Mobile healthcare simulation units: a narrative review.

For healthcare professionals working and living in geographical isolation, there are few opportunities to maintain skills and knowledge, and to update themselves with recent advances in care compared to their citydwelling peers. It is known that within a short period and limited practice, clinical skills erode. A mobile healthcare simulation unit provides high-quality, technologicallyenhanced, convenient, and affordable training for healthcare professionals under expert supervision in any remote setting. The current narrative review was planned to summarise the outcomes and challenges related to developing and effectively utilising mobile healthcare simulation units as experienced globally. A literature search was performed on PubMed, Google Scholar and Cochrane databases for relevant articles published between 2000 and 2020, which resulted in 18 articles that were shortlisted and three major themes. The identification of common strengths, weaknesses and challenges will be a starting point for those engaged in planning and operating such a centre in any location.

Role of microRNAs in non-functioning pituitary adenoma.

Non-functioning pituitary adenomas account for 30% of anterior pituitary tumours. Based on their inability to secrete hormones, these are often diagnosed incidentally or due to pressure symptoms. Understanding the pathogenesis of these adenomas can provide insight into factors leading to its progression and serving as biomarkers for early recognition. A literature search was performed in the current narrative review for articles published in PubMed for the last 10 years till January 2020 on micro-ribonucleic acid involved in the pathogenesis of non-functioning pituitary adenomas. Of the 478 articles found, 21(4.4%) were filtered. In total, 106 micro-ribonucleic acids were identified, 25(23.5%) of which appeared in more than one study. Among them, 7(28%)were up-regulated, 11(44%) down-regulated, and 7(28%) were either up- or down-regulated. Micro- ribonucleic acids allow the screening, diagnosis and treatment of diseases in a relatively easy and inexpensive manner. This can revolutionise tumour management in the years ahead, especially in resource-constrained low- and middle-income countries.

Simulated learning in rural community environment: pushing the boundary.

Experiential learning through simulation can play a very significant role, not only in hospital settings but also in community contexts (Lubbers and Rossman, Nurse Educ. Today 48:140-144; Wheeler and McNelis, Nurs. Educ. Perspect 35:259-261). This paper discusses the concept of creating a novel simulated village set-up within a modern simulation center, to effectively deliver contemporary learning outcomes. It also highlights the challenges and risks of developing a simulated village set-up and strategies to counteract them. Furthermore, it describes the role of simulation specialists as innovators and explicates the gamut of expertise in education, management, and technologies that are required to deliver excellence in simulation-based education.

Neuropathogenic Escherichia coli K1 does not exhibit proteolytic activities to exert its pathogenicity.

BACKGROUND: Proteases are well-known virulence factors that promote survival, pathogenesis and immune evasion of many pathogens. Several lines of evidence suggest that the blood-brain barrier permeability is a prerequisite in microbial invasion of the central nervous system. Because proteases are frequently associated with vascular permeability by targeting junctional proteins, here it is hypothesized that neuropathogenic Escherichia coli K1 exhibit proteolytic activities to exert its pathogenicity. METHODS: Zymographic assays were performed using collagen and gelatin as substrates. The lysates of whole E. coli K1 strain E44, or E. coli K-12 strain HB101 were tested for proteolytic activities. The conditioned media were prepared by incubating bacteria in RPMI-1640 in the presence or absence of serum. The cell-free supernatants were collected and tested for proteases in zymography as mentioned above. Additionally, proteolytic degradation of host immune factors was determined by co-incubating conditioned media with albumin/immunoglobulins using protease assays. RESULTS: When collagen or gelatin were used as substrates in zymographic assays, neither whole bacteria nor conditioned media exhibited proteolytic activities. The conditioned media of neuropathogenic E. coli K1 strain E44, or E. coli K-12 strain HB101 did not affect degradation of albumin and immunoglobulins using protease assays. CONCLUSIONS: Neither zymographic assays nor protease assays detected proteolytic activities in either the whole bacteria or conditioned media of E. coli K1 strain E44 and E. coli K-12 strain HB101. These findings suggest that host cell monolayer disruptions and immune evasion strategies are likely independent of proteolytic activities of neuropathogenic E. coli K1.