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Boeselt T, Terhorst P, Kroenig J, Nell C, Spielmanns M, Boas U, Veith M, Vogelmeier C, Greulich T, Koczulla AR, Beutel B, Huber J, Heers H. Specific molecular peak analysis by ion mobility spectrometry of volatile organic compounds in urine of COVID-19 patients: A novel diagnostic approach. J Virol Methods 2024; 326:114910. [PMID: 38452823 DOI: 10.1016/j.jviromet.2024.114910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/08/2024] [Accepted: 03/02/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION SARS-CoV-2 is usually diagnosed from naso-/oropharyngeal swabs which are uncomfortable and prone to false results. This study investigated a novel diagnostic approach to Covid-19 measuring volatile organic compounds (VOC) from patients' urine. METHODS Between June 2020 and February 2021, 84 patients with positive RT-PCR for SARS-CoV-2 were recruited as well as 54 symptomatic individuals with negative RT-PCR. Midstream urine samples were obtained for VOC analysis using ion mobility spectrometry (IMS) which detects individual molecular components of a gas sample based on their size, configuration, and charge after ionization. RESULTS Peak analysis of the 84 Covid and 54 control samples showed good group separation. In total, 37 individual specific peaks were identified, 5 of which (P134, 198, 135, 75, 136) accounted for significant differences between groups, resulting in sensitivities of 89-94% and specificities of 82-94%. A decision tree was generated from the relevant peaks, leading to a combined sensitivity and specificity of 98% each. DISCUSSION VOC-based diagnosis can establish a reliable separation between urine samples of Covid-19 patients and negative controls. Molecular peaks which apparently are disease-specific were identified. IMS is an additional non-invasive and cheap device for the diagnosis of this ongoing endemic infection. Further studies are needed to validate sensitivity and specificity.
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Affiliation(s)
- T Boeselt
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - P Terhorst
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Kroenig
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Nell
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Spielmanns
- Pulmonary Rehabilitation, Zuercher Reha Zentren Klinik Wald, Switzerland; Faculty of Health, Department of Pneumology, University of Witten, Herdecke, Germany
| | - U Boas
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - M Veith
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - C Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - T Greulich
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - A R Koczulla
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany; Department of Pulmonology, Schoen-Kliniken Berchtesgaden, Philipps-University Marburg, Germany
| | - B Beutel
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, German Center for Lung Research (DZL), Germany
| | - J Huber
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | - H Heers
- Department of Urology, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany.
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Xiao H, Ulmert I, Bach L, Huber J, Narasimhan H, Kurochkin I, Chang Y, Holst S, Mörbe U, Zhang L, Schlitzer A, Pereira CF, Schraml BU, Baumjohann D, Lahl K. Genomic deletion of Bcl6 differentially affects conventional dendritic cell subsets and compromises Tfh/Tfr/Th17 cell responses. Nat Commun 2024; 15:3554. [PMID: 38688934 PMCID: PMC11061177 DOI: 10.1038/s41467-024-46966-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Conventional dendritic cells (cDC) play key roles in immune induction, but what drives their heterogeneity and functional specialization is still ill-defined. Here we show that cDC-specific deletion of the transcriptional repressor Bcl6 in mice alters the phenotype and transcriptome of cDC1 and cDC2, while their lineage identity is preserved. Bcl6-deficient cDC1 are diminished in the periphery but maintain their ability to cross-present antigen to CD8+ T cells, confirming general maintenance of this subset. Surprisingly, the absence of Bcl6 in cDC causes a complete loss of Notch2-dependent cDC2 in the spleen and intestinal lamina propria. DC-targeted Bcl6-deficient mice induced fewer T follicular helper cells despite a profound impact on T follicular regulatory cells in response to immunization and mounted diminished Th17 immunity to Citrobacter rodentium in the colon. Our findings establish Bcl6 as an essential transcription factor for subsets of cDC and add to our understanding of the transcriptional landscape underlying cDC heterogeneity.
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Affiliation(s)
- Hongkui Xiao
- Section for Experimental and Translational Immunology, Institute for Health Technology, Technical University of Denmark (DTU), 2800, Kongens, Lyngby, Denmark
| | - Isabel Ulmert
- Section for Experimental and Translational Immunology, Institute for Health Technology, Technical University of Denmark (DTU), 2800, Kongens, Lyngby, Denmark
| | - Luisa Bach
- Medical Clinic III for Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Johanna Huber
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Hamsa Narasimhan
- Biomedical Center, Institute of Cardiovascular Physiology and Pathophysiology, Faculty of Medicine, Ludwig-Maximillians-Universität München, Planegg-Martinsried, Munich, Germany
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Ilia Kurochkin
- Cell Reprogramming in Hematopoiesis and Immunity Laboratory, Lund Stem Cell Center, Molecular Medicine and Gene Therapy, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Yinshui Chang
- Medical Clinic III for Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, University of Bonn, Bonn, Germany
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Signe Holst
- Section for Experimental and Translational Immunology, Institute for Health Technology, Technical University of Denmark (DTU), 2800, Kongens, Lyngby, Denmark
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada
| | - Urs Mörbe
- Section for Experimental and Translational Immunology, Institute for Health Technology, Technical University of Denmark (DTU), 2800, Kongens, Lyngby, Denmark
| | - Lili Zhang
- Quantitative Systems Biology, Life and Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Andreas Schlitzer
- Quantitative Systems Biology, Life and Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Carlos-Filipe Pereira
- Cell Reprogramming in Hematopoiesis and Immunity Laboratory, Lund Stem Cell Center, Molecular Medicine and Gene Therapy, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Barbara U Schraml
- Biomedical Center, Institute of Cardiovascular Physiology and Pathophysiology, Faculty of Medicine, Ludwig-Maximillians-Universität München, Planegg-Martinsried, Munich, Germany
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Dirk Baumjohann
- Medical Clinic III for Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, University of Bonn, Bonn, Germany.
- Institute for Immunology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried, Munich, Germany.
| | - Katharina Lahl
- Section for Experimental and Translational Immunology, Institute for Health Technology, Technical University of Denmark (DTU), 2800, Kongens, Lyngby, Denmark.
- Department of Microbiology, Immunology, and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
- Calvin, Phoebe and Joan Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.
- Immunology Section, Lund University, Lund, 221 84, Sweden.
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Flegar L, Zeuschner P, Kernig K, Friedersdorff F, Putz J, Stöckle M, Giessing M, Apel H, Huber J. [Report on the 29th annual meeting of the kidney transplantation working group of the German Society of Urology in Marburg 2023]. Urologie 2024; 63:278-281. [PMID: 38270605 DOI: 10.1007/s00120-024-02287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Affiliation(s)
- L Flegar
- Urologische Universitätsklinik Marburg, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland.
| | - P Zeuschner
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - K Kernig
- Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland
| | - F Friedersdorff
- Klinik für Urologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
- Klinik für Urologie, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Deutschland
| | - J Putz
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - M Stöckle
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - M Giessing
- Klinik für Urologie, Kliniken Maria Hilf, Mönchengladbach, Deutschland
| | - H Apel
- Urologische und Kinderurologische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J Huber
- Urologische Universitätsklinik Marburg, Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstraße, 35033, Marburg, Deutschland
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Oettle M, Büttner M, Forster M, Gajdi L, Mücke J, Nieto A, Heuser S, Huber J, Walter F, Corradini S, Niyazi M, Belka C, Dreyling M, Fischer MR, Fleischmann DF. Principles of oncology taught in a one-week course. J Cancer Res Clin Oncol 2023; 149:17071-17079. [PMID: 37750957 PMCID: PMC10657289 DOI: 10.1007/s00432-023-05377-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/29/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Growing challenges in oncology require evolving educational methods and content. International efforts to reform oncology education are underway. Hands-on, interdisciplinary, and compact course formats have shown great effectiveness in the education of medical students. Our aim was to establish a new interdisciplinary one-week course on the principles of oncology using state-of-the-art teaching methods. METHODS In an initial survey, medical students of LMU Munich were questioned about their current level of knowledge on the principles of oncology. In a second two-stage survey, the increase in knowledge resulting from our recently established interdisciplinary one-week course was determined. RESULTS The medical students' knowledge of clinically important oncological topics, such as the diagnostic workup and interdisciplinary treatment options, showed a need for improvement. Knowledge of the major oncological entities was also in an expandable state. By attending the one-week course on the principles of oncology, students improved their expertise in all areas of the clinical workup in oncology and had the opportunity to close previous knowledge gaps. In addition, students were able to gain more in-depth clinical knowledge on the most common oncological entities. CONCLUSION The interdisciplinary one-week course on the principles of oncology proved to be an effective teaching method to expand the knowledge of the future physicians to an appropriate level. With its innovative and interdisciplinary approach, the one-week course could be used as a showcase project for the ongoing development of medical education in Germany.
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Affiliation(s)
- Matthias Oettle
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Marcel Büttner
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Marie Forster
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Laura Gajdi
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Johannes Mücke
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Alexander Nieto
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Sonja Heuser
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Johanna Huber
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Franziska Walter
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Maximilian Niyazi
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Claus Belka
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - Martin Dreyling
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Martin R Fischer
- Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Daniel F Fleischmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
- German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Schmidt-Bäse K, Huber J, Fischer MR, Wijnen-Meijer M. German first-year medical students' expectations of their professional life - concerns and hopes: A project report. GMS J Med Educ 2023; 40:Doc72. [PMID: 38125899 PMCID: PMC10728663 DOI: 10.3205/zma001654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 07/18/2023] [Accepted: 08/08/2023] [Indexed: 12/23/2023]
Abstract
Aim Expectations among medical students towards their future professional life are affected by intrinsic and extrinsic factors which may change during years of medical school. The aim of this study is to gain further insight into students' expectations of their professional life at the beginning of medical school. Findings regarding contextual influences can be used to improve curricula and student guidance. Methods The project report based on an online survey among three cohorts of first year medical students at the LMU. The questionnaire consisted of six open-ended questions which addressed the student's motivation, expectations, anticipations and concerns of their professional life. Questions were also asked about presumed personal development and influence on private life. An inductive coding was used in this qualitative content analysis. Results Written responses from 591 participants were coded, categorized and summarized into four main themes: personal life, work, science, personal issue. Despite coming from different cohorts, the occurrence of the main themes showed the same trend in all student groups. Students are worried most about the work-life-balance, and they expect it to be a difficult issue. But many of our first-year students are optimistic that they will be able to establish a good work-life-balance or that the working conditions will have changed to a manageable workload at the time they will enter their first jobs. The majority of our students expect to become more self-confident with enhanced empathy and team-working ability and more patient and stress-resistant in daily challenges. Conclusion The medical students emphasize the gender-neutral desire for work-life balance. So, they expect improved working conditions for the future - an ongoing challenge for the health care system.
