[Quantitative study on the acupoint effects based on complex network analysis: with the examples of the textbook networks formed by Chinese Acupuncture and Moxibustion Therapy and Practical Acupuncture and Moxibustion].

By extracting the acupoint names and their main indications from cases in Chinese Acupuncture and Moxibustion Therapy and Practical Acupuncture and Moxibustion, the acupoints and their main indications are represented in a reduced dimension, establishing an "acupoint-indication" linkage. Using complex network detection results (node degree values), the specificity of acupoints was assessed. The small-world characteristics of the "acupoint-indication" network are utilized to analyze the consistency of acupoint selection in acupuncture prescriptions and strategies to avoid redundant acupoints. The results show that the "acupoint-indication" network formed by both texts exhibited an approximate "long-tail" distribution, with a large number of node degree values concentrated between 0 and 4 000, while a few nodes have degree values exceeding 10 000. There are significant differences in the number and distribution of nodes with degree values> 10 000 between the two texts. Chinese Acupuncture and Moxibustion Therapy includes 11 acupoints with multiple edges across the body, whereas Practical Acupuncture and Moxibustion contains only 2 such acupoints, located in the lower limbs. Clinically, some acupoints have a broad therapeutic effect and appear in numerous prescriptions. The division of acupoints based on node degree values can coarsely evaluate the body region specificity of acupoints' regulatory effects. The "acupoint-indication" network of Chinese Acupuncture and Moxibustion Therapy has a higher number of edges than that of Practical Acupuncture and Moxibustion, which might be related to the different historical contexts of the two texts. In the future, diagnostic and therapeutic patterns with historical continuity can be utilized to optimize acupuncture prescriptions.

Exploring the usage of learning resources by medical students in the basic science stage and their effect on academic performance.

BACKGROUND: The United States Medical Licensing Examination (USMLE) step 1 is one of the two examinations written after completion of the first two years (basic science stage) of medical school to be eligible to apply for residency training in the USA. A huge number and types of study materials are available to prepare for the exam which might confuse students choosing a resource. We investigated learning resources being used by the third and fifth-semester medical students and their association with academic performance. We also compared learning resources and exam scores of high-performing and low-performing students. METHODS: Data collection was done using structured (quantitative study) and semi-structured (qualitative study) questionnaires during a face-to-face interview. This article is about the quantitative part which was designed as a correlational study. Single factor one-way analysis of variance (ANOVA), Pearson correlation coefficient test, T-test, and Fisher's exact test were used to analyze the data. RESULTS: About half of all students used three or more commercial resources dealing with the same content. A weak negative correlation was observed between the number of commercial resources and the exam scores, especially when the number of these resources was three or more (r = -0.26). The mean exam score of textbook users was statistically significantly higher than the mean score of textbook non-users (p = 0.01). The usage of textbooks was statistically significantly higher in the cohort of top performers in comparison to the rest of the students (p = 0.006). In addition to less usage of textbooks, the mean number of review books was higher in the group of weakest students (2.84 versus 3.7; p = 0.75). CONCLUSIONS: Most students did not use professional textbooks and about half used too many commercial review resources. While the former fact was significantly associated with poor academic performance, the later fact had weak negative correlation with exam score. Pedagogical interventions are urgently needed to make the right type of learning resources available by making professional textbooks more USMLE-oriented and helping the students choose the best and right number of resources for optimum academic performance. By fulfilling the observed needs of the students in this way, they might feel empowered because of self-determination which will motivate studies.

Presentation of the obsolete drug reserpine in three German-language pharmacology textbooks.

For several decades, reserpine was used to treat hypertension and, to a limited extent, psychoses. Over time, however, the indication became more and more restricted to the point of obsolescence. This study examines the extent to which textbooks are up to date in their content and oriented towards therapeutic guidelines, using the obsolete drug reserpine as a paradigm. Three German pharmacology textbook series were examined for the coverage of reserpine from 1964-2023: Allgemeine und Spezielle Pharmakologie und Toxikologie (Aktories), Allgemeine und Spezielle Pharmakologie und Toxikologie (Karow) and Pharmakologie und Toxikologie (Lüllmann). We compared the textbook content with data on reserpine prescriptions and hypertension guidelines and analysed the relevance of reserpine in examinations using German federal exam questions by the Institute for medical and pharmaceutical exam questions (IMPP). The textbooks differ conceptually from each other. The indication of reserpine for hypertension has become more restricted over time in all three textbooks, yet they partially show discrepancies with hypertension guidelines. The reserpine prescription figures show a strong decline , and reserpine has not been queried by the IMPP, which underlines the obsolescence of the drug. Overall, our study shows that the presentation of a representative obsolete drug in pharmacology textbooks lags current medical practice. We also unmasked more differences in the presentation of an obsolete drug in standard textbooks than anticipated. In conclusion, the analysis of obsolete drugs in pharmacology textbooks is an informative way of assessing how up-to-date they are.

