Demanda de cuidado nutricional de crianças com transtorno do espectro autista em uma região de acesso remoto / Demandas de atención nutricional de niños con trastorno del espectro autista en una región de acceso remoto / Nutritional care demands of children with autism spectrum disorder in a remote access region

Introdução: O transtorno do espectro autista é uma condição neuropsiquiátrica que demanda atenção interdisciplinar e multiprofissional. A abordagem nutricional é necessária frente aos possíveis sintomas associados, como seletividade alimentar e alterações do hábito intestinal. Famílias residentes em locais de acesso limitado à serviços de saúde podem possuir dificuldades para o adequado acompanhamento. Objetivo: Relatar a experiência de atendimentos em nutrição realizados pela Liga Acadêmica de Nutrição e Saúde Coletiva a crianças com transtorno do espectro autista explorando as principais demandas identificadas e enfrentadas em uma região de acesso remoto. Metodologia: Abordagem descritiva, do tipo relato de experiência, de atendimentos realizados no município de Coari, interior do Amazonas. Os encontros foram realizados com vista a identificar demandas e refletir sobre a melhor maneira de auxiliar as crianças com essas comorbidades. Resultados: Foram atendidas 9 crianças, nem todas com o diagnóstico fechado. Seletividade alimentar, distúrbios gastrointestinais e excesso de peso foram desafios recorrentes. Nota-se a carência da percepção da importância do acompanhamento nutricional, em um cenário de relatos importantes sobre as dificuldades no acesso a medicações, por falta no município ou por ausência de recursos para aquisição, assim como terapias especializadas. Aspectos que se tornam ainda mais desafiadores frente à distância geográfica e carência de profissionais especializados e que realizem uma atenção multiprofissional. Conclusões: O acompanhamento nutricional adequado é essencial para atender às necessidades específicas e melhorar a qualidade de vida dessas crianças. Diante das limitações identificadas na região, são necessários esforços contínuos para desenvolver soluções que garantam uma assistência inclusiva e eficaz às crianças com transtorno do espectro autista no interior do Amazonas. A colaboração entre instituições, a conscientização da comunidade e o fortalecimento da rede de saúde local são cruciais para promover uma abordagem abrangente e de alta qualidade para essas crianças e suas famílias (AU).

Introduction: Autism spectrum disorder is a neuropsychiatric condition that demands interdisciplinary and multidisciplinary attention. Nutritional intervention is necessary in the face of possible associated symptoms, such as food selectivity and changes in bowel habits. Families living in places with limited access to health services may have difficulties in obtaining adequate support and follow-up.Objective: Reporting the experience of nutrition services provided by the Academic League of Nutrition and Public Health to children with autism spectrum disorder, exploring the main identified demands and challengesfaced in a remote access region. Methodology:Descriptive approach, experience of an report, of services provided in the municipality of Coari, in the interiorof Amazonas. The meetings were held with the aim identifying demands and reflecting on the best way to assistchildren with these comorbidities. Results: Ninechildren attended to, not all with a confirmed diagnosis. Food selectivity, gastrointestinal disorders and overweight were recurring challenges. There is a lack of perception of the importance of nutritional monitoring, in a scenario where there areimportant reportsofdifficulties in accessing medications, either due to lack of availability in the municipality or lack of resources for acquisition, as well as specialized therapies. Theseaspects become even more challenging given the geographical distance and scarcity of specialized professionals whocanprovide multidisciplinary care. Conclusions: Adequate nutritional monitoring is essential to meet the specific needs and improve the quality of life of these children. Given the limitations identified in the region, continuous efforts are needed to develop solutions that guarantee inclusive and effective assistance for children with autism spectrum disorder in the interior of Amazonas. Collaboration between institutions, community awareness, and strengthening the local health network are crucial to promoting a comprehensive, high-quality approach for these children and their families (AU).

Introducción: El trastorno del espectro autista es una condiciónneuropsiquiátrica que requiere atención interdisciplinaria y multidisciplinaria. El enfoque nutricionales frente a losposibles síntomas, como selectividad alimentaria y alteraciones delhábitosintestinales. Las familias que viven en lugares con accesolimitado a los servicios de salud pueden tener dificultades para recibir un seguimiento adecuado. Objetivo: Reportar la experiencia de los servicios de nutrición brindados por la Liga Académica de Nutrición y Salud Pública a niños con trastorno del espectro autista, explorando las principales demandas identificadas y enfrentadas en una región de acceso remoto.Metodología: Enfoque descriptivo, relato de experiencia, de los servicios prestados en Coari, en el interior de Amazonas. Los encuentros se realizaron con el objetivo de identificar demandas y reflexionar sobre la mejor manera de ayudar. Resultados:Se atendieron 9 niños, no todos con diagnóstico confirmado. Selectividad alimentaria, trastornos gastrointestinales y exceso de peso fueron desafíos recurrentes. Se observa una falta percepción de la importancia del seguimiento nutricional, en un escenario de informes importantes sobre las dificultades en el acceso a medicamentos, debido a lafaltade suministro en el municipio o a la falta de recursos para su adquisición, así como terapias especializadas. Estosaspectos que se vuelven aún más desafiantes dada la distancia geográfica y falta de profesionales especializados que brinden una atención multidisciplinaria.Conclusiones: Un adecuado seguimiento nutricional es fundamental para satisfacerlas necesidades específicas y mejorar la calidad de vida de estos niños. Antelas limitaciones identificadas, se necesitan esfuerzos continuos para desarrollar soluciones que garanticen una atención inclusiva y efectiva estosniños en el interior de Amazonas. Colaboración entre instituciones, concientización comunitaria y fortalecimiento de la red de salud local son cruciales para promover un enfoque integral y de alta calidad para estos niños com trastorno del espectro autista y sus familias (AU).