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Affiliation(s)
- Karen Schmidt-Bäse
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johanna Huber
- LMU Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
| | - Martin R. Fischer
- LMU Hospital, LMU Munich, Institute of Medical Education, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, TUM School of Medicine, TUM Medical Education Center, Munich, Germany
- Technical University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
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Heers H, Urhahn F, Pedrosa Carrasco A, Morin A, Gschnell M, Huber J, Flegar L, Volberg C. End of life care - Preferences of patients with advanced urologic malignancies. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Huber J, Karschuck P, Koch R, Ihrig A, Krones T, Neisius A, Von Ahn S, Klopf C, Weikert S, Siebels M, Haseke N, Weißflog C, Baunacke M, Liske P, Tosev G, Benusch T, Schostack M, Stein J, Spiegelhalder P, Thomas C, Groeben C. An online prostate cancer patient decision aid structurally improves patient care: Results from the EvEnt-PCA randomized controlled trial. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00848-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Siltari A, Lönnerbro R, Pang K, Shiranov K, Asiimwe A, Evans-Axelsson S, Franks B, Kiran A, Murtola TJ, Schalken J, Steinbeisser C, Bjartell A, Auvinen A, Smith E, N'Dow J, Plass K, Ribal M, Mottet N, Moris L, Lardas M, Van den Broeck T, Willemse PP, Gandaglia G, Campi R, Greco I, Gacci M, Serni S, Briganti A, Crosti D, Meoni M, Garzonio R, Bangma R, Roobol M, Remmers S, Tilki D, Visakorpi T, Talala K, Tammela T, van Hemelrijck M, Bayer K, Lejeune S, Taxiarchopoulou G, van Diggelen F, Senthilkumar K, Schutte S, Byrne S, Fialho L, Cardone A, Gono P, De Vetter M, Ceke K, De Meulder B, Auffray C, Balaur IA, Taibi N, Power S, Kermani NZ, van Bochove K, Cavelaars M, Moinat M, Voss E, Bernini C, Horgan D, Fullwood L, Holtorf M, Lancet D, Bernstein G, Omar I, MacLennan S, Maclennan S, Healey J, Huber J, Wirth M, Froehner M, Brenner B, Borkowetz A, Thomas C, Horn F, Reiche K, Kreux M, Josefsson A, Tandefekt DG, Hugosson J, Huisman H, Hofmacher T, Lindgren P, Andersson E, Fridhammar A, Vizcaya D, Verholen F, Zong J, Butler-Ransohoff JE, Williamson T, Chandrawansa K, Dlamini D, waldeck R, Molnar M, Bruno A, Herrera R, Jiang S, Nevedomskaya E, Fatoba S, Constantinovici N, Maass M, Torremante P, Voss M, Devecseri Z, Cuperus G, Abott T, Dau C, Papineni K, Wang-Silvanto J, Hass S, Snijder R, Doye V, Wang X, Garnham A, Lambrecht M, Wolfinger R, Rogiers S, Servan A, Lefresne F, Caseriego J, Samir M, Lawson J, Pacoe K, Robinson P, Jaton B, Bakkard D, Turunen H, Kilkku O, Pohjanjousi P, Voima O, Nevalaita L, Reich C, Araujo S, Longden-Chapman E, Burke D, Agapow P, Derkits S, Licour M, McCrea C, Payne S, Yong A, Thompson L, Lujan F, Bussmann M, Köhler I. How well do polygenic risk scores identify men at high risk for prostate cancer? Systematic review and meta-analysis. Clin Genitourin Cancer 2022; 21:316.e1-316.e11. [PMID: 36243664 DOI: 10.1016/j.clgc.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Genome-wide association studies have revealed over 200 genetic susceptibility loci for prostate cancer (PCa). By combining them, polygenic risk scores (PRS) can be generated to predict risk of PCa. We summarize the published evidence and conduct meta-analyses of PRS as a predictor of PCa risk in Caucasian men. PATIENTS AND METHODS Data were extracted from 59 studies, with 16 studies including 17 separate analyses used in the main meta-analysis with a total of 20,786 cases and 69,106 controls identified through a systematic search of ten databases. Random effects meta-analysis was used to obtain pooled estimates of area under the receiver-operating characteristic curve (AUC). Meta-regression was used to assess the impact of number of single-nucleotide polymorphisms (SNPs) incorporated in PRS on AUC. Heterogeneity is expressed as I2 scores. Publication bias was evaluated using funnel plots and Egger tests. RESULTS The ability of PRS to identify men with PCa was modest (pooled AUC 0.63, 95% CI 0.62-0.64) with moderate consistency (I2 64%). Combining PRS with clinical variables increased the pooled AUC to 0.74 (0.68-0.81). Meta-regression showed only negligible increase in AUC for adding incremental SNPs. Despite moderate heterogeneity, publication bias was not evident. CONCLUSION Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone.
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Lange S, Krüger N, Warm M, op den Winkel M, Buechel J, Huber J, Genzel-Boroviczény O, Fischer MR, Dimitriadis K. Online medical history taking course: Opportunities and limitations in comparison to traditional bedside teaching. GMS J Med Educ 2022; 39:Doc34. [PMID: 36119150 PMCID: PMC9469571 DOI: 10.3205/zma001555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/27/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Obtaining a systematic medical history (MH) from a patient is a core competency in medical education and plays a vital role in the diagnosis of diseases. At the Faculty of Medicine at LMU Munich, students have their first course in MH taking during their second year. Due to the COVID-19 pandemic, the traditional bedside MH taking course had to be transformed into an online course (OC). Our objectives were to implement an online MH taking course, to evaluate its feasibility and to compare the evaluation results to a historic cohort that had undertaken the traditional bedside teaching course (BTC). METHODS 874 second-year students participated in the OC (BTC=827). After teaching the theoretical background via asynchronous online lectures, students participated in a practical exercise with fellow students using the video communication platform Zoom where they were able to practice taking a MH on the basis of fictitious, text-based patient cases. Students were then asked to evaluate the course through a standardized online survey with 31 questions on teaching quality and self-perceived learning success, which had also been used in previous years. The survey results were compared to the results of the historic cohort using the Mann-Whitney U test. RESULTS A total of n=162 students (18.5%) evaluated the OC. In the historic cohort, n=252 (30.5%) completed the survey. 85.3% of the OC respondents thought that the atmosphere during the practical exercise was productive and 83.0% greatly appreciated the flexibility in terms of time management. Moreover, they appreciated the online resources as well as having the opportunity to undertake a MH taking course during the COVID-19 pandemic. 27.7% of the respondents thought that traditional BTCs should be supplemented through more online activities in the future. With respect to the ability of independently taking a MH upon completion of the course, the OC was rated significantly lower relative to the BTC (mean OC=2.4, SD=±1.1 vs. mean BTC=1.9, SD=±1.1 (1=strongly agree; 5=strongly disagree); p<0.0001). CONCLUSION OCs are a feasible format and seem to convey the theory and practical implementation in a peer-exercise format of MH taking to medical students. The theoretical background can be acquired with great flexibility. Nevertheless, the students' self-appraisal suggested that the traditional teaching format was more effective at teaching MH taking skills. Thus, we propose a blended learning concept, combining elements of both formats. In this context, we suggest prospective, randomized trials to evaluate blended learning approaches.
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Affiliation(s)
- Silvan Lange
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
| | - Nils Krüger
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
| | - Maximilian Warm
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Internal Medicine III, Munich, Germany
| | - Mark op den Winkel
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Internal Medicine II, Munich, Germany
| | - Johanna Buechel
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Gynecology and Obstetrics, Munich, Germany
| | - Johanna Huber
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
| | - Orsolya Genzel-Boroviczény
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Dr. von Hauner Children's Hospital, Division of Neonatology Campus Innenstadt, Munich, Germany
| | - Martin R. Fischer
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
| | - Konstantinos Dimitriadis
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute of Medical Education, Munich, Germany
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Department of Neurology, Munich, Germany
- University Hospital, Ludwig-Maximilians-University (LMU) Munich, Institute for Stroke and Dementia Research (ISD), Munich, Germany
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Holzmann-Littig C, Zerban NL, Storm C, Ulhaas L, Pfeiffer M, Kotz A, Wijnen-Meijer M, Keil S, Huber J. One academic year under COVID-19 conditions: two multicenter cross-sectional evaluation studies among medical students in Bavarian medical schools, Germany students' needs, difficulties, and concerns about digital teaching and learning. BMC Med Educ 2022; 22:450. [PMID: 35681177 PMCID: PMC9183753 DOI: 10.1186/s12909-022-03480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 05/20/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND Since March 2020, COVID-19 has created a need for adaptation in many areas of life. This study explores medical students' perspectives on digital teaching under conditions of the COVID-19 pandemic. It focuses on expectations and concerns about digital teaching, the evaluation of specific aspects of teaching, and requests for future teaching. METHODS Six German faculties have joined forces within the Bavarian network for medical education to develop and deploy a common core questionnaire. Cross-sectional surveys were conducted at the end of the summer semester 2020 and winter semester 2020/21. Medical students from different semesters participated in the online survey. Data was analyzed descriptively and/or inferentially. Item differences across semesters were examined using contingency tables and Chi2 tests. Mean values were compared using the independent samples t-test; answer frequencies in retrospective and prospective concerns were compared using contingency tables and Chi2 tests with Yates' correction. RESULTS In the summer semester 2020, 1565 students and in winter semester 2020/21, 1727 students took part in the survey. Students' main prospective concern was lack of social exchange between fellow students (70%), but also with teachers. Second and third most often concerns were a lack of practical training (68%) and lack of integration of on-site digital teaching (50%). Approximately 7% of the students lacked sufficient access to technical equipment.. Approximately 39% of the students lacked a sufficient internet connection for synchronous digital teaching, 17% for asynchronous digital teaching. On-site teaching was the preferred form of teaching (60%), and there was a preference for asynchronous (24%) over synchronous (15%) digital teaching. Teaching recordings (79%) were particularly popular to complement future on-site teaching. CONCLUSIONS The following areas of education under COVID-19 conditions are highly important to medical students: adequacy of information sharing, integration of opportunities for exchange with fellow students and teachers, possibility to perform practical trainings. After the normalization of the pandemic situation, on-site teaching should be supplemented with blended learning concepts such as the inverted classroom model. Percentages of results are rounded averages from summer and winter semesters.
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Affiliation(s)
- Christopher Holzmann-Littig
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany.
