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1.
J Clin Microbiol ; : e0062824, 2024 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-39158309

RESUMO

Nanopore sequencing has shown the potential to democratize genomic pathogen surveillance due to its ease of use and low entry cost. However, recent genotyping studies showed discrepant results compared to gold-standard short-read sequencing. Furthermore, although essential for widespread application, the reproducibility of nanopore-only genotyping remains largely unresolved. In our multicenter performance study involving five laboratories, four public health-relevant bacterial species were sequenced with the latest R10.4.1 flow cells and V14 chemistry. Core genome MLST analysis of over 500 data sets revealed highly strain-specific typing errors in all species in each laboratory. Investigation of the methylation-related errors revealed consistent DNA motifs at error-prone sites across participants at read level. Depending on the frequency of incorrect target reads, this either leads to correct or incorrect typing, whereby only minimal frequency deviations can randomly determine the final result. PCR preamplification, recent basecalling model updates and an optimized polishing strategy notably diminished the non-reproducible typing. Our study highlights the potential for new errors to appear with each newly sequenced strain and lays the foundation for computational approaches to reduce such typing errors. In conclusion, our multicenter study shows the necessity for a new validation concept for nanopore sequencing-based, standardized bacterial typing, where single nucleotide accuracy is critical.

2.
Int J Med Microbiol ; 314: 151601, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38359735

RESUMO

BACKGROUND: Klebsiella (K.) pneumoniae is a ubiquitous Gram-negative bacterium and a common coloniser of animals and humans. Today, K. pneumoniae is one of the most persistent nosocomial pathogens worldwide and poses a severe threat/burden to public health by causing urinary tract infections, pneumonia and bloodstream infections. Infections mainly affect immunocompromised individuals and hospitalised patients. In recent years, a new type of K. pneumoniae has emerged associated with community-acquired infections such as pyogenic liver abscess in otherwise healthy individuals and is therefore termed hypervirulent K. pneumoniae (hvKp). The aim of this study was the characterisation of K. pneumoniae isolates with properties of hypervirulence from Germany. METHODS: A set of 62 potentially hypervirulent K. pneumoniae isolates from human patients was compiled. Inclusion criteria were the presence of at least one determinant that has been previously associated with hypervirulence: (I) clinical manifestation, (II) a positive string test as a marker for hypermucoviscosity, and (III) presence of virulence associated genes rmpA and/or rmpA2 and/or magA. Phenotypic characterisation of the isolates included antimicrobial resistance testing by broth microdilution. Whole genome sequencing (WGS) was performed using Illumina® MiSeq/NextSeq to investigate the genetic repertoire such as multi-locus sequence types (ST), capsule types (K), further virulence associated genes and resistance genes of the collected isolates. For selected isolates long-read sequencing was applied and plasmid sequences with resistance and virulence determinants were compared. RESULTS: WGS analyses confirmed presence of several signature genes for hvKp. Among them, the most prevalent were the siderophore loci iuc and ybt and the capsule regulator genes rmpA and rmpA2. The most dominant ST among the hvKp isolates were ST395 capsule type K2 and ST395 capsule type K5; both have been described previously and were confirmed by our data as multidrug-resistant (MDR) isolates. ST23 capsule type K1 was the second most abundant ST in this study; this ST has been described as commonly associated with hypervirulence. In general, resistance to beta-lactams caused by the production of extended-spectrum beta-lactamases (ESBL) and carbapenemases was observed frequently in our isolates, confirming the threatening rise of MDR-hvKp strains. CONCLUSIONS: Our study results show that K. pneumoniae strains that carry several determinants of hypervirulence are present for many years in Germany. The detection of carbapenemase genes and hypervirulence associated genes on the same plasmid is highly problematic and requires intensified screening and molecular surveillance. However, the non-uniform definition of hvKp complicates their detection. Testing for hypermucoviscosity alone is not specific enough to identify hvKp. Thus, we suggest that the classification of hvKp should be applied to isolates that not only fulfil phenotypical criteria (severe clinical manifestations, hypermucoviscosity) but also (I) the presence of at least two virulence loci e.g. iuc and ybt, and (II) the presence of rmpA and/or rmpA2.


