Teledidactic Versus Hands-on Teaching of Abdominal, Thoracic, and Thyroid Ultrasound-The TELUS II Study.

BACKGROUND: The worldwide COVID-19 pandemic has initiated a change in medical education and the development of new teaching concepts has become inevitable to maintain adequate training. OBJECTIVE: This pilot study aims to compare teledidactic teaching with traditional face-to-face teaching for abdominal, thoracic, and thyroid ultrasound. DESIGN: Concurrently, a teledidactic and a face-to-face ultrasound course were held. The students completed seven 90-min modules using mobile ultrasound probes (Butterfly IQ). Each module consisted of a lecture, a demonstration of probe guidance, and independent training. PARTICIPANTS: A total of thirty medical students took part in the study and were randomly assigned to a teledidactic and a face-to-face group. MAIN MEASURES: An objective structured assessment of ultrasound skills (OSAUS) was performed as a pre-test and as the final exam and ultrasound images obtained during the exam were evaluated using the brightness mode quality ultrasound imaging examination (B-QUIET) scale. KEY RESULTS: No significant difference between the two cohorts on the OSAUS final exam was shown (p > 0.05 in all modules). There was a significant difference in the assessment of the images in the focused assessment with sonography for trauma (FAST) (p 0.015) and aorta (p 0.017) modules. Students in the teledidactic group performed better in both modules, scoring 33.59 (± 2.61) out of 44 in the module FAST (face-to-face group 30.95 (± 1.76)) and aortic images averaged 35.41 (± 2.61) points (face-to-face group 32.35 (± 3.08)). CONCLUSIONS: A teledidactic course for abdominal and thoracic ultrasound examinations is equally effective to traditional face-to-face teaching in this pilot study. Digital implementation with a portable ultrasound machine could be a great opportunity to promote ultrasound education worldwide and over great distances.

Prevalences of mental distress and its associated factors in unaccompanied refugee minors in Germany.

Prevalences for mental disorders within minor refugees are comparatively high and heterogeneous. To reduce heterogeneity and identify high-risk subgroups, we compared unaccompanied refugee minors (URM) to accompanied refugee minors (ARM) regarding depressive symptoms and mental distress. Furthermore, we examined associative factors of mental distress in URM on a broad scale. We conducted a survey with a cross-sectional design in four German University hospitals. The sample consisted of n = 172 URM and n = 52 ARM aged 14-21. Depressive symptoms were assessed via the Patient Health Questionnaire (PHQ-9). Mental distress was assessed by the Refugee Health Screener (RHS-15). Mann-Whitney test was used to examine differences between URM and ARM. Associated factors of mental distress were evaluated via a stepwise multiple regression analysis. URM showed significantly higher mean scores for PHQ-9 (p < .001) and RHS-15 (p < .001) compared to ARM indicating medium effect sizes. Furthermore, URM were significantly more likely to surpass the cut-off for depression (61.6% vs. 30.8%) and overall mental distress (81.4% vs. 53.8%) compared to ARM. The factors Number of stressful life events (SLE), Female gender, and Fear of deportation were found to be associated with an increased mental distress in URM, whereas Weekly contact to a family member, School attendance, and German language skills were accompanied with lower distress scores. All six factors accounted for 32% of the variance of mental distress in URM (p < .001). Within minor refugees, URM are a highly vulnerable subgroup, which should receive particular attention and more targeted measures by health authorities. Our results indicate that these measures should comprise a rapid promotion of family contact, school attendance, language acquisition, and the fast processing of asylum applications. However, the cross-sectional design limits the interpretability of the results.

Infants' memory for spoken words.

Infants' long-term retention of the sound patterns of words was explored by exposing them to recordings of three children's stories for 10 days during a 2-week period when they were 8 months old. After an interval of 2 weeks, the infants heard lists of words that either occurred frequently or did not occur in the stories. The infants listened significantly longer to the lists of story words. By comparison, a control group of infants who had not been exposed to the stories showed no such preference. The findings suggest that 8-month-olds are beginning to engage in long-term storage of words that occur frequently in speech, which is an important prerequisite for learning language.

X-ray studies on piroxicam modifications.

The anti-inflammatory drug piroxicam, 4-hydroxy-2-methyl-N-(2-pyridyl)2H-1,2- benzothiazine-3-carboxamide-1,1-dioxide, crystallizes in three different forms, two anhydrates and one monohydrate. Crystal structure analyses of the monohydrate and one of the anhydrate were carried out by Bordner et al. and Kojic-Prodic et al., respectively. In this paper the results of the analysis of the third piroxicam modification and of an independently performed structure determination of the monohydrate are reported. Molecular structures and hydrogen bonding of all modifications are discussed.

[Immunity against poliomyelitis in mothers and their newborn infants. Comparison of Hamburg and Bamako (Mali)]. / Immunitätslage von Müttern und ihren Neugeborenen gegenüber der Poliomyelitis. Vergleich zwischen Hamburg und Bamako (Mali).