- Department of Nephrology, University Hospital rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Nina L Zerban
- Institute of Medical Teaching and Medical Education Research, University Hospital of Würzburg, Würzburg, Germany
- Simulated Patient Program, Faculty of Medicine, Julius-Maximilians-Universität of Würzburg, Würzburg, Germany
| | - Clara Storm
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Lilian Ulhaas
- Faculty of Medicine, Dean's Office and Department of Medical Education Augsburg DEMEDA, Augsburg University, Augsburg, Germany
| | - Mona Pfeiffer
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Alexander Kotz
- Faculty of Medicine, Office of the Dean for Student Affairs, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marjo Wijnen-Meijer
- TUM Medical Education Center, Faculty of Medicine, Technical University of Munich, Munich, Germany
| | - Stephanie Keil
- Faculty of Medicine, Dean's Office, University of Regensburg, Regensburg, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, Ludwig-Maximilians-Universität Munich, Munich, Germany
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Ihrig A, Maatouk I, Friederich HC, Baunacke M, Groeben C, Koch R, Thomas C, Huber J. The Treatment Decision-making Preferences of Patients with Prostate Cancer Should Be Recorded in Research and Clinical Routine: a Pooled Analysis of Four Survey Studies with 7169 Patients. J Cancer Educ 2022; 37:675-682. [PMID: 32940881 PMCID: PMC9205804 DOI: 10.1007/s13187-020-01867-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 05/13/2023]
Abstract
Different patients want to take different roles in the treatment decision-making process; these roles can be classified as passive, collaborative, and active. The aim of this study was to investigate the correlation between decision-making preferences among patients with prostate cancer and personal, disease-related, and structural factors. In four survey studies, we asked 7169 prostate cancer patients about their decision-making preferences using the Control Preferences Scale (CPS) and collected clinical, psychological, and quality-of-life measures. Most patients (62.2%) preferred collaborative decision-making, while 2322 (32.4%) preferred an active role, and only 391 (5.5%) preferred a passive role. Age (p < 0.001), data collection mode (p < 0.001), peer-to-peer support (p = 0.018), treatment status (p < 0.001), performed or planned radical prostatectomy (p < 0.001), metastatic disease (p = 0.001), and quality of life (p < 0.001) showed significant associations with patients' preferred decision-making roles. Oncologic risk group, anxiety, and depression were not significant in the model. In particular, younger prostate cancer patients with higher quality of life completing an online survey want to play a more active role in treatment decision-making. Before treatment has started, patients tend to prefer collaborative decision-making. Few prostate cancer patients in Germany prefer a passive role. These patients are mostly older patients, patients with a metastatic disease, and patients who have opted for prostatectomy. Whether this finding reflects a generational effect or a tendency by age group and disease phase should be investigated. Further research is also needed to describe the causalities of these relationships. The CPS offers valuable information for personal counselling and should be applied in clinical routine. In a large group of patients with prostate cancer, we found that there is a strong desire for joint decision-making with the physician before the actual treatment. Especially younger men, men with active online behaviour, and men with a high quality of life want to be actively involved in therapy decision-making processes.
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Affiliation(s)
- Andreas Ihrig
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany.
| | - I Maatouk
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - H C Friederich
- Division of Psychooncology, Department of General Internal Medicine and Psychosomatic, University Hospital of Heidelberg, INF 410, 69120, Heidelberg, Germany
| | - M Baunacke
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Groeben
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - R Koch
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - C Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - J Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Tevlin R, desJardins-Park H, Huber J, DiIorio S, Longaker M, Wan D. Musculoskeletal tissue engineering: Adipose derived stromal cell implementation for the treatment of osteoarthritis. Biomaterials 2022; 286:121544. [DOI: 10.1016/j.biomaterials.2022.121544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/23/2021] [Accepted: 09/13/2021] [Indexed: 11/02/2022]
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Giesler M, Huber J, Paulmann V. Quality assurance and curricular development of medical faculties using graduate surveys: Challenges - proposal of a core questionnaire - implementation guide. GMS J Med Educ 2022; 39:Doc10. [PMID: 35368835 PMCID: PMC8953197 DOI: 10.3205/zma001531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/20/2021] [Accepted: 11/29/2021] [Indexed: 06/14/2023]
Abstract
Graduate surveys provide valuable information to further improve and develop an academic study program. The aim of this project report is to point out the relevance of these surveys for medical schools and to offer guidance on planning and implementing such surveys so that comparable evaluations of medical degree programs are possible. The authors of this project report were asked by the MFT working subgroup on Quality Assurance in Education to generate quality recommendations for surveying medical graduates. To accomplish this, the questionnaires used by the medical schools to survey graduates were closely inspected and analyzed. A questionnaire containing core and optional questions was created as part of this project. A comprehensive matrix was also developed listing all of the procedural elements of graduate surveys.
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Affiliation(s)
| | - Johanna Huber
- LMU München, Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
| | - Volker Paulmann
- Medizinische Hochschule Hannover, Studiendekanat - Bereich Evaluation & Kapazität, Hannover, Germany
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Tripathee S, Healey J, Beyer K, Venderbos L, Van Hemelrijck M, Roobol M, Huber J, Smith E, Imran Omar M, N'Dow J, Maclennan S, Maclennan S. Outcomes of importance to men with advanced prostate cancer: PIONEER interview study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Flegar L, Zacharis A, Aksoy C, Eisenmenger N, Groeben C, Huber J. Focal therapy trends for prostate cancer: A total population analysis in Germany from 2006 to 2019. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00394-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kiesewetter J, Huber J. A primer of an in-depth resilience status for German medical graduates: results of a cross-sectional survey on the status quo of resilience among graduates of human medicine in Bavaria, Germany - a necessary step in building an emotionally equipped healthcare work-force. BMC Med Educ 2021; 21:573. [PMID: 34772423 PMCID: PMC8588593 DOI: 10.1186/s12909-021-02933-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Resilience is a widely-used catchword in the last couple of years to describe the resistance to psychological strains of life, especially for the healthcare work-force. The promises of resilience to burnout sound great and what we all would want: less health impairment despite stress, higher work satisfaction and last but not least higher work performance. There is research that shows that students and physicians have high emotional distress and low resilience, yet comparably little is known which aspects of resilience are exactly impaired in the upcoming work-force. With our study we investigated the in-depth resilience status of medical graduates from five medical schools within their first year after graduation. In this, additionally to assessing the resilience status as a whole we investigate the answers on the singular items and the relationship of the resilience status with neighboring constructs. METHODS In 2018, 1610 human medical graduates from five Bavarian medical schools were asked to take part at cross-sectional Bavarian graduate survey (Bayerische Absolventenstudie Medizin, MediBAS). The response rate was 38,07, 60% of the participants were female. For the identification of the in-depth resilience status we included the 5-point Likert 10-Item Connor-Davidson Resilience Scale, German Version in a graduate survey posted to 5 medical schools and over 1610 eligible participants of whom 610 (60% female) filled out at least parts of the survey. To identify relationships to other aspects we posed further questionnaires. RESULTS The resilience status showed a mean resilience score of M = 37.1 (SD = 6.30). The score ranges from 3.22 (I am not easily discouraged by failure) to 4.26 (I am able to adapt to change). One third of the participants chose not to answer the item "I am able to handle unpleasant feeling". Relationships to job satisfaction, scientific competence and stress are presented in the article. CONCLUSIONS The study shows that the overall resilience status of medical graduates one year after their graduation is rather high, but subjectively they do not feel equivalently resilient for the different aspects they face in their job. Especially, how to handle their emotions seems to be challenging for some of the young physicians. In the article we sketch ideas how to handle the specific training needs the study has identified.
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Affiliation(s)
- J Kiesewetter
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der LMU München, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8a, 80336, Munich, Germany.
| | - J Huber
- Institut für Didaktik und Ausbildungsforschung in der Medizin am Klinikum der LMU München, Ludwig-Maximilians-Universität München, Pettenkoferstr. 8a, 80336, Munich, Germany
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Sharaf K, Felicio-Briegel A, Widmann M, Huber J, Eggersmann TK, Stadlberger U, Schrötzlmair F, Canis M, Lechner A. [ToSkORL: self- and objective assessment of examination skills in the head and neck region]. HNO 2021; 70:295-303. [PMID: 34622305 PMCID: PMC8964619 DOI: 10.1007/s00106-021-01097-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/27/2022]
Abstract
Hintergrund Ein zentrales Ziel des Medizinstudiums ist der Erwerb theoretischer und praktischer Kompetenzen. Es mangelt jedoch an Evidenz, wie der Erwerb von Kompetenzen in speziellen Untersuchungstechniken gemessen werden kann. ToSkORL (Teaching of Skills in Otorhinolaryngology) ist ein Projekt, das die studentische Selbstwahrnehmung ihrer Kompetenz bei speziellen Untersuchungstechniken der Hals-Nasen-Ohren-Heilkunde und des Kopf-Hals-Bereichs aus didaktisch-wissenschaftlicher Sichtweise beleuchtet. Methodik Im Rahmen des Untersuchungskurses erfolgte eine standardisierte mündlich-praktische Prüfung zu neun verschiedenen Untersuchungstechniken. Vor der Prüfung erfolgte eine Evaluation der studentischen Selbsteinschätzung mittels Fragebogen, die Prüfung wurde mittels Checkliste durch die Prüfenden standardisiert geprüft. Selbst- und Fremdeinschätzung nach der Likert-Skala wurden korreliert. Die neun Untersuchungstechniken wurden jeweils 42-mal von insgesamt 91 Studierenden in gegenseitiger Untersuchung durchgeführt. Ergebnisse Die Selbsteinschätzung der Kompetenz in den Untersuchungstechniken variiert erheblich, insgesamt schätzten Studierende ihre eigene Untersuchungskompetenz weitgehend unabhängig von Alter und Geschlecht meist realistisch ein. Studierende mit einem hohen Interesse an der Hals-Nasen-Ohren-Heilkunde gaben bessere Selbsteinschätzungen an, neigten jedoch auch eher zur Selbstüberschätzung. Bei Untersuchungen des mittleren Schwierigkeitsniveaus ergab sich die größte Divergenz von Selbst- und Fremdeinschätzung. Schlussfolgerung Die studentische Selbsteinschätzung ist ein geeignetes Instrument zur Messung der Untersuchungskompetenz in der Hals-Nasen-Ohren-Heilkunde. Es sollte ein besonderer Fokus auf die Lehre vermeintlich mittelschwerer Untersuchungstechniken gelegt werden, da diese am stärksten über- und unterschätzt werden. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00106-021-01097-y) enthält zwei Mini-Clinical-Exam(CEX)-Evaluationsbögen für Studenten und Untersucher. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte scannen Sie den QR-Code, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“. ![]()
QR-Code scannen & Beitrag online lesen
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Affiliation(s)
- Kariem Sharaf
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland.
| | - Axelle Felicio-Briegel
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland
| | - Magdalena Widmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland
| | - Johanna Huber
- Institut für Didaktik und Ausbildungsforschung in der Medizin, LMU Klinikum, Pettenkoferstraße 8a, 80336, München, Deutschland
| | - Tanja Kristina Eggersmann
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU München, Marchioninistraße 15, 81377, München, Deutschland
| | - Ursula Stadlberger
- Institut für Didaktik und Ausbildungsforschung in der Medizin, LMU Klinikum, Pettenkoferstraße 8a, 80336, München, Deutschland
| | - Florian Schrötzlmair
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland
| | - Martin Canis
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland
| | - Axel Lechner
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland.
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Mühlbauer L, Huber J, Fischer MR, Berberat PO, Gartmeier M. Medical students' engagement in the context of the SARS-CoV-2 pandemic: The influence of psychological factors on readiness to volunteer. GMS J Med Educ 2021; 38:Doc110. [PMID: 34651068 PMCID: PMC8493846 DOI: 10.3205/zma001506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/12/2021] [Accepted: 04/26/2021] [Indexed: 06/13/2023]
Abstract
Objective: To avert staff shortages during the first wave of the SARS-CoV-2 pandemic in spring 2020, the medical faculties of the Technical University of Munich (TUM) and the Ludwig Maximilian University of Munich (LMU) appealed to their students to volunteer for relief work. In this study, we examine the influence of psychological factors on the students' decisions to respond to this call or not. Methodology: We report on a cross-sectional study based on an online survey among medical students at the TUM and LMU. The survey consisted of a questionnaire containing items on motivation and other factors related to the decision for or against volunteering. Questions were also asked about anxieties regarding COVID-19 and the occurrence of depressive symptoms, as well as about resilience. Results: Responses from 244 participants were analysed. Students' decisions to volunteer revealed both altruistic and introjected motivations. For those students who did not volunteer, time overlaps and workload related to other activities played an important role. Between the two groups, no significant difference was detected in terms of their resilience and COVID-19-related anxieties. However, the non-volunteering students reported a significantly higher prevalence of depressive symptoms. Conclusion: Sense of duty and the desire to help were, according to the students, the most important reasons for volunteering. Depressive symptoms and lack of time made volunteering less likely. Resilience and COVID-19-related anxieties do not seem to have had any influence on the decision to volunteer or not.