Global attention based GNN with Bayesian collaborative learning for glomerular lesion recognition.

BACKGROUND: Glomerular lesions reflect the onset and progression of renal disease. Pathological diagnoses are widely regarded as the definitive method for recognizing these lesions, as the deviations in histopathological structures closely correlate with impairments in renal function. METHODS: Deep learning plays a crucial role in streamlining the laborious, challenging, and subjective task of recognizing glomerular lesions by pathologists. However, the current methods treat pathology images as data in regular Euclidean space, limiting their ability to efficiently represent the complex local features and global connections. In response to this challenge, this paper proposes a graph neural network (GNN) that utilizes global attention pooling (GAP) to more effectively extract high-level semantic features from glomerular images. The model incorporates Bayesian collaborative learning (BCL), enhancing node feature fine-tuning and fusion during training. In addition, this paper adds a soft classification head to mitigate the semantic ambiguity associated with a purely hard classification. RESULTS: This paper conducted extensive experiments on four glomerular datasets, comprising a total of 491 whole slide images (WSIs) and 9030 images. The results demonstrate that the proposed model achieves impressive F1 scores of 81.37%, 90.12%, 87.72%, and 98.68% on four private datasets for glomerular lesion recognition. These scores surpass the performance of the other models used for comparison. Furthermore, this paper employed a publicly available BReAst Carcinoma Subtyping (BRACS) dataset with an 85.61% F1 score to further prove the superiority of the proposed model. CONCLUSION: The proposed model not only facilitates precise recognition of glomerular lesions but also serves as a potent tool for diagnosing kidney diseases effectively. Furthermore, the framework and training methodology of the GNN can be adeptly applied to address various pathology image classification challenges.

The Use of QR Codes to Engage Nursing Students With Next Generation NCLEX.

BACKGROUND: The introduction of the Next Generation NCLEX (NGN) necessitates the need to prepare students to demonstrate appropriate clinical judgment and reasoning. Innovative teaching strategies, such as the use of QR codes, may help to engage learners and promote the transition to the new NCLEX testing format. METHOD: A three-phase pediatric-based case study was used to introduce NGN style questions. The QR codes provided resources, answers, and rationales for the case study questions. RESULTS: The students reported an increase in perceived confidence with a case study-based NGN testing item. Student feedback was positive for this active and collaborative learning experience. CONCLUSION: Nurse educators are challenged with finding methods to engage learners and prepare students for practice. Using QR codes in the classroom is an innovative approach to expose students to NGN questions and may help increase students confidence as they prepare for the new NGN. [J Nurs Educ. 2024;63(3):186-187.].

Separated collaborative learning for semi-supervised prostate segmentation with multi-site heterogeneous unlabeled MRI data.

Segmenting prostate from magnetic resonance imaging (MRI) is a critical procedure in prostate cancer staging and treatment planning. Considering the nature of labeled data scarcity for medical images, semi-supervised learning (SSL) becomes an appealing solution since it can simultaneously exploit limited labeled data and a large amount of unlabeled data. However, SSL relies on the assumption that the unlabeled images are abundant, which may not be satisfied when the local institute has limited image collection capabilities. An intuitive solution is to seek support from other centers to enrich the unlabeled image pool. However, this further introduces data heterogeneity, which can impede SSL that works under identical data distribution with certain model assumptions. Aiming at this under-explored yet valuable scenario, in this work, we propose a separated collaborative learning (SCL) framework for semi-supervised prostate segmentation with multi-site unlabeled MRI data. Specifically, on top of the teacher-student framework, SCL exploits multi-site unlabeled data by: (i) Local learning, which advocates local distribution fitting, including the pseudo label learning that reinforces confirmation of low-entropy easy regions and the cyclic propagated real label learning that leverages class prototypes to regularize the distribution of intra-class features; (ii) External multi-site learning, which aims to robustly mine informative clues from external data, mainly including the local-support category mutual dependence learning, which takes the spirit that mutual information can effectively measure the amount of information shared by two variables even from different domains, and the stability learning under strong adversarial perturbations to enhance robustness to heterogeneity. Extensive experiments on prostate MRI data from six different clinical centers show that our method can effectively generalize SSL on multi-site unlabeled data and significantly outperform other semi-supervised segmentation methods. Besides, we validate the extensibility of our method on the multi-class cardiac MRI segmentation task with data from four different clinical centers.