Assuntos
Infecções Comunitárias Adquiridas , Infecções por Klebsiella , Humanos , Klebsiella pneumoniae , Virulência/genética , Fatores de Virulência/genética , Plasmídeos , Infecções Comunitárias Adquiridas/microbiologia , Infecções por Klebsiella/microbiologia , Antibacterianos/farmacologia
3.
Appl Environ Microbiol ; 90(6): e0045324, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38752746

RESUMO

Metals are essential for all living organisms, but the type of metal and its concentration determines its action. Even low concentrations of metals may have toxic effects on organisms and therefore exhibit antimicrobial activities. In this study, we investigate the evolutionary adaptation processes of Staphylococcus aureus to metals and common genes for metal tolerance. Laboratory and clinical isolates were treated with manganese, cobalt, zinc, or nickel metal salts to generate growth-adapted mutants. After growth in medium supplemented with zinc, whole-genome sequencing identified, among others, two genes, mgtE (SAUSA300_0910), a putative magnesium transporter and spoVG (SAUSA300_0475), a global transcriptional regulator, as hot spots for stress-induced single-nucleotide polymorphisms (SNPs). SNPs in mgtE were also detected in mutants treated with high levels of cobalt or nickel salts. To investigate the effect of these genes on metal tolerance, deletion mutants and complementation strains in an S. aureus USA300 LAC* laboratory strain were generated. Both, the mgtE and spoVG deletion strains were more tolerant to cobalt, manganese, and zinc. The mgtE mutant was also more tolerant to nickel exposure. Inductively coupled plasma mass spectrometry analysis demonstrated that the mgtE deletion mutant accumulated less intracellular zinc than the wild type, explaining increased tolerance. From these results, we conclude that mgtE gene inactivation increases zinc tolerance presumably due to reduced uptake of zinc. For the SpoVG mutant, no direct effect on the intracellular zinc concentration was detected, indicating toward different pathways to increase tolerance. Importantly, inactivation of these genes offers a growth advantage in environments containing certain metals, pointing toward a common tolerance mechanism. IMPORTANCE: Staphylococcus aureus is an opportunistic pathogen causing tremendous public health burden and high mortality in invasive infections. Treatment is becoming increasingly difficult due to antimicrobial resistances. The use of metals in animal husbandry and aquaculture to reduce bacterial growth and subsequent acquisition of metal resistances has been shown to co-select for antimicrobial resistance. Therefore, understanding adaptive mechanisms that help S. aureus to survive metal exposure is essential. Using a screening approach, we were able to identify two genes encoding the transporter MgtE and the transcriptional regulator SpoVG, which conferred increased tolerance to specific metals such as zinc when inactivated. Further testing showed that the deletion of mgtE leads to reduced intracellular zinc levels, suggesting a role in zinc uptake. The accumulation of mutations in these genes when exposed to other metals suggests that inactivation of these genes could be a common mechanism for intrinsic tolerance to certain metals.


Assuntos
Proteínas de Bactérias , Staphylococcus aureus , Zinco , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Zinco/metabolismo , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Polimorfismo de Nucleotídeo Único , Infecções Estafilocócicas/microbiologia
4.
J Exp Child Psychol ; 246: 105979, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38861807

RESUMO

The current study examined predictions from embodied cognition for effects of finger counting on number processing. Although finger counting is spontaneous and nearly universal, counting habits reflect learning and culture. European cultures use a sub-base-five system, requiring a full hand plus additional fingers to express numbers exceeding 5. Chinese culture requires only one hand to express such numbers. We investigated the differential impact of early-acquired finger-based number representations on adult symbolic number processing. In total, 53 European and 56 Chinese adults performed two versions of the magnitude classification task, where numbers were presented either as Arabic symbols or as finger configurations consistent with respective cultural finger-counting habits. Participants classified numbers as smaller/larger than 5 with horizontally aligned buttons. Finger-based size and distance effects were larger in Chinese compared with Europeans. These differences did not, however, induce reliably different symbol processing signatures. This dissociation challenges the idea that sensory and motor habits shape our conceptual representations and implies notation-specific processing patterns.