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Affiliation(s)
- Luisa Mühlbauer
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Johanna Huber
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Martin R. Fischer
- LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM) am LMU Klinikum, München, Germany
| | - Pascal O. Berberat
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
| | - Martin Gartmeier
- Technische Universität München, Fakultät für Medizin, Klinikum rechts der Isar, TUM Medical Education Center, München, Germany
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Erl A, Hauenstein K, Huber J, Leyh H, Weingärtner K, Ebert AK, Waidelich R, Necknig U. Improving Drinking and Micturition Habits in Preschool Children: An Educational Project. Urol Int 2021; 105:993-1001. [PMID: 34237743 DOI: 10.1159/000515993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/15/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Children worldwide often do not drink enough. However, sufficient fluids are essential for physical and cognitive health. A regular and adequate supply of fluids also supports bladder maturation in the context of acquiring urinary continence. We investigated whether training preschool children and their caretakers improves drinking and micturition habits. METHODS This field study in a pre-post design was conducted in 6 kindergartens in the district of Garmisch-Partenkirchen from October 2018 to February 2019. An intervention group (IG) received a 3-day training on drinking and micturition habits and was compared to a control group (CG) without any training. Caretakers (IG + CG) were instructed about drinking and voiding management, too. Behavioral changes were identified by questionnaires. To analyze the long-term effect, group interviews were performed with the IG 3 months after training. The training was evaluated on different levels. RESULTS After training, the estimated total daily fluid intake in the IG (1,160 mL) significantly exceeded that of CG (830 mL) (p = 0.015). In the IG, fluid intake until 12:00 a.m. increased (p = 0.001), children took more time for voiding (p = 0.029), and urgency decreased (p = 0.008). Children (IG + CG) used leg support to enable pelvic floor relaxation more often both at home (p = 0.026) and in kindergarten (p = 0.047). Nocturnal enuresis was reduced by approximately 46% in the IG (p = 0.485). Group interviews in the IG showed a considerable learning effect. CONCLUSION The present study could demonstrate an increased intake of fluids and significant changes in micturition behavior in the IG. So far, this is the first educational project in Germany addressing drinking and voiding management. Our results suggest that a training of preschool children and their caretakers is feasible and effective. Further nationwide research will be needed to confirm our results and assess the need for prevention in these areas.
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Affiliation(s)
- Anna Erl
- Department of Urology and Pediatric Urology, District Hospital Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
| | - Katja Hauenstein
- Department of Urology and Pediatric Urology, District Hospital Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Herbert Leyh
- Department of Urology and Pediatric Urology, District Hospital Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
| | - Karl Weingärtner
- Department of Urology, Pediatric Urology and Robot Assisted Minimally Invasive Urology, Sozialstiftung Bamberg, Hospital Bamberg, Bamberg, Germany
| | - Anne-Karoline Ebert
- Department of Urology and Pediatric Urology, University Hospital Ulm, Ulm, Germany
| | - Raphaela Waidelich
- Department of Urology, University Hospital, Ludwig-Maximilian-University Munich, München, Germany
| | - Ulrike Necknig
- Department of Urology and Pediatric Urology, District Hospital Garmisch-Partenkirchen, Garmisch-Partenkirchen, Germany
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Huber J, Karschuck P, Koch R, Ihrig A, Krones T, Neisius A, Von Ahn S, Klopf C, Weikert S, Siebels M, Haseke N, Weißflog C, Baunacke M, Liske P, Tosev G, Benusch T, Schostak M, Stein J, Spiegelhalder P, Thomas C, Groeben C. Match of Patient Reported Outcome Measures (PROMs) and the urologists’ assessment in non-metastatic prostate cancer: Results from a randomized controlled trial. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01519-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Beyer K, Remmers S, Straten V, Maclennan S, Maclennan S, Willemse P, Herrera R, Omar M, Russell B, Huber J, Kreuz M, Abbott T, Asiimwe A, Briganti A, Van Hemelrijck M, Roobol M. Secondary treatment for men with localized prostate cancer: A pooled analysis of PRIAS and ERSPC-Rotterdam datasets within the PIONEER data platform. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01420-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Flegar L, Baunacke M, Groeben C, Borkowetz A, Kraywinkel K, Eisenmenger N, Thomas C, Huber J. Treatment trends for muscle-invasive bladder cancer in Germany from 2006 to 2018: Increasing case numbers facilitate more high-volume centers. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01201-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Huber J, Karschuck P, Groeben C, Thomas C, Praus F, Miernik A, Gratzke C, Alpers GW, Kriegmair M, Michel MS. Erratum zu: Empowerment für unsere Patienten. Gelebte Innovation im urologischen Alltag. Urologe A 2021; 60:521-522. [PMID: 33835208 DOI: 10.1007/s00120-021-01449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Huber
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - P Karschuck
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - C Groeben
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - C Thomas
- Klinik und Poliklinik für Urologie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - F Praus
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, 79106, Freiburg, Deutschland
| | - A Miernik
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, 79106, Freiburg, Deutschland
| | - C Gratzke
- Medizinische Fakultät, Klinik für Urologie, Universitätsklinikum Freiburg, 79106, Freiburg, Deutschland
| | - Georg W Alpers
- Lehrstuhl für Klinische Psychologie und Biologische Psychologie und Psychotherapie, Fakultät für Sozialwissenschaften, Universität Mannheim, Mannheim, Deutschland
| | - M Kriegmair
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68161, Mannheim, Deutschland
| | - M S Michel
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68161, Mannheim, Deutschland
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Bushuven S, Niebel I, Huber J, Diesener P. Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA). Dysphagia 2021; 37:375-391. [PMID: 33817751 PMCID: PMC8019588 DOI: 10.1007/s00455-021-10289-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/16/2021] [Indexed: 01/10/2023]
Abstract
Introduction Patients suffering from swallowing disorders are experiencing emotional effects like anger, anxiety, and sadness. This may be affecting patient–therapist relation and family functioning. To assess emotional reaction and their influence on family systems, we developed a 55-item questionnaire based on the Atlas of Emotion and the Calgary Family Intervention Model. Methods We recruited more than 160 participants to validate an online survey, namely the Jugendwerk Dysphagia Emotion and Family Assessment Score (JDEFA). Forty-Nine health care workers, patients, and family members completed the survey and provided additional comments regarding interactions of emotions and dysphagia. Analysis was accomplished by non-parametric tests and principal component analyses with Varimax rotation. Additionally, we accomplished a qualitative content analysis taking a phenomenological single-coder approach. Results Analysis revealed a Cronbach’s Alpha of 0.93. Using primary component analyses, justified by a Kaiser–Meyer–Olkin value of 0.81, we identified two main factors (emotion and family). Patients experienced sadness and anger more often than health care providers, whereas family members felt anxiety even more often. Our qualitative analysis revealed 20 themes (7 for anger, 2 enjoyment, 4 sadness, 3 anxiety, 2 disgust, 1 shame, and 1 punishment). Predominantly, the fear of choking was mentioned by patients, whereas professionals reported about the fear of making mistakes. Conclusion The JDEFA is a valid and reliable testing tool for the assessment of swallowing disorders concerning emotional aspects and family functioning. Both factors have a significant role in dysphagia and evaluations should go along with functional assessments and psychological scores for a holistic understanding of swallowing disorders.
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Affiliation(s)
- Stefan Bushuven
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany. .,Institute for Infection Control and Infection Prevention, Healthcare Association Constance (GLKN), Hegau-Bodensee-Hospital, 78315, Radolfzell, Germany. .,Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany.
| | - Isabell Niebel
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany
| | - Johanna Huber
- Institute for Medical Education, University Hospital, LMU Munich, Munich, Germany
| | - Paul Diesener
- Department of Neurorehabilitation, Hegau-Jugendwerk Gailingen, Healthcare Association Constance (GLKN), Gailingen, Germany
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Huber J, Witti M, Schunk M, Fischer MR, Tolks D. The use of the online Inverted Classroom Model for digital teaching with gamification in medical studies. GMS J Med Educ 2021; 38:Doc3. [PMID: 33659608 PMCID: PMC7899094 DOI: 10.3205/zma001399] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/30/2020] [Accepted: 11/19/2020] [Indexed: 05/19/2023]
Abstract
Introduction: In 2014, a newly designed, case-based seminar was successfully implemented in the subjects of health systems, health economics and public health care (GGG). The seminar "The Lonely Patient" is based on a real patient case and deals with the German health care system from the perspective of a patient. In order to create more space for discussion and exchange among students, the seminar was redesigned on the basis of the Inverted Classroom Method (ICM). Project description: Due to the COVID-19 pandemic, new, purely digital teaching formats had to be developed quickly in the sense of Emergency Remote Teaching. Therefore, the Inverted Classroom concept of the seminar was transformed into an online ICM. In order to promote active learning based on the ICAP model (Interactive, Constructive, Active, Passive), the online face-to-face part was designed as a synchronous interactive learner-centered course using the gamified audience response system Kahoot! Results: Evaluation results to date and feedback rounds with students indicate that the online ICM-version of the seminar leads to at least as good evaluation results as the previous face-to-face course. In particular, the students positively emphasize the use of Kahoot! as an activating digital medium. Discussion: Through the use of the ICM and the gamified audience response system Kahoot!, students could be activated in meaningful ways. The resulting discussions about the patient case and teaching content of the quiz questions in the synchronous online course could be implemented just as well as in the classroom-based course of previous semesters. Conclusion: The application of the online ICM, along with the consideration of the ICAP Model, has led to the successful implementation of a digital course within the context of the increased difficulty surrounding the emergency remote teaching. Additionally, students' learning success has remained at a similar level as during traditional classroom-based courses of previous semesters.