Investigating the conception of collaborative learning (CL) and student engagement in the acquisition of practical skills (SEPSA) among prospective physical education and sports students.

The study aims to explore the association between collaborative learning and practical skills acquisition (SEPSA) among 310 students from second-year, third-year, and fourth-year (First stage of higher education) from the Institute of Arts, Culture, and Sports- Abai Kazakh National Pedagogical University. The data was collected using the time-lag approach at three intervals; 3rd week, 7th week, and 14th week. The mediation analysis suggests that collaborative learning (CL) has a positive mediating association with self-efficacy, and student engagement in practical skills acquisition (SEPSA). Additionally, collaborative learning (CL) has a positive mediating association with value-benefits, and practical skills acquisition (SEPSA). Furthermore, Collaborative learning (CL) has a positive significant association with practical skills acquisition (SEPSA). Our findings highlight the important potential of CL for increasing SEPSA. The finding of the study has implications for higher education teachers, students, administrators, and policymakers for developing more effective teaching and learning approaches using the concept of sharing and discussion with a specific focus on students' engagement.

A novel collaborative learning model for mixed dentition and fillings segmentation in panoramic radiographs.

INTRODUCTION: It is critical for dentists to identify and differentiate primary and permanent teeth, fillings, dental restorations and areas with pathological findings when reviewing dental radiographs to ensure that an accurate diagnosis is made and the optimal treatment can be planned. Unfortunately, dental radiographs are sometimes read incorrectly due to human error or low-quality images. While secondary or group review can help catch errors, many dentists work in practice alone and/or do not have time to review all of their patients' radiographs with another dentist. Artificial intelligence may facilitate the accurate interpretation of radiographs. To help support the review of panoramic radiographs, we developed a novel collaborative learning model that simultaneously identifies and differentiates primary and permanent teeth and detects fillings. METHODS: We used publicly accessible dental panoramic radiographic images and images obtained from the University of Missouri-Kansas City, School of Dentistry to develop and optimize two high-performance classifiers: (1) a system for tooth segmentation that can differentiate primary and permanent teeth and (2) a system to detect dental fillings. RESULTS: By utilizing these high-performance classifiers, we created models that can identify primary and permanent teeth (mean average precision [mAP] 95.32 % and performance [F-1] 92.50 %), as well as their associated dental fillings (mAP 91.53 % and F-1 91.00 %). We also designed a novel method for collaborative learning that utilizes these two classifiers to enhance recognition performance (mAP 94.09 % and F-1 93.41 %). CONCLUSIONS: Our model improves upon the existing machine learning models to simultaneously identify and differentiate primary and permanent teeth, and to identify any associated fillings. CLINICAL SIGNIFICANCE: Human error can lead to incorrect readings of panoramic radiographs. By developing artificial intelligence and machine learning methods to analyze panoramic radiographs, dentists can use this information to support their radiograph interpretations, help communicate the information to patients, and assist dental students learning to read radiographs.

Identity-Guided Collaborative Learning for Cloth-Changing Person Reidentification.

Cloth-changing person reidentification (ReID) is a newly emerging research topic aimed at addressing the issues of large feature variations due to cloth-changing and pedestrian view/pose changes. Although significant progress has been achieved by introducing extra information (e.g., human contour sketching information, human body keypoints, and 3D human information), cloth-changing person ReID remains challenging because pedestrian appearance representations can change at any time. Moreover, human semantic information and pedestrian identity information are not fully explored. To solve these issues, we propose a novel identity-guided collaborative learning scheme (IGCL) for cloth-changing person ReID, where the human semantic is effectively utilized and the identity is unchangeable to guide collaborative learning. First, we design a novel clothing attention degradation stream to reasonably reduce the interference caused by clothing information where clothing attention and mid-level collaborative learning are employed. Second, we propose a human semantic attention and body jigsaw stream to highlight the human semantic information and simulate different poses of the same identity. In this way, the extraction features not only focus on human semantic information that is unrelated to the background but are also suitable for pedestrian pose variations. Moreover, a pedestrian identity enhancement stream is proposed to enhance the identity importance and extract more favorable identity robust features. Most importantly, all these streams are jointly explored in an end-to-end unified framework, and the identity is utilized to guide the optimization. Extensive experiments on six public clothing person ReID datasets (LaST, LTCC, PRCC, NKUP, Celeb-reID-light, and VC-Clothes) demonstrate the superiority of the IGCL method. It outperforms existing methods on multiple datasets, and the extracted features have stronger representation and discrimination ability and are weakly correlated with clothing.