The polio neutralisation test was performed in 199 paired sera from mothers and their newborn infants from the Hamburg area and in 69 paired sera from Bamako (Mali). Antibodies against all 3 poliovirus types were demonstrated in 52.3% of Hamburg and in 78.0% of bamako mothers. The significantly inferior protection of Hamburg mothers was caused by a lower rate of polio 3 antibodies. Only 65.3% of the Hamburg mothers had polio 3 antibodies in contrast to 88.0% of Malian mothers. Newborn infants from Hamburg had significantly higher polio 2 antibody titres than their mothers, newborn infants from Bamako in contrast had significantly lower polio 2 and 3 antibody titres than their mothers. Both groups share an insufficient transferral of polio 3 antibodies. When only titres outside the range of error of the neutralisation test (1 titre step) are considered as different, all 3 polio types in both groups show agreement of titres in mother and child in more than 90%.

Two-month-old infants' sensitivity to allophonic differences.

The present study investigated 2-month-olds' abilities to discriminate allophonic differences that are potentially useful in segmenting fluent speech. Experiment 1 investigated infants' sensitivity to the kind of distinction that may signal the presence or absence of a word boundary. When tested with the high-amplitude sucking procedure, infants discriminated pairs of items, such as "nitrate" versus "night rate" and "nikrate" versus "nike rate". By greatly reducing the potential contribution of prosodic differences to these contrasts, Experiment 2 evaluated whether the allophonic differences for /t/ and /r/ were sufficient for infants to distinguish the "nitrate" versus "night rate" pair. Infants distinguished "nitrate" from a cross-spliced version of "night rate," which differed only in the allophones for /t/ and /r/ that it included. Thus, infants appear to possess one of the prerequisite capacities (i.e., the ability to discriminate allophonic distinctions) necessary to use allophonic information in segmenting fluent speech.

[In situ fluoride uptake of initial caries lesions following application of two children's toothpastes]. / In-situ-Fluoridaufnahme initialer Karieslsionen nach Applikation zweier Kinderzahnpasten.

Cylindrical blocks of enamel with initial caries lesions were brushed twice a day for 6 days using amine fluoride or monofluorophosphate children's toothpaste (250 ppm F-). Some of the enamel samples were left in the oral cavity for three further days after the end of the trial, during which time a fluoride-free toothpaste was used for daily oral hygiene. Half of the enamel blocks showed plaque formation during this period. The other half were kept clean. Fluoride soluble in KOH was only detected on the enamel blocks that had been brushed with amine fluoride children's toothpaste. The amount of solidly bound fluoride was significantly higher following the use of amine fluoride children's toothpaste than with monofluorophosphate children's toothpaste. The amounts of KOH-soluble fluoride and solidly bound fluoride fell again 3 days after discontinuation of fluoride application. But only the drop in the amount of KOH-soluble fluoride in demineralised tooth enamel after application of the two children's toothpastes can be explained by the differing reaction mechanisms of the two fluoride compounds.

Infants' sensitivity to allophonic cues for word segmentation.

A series of four experiments was conducted to determine whether English-learning infants can use allophonic cues to word boundaries to segment words from fluent speech. Infants were familiarized with a pair of two-syllable items, such as nitrates and night rates and then were tested on their ability to detect these same words in fluent speech passages. The presence of allophonic cues to word boundaries did not help 9-month-olds to distinguish one of the familiarized words from an acoustically similar foil. Infants familiarized with nitrates were just as likely to listen to a passage about night rates as they were to listen to one about nitrates. Nevertheless, when the passages contained distributional cues that favored the extraction of the familiarized targets, 9-month-olds were able to segment these items from fluent speech. By the age of 10.5 months, infants were able to rely solely on allophonic cues to locate the familiarized target words in passages. We consider what implications these findings have for understanding how word segmentation skills develop.

Molecular mechanics and X-ray crystal structure investigations on conformations of 11 beta substituted 4,9-dien-3-one steroids.

The influence of 11 beta-phenyl substitution upon 4,9-dien-3-one steroid-backbone conformations is calculated by means of the MM2p molecular mechanics scheme. In the case of steroids having a 13 beta configuration, the lowest strain energy is always evaluated for the conformational combination of rings A(inverted) B(normal) while, moreover, the 11 beta substitution increases the relative stability of the conformation A(normal) B(normal) compared to the nonsubstituted compound. Introduction of the 11 beta substituent causes some bowing of the energy-minimum structures in the A-ring region toward the beta side. For 13 alpha configurated steroids, the ring conformations A(inverted) B(normal) C(boat) and A(normal) B(inverted) C(twist/boat) are found to be energetically preferred. Quantitative description of different ring conformations using asymmetry and pseudorotational parameters as well as the comparison of molecular mechanics and available X-ray structure data give an impression of the conformational mobility. Whereas the effect of 11 beta substitution within a given ring conformation is limited, contributions to molecular flexibility can be found in the ability to adopt different basic conformations and in the occupation of near-minimum structures. An X-ray crystal structure analysis of a potential antiprogestational steroid has been performed, and the results are in good agreement with the calculated structure.