Teaching Tip: Development of Veterinary Anesthesia Simulations for Pre-Clinical Training: Design, Implementation, and Evaluation Based on Student Perspectives.

Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access. The simulation outputs are determined by a script that outlines routine anesthesia scenarios and describes the consequences of students' hands-on actions and interventions during preestablished anesthetic tasks and critical incidents. Patients' monitored physiologic parameters may be changed according to predetermined learner events and students' interventions to provide immediate learner feedback and clinical realism. A total of 96 students from the pre-clinical anesthesia course participated in the simulations and the pre- and post-simulation surveys evaluating students' perspectives. Results of the surveys and comparisons of overall categorical cumulative responses in the pre- and post-simulation surveys indicated improvement in learners' perceived preparedness and confidence as a result of the simulated anesthesia experience, with significant improvement in the strongly agree, moderately agree, and agree categories (p<.05 at a 95% CI). These results suggest that anesthesia simulations in the VASE may complement traditional teaching methods through experiential learning and may help foster classroom-to-clinic transference of knowledge and skills without harm to an animal.

Development of Veterinary Anesthesia Simulations for Pre-Clinical Training: Design, Implementation, and Evaluation Based on Student Perspectives.

Anesthesia simulations have been used in pre-clinical medical training for decades to help learners gain confidence and expertise in an operating room environment without danger to a live patient. The authors describe a veterinary anesthesia simulation environment (VASE) with anesthesia scenarios developed to provide a re-creation of a veterinarian's task environment while performing anesthesia. The VASE uses advanced computer technology with simulator inputs provided from standard monitoring equipment in common use during veterinary anesthesia and a commercial canine training mannequin that allows intubation, ventilation, and venous access. The simulation outputs are determined by a script that outlines routine anesthesia scenarios and describes the consequences of students' hands-on actions and interventions during preestablished anesthetic tasks and critical incidents. Patients' monitored physiologic parameters may be changed according to predetermined learner events and students' interventions to provide immediate learner feedback and clinical realism. A total of 96 students from the pre-clinical anesthesia course participated in the simulations and the pre- and post-simulation surveys evaluating students' perspectives. Results of the surveys and comparisons of overall categorical cumulative responses in the pre- and post-simulation surveys indicated improvement in learners' perceived preparedness and confidence as a result of the simulated anesthesia experience, with significant improvement in the strongly agree, moderately agree, and agree categories (p<.05 at a 95% CI). These results suggest that anesthesia simulations in the VASE may complement traditional teaching methods through experiential learning and may help foster classroom-to-clinic transference of knowledge and skills without harm to an animal.

Synthesis of a FTO inhibitor with anticonvulsant activity.

We describe the rationale for and the synthesis of a new class of compounds utilizing a modular approach that are designed to mimic ascorbic acid and to inhibit 2-oxoglutarate-dependent hydroxylases. Preliminary characterization of one of these compounds indicates in vivo anticonvulsant activity (6 Hz mouse model) at nontoxic doses, inhibition of the 2-oxoglutarate-dependent hydroxylase FTO, and expected increase in cellular N(6)-methyladenosine. This compound is also able to modulate various microRNA, an interesting result in light of the recent view that modulation of microRNAs may be useful for the treatment of CNS disease.

FTO, RNA epigenetics and epilepsy.

Several recent landmark papers describing N(6) -methyladenosine (m(6) A) RNA modifications have provided valuable new insights as to the importance of m(6) A in the RNA transcriptome and in furthering the understanding of RNA epigenetics. One endogenous enzyme responsible for demethylating RNA m(6) A, FTO, is highly expressed in the CNS and is likely involved in mRNA metabolism, splicing or other nuclear RNA processing events. microRNAs (miRNAs), a family of small, non-coding transcripts that bind to target mRNAs and inhibit subsequent translation, are highly expressed in the CNS and are associated with several neurological disorders, including epilepsy. miRNAs frequently bind to recognition sequences in the 3'UTR, a region that is also enriched for m(6) A. Certain specific miRNAs are upregulated by neuronal activity and are coupled to epileptogenesis; these miRNAs contain a consensus m(6) A site that if methylated could possibly regulate miRNA processing or function. This commentary highlights aspects from recent papers to propose a functional association between FTO, RNA epigenetics and epilepsy.

A review of the investigational antiarrhythmic agent dronedarone.

Arrhythmias are a major cause of morbidity and mortality, and atrial fibrillation is the most widespread disorder of cardiac rhythm. Amiodarone is an effective antiarrhythmic agent that has been in clinical use for about 20 years. It is effective for multiple types of arrhythmias, including atrial fibrillation, and has a low incidence of cardiac adverse events, including Torsade de Pointes. It has many noncardiac adverse effects that are serious and limit its long-term use. Dronedarone is an investigational antiarrhythmic agent that is designed to have similar cardiac effects to amiodarone but with fewer adverse effects. This review presents some of the animal and human studies that evaluate the effects of dronedarone.