O uso de capacete ELMO para o tratamento de pacientes com a COVID-19: relato de experiência / The use of ELMO helmets for the treatment of patients with COVID-19: experience reportEl

Objetivo: descrever a experiência de enfermeiros sobre o uso do capacete ELMO para o tratamento de pacientes com a COVID-19. Métodos: relato de experiência em unidade de pronto-atendimento localizada numa cidade metropolitana do Ceará, Brasil, no período de 15 de março a 22 de junho de 2021. Utilizou-se a Análise de Conteúdo para a organização e a análise por meio de referencial da área. Resultados: foram observadas as potencialidades do cuidado durante o uso do capacete ELMO, como a diminuição das indicações de intubação orotraqueal, melhora de desconforto respiratório e diminuição da morbidade, mas, também as fragilidades como a comunicação paciente-profissional de saúde diminuída, necessidade de criteriosa avaliação do tempo de uso e a resposta do paciente, o risco de instabilidade psicológica e de broncoaspiração; além disso, aspectos colaborativos da equipe de saúde como comunicação intraequipe aumentada, interação efetiva e maior tomada de decisão foram registrados. Conclusão: importantes resultados no tratamento da COVID-19 podem advir da empregabilidade dessa ferramenta, no entanto, há a necessidade de acompanhamento rígido para que se evitem as complicações respiratórias maiores, assim como as sequelas físicas e psicológicas pelo uso do ELMO. Descritores: Cuidados de enfermagem. Equipe de assistência ao paciente. Práticas interdisciplinares. COVID-19

Objective:to describe nurses' experience with the use of the ELMO helmet for the treatment of patients with COVID-19. Methods:experience report in an emergency care unit located in a metropolitan city of Ceará, Brazil, in the period from March 15 to June 22, 2021. Content Analysis was used for organization and analysis through references in the area. Results:the potentialities of care during the ELMO helmet use were observed, such as a decrease in indications for orotracheal intubation, improvement in respiratory distress, and decrease in morbidity, but also weaknesses such as diminished patient-healthcare professional communication, need for careful evaluation of the time of use and patient response, risk of psychological instability, and risk of broncho-aspiration; moreover, health teams collaborative aspects such as increased intra-team communication, effective interaction, and greater decision-making were registered. Conclusion:important results in treating COVID-19 can result from the use of this tool; however, there is a need for strict monitoring in order to avoid major respiratory complications as well as physical and psychological sequelae from the wearing of ELMO.Descriptors:Nursing Care. Patient Care Team. Interdisciplinary Placement. COVID-19

Práticas educacionais colaborativas em saúde mediadas pelas tecnologias da informação e comunicação: uma revisão de literatura / Collaborative educational practices in health mediated by information and communication technologies: a literature review / Prácticas educativas colaborativas en salud mediadas por las tecnologías de la información y comunicación: una revisión de literatura

O objetivo do presente estudo foi identificar elementos estruturantes do processo de trabalho das redes educacionais colaborativas em saúde mediadas por tecnologias de informação e comunicação, assinalando suas características-chave e sua dinâmica de funcionamento. Trata-se de uma revisão de escopo, realiza-da nas bases de dados: Medline, Lilacs e no portal Oasisbr. Foram encontrados 1.499 estudos, dos quais, oito atenderam aos critérios de inclusão. Os resultados da investigação apontam as práticas educacionais colaborativas em saúde mediados por essas tecnologias como processos amplos e complexos, envolvendo a associação de diversos fatores. Destacam-se a dimensão técnico-pedagógica, a gestão estratégica, o gerenciamento do fluxo de informações, os aspectos relacionais, as competências de cada membro e a mediação do processo colaborativo. A integração dos diferentes aspectos da rede traduz um conjunto de desafios para a estruturação dos processos colaborativos que não se limita à pura acumulação cognitiva, mas vincula-se a processos de aprendizagem e desenvolvimento dos sujeitos

The aim of the present study was to identify structural elements of the work process of collaborative educational networks in health, mediated by information and communication technologies, by pointing out its key characteristics and its operating dynamics. This is a scope review, accomplished in the following databases Medline and Lilacs and in the Oasisbr portal. A total of 1.499 studies were found, and eight of them met the inclusion criteria. The search results indicate the collaborative educational practices in health mediated by these technologies as broad and complex processes, involving the association of several factors. The technical-pedagogical dimension, the strategic management, the management of the information flow, the relational aspects, the competencies of each member, and the mediation of the collaborative process are highlighted. The integration of the different aspects of the network translates a set of challenges for the structuring of collaborative processes, which is not limited to pure cognitive accumulation, but is bound to learning processes and to the subjects' development.

El objetivo del presente estudio es identificar elementos estructurantes del proceso de trabajo de las redes educativas colaborativas en salud mediadas por tecnologías de la información y comunicación, señalando sus características claves y su dinámica de funcionamiento. El trabajo presenta una revisión de escopo, realizada en las bases de datos: Medline, Lilacs y en el portal Oasisbr. Fueron encontrados 1.499 estudios, de los cuales ocho cumplieron los criterios de inclusión. Los resultados de la investigación apuntan a las prácticas educativas colaborativas en salud mediadas por estas tecnologías como procesos amplios y com-plejos, que abarcan la asociación de diversos factores. Se destacan la dimensión técnico-pedagógica, la gestión estratégica, el gerenciamiento del flujo de información, los aspectos relacionales, las competencias de cada miembro y la mediación del proceso colaborativo. La integración de los diferentes aspectos de la red traduce un conjunto de desafíos para la estructuración de los procesos colaborativos, que no se limitan a la acumulación cognitiva, sino que se vinculan a los procesos de aprendizaje y desarrollo de los sujetos

Enhancing collaborative learning in health management education: an investigation of Padlet-mediated interventions and the influence of flexible thinking.