Assuntos
Comparação Transcultural , Dedos , Humanos , Feminino , Masculino , Adulto , Adulto Jovem , População Branca/psicologia , Povo Asiático , Adolescente , Cognição
5.
Mem Cognit ; 52(4): 894-908, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38153647

RESUMO

In many Western cultures, the processing of temporal words related to the past and to the future is associated with left and right space, respectively - a phenomenon known as the horizontal Mental Time Line (MTL). While this mapping is apparently quite ubiquitous, its regularity and consistency across different types of temporal concepts remain to be determined. Moreover, it is unclear whether such spatial mappings are an essential and early constituent of concept activation. In the present study, we used words denoting time units at different scales (hours of the day, days of the week, months of the year) associated with either left space (e.g., 9 a.m., Monday, February) or right space (e.g., 8 p.m., Saturday, November) as cues in a line bisection task. Fifty-seven healthy adults listened to temporal words and then moved a mouse cursor to the perceived midpoint of a horizontally presented line. We measured movement trajectories, initial line intersection coordinates, and final bisection response coordinates. We found movement trajectory displacements for left- vs. right-biasing hour and day cues. Initial line intersections were biased specifically by month cues, while final bisection responses were biased specifically by hour cues. Our findings offer general support to the notion of horizontal space-time associations and suggest further investigation of the exact chronometry and strength of this association across individual time units.


Assuntos
Percepção Espacial , Percepção do Tempo , Humanos , Percepção Espacial/fisiologia , Adulto , Adulto Jovem , Percepção do Tempo/fisiologia , Feminino , Masculino , Sinais (Psicologia) , Fatores de Tempo , Desempenho Psicomotor/fisiologia
6.
Euro Surveill ; 29(23)2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38847120

RESUMO

BackgroundThe war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients.AimTo investigate the genomic epidemiology of New Delhi metallo-ß-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries.MethodsWhole-genome sequencing of 66 isolates sampled in 2022-2023 in 10 European countries enabled whole-genome multilocus sequence typing (wgMLST), identification of resistance genes, replicons, and plasmid reconstructions. Five bla NDM-1-carrying-P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a bla NDM-1-carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire.ResultswgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked to Ukrainian patients. Of these three, two comprised bla NDM-1-carrying-P. stuartii and the third bla NDM-5-carrying-P. stuartii. The bla NDM-1 clusters (PstCluster-001, n = 22 isolates; PstCluster-002, n = 8 isolates) comprised strains from seven and four countries, respectively. The bla NDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring bla NDM-1, bla OXA-10, bla CMY-16, rmtC and armA, which was transferrable in vitro and, for some Ukrainian patients, shared by other Enterobacterales. AST revealed PstCluster-001 isolates to be extensively drug-resistant (XDR), but susceptible to cefiderocol and aztreonam-avibactam. Patients with data on age (n = 41) were 19-74 years old; of 49 with information on sex, 38 were male.ConclusionXDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana Múltipla , Infecções por Enterobacteriaceae , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Plasmídeos , Providencia , Sequenciamento Completo do Genoma , beta-Lactamases , Humanos , Ucrânia/epidemiologia , beta-Lactamases/genética , Infecções por Enterobacteriaceae/microbiologia , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla/genética , Providencia/genética , Providencia/isolamento & purificação , Providencia/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Europa (Continente)/epidemiologia , Plasmídeos/genética , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Idoso , Adulto Jovem
7.
BMC Med Educ ; 24(1): 568, 2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38789955