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Affiliation(s)
- Johanna Huber
- LMU Klinikum München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
- *To whom correspondence should be addressed: Johanna Huber, LMU Klinikum München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Ziemssenstr. 1, D-80336 Munich, Germany, E-mail:
| | - Matthias Witti
- LMU Klinikum München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Michaela Schunk
- LMU Klinikum München, Klinik und Poliklinik für Palliativmedizin, Munich, Germany
| | - Martin R. Fischer
- LMU Klinikum München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Daniel Tolks
- LMU Klinikum München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
- Leuphana Universität Lüneburg, Zentrum für Gesundheitswissenschaften, Lüneburg, Germany
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Zottmann JM, Horrer A, Chouchane A, Huber J, Heuser S, Iwaki L, Kowalski C, Gartmeier M, Berberat PO, Fischer MR, Weidenbusch M. Isn't here just there without a "t" - to what extent can digital Clinical Case Discussions compensate for the absence of face-to-face teaching? GMS J Med Educ 2020; 37:Doc99. [PMID: 33364378 PMCID: PMC7740012 DOI: 10.3205/zma001392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 06/01/2023]
Abstract
Objective: COVID-19 challenges curriculum managers worldwide to create digital substitutes for classroom teaching. Case-based teaching formats under expert supervision can be used as a substitute for practical bedside teaching, where the focus is on teaching clinical reasoning skills. Methods: For medical students of LMU and TU Munich, the interactive, case-based, and supervised teaching format of Clinical Case Discussion (CCD) was digitised and implemented as dCCD in their respective curricula. Case discussions were realised as videoconferences, led by a student moderator, and took place under the supervision of a board-certified clinician. To prevent passive participation, additional cognitive activations were implemented. Acceptance, usability, and subjective learning outcomes were assessed in dCCDs by means of a special evaluation concept. Results: With regard to acceptance, students were of the opinion that they had learned effectively by participating in dCCDs (M=4.31; SD=1.37). The majority of students also stated that they would recommend the course to others (M=4.23; SD=1.62). The technical implementation of the teaching format was judged positively overall, but findings for usability were heterogeneous. Students rated their clinical reasoning skills at the end of the dCCDs (M=4.43; SD=0.66) as being significantly higher than at the beginning (M=4.33; SD=0.69), with low effect size, t(181)=-2.352, p=.020, d=0.15. Conclusion: Our evaluation data shows that the dCCD format is well-accepted by students as a substitute for face-to-face teaching. In the next step, we plan to examine the extent to which participation in dCCDs leads to an increase in objectively measured clinical reasoning skills, analogous to a face-to-face CCD with on-site attendance.
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Affiliation(s)
- Jan M. Zottmann
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Anna Horrer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Amir Chouchane
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Johanna Huber
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Sonja Heuser
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Lica Iwaki
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Christian Kowalski
- LMU Munich, University Hospital, Department of Anesthesiology, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, School of Medicine, TUM Medical Education Center, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Marc Weidenbusch
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
- LMU Munich, University Hospital, Department of Internal Medicine IV, Munich, Germany
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Baunacke M, Schmidt ML, Groeben C, Borkowetz A, Thomas C, Koch R, Chun F, Weissbach L, Huber J. Treatment of postprostatectomy urinary incontinence and erectile dysfunction: Is there insufficient access to care in Germany? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Tolks D, Romeike BFM, Ehlers J, Kuhn S, Kleinsorgen C, Huber J, Fischer MR, Bohne C, Hege I, Merz L, Sailer M. The online inverted classroom model (oICM). A blueprint to adapt the inverted classroom to an online learning setting in medical and health education. MedEdPublish (2016) 2020; 9:113. [PMID: 38073851 PMCID: PMC10702666 DOI: 10.15694/mep.2020.000113.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
This article was migrated. The article was marked as recommended. The idea of this paper is to offer a blueprint, with that facilitators have a guide to set up a complete digital teaching scenario according to the latest insights of didactical research. The corona pandemic forced higher education institutions all around the world to radically shift their curricula from a mix of face-to-face and remote teaching methods to a fully remote curriculum. Though challenging, this time provides opportunities to implement new educational methods and improve the quality of digital teaching. The classical concept of the inverted classroom was modified to meet the special needs of online settings. The proposed online Inverted Classroom Model (oICM) includes the following phases: (1) pre-phase, (2) self-learning-phase, (3) Synchronous online face-to-face phase, (4) transfer-phase, (5) evaluation. Recommendations and potential tools are provided for each phase. The oICM is an innovative and easy to use approach to shape digital teaching and learning processes during and after the CoVid19 pandemic. This blueprint is developed by the committee "Digitalization" of the German Association for Medical Education (GMA) for facilitators without any prior experience with the ICM, but also for those who already teach in a traditional ICM.
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Affiliation(s)
- Daniel Tolks
- Institute for Medical Education of the University Hospital
- Institute for Medical Education of the University Hospital
| | | | - Jan Ehlers
- Didactics and Educational Research in Health Science
- Didactics and Educational Research in Health Science
| | - Sebastian Kuhn
- Department of Orthopaedics and Traumatology
- Department of Orthopaedics and Traumatology
| | | | - Johanna Huber
- Institute for Medical Education of the University Hospital
- Institute for Medical Education of the University Hospital
| | - Martin R Fischer
- Institute for Medical Education of the University Hospital
- Institute for Medical Education of the University Hospital
| | - Christoph Bohne
- Brandenburg Medical School Theodor Fontane
- Brandenburg Medical School Theodor Fontane
| | - Inga Hege
- Department for Medical Education Sciences
- Department for Medical Education Sciences
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Gartmeier M, Reimer M, Huber J, Epstein N, Fischer MR, Berberat PO. International mobility of students in the medical disciplines from a comparative perspective. GMS J Med Educ 2020; 37:Doc34. [PMID: 32566736 PMCID: PMC7291386 DOI: 10.3205/zma001327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 05/28/2023]
Abstract
Objective: We analyze the extent to which students of human, veterinary and dental medicine complete study-related stays abroad (frequency, type and duration of stays abroad and countries visited). Furthermore, we investigate the possible correlations between completed stays abroad and the duration of studies, the completion of a doctorate and entering professional life. Methods: The data come from a written cross-sectional survey of 742 graduates of their respective study programs at Bavarian universities. The evaluation was carried out using descriptive and inferential statistical methods. Results: Slightly more than half of the surveyed students completed study-associated stays abroad, with notable differences between the three study programs. The students most frequently completed internships abroad lasting an average of nine weeks. Switzerland was the most common country of destination for the stays abroad. Furthermore, there were no or only weak correlations between stays abroad, the duration of studies and progress towards a doctorate or the commencement of professional employment abroad. There were no correlations with the stress experienced as part of initial employment after graduation. Conclusion: The results clearly indicate that stays abroad are quite usual for students in the medical disciplines and are almost standard in the study of human medicine. The selection of the countries visited indicates that the primary goal of the students' stays abroad is to deepen their competence with a view to later employment in their home country.
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Affiliation(s)
- Martin Gartmeier
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maike Reimer
- Bayrisches Staatsinstitut für Hochschulforschung und Hochschulplanung, Munich, Germany
| | - Johanna Huber
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Nurith Epstein
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Martin R. Fischer
- LMU Munich, Hospital University Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, Faculty of Medicine, Hospital rechts der Isar, TUM Medical Education Center, Munich, Germany
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Boughalleb‐M'Hamdi N, Fathallah A, Benfradj N, Mahmoud SB, Ali ABH, Medhioub L, Jaouadi I, Huber J, Jeandel C, Ioos R. First report of citrus black spot disease caused by
Phyllosticta citricarpa
on
Citrus limon
and
C. sinensis
in Tunisia. ACTA ACUST UNITED AC 2020. [DOI: 10.5197/j.2044-0588.2020.041.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- N. Boughalleb‐M'Hamdi
- Laboratoire de PhytopathologieUnité de Recherche UR03AGR13Université de SousseInstitut Supérieur Agronomique de Chott MariemSousseTunisia
| | - A. Fathallah
- Direction Générale de la Santé Végétale et du Contrôle des Intrants AgricolesMinistère de l'Agriculture, des Ressources Hydrauliques et de la PêcheTunisia
| | - N. Benfradj
- Laboratoire de PhytopathologieUnité de Recherche UR03AGR13Université de SousseInstitut Supérieur Agronomique de Chott MariemSousseTunisia
| | - S. Ben Mahmoud
- Direction Générale de la Santé Végétale et du Contrôle des Intrants AgricolesMinistère de l'Agriculture, des Ressources Hydrauliques et de la PêcheTunisia
| | - A. Bel Hadj Ali
- Direction Générale de la Santé Végétale et du Contrôle des Intrants AgricolesMinistère de l'Agriculture, des Ressources Hydrauliques et de la PêcheTunisia
| | - L. Medhioub
- Direction Générale de la Santé Végétale et du Contrôle des Intrants AgricolesMinistère de l'Agriculture, des Ressources Hydrauliques et de la PêcheTunisia
| | - I. Jaouadi
- Direction Générale de la Santé Végétale et du Contrôle des Intrants AgricolesMinistère de l'Agriculture, des Ressources Hydrauliques et de la PêcheTunisia
| | - J. Huber
- Laboratoire de la Santé des Végétaux ‐ Unité de Mycologie Domaine de Pixérécourt ‐ Bât. ECS 40009F54220MalzévilleFrance
| | - C. Jeandel
- Laboratoire de la Santé des Végétaux ‐ Unité de Mycologie Domaine de Pixérécourt ‐ Bât. ECS 40009F54220MalzévilleFrance
| | - R. Ioos
- Laboratoire de la Santé des Végétaux ‐ Unité de Mycologie Domaine de Pixérécourt ‐ Bât. ECS 40009F54220MalzévilleFrance
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Tolks D, Romeike BFM, Ehlers J, Kuhn S, Kleinsorgen C, Huber J, Fischer MR, Bohne C, Merz L, Sailer M, Hege I. The online inverted classroom model (oICM). A blueprint to adapt the inverted classroom to an online learning setting in medical and health education [Version 2]. MedEdPublish 2020. [DOI: 10.15694/mep.2020.000113.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Tolks D, Romeike BFM, Ehlers J, Kuhn S, Kleinsorgen C, Huber J, Fischer MR, Bohne C, Hege I. The online inverted classroom model (oICM). A blueprint to adapt the inverted classroom to an online learning setting in medical and health education [Correction]. MedEdPublish 2020. [DOI: 10.15694/mep.2020.000113.1c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Ben Abdelahfidh L, Huber J, Rojas López F, Glorie C, Vanden Bussche I, Coiret C, Spoel E, Pignard AL, Heymans S, De Bethune X. Access to abortion of undocumented migrants seen by Médecins du Monde in the Humanitarian Hub. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
As of June 2017, the population of the Maximillian Park (an undocumented migrant camp in Brussels) is mainly Eritrean and Sudanese migrants who intend to continue their journey to the United Kingdom (Depraetere, 2017; Daher, 2018). In response to demanding needs, Médecins du Monde together with 8 organisations, created a one-stop service centre, The Humanitarian Hub, in January 2018 to offer a set of basic services to the migrants.
The Hub implemented a voluntary de-medicalized midwifery clinic. The medical team noted an under-representation of women, 40 out of 745 (5,4%), while the coordination team identified a number of complex unwanted pregnancies, many of which relating to violence. Accessing free abortion for undocumented women in Belgium requires the Urgent Medical Assistance certificate. This often takes several weeks, making it unrealistic to obtain in time for an abortion. Accordingly, the women or family planning centres cover the financial cost. The Hub’s midwifery clinic thus focused on building trust with the women, and facilitated referrals to family planning centres.
By taking steps to create a more gender-sensitive Hub, the proportion of women seeking consultations doubled. In 2018, 955 out of 8990 (10,6%) patients were women, totalling 324 midwifery consultations. 65 of these women were pregnant, and the 23 who sought abortion were referred to family planning centres. None had Urgent Medical Assistance.
It is crucial to consider the particularities of a population and their social determinants of health when implementing a holistic system. For instance, focusing on violent experiences in medical consultations can help better understand women’s situation. The coordination between The Hub and family planning centres helped in reducing barriers for migrant women. The project has seen success, thanks to the flexibility of the family planning centres in quickly receiving these pregnant women, and to the four centres who covered abortion costs.
