Telecommunications Engineering (ETSIT), Universidad de Valladolid, Valladolid, Spain
- * E-mail:
| | - Elena Verdú
- School of Engineering and Technology, Universidad Internacional de La Rioja, Logroño, Spain
| | - María J. Verdú
- Higher Technical School of Telecommunications Engineering (ETSIT), Universidad de Valladolid, Valladolid, Spain
| | - Juan P. de Castro
- Higher Technical School of Telecommunications Engineering (ETSIT), Universidad de Valladolid, Valladolid, Spain
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Gair J, Horton G, Wojcik S, Wong A. Promoting the Learning of Basic Sciences in a Changing Small-Group Learning Landscape. Interviews of tutors and students in a medical program. MEDEDPUBLISH 2018; 7:8. [PMID: 38089218 PMCID: PMC10711955 DOI: 10.15694/mep.2018.000008.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Tomorrow's medical graduate needs to be equipped today to be able to make sense of continued advancements in medical science and then apply these to the benefit of patents and communities. It is important that current methods of teaching and learning in medical programs such as problem-based learning are subject to critical evaluation as to whether they are fit for purpose, and many medical programs are questioning whether problem-based learning provides adequate grounding in basic science. In this context, we interviewed twelve tutors and four students of one distributed medical program in order to explore their views on what elements of PBL promoted understanding of basic science. Our participants reported that setting a clear agenda about basic science learning was crucial; that tutor preparation and guides needed to take account of different tutor backgrounds; particular styles of prompting and questioning from the tutor were valuable; and that students could benefit from being primed with key introductory concepts about how basic sciences related to each other prior to commencing PBL. These findings will be useful for medical curriculum developers who are seeking to innovate with their curriculum but wish to retain what may be currently most valuable by stakeholders.
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Affiliation(s)
- Jane Gair
- University of Victoria/ University of British Columbia
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Sayyah M, Shirbandi K, Saki-Malehi A, Rahim F. Use of a problem-based learning teaching model for undergraduate medical and nursing education: a systematic review and meta-analysis. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2017; 8:691-700. [PMID: 29042827 PMCID: PMC5633274 DOI: 10.2147/amep.s143694] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the problem-based learning (PBL) method as an alternative to conventional educational methods in Iranian undergraduate medical courses. MATERIALS AND METHODS We systematically searched international datasets banks, including PubMed, Scopus, and Embase, and internal resources of banks, including MagirIran, IranMedex, IranDoc, and Scientific Information Database (SID), using appropriate search terms, such as "PBL", "problem-based learning", "based on problems", "active learning", and" learner centered", to identify PBL studies, and these were combined with other key terms such as "medical", "undergraduate", "Iranian", "Islamic Republic of Iran", "I.R. of Iran", and "Iran". The search included the period from 1980 to 2016 with no language limits. RESULTS Overall, a total of 1,057 relevant studies were initially found, of which 21 studies were included in the systematic review and meta-analysis. Of the 21 studies, 12 (57.14%) had a high methodological quality. Considering the pooled effect size data, there was a significant difference in the scores (standardized mean difference [SMD]=0.80, 95% CI [0.52, 1.08], P<0.000) in favor of PBL, compared with the lecture-based method. Subgroup analysis revealed that using PBL alone is more favorable compared to using a mixed model with other learning methods such as lecture-based learning (LBL). CONCLUSION The results of this systematic review showed that using PBL may have a positive effect on the academic achievement of undergraduate medical courses. The results suggest that teachers and medical education decision makers give more attention on using this method for effective and proper training.