RESUMO

BACKGROUND: Entrustable professional activities (EPAs) are observable process descriptions of clinical work units. EPAs support learners and tutors in assessment within healthcare settings. For use amongst our pharmacy students as well as pre-registration pharmacists we wanted to develop and validate an EPA for use in a clinical pharmacy setting at LMU University Hospital. METHODS: The development of the clinical pharmacy EPA followed a set pathway. A rapid literature review informed the first draft, an interprofessional consensus group consisting of pharmacists, nurses, and medical doctors refined this draft. The refined version was then validated via online survey utilising clinical pharmacists from Germany. RESULTS: We designed, refined and validated an EPA regarding medication reconciliation for assessment of pharmacy students and trainees within the pharmacy department at LMU University Hospital in Munich. Along with the EPA description an associated checklist to support the entrustment decision was created. For validation an online survey with 27 clinical pharmacists from all over Germany was conducted. Quality testing with the EQual rubric showed a good EPA quality. CONCLUSIONS: We developed the first clinical pharmacy EPA for use in a German context. Medication reconciliation is a suitable EPA candidate as it describes a clinical activity performed by pharmacists in many clinical settings. The newly developed and validated EPA 'Medication Reconciliation' will be used to assess pharmacy students and trainees.


Assuntos
Reconciliação de Medicamentos , Humanos , Alemanha , Competência Clínica/normas , Educação em Farmácia , Serviço de Farmácia Hospitalar , Estudantes de Farmácia , Educação Baseada em Competências , Inquéritos e Questionários , Avaliação Educacional
8.
BMC Nurs ; 23(1): 451, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956561

RESUMO

BACKGROUND: Undergraduate training in hand hygiene is a keystone of infection control. Several studies have shown overconfidence effects in hand hygiene practices, which can impair metacognition. We hypothesized that overconfidence might be prevalent in the early education stages of nursing students and that these effects could be reduced through frequent interactive learning formats, such as learning groups. METHODS: We conducted a multicenter cross-sectional questionnaire with 196 German nursing students, including general, surgical, and anesthetic nursing specializations. RESULTS: Overconfidence was observed in nursing students across all specialties and years of education. The cluster analyses showed three different types of learners: two characterized by overconfidence and one demonstrating justifiable confidence. Furthermore, the moderation analysis indicated that providing feedback and promoting metacognition regarding students' learning achievements could mitigate overplacement, particularly through the frequent implementation of interactive teaching formats. DISCUSSION: Despite some limitations, these findings highlight the prevalence of overconfidence effects in nursing students, the presence of different learning profiles, and the importance of incorporating feedback within interactive learning formats concerning hand hygiene. Accordingly, educators need to be trained and supervised to deliver these learning formats and provide feedback to students effectively.

9.
Eur J Dent Educ ; 2024 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-39082447

RESUMO

INTRODUCTION: Radiographic diagnostic competences are a primary focus of dental education. This study assessed two feedback methods to enhance learning outcomes and explored the feasibility of artificial intelligence (AI) to support education. MATERIALS AND METHODS: Fourth-year dental students had access to 16 virtual radiological example cases for 8 weeks. They were randomly assigned to either elaborated feedback (eF) or knowledge of results feedback (KOR) based on expert consensus. Students´ diagnostic competences were tested on bitewing/periapical radiographs for detection of caries, apical periodontitis, accuracy for all radiological findings and image quality. We additionally assessed the accuracy of an AI system (dentalXrai Pro 3.0), where applicable. Data were analysed descriptively and using ROC analysis (accuracy, sensitivity, specificity, AUC). Groups were compared with Welch's t-test. RESULTS: Among 55 students, the eF group by large performed significantly better than the KOR group in detecting enamel caries (accuracy 0.840 ± 0.041, p = .196; sensitivity 0.638 ± 0.204, p = .037; specificity 0.859 ± 0.050, p = .410; ROC AUC 0.748 ± 0.094, p = .020), apical periodontitis (accuracy 0.813 ± 0.095, p = .011; sensitivity 0.476 ± 0.230, p = .003; specificity 0.914 ± 0.108, p = .292; ROC AUC 0.695 ± 0.123, p = .001) and in assessing the image quality of periapical images (p = .031). No significant differences were observed for the other outcomes. The AI showed almost perfect diagnostic performance (enamel caries: accuracy 0.964, sensitivity 0.857, specificity 0.074; dentin caries: accuracy 0.988, sensitivity 0.941, specificity 1.0; overall: accuracy 0.976, sensitivity 0.958, specificity 0.983). CONCLUSION: Elaborated feedback can improve student's radiographic diagnostic competences, particularly in detecting enamel caries and apical periodontitis. Using an AI may constitute an alternative to expert labelling of radiographs.