Representation of dark skin tones in foundational nursing textbooks: An image analysis.

PURPOSE: This study aimed to analyze and quantify the representation of dark skin tones (DST) images/graphics across fifteen foundational and clinical nursing textbooks to understand the degree of portrayed diversity in current nursing texts. BACKGROUND: The United States (U.S.) population is becoming more ethnically and racially diverse. There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of common skin assessment in patients with dark skin tones (DST). The underrepresentation of people with DST images in didactic material suggests that omissions of these images in educational resources may introduce bias in health care provider education and practice. METHODS: Fifteen popular foundational and clinical nursing textbooks were selected and analyzed. All the photo images and drawn graphics in these textbooks were coded according to Fitzpatrick's skin phototype (FSP) scale, which categorizes skin tone as (a) "Light" or Fitzpatrick scale I or II, (b) "Medium" or Fitzpatrick scale III or IV, and (c) "Dark" or Fitzpatrick scale V or VI. The training was provided for data collectors before analysis to ascertain good inter-rater reliability (Cohen's kappa = 0.960 for light skin tone, Cohen's kappa = 0.899 for medium skin tone, and Cohen's kappa = 0.913 for dark skin tone). RESULTS: Analysis of 14,192 photo images and drawn graphics depicting skin tone was completed across 15 foundational and clinical nursing textbooks. 12.3 % of photo images and 2.4 % of drawn graphics depicted dark skin tones, compared to 60.9 % of photo images and 82.8 % of drawn graphics that displayed light skin tones in these textbooks. CONCLUSIONS: Nursing textbooks overrepresent light skin tones and underrepresent dark skin tones. While the approximate racial distribution of the U.S. population is 59.3 % non-Hispanic-White, 13.6 % Black/African American, and 26.6 % Person of Color, the images and graphics of skin tones represented 68 % light, 15 % medium, and 9.4 % dark. RELEVANCE TO CLINICAL PRACTICE: All healthcare providers are expected and required to deliver competent clinical care to an increasingly diverse population. For teaching-learning, more visual representations of DST and comparative images between what to expect in dark, medium, and light skin tones can help improve knowledge deficits and increase health equity.

On Kidney and Bladder Diseases in Nuzhat al-adhhan fi islah al-abdan by Physician Dawud b. 'Umar al-Antaki.

OBJECTIVES: Dawud b. 'Umar al-Antaki, known as the Avicenna of his time, was an Ottoman physician and scholar who wrote medical texts in Arabic in the 16th century. He was taught by an Iranian medical scholar, Muhammad Sharif, in the fields of logic, physical sciences, Greek, and medicine. After leaving Antioch, he traveled to Lebanon and then to Damascus, where he began writing his work, Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. Dawud b. 'Umar al-Antaki settled in Egypt, where he taught at the Zahiriyya Madrasa and practiced medicine before dying in Mecca in 1599. Here, we examined al-Antaki's writings on kidney and bladder diseases in his work Nuzhat al-adhhan fi islah al-abdan. MATERIALS AND METHODS: We translated sections on kidney and bladder diseases into English and compared Ilter Uzel's copy of Nuzhat al-adhhan fi islah al-abdan with a printed copy. We compared the relevant sections of Nuzhat al-adhhan fi islah al-abdan with the relevant sections of other important works of al-Antaki, al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija, and Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. The similarities and differences between these works were revealed. RESULTS: Kidney and bladder diseases are briefly discussed in Nuzhat al-adhhan fi islah al-abdan under the headings "amrad al-kula wa l-mathana," "al-hisa," and "harqan al-bawl wa taqtiruhu." CONCLUSIONS: Issues concerning kidney and bladder diseases are addressed more briefly in Nuzhat al-adhhan fi islah al-abdan than in al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija. Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab consists solely of kidney and bladder stones. When these works are combined, the information in them complements each other.