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Affiliation(s)
- Mehdi Sayyah
- Department of Medical Education, Ahvaz Jundishapur of Medical Sciences, Ahvaz, Iran
| | - Kiarash Shirbandi
- Department of Radiology, Allied Health Sciences School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki-Malehi
- Department of Biostatistics and Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Research Center of Thalassemia and Hemoglobinopathy, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Chang HC, Wang NY, Ko WR, Yu YT, Lin LY, Tsai HF. The effectiveness of clinical problem-based learning model of medico-jurisprudence education on general law knowledge for Obstetrics/Gynecological interns. Taiwan J Obstet Gynecol 2017; 56:325-330. [DOI: 10.1016/j.tjog.2017.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2016] [Indexed: 10/19/2022] Open
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Wang J, Xu Y, Liu X, Xiong W, Xie J, Zhao J. Assessing the effectiveness of problem-based learning in physical diagnostics education in China: a meta-analysis. Sci Rep 2016; 6:36279. [PMID: 27808158 PMCID: PMC5093758 DOI: 10.1038/srep36279] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 10/13/2016] [Indexed: 11/09/2022] Open
Abstract
Problem-based learning (PBL) has been extensively applied as an experimental educational method in Chinese medical schools over the past decade. A meta-analysis was performed to assess the effectiveness of PBL on students' learning outcomes in physical diagnostics education. Related databases were searched for eligible studies evaluating the effects of PBL compared to traditional teaching on students' knowledge and/or skill scores of physical diagnostics. Standardized mean difference (SMD) with 95% confidence interval (CI) was estimated. Thirteen studies with a total of 2086 medical students were included in this meta-analysis. All of these studies provided usable data on knowledge scores, and the pooled analysis showed a significant difference in favor of PBL compared to the traditional teaching (SMD = 0.76, 95%CI = 0.33-1.19). Ten studies provided usable data on skill scores, and a significant difference in favor of PBL was also observed (SMD = 1.46, 95%CI = 0.89-2.02). Statistically similar results were obtained in the sensitivity analysis, and there was no significant evidence of publication bias. These results suggested that PBL in physical diagnostics education in China appeared to be more effective than traditional teaching method in improving knowledge and skills.
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Affiliation(s)
- Jianmiao Wang
- Teaching and Research Section of Diagnostics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China.,Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
| | - Yongjian Xu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
| | - Xiansheng Liu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
| | - Weining Xiong
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
| | - Jungang Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
| | - Jianping Zhao
- Teaching and Research Section of Diagnostics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China.,Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Road, Wuhan 430030, China
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Xu Z, Zhao H, Chen Z. The efficacy and safety of rufinamide in drug-resistant epilepsy: A meta-analysis of double-blind, randomized, placebo controlled trials. Epilepsy Res 2016; 120:104-10. [PMID: 26811934 DOI: 10.1016/j.eplepsyres.2016.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 10/08/2015] [Accepted: 01/06/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of rufinamide in drug-resistant epilepsy. METHODS We searched PubMed, Web of Science and Clinical trial.org up to August 6, 2015. Study selection, extraction and risk of bias assessment were performed independently by two authors. A random or fixed-effect model was used to derive pooled effects risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS Five randomized controlled trials were included in the final analysis with a total of 1512 patients. Rufinamide increased the 50% (RR 1.852, 95%CI 1.446-2.372, P<0.001) and 75% (RR 8.547, 95%CI 2.534-28.832, P<0.001) responder rates but not the seizure-free rate (RR 1.740, 95%CI 0.511-5.924, P=0.376) compared to placebo. Subgroup analysis demonstrated that the effect of rufinamide may be dose-dependent and related to seizure type. Regarding safety, rufinamide increased the rate of at least one adverse event (RR 1.103, 95%CI 1.047-1.161, P<0.001) and the withdrawal rate due to adverse events (RR 2.341, 95%CI 1.556-3.522, P<0.001), but it did not increase the rate of severe adverse events (RR 1.454, 95%CI 0.945-2.241, P=0.090). Individual adverse events (headache, dizziness, fatigue, somnolence, nausea, diplopia and vomiting) were significantly higher in the rufinamide group. CONCLUSIONS This study confirmed significant effects of rufinamide as adjunctive treatment for drug-resistant seizures, both partial and tonic-atonic. However, rufinamide may induce more tolerable (but not severe) adverse events. Further large clinical trials to investigate the long-term efficacy and safety of rufinamide are warranted.
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Affiliation(s)
- Zhenghao Xu
- Laboratory of Brain Function and Disease in Chinese Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Huawei Zhao
- The Affiliated Children's Hospital, College of Medical Sciences, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhong Chen
- Laboratory of Brain Function and Disease in Chinese Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China; Department of Pharmacology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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