This study had three primary goals. First, it aimed to craft an intervention program centered around collaborative learning enabled by Padlet. Second, it aimed to gauge the perceptions of health management students regarding this intervention and how it affected their collaborative learning experiences. Additionally, the third objective of the study aimed to investigate how students' flexible thinking within the learning process might shape their perceptions of the advantages derived from this instructional activity within the domain of online collaborative learning. Data for the analysis were gathered from 100 Israeli undergraduate students by two measurements: Flexible thinking in learning and Student perceptions of collaborative learning via Padlet. The intervention program included several stages. First, the students discussed the pedagogic objective of using Padlet. In the second stage, the students were presented with ill-structured problems related to the course content. Each group had to choose one problem and analyze it from three perspectives discussed in the course-healthcare provider, patient, and organization. Next, the students presented and explained their solutions employing the shared knowledge base. The final work was presented in different formats using various technologies. The PLS-SEM analysis has corroborated our hypothesis that students' flexible thinking might positively contribute to their perception of Padlet utilization. According to the empirical model, in general, students who perceived themselves as more flexible were found more receptive to utilizing the proposed technological tool (Padlet) and hence tended to appreciate its function as a collaborative learning platform enabler. This study mainly underscores the important role flexible thinking plays in motivating managers and medical professionals to embrace innovative technologies or methods for teamwork, that could enable them to weigh arguments, seek alternative solutions to authentic problems, and adjust their approaches effectively and collaboratively as new challenges emerge.

SCREENER: Streamlined collaborative learning of NER and RE model for discovering gene-disease relations.

Finding relations between genes and diseases is essential in developing a clinical diagnosis, treatment, and drug design for diseases. One successful approach for mining the literature is the document-based relation extraction method. Despite recent advances in document-level extraction of entity-entity, there remains a difficulty in understanding the relations between distant words in a document. To overcome the above limitations, we propose an AI-based text-mining model that learns the document-level relations between genes and diseases using an attention mechanism. Furthermore, we show that including a direct edge (DE) and indirect edges between genetic targets and diseases when training improves the model's performance. Such relation edges can be visualized as graphs, enhancing the interpretability of the model. For the performance, we achieved an F1-score of 0.875, outperforming state-of-the-art document-level extraction models. In summary, the SCREENER identifies biological connections between target genes and diseases with superior performance by leveraging direct and indirect target-disease relations. Furthermore, we developed a web service platform named SCREENER (Streamlined CollaboRativE lEarning of NEr and Re), which extracts the gene-disease relations from the biomedical literature in real-time. We believe this interactive platform will be useful for users to uncover unknown gene-disease relations in the world of fast-paced literature publications, with sufficient interpretation supported by graph visualizations. The interactive website is available at: https://ican.standigm.com.

Sistema de procedimientos para la formación interdisciplinar de la habilidad diagnosticar en residentes de dermatología / A System of Procedures for the Interdisciplinary Training of the Dill To Diagnose in Dermatology Residents

Introducción: En las prácticas de laboratorio se adquiere la habilidad que permite corroborar el diagnóstico de las enfermedades de la piel y anejos después de un diagnóstico presuntivo, con la utilización del método clínico. Esto se respalda en las exigencias establecidas en los documentos normativos de ese proceso formativo. Objetivo: Proponer un sistema de procedimientos para la formación interdisciplinar de la habilidad "diagnosticar enfermedades dermatológicas en los residentes de dermatología, a partir de insuficiencias detectadas en el programa de la especialidad. Métodos: La investigación fue cualitativa, con un estudio descriptivo en el Hospital Provincial General Docente Dr. Antonio Luaces Iraola, de Ciego de Ávila, desde 2018 hasta 2022. Se trabajó con toda la población conformada por 16 residentes de primer año en dermatología. Se utilizaron métodos de nivel teórico, empírico y estadístico. Resultados: En el sistema de procedimientos propuesto, se concretan fortalezas y debilidades, objetivo general, orientaciones metodológicas, precisión de los objetivos específicos y sistema de acciones para cada procedimiento, y sistema de control y evaluación de la efectividad de las acciones realizadas. La demostración de la formación de la habilidad diagnosticar, a través de un caso clínico real, reveló como esencial la consecutividad lógica de las acciones del residente desde la atención médica del caso y la formulación del diagnóstico presuntivo hasta el establecimiento del diagnóstico corroborativo en los laboratorios de anatomía patológica, microbiología y parasitología médica. Conclusiones: Se aporta un sistema de procedimientos que posibilita la formación de la habilidad "diagnosticar enfermedades dermatológicas en los residentes, con carácter secuencial, interdisciplinar e investigativo(AU)

