Train-the-trainer: E-learning zur Förderung einer praxisorientiertem Vermittlung von evidenzbasierter Medizin

Hintergrund: Trotz ihrer Etablierung als essentieller Bestandteil der medizinischen Weiter-/Fortbildung werden europa- wie schweizweit kaum Kurse in evidenzbasierter Medizin (ebm) angeboten, die - integriert im klinischen Alltag - gezielt Fertigkeiten in ebm vermitteln. Noch grössere Defizite finden sich bei ebm- Weiterbildungsmöglichkeiten für klinische Ausbilder (z.B. Oberärzte). Als Weiterführung eines EU-finanzierten, klinisch integrierten E-learning- Programms für Weiterbildungsassistenten (www.ebm-unity.org) entwickelte eine europäische Gruppe von medical educators gezielt für Ausbilder ein e-learning-Curriculum zur Vermittlung von ebm im Rahmen der klinischen Weiterbildung. Methode: Die Entwicklung des Curriculums umfasst folgende Schritte: Beschreibung von Lernzielen, Identifikation von klinisch relevanten Lernumgebungen, Entwicklung von Lerninhalten und exemplarischen didaktischen Strategien, zugeschnitten auf die jeweilige Lernumgebungen, Design von web-basierten Selbst-Lernsequenzen mit Möglichkeiten zur Selbstevaluation, Erstellung eines Handbuchs. Ergebnisse: Lernziele des Tutoren-Lehrgangs sind der Erwerb von Fertigkeiten zur Vermittlung der 5 klassischen ebm-Schritte: PICO- (Patient-Intervention-Comparison-Outcome)-Fragen, Literatursuche, kritische Literaturbewertung, Übertragung der Ergebnisse im eigenen Setting und Implementierung). Die Lehrbeispiele zeigen angehenden ebm-Tutoren, wie sich typische klinische Situationen wie z.B. Stationsvisite, Ambulanzsprechstunde, Journalclub, offizielle Konferenzen, Audit oder das klinische Assessment von Weiterbildungsassistenten gezielt für die Vermittlung von ebm nutzen lassen. Kurze E-Learning-Module mit exemplarischen «real-life»-Video-Clips erlauben flexibles Lernen zugeschnitten auf das knappe Zeitkontingent von Ärzten. Eine Selbst-Evaluation ermöglicht die Überprüfung der gelernten Inhalte. Die Pilotierung des Tutoren-Lehrgangs mit klinisch tätigen Tutoren sowie die Übersetzung des Moduls in weitere Sprachen sind derzeit in Vorbereitung. chlussfolgerung: Der modulare Train-the-Trainer-Kurs zur Vermittlung von ebm im klinischen Alltag schliesst eine wichtige Lücke in der Dissemination von klinischer ebm. Webbasierte Beispiele mit kurzen Sequenzen demonstrieren typische Situationen zur Vermittlung der ebm-Kernfertigkeiten und bieten medical educators wie Oberärzten einen niedrigschwelligen Einstieg in «ebm» am Krankenbett. Langfristiges Ziel ist eine europäische Qualifikation für ebm- Learning und -Teaching in der Fort- und Weiterbildung. Nach Abschluss der Evaluation steht das Curriculum interessierten Personen und Gruppen unter «not-for-profit»-Bedingungen zur Verfügung. Auskünfte erhältlich von rkunz@uhbs.ch. Finanziert durch die Europäische Kommission - Leonardo da Vinci Programme - Transfer of Innovation - Pilot Project for Lifelong Learn- ing 2007 und das Schweizerische Staatssekretariat für Bildung und Forschung.

Implementing statistical learning methods through Bayesian networks (Part 2): bayesian evaluations for results of black toner analyses in forensic document examination

This paper presents and discusses the use of Bayesian procedures - introduced through the use of Bayesian networks in Part I of this series of papers - for 'learning' probabilities from data. The discussion will relate to a set of real data on characteristics of black toners commonly used in printing and copying devices. Particular attention is drawn to the incorporation of the proposed procedures as an integral part in probabilistic inference schemes (notably in the form of Bayesian networks) that are intended to address uncertainties related to particular propositions of interest (e.g., whether or not a sample originates from a particular source). The conceptual tenets of the proposed methodologies are presented along with aspects of their practical implementation using currently available Bayesian network software.

