Notes

Structural Reason for Regulation of the MmpL Transporters involving Mycobacterium t . b.
Although high activity is a risk factor for graft failure after anterior cruciate ligament (ACL) reconstruction, the risk factors for postoperative laxity after ACL reconstruction in recreational athletes are unknown.

We enrolled 91 patients (40 males, 51 females; mean age 29.2years; mean follow-up 4.3years) who scored≤6 on the Tegner activity scale, underwent double-bundle ACL reconstruction between 2010 and 2018, and did not experience re-injury. In the stable group (75 patients, <3.0mm side-to-side difference (SSD) in anterior translation, grade 0 or 1 pivot shift 1year after surgery) and unstable group (16 patients, ≥3.0mm SSD, ≥grade 2 pivot shift), multivariate logistic regression analyses adjusted for factors showing P≤0.3 on univariate analysis assessed risk factors for graft laxity. Lysholm score and graft intensity on MRI (Howell grade) were compared at final follow-up.

Mean SSD in anterior translation was 0.7mm (stable group) and 3.3mm (unstable group). Pivot shift grades were 0 (88%) and 1 (12%) in the stable group, and 0 (12.5%), 1 (50%), and 2 (37.5%) in the unstable group. Multivariate regression analyses showed that younger age and knee hyperextension were significant risk factors for graft laxity (P=0.018 and 0.0016; cutoffs 18years old and 8°, respectively). Lysholm scores in both groups were comparable, but graft intensity on MRI demonstrated significantly worse Howell grade in the unstable group (P=0.002).

Younger age and knee hyperextension were risk factors for postoperative graft laxity without re-injury in recreational athletes.
Younger age and knee hyperextension were risk factors for postoperative graft laxity without re-injury in recreational athletes.
High-fidelity clinical simulation has implied a revolution in health science training. Despite its benefits, some drawbacks could hinder the learning process, especially the anxiety produced during such scenarios.

The aim of the present work is to develop a predictive model capable of determining which students will present high levels of anxiety.

We performed a randomized, sham-controlled, blinded trial in which students were randomly assigned to four scenarios and played one of two possible roles.

Before and after the simulation we assessed the anxiety level along with physiological and analytical parameters. The main analyzed outcome was an increase of ≥25% in anxiety compared with baseline.

The type of scenario or the role played had no effect on anxiety. The predictive model presented an Area Under the Receiver Operating Characteristics of 0.798 (95% CI 0.69-0.90; p<0.001), with age and systolic blood pressure being protective factors against anxiety.

Our results showed that the anxiety level developed during simulation could be predicted. The application of this predictive model when associated to appropriate techniques to deal with increased anxiety levels could improve the learning process of medical students during simulations.
Our results showed that the anxiety level developed during simulation could be predicted. The application of this predictive model when associated to appropriate techniques to deal with increased anxiety levels could improve the learning process of medical students during simulations.
Smartphones are technological devices that have a great impact on people's daily lives changing their habits and behaviors. The utilities and capabilities of these devices are increasing and the foresight is that this tendency will grow in the next years. However, the problematic use of the smartphone has increased dangerously, interfering with the clinical practice of healthcare professionals.

To conduct a systematic review and a meta-analysis to estimate the prevalence of smartphone addiction, also known as nomophobia, in nursing students and to identify its related factors and its negative effects.

Systematic Review and Meta-analysis.

The literature search was done in CINAHL, Proquest, Pubmed, Scopus and Web of Science databases.

The search equation was "(nomophobia OR smartphone) AND nurs* student*". n=16 articles were identified.

The meta-analytic estimation of nomophobia or smartphone addiction was 22% (CI95% 18%-26%] in a sample of n=2780 nursing students. DBZ inhibitor Smartphone usability is very extended during the clinical practice by nursing students. They indicated using the device or watching other students distracted with their smartphone. Some variables related to excessive use in nursing students are lower sleep quality, lower self-esteem, higher social distress, lower perceived social support or lower communication skills between others.

The main use of the smartphone by nursing students is for communication with other people and some of them indicate that it can be a distraction.
The main use of the smartphone by nursing students is for communication with other people and some of them indicate that it can be a distraction.Students on clinical placement may encounter practice that deviates from what they perceive to be evidence-based. However, queries by students about the evidence-base of their clinical educators decision-making and practice can be a challenging conversation to initiate. It is unclear how these conversations occur, and what impact engaging in these challenging conversations may have on practice, the learning experience, and the relationship with the educator. This study sought to explore clinical educators' experiences of student-initiated discussions that question the evidence-base of their clinical practice. And to identify their preferred approaches for students to initiate these conversations. Individual interviews were conducted with 23 clinical educators from five professions at three different hospitals in Victoria, Australia. Semi-structured interviewing techniques were employed to identify participants' context and experiences. Participants described student-initiated conversations about deviations from evidence-based practice as challenging encounters with potential for positive or negative impact on clinical educators, students and patients. They noted that the perceived appropriateness of the discussion could be influenced by the method utilised by students to initiate the conversation. Elements identified by clinical educators as barriers or enablers to support students to appropriately initiate conversations about clinical practice may be utilised by education and health providers to enhance opportunities for learning conversations to occur.
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