10.
Biochim Biophys Acta Rev Cancer ; 1879(4): 189111, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38740351

RESUMO

The transcription factor p53 is activated in response to a variety of cellular stresses and serves as a prominent and potent tumor suppressor. Since its discovery, we have sought to understand how p53 functions as both a transcription factor and a tumor suppressor. Two decades ago, the field of gene regulation entered the omics era and began to study the regulation of entire genomes. The omics perspective has greatly expanded our understanding of p53 functions and has begun to reveal its gene regulatory network. In this mini-review, I discuss recent insights into the p53 transcriptional program from high-throughput analyses.


Assuntos
Redes Reguladoras de Genes , Proteína Supressora de Tumor p53 , Humanos , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Genômica , Regulação Neoplásica da Expressão Gênica , Neoplasias/genética , Animais
11.
Ann N Y Acad Sci ; 1537(1): 5-12, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38943430

RESUMO

Interdisciplinary investigations of the human mind through the cognitive sciences have identified a key role of the body in representing knowledge. After characterizing knowledge at grounded, embodied, and situated levels, number knowledge is analyzed from this hierarchical perspective. Lateralized cortical processing of coarse versus fine detail is identified as a grounding substrate for the population stereotype few/left, many/right, which then contributes to number-related sensory and motor biases at the embodied and situated levels. Implications of this perspective for education and rehabilitation are discussed.


Assuntos
Conhecimento , Neurônios , Humanos , Cognição/fisiologia , Neurônios/fisiologia
12.
Cell Death Differ ; 31(7): 836-843, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38951700

RESUMO

The extent to which transcription factors read and respond to specific information content within short DNA sequences remains an important question that the tumor suppressor p53 is helping us answer. We discuss recent insights into how local information content at p53 binding sites might control modes of p53 target gene activation and cell fate decisions. Significant prior work has yielded data supporting two potential models of how p53 determines cell fate through its target genes: a selective target gene binding and activation model and a p53 level threshold model. Both of these models largely revolve around an analogy of whether p53 is acting in a "smart" or "dumb" manner. Here, we synthesize recent and past studies on p53 decoding of DNA sequence, chromatin context, and cellular signaling cascades to elicit variable cell fates critical in human development, homeostasis, and disease.


Assuntos
Regulação da Expressão Gênica , Proteína Supressora de Tumor p53 , Proteína Supressora de Tumor p53/metabolismo , Proteína Supressora de Tumor p53/genética , Humanos , DNA/metabolismo , Animais , Diferenciação Celular , Cromatina/metabolismo , Ligação Proteica , Transdução de Sinais , Sítios de Ligação
13.
HardwareX ; 19: e00548, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39092421

RESUMO

In optical experiments, shutters are devices that open or close a path of light. They are often used to limit the duration of light exposure onto a target or onto a detector to reduce possible light-induced damage. Many commercial shutters are available for different applications - some provide very fast opening and closing times, some can handle large optical powers, and others allow for fail-safe operation. Many of these devices are costly and offer limited control options. Here we provide an open-source design for a low-cost, general purpose shutter system based on ubiquitous actuators (servo motors or solenoids) that are connected to an Arduino-based controller. Several shutters can be controlled by one controller, further reducing system cost. The state of the shutters can be controlled via a display built into the controller, by serial commands via USB, or by electrical control lines. The use of a microcontroller makes the shutter controller adaptable - only control options that are used need to be included, and the design accommodates a selection of display and actuator options. We provide designs for all required components, including 3D print files for the actuator holders and cases, the Arduino code, libraries for serial communication (C and python), and example graphical user interfaces for testing.