Key messages
It is evident that the magnitude of these women’s situation is undervalued, thus it is important to increase sensitization and advocacy in order to offer them greater support. The Hub has provided a number of services for undocumented migrants, notably abortion, and removed some barriers in accessing care. However, it is a fragile solution to a structural problem.
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Affiliation(s)
| | - J Huber
- Département Santé, Médecins du Monde, Brussels, Belgium
| | - F Rojas López
- Département Santé, Médecins du Monde, Brussels, Belgium
| | - C Glorie
- Département Opérationel, Médecins du Monde, Brussels, Belgium
| | | | - C Coiret
- Département Santé, Médecins du Monde, Brussels, Belgium
| | - E Spoel
- Département Santé, Médecins du Monde, Brussels, Belgium
| | - A-L Pignard
- Département Opérationel, Médecins du Monde, Brussels, Belgium
| | - S Heymans
- Département Opérationel, Médecins du Monde, Brussels, Belgium
| | - X De Bethune
- Département Santé, Médecins du Monde, Brussels, Belgium
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Bugaj TJ, Blohm M, Schmid C, Koehl N, Huber J, Huhn D, Herzog W, Krautter M, Nikendei C. Peer-assisted learning (PAL): skills lab tutors' experiences and motivation. BMC Med Educ 2019; 19:353. [PMID: 31521146 PMCID: PMC6744669 DOI: 10.1186/s12909-019-1760-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/20/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Peer-assisted learning (PAL) is a common teaching and learning method in medical education worldwide. In the setting of skills laboratories (skills labs), student tutors are often employed as an equivalent alternative to faculty teachers. However, to the best of our knowledge, there is a lack of qualitative studies which explore the reasons for the personal commitment of student tutors. The aim of our study was to examine how undergraduate students experienced and evaluated their roles as skills lab student tutors, what their motivation was, and whether social and cognitive congruence played a role in their teaching experiences. METHODS We conducted in-depth, semi-structured interviews with student tutors who were currently teaching in a skills lab. After the interviews had been transcribed verbatim, two independent investigators performed a qualitative content analysis according to Mayring. RESULTS In total, we conducted nine interviews with student tutors. Our results revealed that all student tutors showed great enthusiasm and motivation for their jobs as peer teachers. One of the main motivating factors for student tutors to teach in a skills lab was the possibility to simultaneously share and improve their knowledge and expertise. In general, the participants of our study had high aspirations for their teaching. They found it particularly important to be empathetic with the student learners. At the same time, they thought they would personally benefit from their teaching activities and develop a certain expertise as student tutors. CONCLUSIONS With the present study we are able to gain some insight into what motivates student tutors to teach in a skills lab and what kind of experiences they have. Our results provide an important input for the future training of highly qualified student tutors.
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Affiliation(s)
- T. J. Bugaj
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Blohm
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum Esslingen, Esslingen, Germany
| | - C. Schmid
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - N. Koehl
- Practice Drs./NL Albertus Arends, Heidelberg, Germany
| | - J. Huber
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - D. Huhn
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - W. Herzog
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - M. Krautter
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- Clinic for Kidney, Hypertension and Autoimmune Diseases, Klinikum Stuttgart, Stuttgart, Germany
| | - C. Nikendei
- Department of General Internal and Psychosomatic Medicine, University of Heidelberg Medical Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
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Tolks D, Kiessling C, Wershofen B, Pudritz Y, Schunk M, Härtl A, Fischer MR, Huber J. [Learning from Mistakes using a Case-based Curriculum in Medical Education for Health Systems/health Economics and Public Health Care]. Gesundheitswesen 2019; 82:909-914. [PMID: 31185501 DOI: 10.1055/a-0894-4583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM OF THE STUDY There are hardly any concepts on how to impart knowledge about the own health system to students and to clarify the importance and practical relevance of the topic. The case-based approach and the errors described therein should highlight the relevance of the topic to the medical profession. METHODOLOGY A course concept was developed with focus on the practical relevance of the content to students. This was based on a method mix of game-based learning, case-based and cooperative learning. The seminar describes the path of a cancer patient through health care, an issue which, due to a lack of agreements and other interface problems, is dealt with unsatisfactorily. RESULTS Analyses showed that students (n=1162) had moderate interest in the topic of the seminar during both survey periods. However, they found the method of case-based learning to be good and rated the relevance of the topic as high. CONCLUSIONS The relevance of the topic complex GGG for later professional activity was apparently recognized by the students. The low motivation of the students to engage with this topic could be reduced, as confirmed by reports of the lecturers.
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Affiliation(s)
- Daniel Tolks
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München.,Zentrum fur Angewandte Gesundheitswissenschaften, Leuphana Universität Lüneburg, Lüneburg
| | - Claudia Kiessling
- Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Universität Witten/Herdecke, Witten
| | - Birgit Wershofen
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München
| | - Yvonne Pudritz
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München
| | - Michaela Schunk
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München
| | - Anja Härtl
- Abteilung Medizindidaktik Augsburg, Medizinische Fakultät, Universität Augsburg, Augsburg
| | - Martin R Fischer
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München
| | - Johanna Huber
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der Universität München, LMU München
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Huber J, Woods T, Fushi A, Duong MT, Eidelman AS, Zalal AR, Urquhart O, Colangelo E, Quinn S, Carrasco-Labra A. Social Media Research Strategy to Understand Clinician and Public Perception of Health Care Messages. JDR Clin Trans Res 2019; 5:71-81. [PMID: 31067411 PMCID: PMC6918023 DOI: 10.1177/2380084419849439] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Despite the potential of social media to influence public health and generate
insights, the process of monitoring and analyzing the dissemination of
health care messages on social media has been described as difficult and in
need of improvement. Objectives: The objective of this study was to describe and demonstrate a reproducible
methodology for cataloging and analyzing health care–related social media
comments and provide insight into how clinicians and members of the general
public respond to health care messaging on social media. Methods: We collected social media comments related to the American Dental
Association’s 2016 “Evidence-Based Clinical Practice Guideline for the Use
of Pit-and-Fissure Sealants” between April 10, 2017, and October 31, 2017,
from Facebook, Twitter, LinkedIn, Reddit, and online message boards for the
New York Times, FiveThirtyEight, and Dentaltown. Using
data provided in the comments, we conducted engagement analysis as well as
content, network, and sentiment analysis across 8 categories. Results: We collected 671 comments. Among our findings, Facebook (472 of 671) was the
most popular platform among commentators; almost half of all comments (335
of 671) aligned with the recommendations of the 2016 American Dental
Association sealants guideline; clinicians were more likely than the general
public to like a comment that suggested an improvement to the guideline; and
>75% of comments (521 of 671) were supported by anecdotal evidence. Conclusion: As the prevalence of anecdotes on social media suggests, the likelihood of
falsehoods spreading on social media is high. Insights gleaned from the
methodology described in this research could help combat the spread of such
misinformation by providing disseminators of health care messaging with
insight into their target audiences. Armed with this knowledge,
disseminators can craft health care messages that more effectively engage
clinicians and the general public. Knowledge Transfer Statement: The methodology used in this research provides a reproducible strategy for
tracking social media engagement with health care messages. Engagement
results can assist future delivery of health care messages to key
stakeholders and ensure better implementation and adoption of these
communications.
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Affiliation(s)
- J Huber
- Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - T Woods
- Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - A Fushi
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - M T Duong
- The Center for Advanced Oral Health, Arizona School of Dentistry & Oral Health, Mesa, AZ, USA.,Sundance Dental Care, Phoenix, AZ, USA
| | - A S Eidelman
- School of Dental Medicine, Tufts University, Boston, MA, USA
| | - A R Zalal
- School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - O Urquhart
- Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - E Colangelo
- Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA.,Current affiliation: Center for Dental Practice / Practice Institute, American Dental Association, Chicago, IL, USA
| | - S Quinn
- American Dental Association, Chicago, IL, USA.,Current affiliation: Walgreens, Deerfield, IL, USA
| | - A Carrasco-Labra
- Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
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Zemp M, Huss M, Thibert E, Eckert N, McNabb R, Huber J, Barandun M, Machguth H, Nussbaumer SU, Gärtner-Roer I, Thomson L, Paul F, Maussion F, Kutuzov S, Cogley JG. Global glacier mass changes and their contributions to sea-level rise from 1961 to 2016. Nature 2019; 568:382-386. [PMID: 30962533 DOI: 10.1038/s41586-019-1071-0] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/24/2019] [Indexed: 11/09/2022]
Abstract
Glaciers distinct from the Greenland and Antarctic ice sheets cover an area of approximately 706,000 square kilometres globally1, with an estimated total volume of 170,000 cubic kilometres, or 0.4 metres of potential sea-level-rise equivalent2. Retreating and thinning glaciers are icons of climate change3 and affect regional runoff4 as well as global sea level5,6. In past reports from the Intergovernmental Panel on Climate Change, estimates of changes in glacier mass were based on the multiplication of averaged or interpolated results from available observations of a few hundred glaciers by defined regional glacier areas7-10. For data-scarce regions, these results had to be complemented with estimates based on satellite altimetry and gravimetry11. These past approaches were challenged by the small number and heterogeneous spatiotemporal distribution of in situ measurement series and their often unknown ability to represent their respective mountain ranges, as well as by the spatial limitations of satellite altimetry (for which only point data are available) and gravimetry (with its coarse resolution). Here we use an extrapolation of glaciological and geodetic observations to show that glaciers contributed 27 ± 22 millimetres to global mean sea-level rise from 1961 to 2016. Regional specific-mass-change rates for 2006-2016 range from -0.1 metres to -1.2 metres of water equivalent per year, resulting in a global sea-level contribution of 335 ± 144 gigatonnes, or 0.92 ± 0.39 millimetres, per year. Although statistical uncertainty ranges overlap, our conclusions suggest that glacier mass loss may be larger than previously reported11. The present glacier mass loss is equivalent to the sea-level contribution of the Greenland Ice Sheet12, clearly exceeds the loss from the Antarctic Ice Sheet13, and accounts for 25 to 30 per cent of the total observed sea-level rise14. Present mass-loss rates indicate that glaciers could almost disappear in some mountain ranges in this century, while heavily glacierized regions will continue to contribute to sea-level rise beyond 2100.