Introduction: Laboratory practices provide the ability that allows corroborating the diagnosis of skin and adnexal diseases after a presumptive diagnosis, with the use of the clinical method. This is supported by the requirements established in the standardization documents of this training process. Objective: To propose a system of procedures for the interdisciplinary training of the skill to diagnose dermatological diseases in Dermatology residents, based on insufficiencies detected in the specialty program. Methods: The research was qualitative and consisted in a descriptive study carried out in Hospital General Docente Dr. Antonio Luaces Iraola, of Ciego de Avila, from 2018 to 2022. The work was done with the entire population made up of 16 first-year residents in Dermatology. Theoretical, empirical and statistical methods were used. Results: In the proposed system of procedures, strengths and weaknesses are specified, together with general objective, methodological guidelines, precision of specific objectives and system of actions for each procedure, as well as system of control and evaluation of the effectiveness of the actions. Demonstrating the received formation for the diagnostic skill, through a real clinical case, revealed as essential the logical consecutivity of the resident's actions from the medical attention of the case and the formulation of the presumptive diagnosis to the establishment of the corroborative diagnosis in the laboratories of pathological anatomy, microbiology and medical parasitology. Conclusions: A system of procedures is provided that makes possible the formation of the skill to diagnose dermatological diseases in residents, with sequential, interdisciplinary and investigative character(AU)

Para além dos limites da saúde: cuidado em perspectiva interdisciplinar / Beyond the limits of health: care from an interdisciplinary perspectivea / Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria

Este relato apresenta reflexões sobre uma experiência interdisciplinar que envolveu idealização, planejamento, organização, realização e divulgação de um evento científico virtual como requisito da disciplina Seminários Avançados de Pesquisa 1, oferecida pelo Programa de Pós-graduação em Informação e Comunicação em Saúde desenvolvido pelo Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, uma das unidades técnico-científicas da Fundação Oswaldo Cruz. Os doutorandos da turma de 2020 promoveram o webinário "Para além dos limites da saúde: cuidado em perspectiva interdisciplinar", como parte da formação acadêmica, e este relato é produto científico daquele evento. Além do desenvolvimento de habilidades e atitudes, essa experiência representou um aprendizado pessoal, intangível e emocional do cuidado para além dos limites da saúde, e também ético sobre as "coisas negligenciadas" e acerca da força dos consensos diante de um cenário complexo marcado por uma pandemia causada pelo vírus SARS-CoV-2, a pandemia de covid-19

This report presents reflections about an interdisciplinary experience that involved the idealization, planning, organization, implementation and dissemination of a virtual scientific event as requisite for the Seminários Avançados de Pesquisa 1 (Advanced Research Seminars 1), one of the disciplines offered by the Programa de Pós-graduação em Informação e Comunicação em Saúde (Postgraduate Program in Health Information and Communication) developed by the Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Institute of Communication and Scientific and Technological Information in Health), one of the technical-scientific units of the Fundação Oswaldo Cruz (Oswaldo Cruz Foundation). The students who began in 2020 their classes to obtain the PhD Degree promoted the webinar "Beyond the limits of health: care from an interdisciplinary perspective" as part of the academic education, and this report is a scientific product of that event. In addition to the development of skills and attitudes, that experience represented a personal, intangible and emotional learning of the care beyond the limits of health as well as an important ethical learning about the "neglected things" and the strength of consensus in the face of a complex scenario marked by a pandemic caused by the SARS-CoV-2, the Covid-19 pandemic

Este relato presenta reflexiones sobre una experiencia interdisciplinar que implicó la idealización, planificación, organización, realización y difusión de un evento científico virtual como requisito de la disciplina Seminários Avançados de Pesquisa 1 (Seminarios Avanzados de Investigación 1), ofrecida por el Programa de Pós-graduação em Informação e Comunicação em Saúde (Programa de Posgrado en Información y Comunicación en Salud) desarrollado por el Instituto de Comunicação e Informação Científica e Tecnológica em Saúde (Instituto de Comunicación y Información Científica y Tecnológica en Salud), una de las unidades técnicas y científicas de la Fundação Oswaldo Cruz (Fundación Oswaldo Cruz). Los doctorandos del curso de 2020 promovieron el webinario "Más allá de los límites de la salud: cuidado desde una perspectiva interdisciplinaria" como parte de la formación académica, y este relatoes producto científico de aquel evento. Además del desarrollo de habilidades y actitudes, esa experiencia representó un aprendizaje personal, intangible y emocional del cuidado más allá de los límites de la salud, y también un importante aprendizaje ético sobre las "cosas tratadas con negligencia" y aún acerca de la fuerza de los consensos ante un escenario complejo marcado por una pandemia provocada por el virus SARS-CoV-2, la pandemia de Covid-19

Effects of a Moodle-based E-learning environment on E-collaborative learning, perceived satisfaction, and study achievement among nursing students: A cross-sectional study.