Análisis de los textos escolares del estudiante de ciencias naturales en primer ciclo básico desde la perspectiva de la terminología anatómica internacional / Analysis of science and biology school textbooks in primary from the perspective of international anatomical terminology

A pesar de los esfuerzos por generar una terminología unificada, hoy en día aún se implementan términos morfológicos obsoletos en diferentes contextos, como por ejemplo, los textos escolares, que son herramientas ampliamente utilizadas por el sistema escolar chileno. Se analizó la terminología morfológica utilizada en textos del estudiante de enseñanza básica (1° básico a 6° básico) propuestos por el Ministerio de Educación de Chile. Este análisis se realizó comparando los términos hallados en los textos mencionados, con la terminología morfológica propuesta por la federación internacional de terminología anatómica. Además, se propone una traducción al español para aquellos términos que se encuentran erróneos en los textos analizados. Los resultados muestran que de un total de 254 términos el 35,8 % es incorrecto. De estos, los más mencionados por los textos son: sistema locomotor, sistema circulatorio, brazo, entre otros. Frente a esto, se concluye que es importante que los textos escolares utilizados en el sistema educativo sean revisados por expertos, para evitar obstáculos en el aprendizaje de la anatomía.

SUMMARY: Despite efforts to generate a unified terminology, obsolete morphological terms are still used in different contexts, such as school textbooks, which are tools widely used by the Chilean school system. The morphological terminology used in texts for elementary school students (grades 1 to 6) proposed by the Chilean Ministry of Education was analyzed. This analysis was carried out by comparing the terms found in the school texts with the morphological terminology proposed by the international federation of anatomical terminology. In addition, a translation into Spanish is proposed for those terms that are found to be erroneous in the texts analyzed. The results show that out of a total of 254 terms, 35.8 % are incorrect. Among the terms with errors, the most mentioned by the texts are: locomotor system, circulatory system, arm, among others. In view of this, we conclude that it is important that the textbooks used in the educational system be reviewed by experts to avoid obstacles in the learning of anatomy.

A Legacy of Scientific Racism: William Osler's "An Alabama Student".

William Osler's essay "An Alabama Student" made John Young Bassett (1804-1851) a widely admired avatar of idealism in medicine. However, Bassett fiercely attacked the idea that all humans are members of the same species (known as monogenesis) and asserted that Black inferiority was a justification for slavery. Antebellum physician-anthropologists bequeathed a legacy of scientific racism that in subtler forms still runs deep in American society, including in the field of medicine.

Legacy of Syriac-Aramaic Scholars in Transmitting Neurosurgical Knowledge Between Antiquity and the Middle Ages.

The link between ancient Greek medicine and the Arabic translation period in the 9th century cannot be understood without studying the contributions of Syriac scholars. With their mastery of Greek and the related Semitic languages of Syriac and Arabic, they initiated a scientific translation process with methods that prevail to this day. In this paper, we reviewed Hunayn Ibn Isshaq's Ten Treatises on the Eye to elucidate the original contributions of the Syriac physicians to the field of neurologic surgery. We analyzed the oldest known diagram of orbital anatomy along with Hunayn's genuine ideas on the optic nerve anatomy and pathology, optic chiasm, afferent pupillary reflex, and papilledema and venous congestion. We also reviewed the neurosurgical elements found in the Syriac Book of Medicines including the thought process in localizing neurologic deficits based on clinical experience and anatomic dissections and the earliest recorded description of brachial plexus pathology.

Kenyan school book knowledge for water, sanitation, hygiene and health education interventions: Disconnect, integration or opportunities?