14.
Sci Rep ; 14(1): 9675, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678052

RESUMO

The existence of a consistent horizontal spatial-conceptual mapping for words denoting time is a well-established phenomenon. For example, words related to the past or future (e.g., yesterday/tomorrow) facilitate respective leftward/rightward attentional shifts and responses, suggesting the visual-spatial grounding of temporal semantics, at least in the native language (L1). To examine whether similar horizontal bias also accompanies access to time-related words in a second language (L2), we tested 53 Russian-English (Experiment 1) and 48 German-English (Experiment 2) bilinguals, who classified randomly presented L1 and L2 time-related words as past- or future-related using left or right response keys. The predicted spatial congruency effect was registered in all tested languages and, furthermore, was positively associated with higher L2 proficiency in Experiment 2. Our findings (1) support the notion of horizontal spatial-conceptual mapping in diverse L1s, (2) demonstrate the existence of a similar spatial bias when processing temporal words in L2, and (3) show that the strength of time-space association in L2 may depend on individual L2 proficiency.

15.
J Exp Psychol Gen ; 153(4): 994-1016, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38300541

RESUMO

Numbers are a constant presence in our daily lives: A brain devoid of the ability to process numbers would not be functional in its external environment. Comparing numerical magnitudes is a fundamental ability that requires the processing of numerical distances. From magnitude comparison tasks, a comparison distance effect (DE) emerges: It describes better performance when comparing numerically distant rather than close numbers. Unlike other signatures of number processing, the comparison DE has been assessed only implicitly, with numerical distance as nonsalient task property. Different assessments permit identification of different cognitive processes underlying a specific effect. To investigate whether explicit and implicit assessment of the comparison DE influences numerical cognition differently, we introduced the distance classification task, involving explicit classification of numbers as close or far from a reference. N = 93 healthy adults classified numbers either by magnitude or by numerical distance. To investigate associations between numerical and physical distance, response buttons were positioned horizontally (Experiment 1) or radially (Experiment 2). In both experiments, there was an advantage for both the closest and farthest numbers with respect to the reference during distance classification, but not during magnitude classification. In Experiment 2, numerically close/far numbers were classified faster with the close/far response button, respectively, suggesting radial correspondence between physical and representational distances. These findings provide new theoretical and methodological insights into the mental representation of numbers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Encéfalo , Cognição , Adulto , Humanos , Tempo de Reação/fisiologia , Encéfalo/fisiologia
16.
GMS J Med Educ ; 41(2): Doc20, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38779693

RESUMO

As medical educators grapple with the consistent demand for high-quality assessments, the integration of artificial intelligence presents a novel solution. This how-to article delves into the mechanics of employing ChatGPT for generating Multiple Choice Questions (MCQs) within the medical curriculum. Focusing on the intricacies of prompt engineering, we elucidate the steps and considerations imperative for achieving targeted, high-fidelity results. The article presents varying outcomes based on different prompt structures, highlighting the AI's adaptability in producing questions of distinct complexities. While emphasizing the transformative potential of ChatGPT, we also spotlight challenges, including the AI's occasional "hallucination", underscoring the importance of rigorous review. This guide aims to furnish educators with the know-how to integrate AI into their assessment creation process, heralding a new era in medical education tools.


Assuntos
Inteligência Artificial , Currículo , Educação Médica , Avaliação Educacional , Humanos , Educação Médica/métodos , Avaliação Educacional/métodos
17.
Psychon Bull Rev ; 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38806790

RESUMO

Grounded cognition states that mental representations of concepts consist of experiential aspects. For example, the concept "cup" consists of the sensorimotor experiences from interactions with cups. Typical modalities in which concepts are grounded are: The sensorimotor system (including interoception), emotion, action, language, and social aspects. Here, we argue that this list should be expanded to include physical invariants (unchanging features of physical motion; e.g., gravity, momentum, friction). Research on physical reasoning consistently demonstrates that physical invariants are represented as fundamentally as other grounding substrates, and therefore should qualify. We assess several theories of concept representation (simulation, conceptual metaphor, conceptual spaces, predictive processing) and their positions on physical invariants. We find that the classic grounded cognition theories, simulation and conceptual metaphor theory, have not considered physical invariants, while conceptual spaces and predictive processing have. We conclude that physical invariants should be included into grounded cognition theories, and that the core mechanisms of simulation and conceptual metaphor theory are well suited to do this. Furthermore, conceptual spaces and predictive processing are very promising and should also be integrated with grounded cognition in the future.