BACKGROUND: Studies suggest that e-learning environments (ELEMs) in nursing education may be more effective than traditional face-to-face teaching, as they lead to learning outcomes that equal or exceed those of face-to-face teaching. OBJECTIVES: To determine whether using ELEM for educational applications can significantly improve e-collaborative learning, perceived satisfaction, and study achievement among nursing students in a paediatric nursing course. DESIGN: Nonrandomized pretest-posttest quasi-experimental research design. SETTINGS: A medical college in northern Taiwan. PARTICIPANTS: Eighty-four students (52 in the non-ELEM group and 32 in the ELEM group) completed both the pretest and posttest. METHODS: Third-year nursing students were recruited and nonrandomly assigned to an experimental group (ELEM) and a nonexperimental group (non-ELEM) of their choice. Students in the former group received traditional classroom teaching without the use of Moodle-based ELEMs, while those in the latter completed the course through Moodle-based ELEMs and classroom lectures. RESULTS: Regarding perceived satisfaction, e-collaborative learning, and study achievement, the overall test results indicated a significant difference in the posttest between the two groups (F (1,82) = 10.622, P = 0.002), (F (1,82) = 9.481, P = 0.003), (F (1,82) = 59.301, P < 0.001, respectively). The explanatory power η2 reached 11.5 %, 10.4 %, and 42.0 %, respectively. CONCLUSION: The students who used Moodle-based ELEMs combined with classroom teaching showed significantly higher levels of e-collaborative learning, perceived satisfaction, and study achievement in the paediatric nursing course. ELEMs for educational purposes can serve as effective complementary learning tools for paediatric nursing courses.

Improving autonomy support: a collaborative learning experience / Améliorer les pratiques d'accompagnement à l'autonomie en santé : effets d'un dispositif d'apprentissage coopératif

Introduction: The ACESO project, which was part of the Autonomy support in health national experimentation, brought together 21 partners from Ile-de-France. Among these partners, 14 had practices similar to autonomy support. Partners' presupposition was that experimenting a cooperative approach would encourage the empowerment of participants, improve their autonomy support and put into place the conditions necessary for the empowerment of people who would be supported. To help participants to meet this goal, the project leader took on a role as third party whose function was to facilitate the cooperative approach by proposing a framework and a method. Purpose of research: The study aimed to report the effects of this approach on the participants' practices as well as to identify the process for achieving this. Results: The participants' learning enabled them to align themselves with the good practice guidelines collectively constructed within the project. With the project leader's support, they initiated a transformative learning process that allowed them to develop their reflexivity and empowerment. These transformations had repercussions on their teams and structures, through a halo effect. The halo effect varied, in each partner structure, according to the participation and involvement of the project referent and the other members of the structure, in particular managers. Conclusions: This study has highlighted the value of a cooperative approach to facilitate the learning necessary for sustainable practices transformations and the improvement partners autonomy supports. This resulted in gains in autonomy for the autonomy support practitioners and the people they supported.

Introduction: Le projet ACESO, participant à l'expérimentation nationale des dispositifs d'accompagnement à l'autonomie en santé (AAS), a rassemblé 21 partenaires franciliens parmi lesquels 14 portaient des pratiques qui empruntent à l'accompagnement. Son présupposé était qu'en expérimentant une démarche coopérative favorisant l'empowerment des partenaires, ceux-ci amélioreraient leurs pratiques d'accompagnement et mettraient notamment en place les conditions nécessaires à l'empowerment des personnes accompagnées. Pour les y aider, le porteur de projet a tenu un rôle de tiers dont la fonction était de faciliter la démarche coopérative en proposant un cadre et une méthode. But de l'étude: L'étude visait à rendre compte des effets de cette démarche sur les pratiques des partenaires, ainsi qu'à identifier le processus pour y parvenir. Résultats: Les apprentissages réalisés ont permis aux partenaires de se donner des balises de bonnes pratiques construites collectivement au sein du projet (valeurs, principes et postures). Avec le soutien du tiers, ils ont initié un processus d'apprentissage transformationnel développant leur réflexivité et leur empowerment. Ces transformations ont eu des répercussions sur leurs équipes et structures, par effet de halo. Ce dernier a varié, dans chaque structure partenaire, en fonction de la participation et de l'implication du référent-projet et des membres de la structure, en particulier la direction. Conclusion: Cette étude met en évidence l'intérêt d'une démarche coopérative pour faciliter l'apprentissage nécessaire aux transformations durables des pratiques et l'amélioration des pratiques de partenaires d'un collectif apprenant. Dans le cas de l'AAS, ceci s'est traduit par des gains d'autonomie pour les accompagnants et les personnes accompagnées.

Shared learning experiences: Pilot study of an online exchange project between pharmacy students in South Africa and the United States.