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Affiliation(s)
- M Zemp
- Department of Geography, University of Zurich, Zurich, Switzerland.
| | - M Huss
- Laboratory of Hydraulics, Hydrology and Glaciology (VAW), ETH Zurich, Zurich, Switzerland.,Department of Geosciences, University of Fribourg, Fribourg, Switzerland
| | - E Thibert
- Université Grenoble Alpes, Irstea, UR ETGR, Grenoble, France
| | - N Eckert
- Université Grenoble Alpes, Irstea, UR ETGR, Grenoble, France
| | - R McNabb
- Department of Geosciences, University of Oslo, Oslo, Norway
| | - J Huber
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - M Barandun
- Department of Geosciences, University of Fribourg, Fribourg, Switzerland
| | - H Machguth
- Department of Geography, University of Zurich, Zurich, Switzerland.,Department of Geosciences, University of Fribourg, Fribourg, Switzerland
| | - S U Nussbaumer
- Department of Geography, University of Zurich, Zurich, Switzerland.,Department of Geosciences, University of Fribourg, Fribourg, Switzerland
| | - I Gärtner-Roer
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - L Thomson
- Department of Geography and Planning, Queen's University, Kingston, Ontario, Canada
| | - F Paul
- Department of Geography, University of Zurich, Zurich, Switzerland
| | - F Maussion
- Department of Atmospheric and Cryospheric Sciences, University of Innsbruck, Innsbruck, Austria
| | - S Kutuzov
- Department of Glaciology, Institute of Geography, Russian Academy of Sciences, Moscow, Russia
| | - J G Cogley
- Department of Geography, Trent University, Peterborough, Ontario, Canada
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Drouin O, Johnson JA, Chaemsaithong P, Metcalfe A, Huber J, Schwarzenberger J, Winters E, Stavness L, Tse AWT, Lu J, Lim WT, Leung TY, Bujold E, Sahota D, Poon LC. Transverse technique: complementary approach to measurement of first-trimester uterine artery Doppler. Ultrasound Obstet Gynecol 2018; 52:639-647. [PMID: 28976627 DOI: 10.1002/uog.18917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/06/2017] [Accepted: 09/13/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To define a protocol for the first-trimester assessment of uterine artery pulsatility index (UtA-PI) using the new transverse technique, to evaluate UtA-PI measured using the transverse approach vs that obtained using the conventional sagittal approach and to determine if accelerated onsite training (in both methods) of inexperienced sonographers can achieve reproducible UtA-PI measurements comparable with those obtained by an experienced sonographer. METHODS This was a prospective observational study of women with a singleton pregnancy attending for routine combined first-trimester screening at 11 to 13 + 6 weeks' gestation. The study consisted of two parts, each conducted at a different center (Part 1 in Calgary, Canada and Part 2 in Hong Kong). In Part 1, UtA-PI measurements were performed using the transverse and sagittal techniques by four sonographers trained in both methods, in 10 cases each, and measurement indices (PI), time required and subjective difficulty in obtaining satisfactory measurements were compared. The one sample t-test and Wilcoxon signed rank test were used when appropriate. Bland-Altman plots were used to assess measurement agreement, and intraclass correlation coefficient (ICC) was used to evaluate measurement reliability. A target plot was used to assess measures of central tendency and dispersion. In Part 2, one experienced and three inexperienced sonographers prospectively measured UtA-PI using both approaches in 42 and 35 women, respectively. Inexperienced sonographers underwent accelerated onsite training by the experienced sonographer. Measurement approach and sonographer order were on a random basis. ICC, Bland-Altman and Passing-Bablok analyses were performed to assess measurement agreement and reliability and effect of accelerated training. RESULTS In Part 1, no difference was observed between the two techniques in mean time to acquire the measurements (118 s for sagittal vs 106 s for transverse; P = 0.38). The four sonographers reported that the transverse technique was subjectively easier to perform (P = 0.04). Bias and ICC for mean UtA-PI between sagittal and transverse measurements were -0.05 (95% limits of agreement, -0.48 to 0.37) and 0.94, respectively. Measurements obtained using the transverse technique after correcting for gestational age were significantly closer to the expected distribution than those obtained using the sagittal technique. In Part 2, there were no significant differences in median UtA-PI measured using the different approaches for both experienced and inexperienced sonographers (P > 0.05 for all sonographers). Mean UtA-PI measurement reliability between approaches was high for the experienced (ICC = 0.92) and inexperienced (ICC > 0.80) sonographers. UtA-PI measurement approaches did not deviate from linearity, while bias ranged from -0.10 to 0.07. The median time required was similar between the techniques (56.1 s for sagittal vs 49.3 s for transverse; P = 0.054). CONCLUSIONS This novel transverse approach for the measurement of UtA-PI in the first trimester appears to be comparable with the sagittal approach in terms of reliability, reproducibility and time required, and may be easier to perform. Providing accelerated onsite training can be helpful for improving the reliability of UtA-PI measurements and could potentially facilitate the broad implementation of first-trimester pre-eclampsia screening. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- O Drouin
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynaecology, Université Laval, Québec, Canada
| | - J-A Johnson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - P Chaemsaithong
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - A Metcalfe
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - J Huber
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - J Schwarzenberger
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - E Winters
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - L Stavness
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| | - A W T Tse
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - J Lu
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - W T Lim
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - T Y Leung
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - E Bujold
- Department of Obstetrics and Gynaecology, Université Laval, Québec, Canada
| | - D Sahota
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | - L C Poon
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
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Sherriff N, Huber J, McGlynn N, Llewellyn C, Folch C, Lorente N, Marcus U, Cawley C, Panochenko O, Dutarte M. The European Community Health Worker Online Survey (ECHOES). Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Sherriff
- School of Health Sciences, University of Brighton, Brighton, UK
| | - J Huber
- School of Health Sciences, University of Brighton, Brighton, UK
| | - N McGlynn
- School of Environment & Technology, University of Brighton, Brighton, UK
| | - C Llewellyn
- Brighton and Sussex Medical School, Brighton, UK
| | - C Folch
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Barcelona, Spain
| | - N Lorente
- Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Barcelona, Spain
| | - U Marcus
- Robert Koch Institute, Berlin, Germany
| | - C Cawley
- Robert Koch Institute, Berlin, Germany
| | | | - M Dutarte
- European Aids Treatment Group, Brussels, Belgium
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Dati F, Barthels M, Conard J, Flückiger J, Girolami A, Hänseler E, Huber J, Keller F, Kolde HJ, Müller-Berghaus G, Samama M, Thiel W. Multicenter Evaluation of a Chromogenic Substrate Method for Photometric Determination of Prothrombin Time. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1646005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryA multicenter study of a chromogenic substrate method for photometric determination of prothrombin time was conducted in order to evaluate its clinical application. Seven laboratories pailicipaled in the study using a total of 742 plasma samples from 417 patients on oral anticoagulant therapy, 261 healthy subjects and 64 patients with different diseases especially of the liver as well as 30 patients with hereditary deficiency of coagulation factors II, V, VII, X. The chromogenic PT method was compared to a standardized coagulometric PT assay which uses the same sensitive human placenta thromboplastin calibrated against international reference preparations. A high correlation of the prothrombin ratio values of the chromogenic and the coagulometric assay was obtained in 402 plasma samples (r = 0.940; y = 1.02x − 0.1). The study showed that the chromogenic PT reagent is sensitive to deficiency of the coagulation factors of the extrinsic pathway but not affected by heparin up to 1 IU/ml because of the heparin antagonist added. The precision (coefficient of variation) of the photometric method ranged between 0.6 and 3% (intraassay CV) and between 1.4 and 5.8 (interassay CV). The International Sensitivity Index (ISI) obtained for the used lot was 1.09. The therapeutical range in percentage activity for patients in a stable phase of an anticoagulant therapy was found to be from 15 to 27 percent of normal. The results of the clinical evaluation proved the good comparability of the new chromogenic PT test with coagulometric methods, its high factor sensitivity, good reproducibility and easy performance.
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Affiliation(s)
- F Dati
- The Research Laboratories of Behringwerke AG, Marburg, Germany
| | - M Barthels
- The Dept. of Hematology and Oncology, University Medical School, Hannover, Germany
| | - J Conard
- The Laboratoire Central d’Hematologie, Hôtel-Dieu Hospital, Paris, France
| | - J Flückiger
- The Central Laboratory of Clinical Chemistry, University Hospital Zürich, Switzerland
| | - A Girolami
- The Istituto di Semeiotica Medica, University of Padua, Padua, Italy
| | - E Hänseler
- The Central Laboratory of Clinical Chemistry, University Hospital Zürich, Switzerland
| | - J Huber
- The Central Laboratory of the Medical University Clinic, Würzburg, Germany
| | - F Keller
- The Central Laboratory of the Medical University Clinic, Würzburg, Germany
| | - H -J Kolde
- The Research Laboratories of Behringwerke AG, Marburg, Germany
| | - G Müller-Berghaus
- The Clinical Research Unit for Blood Coagulation and Thrombosis, Max-Planck-Gesellschaft, Giessen, Germany
| | - M Samama
- The Laboratoire Central d’Hematologie, Hôtel-Dieu Hospital, Paris, France
| | - W Thiel
- The Clinical Research Unit for Blood Coagulation and Thrombosis, Max-Planck-Gesellschaft, Giessen, Germany
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Epstein N, Huber J, Gartmeier M, Berberat PO, Reimer M, Fischer MR. Investigation on the acquisition of scientific competences during medical studies and the medical doctoral thesis. GMS J Med Educ 2018; 35:Doc20. [PMID: 29963610 PMCID: PMC6022582 DOI: 10.3205/zma001167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/12/2017] [Accepted: 01/26/2018] [Indexed: 05/30/2023]
Abstract
Background: Not only the amount of research related contents in German medical studies are objects of criticism, but also the medical doctoral thesis. However, the question which research competences are truly acquired within medical school and the doctoral phase is empirically open, and is thus pursued in the following research study. Methods: We used data from the Bavarian Medical Graduate Panel Survey (MediBAP) (N=455), where respondents assessed their own research competences. To consolidate the data, we analysed qualitative interviews with doctoral medical graduates and students from the E-Prom study (N=14). Results: The quantitative analyses show that medical graduates evaluate the medical curriculum's research contents and their acquired competences as rather low. Doctoral graduates rate their competence of pursuing research independently higher than medical graduates who have not finished their doctorate. The qualitative analyses are in line with these results, as they point to the predominant development of competences during the doctoral phase. Despite this clearly positive trend, the majority of the respondents don't feel confident enough to undertake research independently also after attaining their doctoral degree. Conclusion: The results of this study emphasize the need for a more systematic and targeted mediation and review of research competences within the regular medical curriculum.
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Affiliation(s)
- Nurith Epstein
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Johanna Huber
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
| | - Martin Gartmeier
- Technical University of Munich, University Hospital Rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O. Berberat
- Technical University of Munich, University Hospital Rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Maike Reimer
- Bavarian State Institute for Higher Education Research and Planning (IHF), Munich, Germany
| | - Martin R. Fischer
- LMU Munich, University Hospital, Institute for Medical Education, Munich, Germany
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Lisiński P, Huber J, Samborski W, Witkowska A. Neurophysiological Assessment of the Electrostimulation Procedures Used in Stroke Patients during Rehabilitation. Int J Artif Organs 2018; 31:76-86. [DOI: 10.1177/039139880803100111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the effectiveness of the associated electrotherapeutical and kinesiotherapeutical treatment in patients after ischemic stroke (N=24), mainly by means of neurophysiological tests. All patients underwent the same 20 days of neurorehabilitation procedures. Particular attention was paid to three-stage modified electrotherapy procedures such as: oververtebral functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS) and the alternate neuromuscular functional electrical stimulation (NMFES) of antagonistic muscles of the wrist and the ankle (N=16). Electrotherapy was supplemented with kinesiotherapeutic (mainly PNF) procedures acting as an amplifier. Clinical assessment included muscle tension (Ashworth's scale), muscle force (Lovett's scale) and reflex scoring at wrist and ankle. However, the effectiveness of the procedures was measured by the assessment of results in complex and repetitive, bilaterally performed global electromyography (EMG) and electroneurography (ENG; M-wave studies). The statistical analysis obtained from results in clinical and neurophysiological examinations suggested that the dorsiflexion of wrist and ankle was improved in the majority of patients who took part in this study. EMG and ENG examinations showed that 20 days of therapy improved both activity in muscle motor units on the more paralyzed side (mainly within upper extremities) and to a lesser degree in the transmission of efferent impulses within motor fibers of nerves. The results obtained suggest that patients after ischemic strokes never show an isolated unilateral disability in motor functions. No definite similarities between the results of clinical and neurophysiological studies were found, which may suggest greater accuracy of the neurophysiological evaluation.