BACKGROUND: Schools, depending on their access to and quality of water, sanitation and hygiene (WASH) and the implementation of healthy behaviours, can be critical for the control and spread of many infectious diseases, including COVID-19. Schools provide opportunities for pupils to learn about the importance of hygiene and WASH-related practice, and build healthy habits and skills, with beneficial medium- and long-term consequences particularly in low- and middle-income countries: reducing pupils' absenteeism due to diseases, promoting physical, mental and social health, and improving learning outcomes. WASH services alone are often not sufficient and need to be combined with educational programmes. As pupils disseminate their acquired health-promoting knowledge to their (extended) families, improved WASH provisions and education in schools have beneficial effects also on the community. International organisations frequently roll out interventions in schools to improve WASH services and, in some cases, train pupils and teachers on safe WASH behaviours. How such interventions relate to local school education on WASH, health promotion and disease prevention knowledge, whether and how such knowledge and school books are integrated into WASH education interventions in schools, are knowledge gaps we fill. METHODS: We analyzed how Kenyan primary school science text book content supports WASH and health education by a book review including books used from class 1 through class 8, covering the age range from 6 to 13 years. We then conducted a rapid literature review of combined WASH interventions that included a behaviour change or educational component, and a rapid review of international policy guidance documents to contextualise the results and understand the relevance of books and school education for WASH interventions implemented by international organisations. We conducted a content analysis based on five identified thematic categories, including drinking water, sanitation, hygiene, environmental hygiene & health promotion and disease risks, and mapped over time the knowledge about WASH and disease prevention. RESULTS: The books comprehensively address drinking water issues, including sources, quality, treatment, safe storage and water conservation; risks and transmission pathways of various waterborne (Cholera, Typhoid fever), water-based (Bilharzia), vector-related (Malaria) and other communicable diseases (Tuberculosis); and the importance of environmental hygiene and health promotion. The content is broadly in line with internationally recommended WASH topics and learning objectives. Gaps remain on personal hygiene and handwashing, including menstrual hygiene, sanitation education, and related health risks and disease exposures. The depth of content varies greatly over time and across the different classes. Such locally available education materials already used in schools were considered by none of the WASH education interventions in the considered intervention studies. CONCLUSIONS: The thematic gaps/under-representations in books that we identified, namely sanitation, hygiene and menstrual hygiene education, are all high on the international WASH agenda, and need to be filled especially now, in the context of the current COVID-19 pandemic. Disconnects exist between school book knowledge and WASH education interventions, between policy and implementation, and between theory and practice, revealing missed opportunities for effective and sustainable behaviour change, and underlining the need for better integration. Considering existing local educational materials and knowledge may facilitate the buy-in and involvement of teachers and school managers in strengthening education and implementing improvements. We suggest opportunities for future research, behaviour change interventions and decision-making to improve WASH in schools.

Representation Matters: An Assessment of Diversity in Current Major Textbooks on Burn Care.

Ethnic and gender disparities in healthcare have been well described. Increasing attention is paid to representative diversity in the images and educational resources used during medical training. Nearly 40% of the population of the United States identifies as a person of color, and patients of color reflect 41% of the total burn population seen in the United States. Additionally, national data on providers suggest about 5% of the Burn Team should be people of color. A better understanding of the diversity represented by burn-related medical literature could affect the management of patients with diverse backgrounds, as well as recruitment of black, indigenous, and people of color (BIPOC) into this field. The goal of this study is to investigate the representation of diverse skin tones in several leading medical textbooks of burn care. All photographs that contained people were evaluated for the number of people present and the depicted role of the person present. Diversity count was assessed in a binary fashion-was the individual represented a BIPOC? About 2579 total individuals were identified. BIPOC was represented in 363 total images (14%). There were 6 providers of color identified out of a total of 161 (3.7%); 30 providers were women (19%), of whom only 1 was a female provider of color. BIPOC patients and providers are underrepresented in the leading textbooks of burn care. Proper representation must be included in modern educational materials to better prepare providers for a diverse population of burn-injured patients and ensure effective and thoughtful care.

Video-Based Coaching: An Efficient Learning and Teaching Modality for Pediatric Surgery and Pediatric Urology Training Program.

Objective: The development of integrated multimedia operating rooms has made possible to record surgical procedures mainly in minimally invasive surgery (MIS) and robotic surgery. This modality of video storage allows the trainees to study surgical procedures based on video analysis. The aim of this study is to compare two learning methods of surgical procedures, operative textbooks and video-based coaching, in a group of 10 pediatric surgery trainees. Patients and Methods: We selected five surgical procedures to study: three MIS procedures, Nissen fundoplication, partial nephrectomy, and cholecystectomy; and two robotic procedures, Lich-Gregoir reimplantation for vesicoureteral reflux and Henderson-Hynes pyleoplasty for ureteropelvic junction obstruction. Ten trainees were divided into two groups of 5 each, Group 1 (G1) and Group 2 (G2). G1 studied the procedures analyzing videos, G2 studied the same procedure classically reading textbooks. Tutors prepared a questionnaire of 100 multianswered questions that was submitted to both groups, divided into 20 questions for each surgical technique. The questionnaire focused on the different steps of surgical techniques. Results: Analyzing the 10 questionnaires, G1 (video group) obtained a median result of 82 exact answers (74-97), whereas G2 (textbook group) obtained a median result of 64.2 correct answers (53-79). Analyzing statistically the results of two groups, using unpaired t-Student's test with a level of statistical significance >95%, the results of G1 were statistically significantly better that G2 with a P = .0265 for the average scores. Conclusion: Video-based coaching to learn surgical techniques is a novel, feasible, and excellent modality for supplementing surgical techniques learning for pediatric surgery trainees. Objective evaluation using a multianswered questionnaire demonstrates that video-based coaching in pediatric surgery is statistically better than textbook classic education. We suggest to adopt this teaching modality in every surgical training program above all to teach MIS and robotic surgery.