Prediction of Graduate Learners' Academic Achievement in an Online Learning Environment Using a Blended Trauma Course.

Background: The concepts of online and blended education came into the limelight in the 19th century. Over time, the concepts expanded and reached a peak in 2021 in response to the COVID-19 lockdown. One of the challenges is the monitoring of the performance of distant learners. In face-to-face courses, an instructor can easily identify struggling learners during the regular meetings. Aim of the Study: This study explored variables that can predict the academic achievement of learners early in online learning environments. Although there was no consensus, the factors were still hypothesized as predictors for academic achievement. Methods: A quasi-experimental study was conducted to test the hypothesis. Thirty-three graduate learners were enrolled in a blended trauma course. The learners' age, their previous experiences in online education, pre-test scores, and the number of logs to the online platform were studied. These elements were considered as predictors of academic achievement in the online aspect of the course. Results: The findings revealed that there was no statistically significant correlation between the age, the previous experience in online education, the pre-test scores, and the number of logs in the first two weeks. However, there was a statistically significant correlation between the number of logs into the online platform in the first three weeks of study and the learners' academic achievement. Additionally, the number of logs in the first three weeks was a statistically significant predictor for academic achievement in online education. This early prediction can help instructors to identify and support struggling learners. Conclusion: The records of the online activity of learners in the first three weeks of study can help in early prediction of their academic achievement. Age, previous online education, and pretest scores were not statistically significant predictors.

Do entrustment scales make a difference in the inter-rater reliability of the workplace-based assessment?

BACKGROUND: A workplace-based assessment (WBA) is used to assess learners' competencies in their workplaces. Many workplace assessment tools are available and validated to assess various constructs. The implementation of workplace-based assessment requires proper training of the staff. OBJECTIVE: This study aimed to explore the impact of staff training on WBA practices and evaluate the inter-rater reliability of these practices while using entrustment scales, performance descriptors, and personal judgment. DESIGN: A quasi-experimental study, in which the staff members of the orthopedic department were invited to participate in a training program on the use of entrustment scales and assessment descriptors within the WBA tools. As a response to the training, subjective judgment was replaced by entrustment scales and performance descriptors in a trauma course offered by the orthopedic department. The inter-rater reliability of the WBA was evaluated using various rating scales. RESULTS: The entrustment scales had higher inter-rater reliability of the assessment tools than performance descriptors and the personal judgment. CONCLUSION: The inter-rater reliability was highest when using entrustment scales for WBAs, which could indicate that the entrustment scales achieve good psychometric properties as regards consistency among different raters. Thus, they decrease the confounding effect of differences in assessors. They may also give a clearer image of the actual academic level of the learners.

The vascular impact of dapagliflozin, liraglutide, and atorvastatin alone or in combinations in type 2 diabetic rat model.

Diabetic dyslipidemia is a significant contributor in the pathogenesis of type 2 diabetes (T2D). The study aimed at comparing the effect of dapagliflozin, liraglutide, and atorvastatin alone or their combinations on lipids and inflammatory markers and their vascular impact in T2D rats. There were 56 male albino rats included in the study and divided into two main groups. Group A (8 rats) served as normal control. Group B (48 rats) were streptozotocin-nicotinamide-induced diabetic rats. Subgroups (B-1, B-2, B-3, B-4, B-5, and B-6) received (no medications, dapagliflozin, liraglutide, atorvastatin, dapagliflozin + atorvastatin, and liraglutide + atorvastatin), respectively. Urine albumin/creatinine ratio (UACR), glycosylated hemoglobin (HBA1c), fasting serum glucose (FSG), serum low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), TGs, lipoprotein(a) Lp (a), serum thyrotropin (TSH), highly sensitive C-reactive protein (hs-CRP) and advanced glycation end products (AGEs), were assessed. Qualitative and quantitative histological examination of kidneys focused on renal corpuscles. Dapagliflozin improved the studied parameters but with statistically insignificant increase in LDL-C, Lp (a) and significant increase in UACR. Atorvastatin improved the studied parameters but with statistically insignificant increase in FSG and HbA1C. Liraglutide and the combination groups significantly improved all studied parameters. Histologically, liraglutide and atorvastatin produced therapeutic effect, while dapagliflozin depicted nephrotoxic effect. Combination groups resulted in better effects with normalization of most of renal corpuscles. There were positive correlations between LDL-C and hs-CRP, AGEs, TSH and mesangial expansion. Combination of atorvastatin with liraglutide can improve its vasculoprotective effect. Moreover, combination of atorvastatin with dapagliflozin can ameliorate its possible nephrotoxic effect.