INTRODUCTION: Internationalisation enhances students' understanding of social, cultural, and ethical differences, preparing them to be global-minded, socially accountable healthcare practitioners. Traditionally, internationalisation of education involves international student travel. Online tools provide opportunities for international, peer-driven learning and collaboration without costly travel. This research described the experiences of pharmacy students from South Africa (SA) and the United States (US) that participated in a virtual peer exchange project during the COVID-19 pandemic. METHODS: The virtual peer exchange project allowed students in SA and the US to establish connections within the global pharmacy community and compare healthcare, pharmacy education, and pharmacy practice between the countries. Students engaged in facilitated dialogue through video recordings, video conferencing, and a group discussion board. Student introduction video comments and discussion board posts were thematically analysed. RESULTS: Twenty-one students participated in the pilot project that met some of the intentions and goals of internationalisation via a virtual platform. Two over-arching themes of Practice of Pharmacy and Pharmacy Education emerged from both the introduction video and discussion board comments. Students described lessons learned about similarities and differences in socioeconomic determinants of health as well as structure, functioning, and financing of the different healthcare systems. CONCLUSIONS: This project was a unique way to conduct exchange programmes via a virtual platform, and bypassed challenges of traditional exchange programmes. Through technology, more students in diverse geographic locations can be exposed to various perspectives and healthcare experiences with international students.

A Federated Attention-Based Multimodal Biometric Recognition Approach in IoT.

The rise of artificial intelligence applications has led to a surge in Internet of Things (IoT) research. Biometric recognition methods are extensively used in IoT access control due to their convenience. To address the limitations of unimodal biometric recognition systems, we propose an attention-based multimodal biometric recognition (AMBR) network that incorporates attention mechanisms to extract biometric features and fuse the modalities effectively. Additionally, to overcome issues of data privacy and regulation associated with collecting training data in IoT systems, we utilize Federated Learning (FL) to train our model This collaborative machine-learning approach enables data parties to train models while preserving data privacy. Our proposed approach achieves 0.68%, 0.47%, and 0.80% Equal Error Rate (EER) on the three VoxCeleb1 official trial lists, performs favorably against the current methods, and the experimental results in FL settings illustrate the potential of AMBR with an FL approach in the multimodal biometric recognition scenario.

Kickstart in nursing home-Nursing students experiences of a model for active and collaborative learning in clinical placement.

AIMS AND OBJECTIVES: To explore students' experiences from a pilot project testing out a model for active, collaborative learning in first-year placement at a nursing home. BACKGROUND: There is a need for innovative learning activities and projects to improve clinical education in nursing homes. Active, collaborative approaches in placement learning may enhance students learning outcome. DESIGN: The study had a qualitative and explorative design, in which the experiences of students participating in the pilot were investigated through paired interviews at the end of their placement. METHODS: Twenty-two students participated in the study, and data from paired interviews were analysed using qualitative content analysis. COREQ reporting guidelines were used. RESULTS: Three themes emerged from the analysis: (1) The learning cell as facilitator for learning; (2) Discovering learning possibilities in nursing homes and (3) Applying tools and resources for learning. CONCLUSIONS: The model could reduce tension and anxiety while helping the students focus on learning options and use their environment more actively for learning. Working with a learning partner seems to increase student learning through common planning, feedback and reflection. The study emphasises the importance of facilitating active learning through the scaffolding structures and configuration of the students' learning space. RELEVANCE TO CLINICAL PRACTICE: This study indicates the potential for introducing active and collaborative pedagogical models in clinical placement. The model can promote nursing homes as a conducive learning arena for nursing students and help prepare students for a future work role in a rapidly changing health care field. PATIENT OR PUBLIC CONTRIBUTION: The result of the research is shared and discussed with stakeholders prior to finalising the article.

Shared learning from a physiologically based pharmacokinetic modeling strategy for human pharmacokinetics prediction through retrospective analysis of Genentech compounds.

The quantitative prediction of human pharmacokinetics (PK) including the PK profile and key PK parameters are critical for early drug development decisions, successful phase I clinical trials, and the establishment of a range of doses to enable phase II clinical dose selection. Here, we describe an approach employing physiologically based pharmacokinetic (PBPK) modeling (Simcyp) to predict human PK and to validate its performance through retrospective analysis of 18 Genentech compounds for which clinical data are available. In short, physicochemical parameters and in vitro data for preclinical species were integrated using PBPK modeling to predict the in vivo PK observed in mouse, rat, dog, and cynomolgus monkey. Through this process, the in vitro to in vivo extrapolation (IVIVE) was determined and then incorporated into PBPK modeling in order to predict human PK. Overall, the prediction obtained using this PBPK-IVIVE approach captured the observed human PK profiles of the compounds from the dataset well. The predicted Cmax was within 2-fold of the observed Cmax for 94% of the compounds while the predicted area under the curve (AUC) was within 2-fold of the observed AUC for 72% of the compounds. Additionally, important IVIVE trends were revealed through this investigation, including application of scaling factors determined from preclinical IVIVE to human PK prediction for each molecule. Based upon the analysis, this PBPK-based approach now serves as a practical strategy for human PK prediction at the candidate selection stage at Genentech.