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Affiliation(s)
- P. Lisiński
- Clinic for Physiotherapy, Rheumatology and Rehabilitation, Wiktor Dega Clinical Orthopedic and Rehabilitation Hospital No 4, Karol Marcinkowski University of Medicine in Poznań - Poland
| | - J. Huber
- Department of Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopedic and Rehabilitation Hospital No 4, Karol Marcinkowski University of Medicine in Poznań - Poland
| | - W. Samborski
- Clinic for Physiotherapy, Rheumatology and Rehabilitation, Wiktor Dega Clinical Orthopedic and Rehabilitation Hospital No 4, Karol Marcinkowski University of Medicine in Poznań - Poland
| | - A. Witkowska
- Department of Pathophysiology of Locomotor Organs, Wiktor Dega Clinical Orthopedic and Rehabilitation Hospital No 4, Karol Marcinkowski University of Medicine in Poznań - Poland
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Baunacke M, Groeben C, Borgmann H, Salem J, Kliesch S, Huber J. Andrology on the Internet: Most wanted, controversial and often primary source of information for patients. Andrologia 2017; 50. [DOI: 10.1111/and.12877] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- M. Baunacke
- Department of Urology; TU Dresden; Dresden Germany
| | - C. Groeben
- Department of Urology; TU Dresden; Dresden Germany
| | - H. Borgmann
- Department of Urology; University Hospital Mainz; Mainz Germany
| | - J. Salem
- Department of Urology; University Hospital Cologne; Cologne Germany
| | - S. Kliesch
- Centre of Andrology and Reproductive Medicine; University of Muenster; Muenster Germany
| | - J. Huber
- Department of Urology; TU Dresden; Dresden Germany
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Phan J, Jegathesan T, Dunlap H, Young E, Huber J, Minhas R. EXPLORING THE ROLE OF COMMUNITY AGENCY EMPLOYEES WHEN ACTING AS PRIMARY POINT OF CARE CONTACTS FOR FAMILIES OF CHILDREN WITH SUSPECTED DEVELOPMENTAL DISABILITIES IN TORONTO ONTARIO. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ho K, Jegathesan T, Fung K, Young E, Minhas R, Huber J. ANTICIPATORY GUIDANCE FOR THE PREVENTION OF PEDIATRIC DEATHS DUE TO HEAT STROKE CAUSED BY BEING LEFT UNATTENDED IN VEHICLES. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Young E, Loveday S, Fung KCK, Green L, Barozzino T, Minhas R, Huber J, Milligan K. A NEW MODEL OF INTEGRATED CARE: DEVELOPMENTAL OUTREACH WITHIN A FAMILY HEALTH TEAM PRACTICE. Paediatr Child Health 2017. [DOI: 10.1093/pch/pxx086.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aditya S, Humer E, Pourazad P, Khiaosa-Ard R, Huber J, Zebeli Q. Intramammary infusion of Escherichia coli lipopolysaccharide negatively affects feed intake, chewing, and clinical variables, but some effects are stronger in cows experiencing subacute rumen acidosis. J Dairy Sci 2016; 100:1363-1377. [PMID: 27939552 DOI: 10.3168/jds.2016-11796] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/07/2016] [Indexed: 12/29/2022]
Abstract
Feeding high-grain diets increases the risk of subacute rumen acidosis (SARA) and adversely affects rumen health. This condition might impair the responsiveness of cows when they are exposed to external infectious stimuli such as lipopolysaccharide (LPS). The main objective of this study was to evaluate various responses to intramammary LPS infusion in healthy dairy cows and those experimentally subjected to SARA. Eighteen early-lactating Simmental cows were subjected to SARA (n = 12) or control (CON; n = 6) feeding conditions. Cows of the control group received a diet containing 40% concentrates (DM basis) throughout the experiment. The intermittent SARA feeding regimen consisted in feeding the cows a ration with 60% concentrate (DM basis) for 32 d, consisting of a first SARA induction for 8 d, switched to the CON diet for 7 d, and re-induction during the last 17 d. On d 30 of the experiment, 6 SARA (SARA-LPS) and 6 CON (CON-LPS) cows were intramammary challenged once with a single dose of 50 μg of LPS from Escherichia coli (O26:B6), whereas the other 6 SARA cows (SARA-PLA) received 10 mL of sterile saline solution as placebo. To confirm the induction of SARA, the reticular pH was continuously monitored via wireless pH probes. The DMI remained unchanged between SARA and CON cows during the feeding experiment, but was reduced in both treatment groups receiving the LPS infusion compared with SARA-PLA, whereby a significant decline was observed for cows of the SARA-LPS treatment (-38%) compared with CON-LPS (-19%). The LPS infusion did not affect the reticuloruminal pH dynamics, but significantly enhanced ruminal temperature and negatively affected chewing behavior. The ruminal temperature increased after the LPS infusion and peaked about 1 h earlier in SARA-LPS cows compared with the cows of the CON-LPS treatment. Moreover, a significant decline in milk yield was found in SARA-LPS compared with CON-LPS following the LPS infusion. Cows receiving LPS had elevated somatic cell counts, protein, and fat contents in milk as well as decreased lactose contents and pH following the LPS infusion, whereby the changes in milk constituents were more pronounced in SARA-LPS than CON-LPS cows. Rectal temperature and pulse rate were highest 6 h after LPS infusion, but rumen contractions were not affected by the LPS infusion. The data suggest that a single intramammary LPS infusion induced fever and negatively affected feed intake, chewing activity, rectal temperature, and milk yield and composition, whereby these effects were more pronounced in SARA cows.
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Affiliation(s)
- S Aditya
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria; Directorate General of Human Resource for Science, Technology, and Higher Education-Indonesia, 10270 Jakarta, Indonesia
| | - E Humer
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - P Pourazad
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - R Khiaosa-Ard
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - J Huber
- University Clinic for Ruminants, Clinical Unit for Herd Health Management in Ruminants, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Q Zebeli
- Institute of Animal Nutrition and Functional Plant Compounds, Department for Farm Animals and Veterinary Public Health, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210 Vienna, Austria.
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Ware E, Patterson M, Smith T, Halsey L, Huber J, Reeves S. Does manipulation of breakfast behaviour effect reported level of pre-prandial hunger and serum ghrelin levels? Appetite 2016. [DOI: 10.1016/j.appet.2016.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Idler N, Huber J, von Mutius S, Welbergen L, Fischer MR. Prevention and health promotion from theory to practice: The interprofessional MeMPE Summer University for students of Medicine, Master of Public Health and Epidemiology. GMS J Med Educ 2016; 33:Doc72. [PMID: 27990468 PMCID: PMC5135415 DOI: 10.3205/zma001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/27/2016] [Accepted: 08/27/2016] [Indexed: 06/06/2023]
Abstract
Objective: During the 2015 summer semester of Munich's Ludwig Maximilian University (LMU) medical school, the pilot project "MeMPE Summer University - An Interprofessional Seminar on Prevention and Health Promotion" was implemented as a compulsory elective subject. In 90 teaching units of 45 minutes each, 20 students from the degree programs of Medicine, Master of Public Health and Master of Science Epidemiology (MeMPE) completed modules in theoretical introduction, scientific project work as well as practical assignments and conference attendance. Methods: The project was evaluated by students using pre- and post-project questionnaires (26 and 57 items, evaluated on a Five-level Likert scale of 1="fully agree" to 5="fully disagree"). The evaluation interviews of the instruction participants were recorded, transcribed and analyzed according to Mayring's qualitative content analysis. Results: Questionnaire response rate was 100 %. In pre/post comparison, the students reported an improvement in factual knowledge (pre median=3.0; post median=2.0; p<0.0001), in scientific work (pre median=3.0; post median=1.0; p<0.0001) and in interprofessional work (pre median=2.0; post median=1.0; p=0.024). In 18 interviews, the instructors largely expressed their motivation to participate in the project again. Conclusion: The MeMPE Summer University can serve as an example of best practice for interprofessional communication of prevention and health-promotion topics in theory and practice. The evaluation results show that the project enjoyed a high level of acceptance among students and instructors, and that it should be conducted in a revised version again in 2016.
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Affiliation(s)
- Nadja Idler
- LMU Munich, Medical Faculty, Support Program Lehre@LMU, Munich, Germany
| | - Johanna Huber
- University Hospital of LMU Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
| | - Sabine von Mutius
- LMU Munich, Medical Faculty, Institute for Information Processing, Biometry and Epidemiology, Munich, Germany
| | - Lena Welbergen
- University Hospital of LMU Munich, Dr. von Haunersches Children's Hospital, Munich, Germany
| | - Martin R. Fischer
- University Hospital of LMU Munich, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany
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Huber J, Pötsch B, Gantschacher M, Templ M. Routine Treatment of Cervical Cytological Cell Changes: Diagnostic Standard, Prevention and Routine Treatment of Cervical Cytological Cell Changes - An Assessment of Primary and Secondary Prevention and Routine Treatment Data in the Context of an Anonymous Data Collection from Practicing Gynaecologists; an Academic, Non-Interventional Study. Geburtshilfe Frauenheilkd 2016; 76:1086-1091. [PMID: 27761030 DOI: 10.1055/s-0042-105286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Introduction: Diagnosis and treatment of vaginal and cervical cytological cell changes are described in European and national guidelines. The aim of this data collection was to evaluate the remission rates of PAP III and PAP III D cytological findings in patients over a period of 3-4 months. Method: The current state of affairs in managing suspicious and cytological findings (PAP III, and III D) in gynecological practice was assessed in the context of a data collection survey. An evaluation over a period of 24 months was conducted on preventative measures, the occurrence and changes to normal/suspect/pathological findings and therapy management (for suspicious or pathological findings). Results: 307 female patients were included in the analysis. At the time of the survey 186 patients (60.6 %) had PAP III and 119 (38.8 %) had PAP III D findings. The spontaneous remission rate of untreated PAP III patients was 6 % and that of untreated PAP III D patients was 11 %. The remission rates of patients treated with a vaginal gel were 77 % for PAP III and 71 % for PAP III D. Conclusion: A new treatment option was used in gynecological practice on patients with PAP III and PAP III D findings between confirmation and the next follow-up with excellent success.
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Affiliation(s)
- J Huber
- ANISNet Academic Non-Interventional Study Net; Specialist in Gynecology and Obstetrics, Vienna, Austria
| | - B Pötsch
- Specialist in Gynecology and Obstetrics, Leibnitz, Austria
| | - M Gantschacher
- Head of Department of Health Legislation and Health Science, and WHO Austrian Drug Monitoring Center, Sigmund Freud Private University, Vienna; Assistant Director of the ESQH Vienna Office, Vienna, Austria
| | - M Templ
- Data-analysis OG, Vienna, Austria
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