18.
Nutrients ; 16(14)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39064678

RESUMO

Malnutrition plays a crucial role as a risk factor in patients undergoing major abdominal surgery. To mitigate the risk of complications, nutritional prehabilitation has been recommended for malnourished patients and those at severe metabolic risk. Various approaches have been devised, ranging from traditional short-term conditioning lasting 7-14 days to longer periods integrated into a comprehensive multimodal prehabilitation program. However, a significant challenge is the considerable heterogeneity of nutritional interventions, leading to a lack of clear, synthesizable evidence for specific dietary recommendations. This narrative review aims to outline the concept of nutritional prehabilitation, offers practical recommendations for clinical implementation, and also highlights the barriers and facilitators involved.


Assuntos
Abdome , Desnutrição , Complicações Pós-Operatórias , Cuidados Pré-Operatórios , Humanos , Desnutrição/prevenção & controle , Cuidados Pré-Operatórios/métodos , Abdome/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Exercício Pré-Operatório , Estado Nutricional , Apoio Nutricional/métodos
19.
Nutrients ; 16(6)2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38542776

RESUMO

(1) Multimodal treatment is a standard treatment for patients with obesity. However, weight loss also leads to reductions in fat-free mass. The aim was to investigate whether additional protein intake contributes to better preservation of lean body mass (LBM). (2) A total of 267 obesity patients (age 45.8 years; BMI 47.3 kg/m2) were included in this analysis. For the first 12 weeks of the program, patients were given a formula-based diet of 800-1000 kcal per day. Patients were divided into a control group (CG) (n = 148) and a protein group (PG) (n = 119). The PG was characterized by an additional protein intake with the aim of consuming 1.5 g of protein per kilogram of normalized body weight, whereas the CG had a protein intake of 1 g/kg/d. Bioelectrical impedance analysis was performed at the beginning (t0) and after 12 weeks (t1) of the program. (3) There were no significant differences between the groups with respect to weight loss (p = 0.571). LBM was also significantly reduced in both groups, without significant differences between CG and PG. (4) Increased protein intake had no significant effect on body composition of morbidly obese patients during a 12-week formula-based diet and multimodal treatment.


Assuntos
Obesidade Mórbida , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/terapia , Composição Corporal , Redução de Peso , Terapia Combinada , Índice de Massa Corporal
20.
Sci Rep ; 14(1): 12875, 2024 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-38834639

RESUMO

The millions of specimens stored in entomological collections provide a unique opportunity to study historical insect diversity. Current technologies allow to sequence entire genomes of historical specimens and estimate past genetic diversity of present-day endangered species, advancing our understanding of anthropogenic impact on genetic diversity and enabling the implementation of conservation strategies. A limiting challenge is the extraction of historical DNA (hDNA) of adequate quality for sequencing platforms. We tested four hDNA extraction protocols on five body parts of pinned false heath fritillary butterflies, Melitaea diamina, aiming to minimise specimen damage, preserve their scientific value to the collections, and maximise DNA quality and yield for whole-genome re-sequencing. We developed a very effective approach that successfully recovers hDNA appropriate for short-read sequencing from a single leg of pinned specimens using silica-based DNA extraction columns and an extraction buffer that includes SDS, Tris, Proteinase K, EDTA, NaCl, PTB, and DTT. We observed substantial variation in the ratio of nuclear to mitochondrial DNA in extractions from different tissues, indicating that optimal tissue choice depends on project aims and anticipated downstream analyses. We found that sufficient DNA for whole genome re-sequencing can reliably be extracted from a single leg, opening the possibility to monitor changes in genetic diversity maintaining the scientific value of specimens while supporting current and future conservation strategies.


Assuntos
DNA , Animais , DNA/isolamento & purificação , DNA/genética , Borboletas/genética , DNA Mitocondrial/genética , Manejo de Espécimes/métodos , Lepidópteros/genética , Estudos Retrospectivos , Variação Genética , Genoma de Inseto , Análise de Sequência de DNA/métodos
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