Lipid-Based Gliclazide Nanoparticles for Treatment of Diabetes: Formulation, Pharmacokinetics, Pharmacodynamics and Subacute Toxicity Study.

INTRODUCTION: Solid lipid nanoparticles (SLNs) are considered a promising system in enhancing the oral bioavailability of poorly water-soluble drugs; owing to their intrinsic ability to increase the solubility together with protecting the incorporated drugs from extensive metabolism. OBJECTIVE: Exploiting such properties, SLNs loaded with gliclazide (GLZ) were developed in an attempt to improve the oral bioavailability and the anti-diabetic action of GLZ, together with prolonging its duration of action for better glycemic control. METHODS: SLNs were prepared by ultra-sonication technique using glyceryl behenate (Compritol®888 ATO) as a lipid matrix and poloxamer 188 (PLX) as a stabilizer. A 2*3 asymmetrical factorial design was adopted to study the effect of different stabilizer concentrations at different sonication times on the shape, and size of the particles, PDI and drug loading. The selected optimum formulation was then freeze dried using trehalose di-hydrate as a cryo-protectant in different ratios with respect to glyceryl behenate concentration. After freeze drying, the formulation was tested for in-vitro drug release, pharmacokinetics, and pharmacodynamics. Safety of the selected formula was established after carrying out a subacute toxicity study. RESULTS: The factorial design experiment resulted in an optimum formulation coded 10F2 (150 mg PLX/10 min sonication). Scanning electron micrographs showed spherical particles with smooth surface, whereas a ratio of 2:1 cryo-protectant:lipid was found to be optimum with particle size of 245.9 ± 26.2 nm, polydispersity index of 0.482 ± 0.026, and biphasic in-vitro release with an initial burst effect, followed by a prolonged release phase. On the other hand, the selected SLNs exhibited prolonged drug release when compared with the GLZ commercial immediate release (IR) tablets (Diamicron®). Pharmacokinetics study showed about 5-fold increase in GLZ oral bioavailability loaded in SLNs when compared with raw GLZ powder. Pharmacodynamics study on a diabetic rat model confirmed the better anti-diabetic action of GLZ loaded SLNs when compared to raw GLZ powder. Subacute toxicity study indicated the safety of SLNs upon repetitive oral administration.

The nasal seromucinous glands after endoscopic sphenopalatine artery coagulation.

Endoscopic coagulation of the sphenopalatine artery (SPA) is indicated in patients with recurrent or severe posterior epistaxis. The present work aimed at studying the effects of the sphenopalatine artery coagulation on the nasal seromucinous glands. The study was carried out on 30 patients who were scheduled for endoscopic SPA coagulation. All patients signed informed consents that were approved by the Committee of Medical Ethics. Minute punch biopsies were taken from the inferior turbinates, under local anesthesia, just before the procedure as well as 12 weeks and 1 year postoperatively. The biopsies were stained with hematoxylin and eosin and PAS Alcian blue. Histochemical examination was done for the activity of the succinic dehydrogenase, alkaline phosphatase and cholinesterase enzymes. Morphometric analysis as well as analysis of the histological and histochemical results showed that SPA coagulation was followed by an early decrease in the size, number and secretory activity of the nasal seromucinous glands, which was associated with decreased activity of the alkaline phosphatase enzyme in the endothelial cells of the nasal blood vessels and decreased activity of the cholinesterase enzyme in the cholinergic nerve fibers. These changes, however, were temporary and reversible since examination of the late postoperative biopsies, at 1 year, showed normalization of the number, appearance, and histochemical activity of the glandular acini as well as the surrounding blood vessels and cholinergic nerve fibers.