Cap a una definició inclusiva de l'e-learning

Peer-reviewed

An electronic voting platform with elliptic curve cryptography

The future of elections seems to be electronic voting systems du to its advantatges over the traditional voting. Nowadays, there are some different paradigms to ensure the security and reliability of e-voting. This document is part of a wider project which presents an e-Voting platform based on elliptic curve cryptography. It uses an hybrid combination of two of the main e-Voting paradigms to guarantee privacy and security in the counting phase, these are precisely, the mixnets and the homomorphic protocols. This document is focused in the description of the system and the maths and programming needed to solve the homomorphic part of it. In later chapters, there is a comparison between a simple mixing system and our system proposal.

Learning spatial filters for multispectral image segmentation

We present a novel filtering method for multispectral satellite image classification. The proposed method learns a set of spatial filters that maximize class separability of binary support vector machine (SVM) through a gradient descent approach. Regularization issues are discussed in detail and a Frobenius-norm regularization is proposed to efficiently exclude uninformative filters coefficients. Experiments carried out on multiclass one-against-all classification and target detection show the capabilities of the learned spatial filters.

Shoulder sensorimotor control assessment by force platform: feasibility and reliability.

Given the important role of the shoulder sensorimotor system in shoulder stability, its assessment appears of interest. Force platform monitoring of centre of pressure (CoP) in upper-limb weight-bearing positions is of interest as it allows integration of all aspects of shoulder sensorimotor control. This study aimed to determine the feasibility and reliability of shoulder sensorimotor control assessment by force platform. Forty-five healthy subjects performed two sessions of CoP measurement using Win-Posturo(®) Medicapteurs force platform in an upper-limb weight-bearing position with the lower limbs resting on a table to either the anterior superior iliac spines (P1) or upper patellar poles (P2). Four different conditions were tested in each position in random order: eyes open or eyes closed with trunk supported by both hands and eyes open with trunk supported on the dominant or non-dominant side. P1 reliability values were globally moderate to high for CoP length, CoP velocity and CoP standard deviation (SD), standard error of measurement ranged from 6·0% to 26·5%, except for CoP area. P2 reliability values were globally low and not clinically acceptable. Our results suggest that shoulder sensorimotor control assessment by force platform is feasible and has good reliability in upper-limb weight-bearing positions when the lower limbs are resting on a table to the anterior superior iliac spines. CoP length, CoP velocity and CoP SD velocity appear to be the most reliable variables.

Searching for and positioning of contextualized learning objects

Learning object economies are marketplaces for the sharing and reuse of learning objects (LO). There are many motivations for stimulating the development of the LO economy. The main reason is the possibility of providing the right content, at the right time, to the right learner according to adequate quality standards in the context of a lifelong learning process; in fact, this is also the main objective of education. However, some barriers to the development of a LO economy, such as the granularity and editability of LO, must be overcome. Furthermore, some enablers, such as learning design generation and standards usage, must be promoted in order to enhance LO economy. For this article, we introduced the integration of distributed learning object repositories (DLOR) as sources of LO that could be placed in adaptive learning designs to assist teachers’ design work. Two main issues presented as a result: how to access distributed LO, and where to place the LO in the learning design. To address these issues, we introduced two processes: LORSE, a distributed LO searching process, and LOOK, a micro context-based positioning process, respectively. Using these processes, the teachers were able to reuse LO from different sources to semi-automatically generate an adaptive learning design without leaving their virtual environment. A layered evaluation yielded good results for the process of placing learning objects from controlled learning object repositories into a learning design, and permitting educators to define different open issues that must be covered when they use uncontrolled learning object repositories for this purpose. We verified the satisfaction users had with our solution

Anachronistic facies from a drowned Lower Triassic carbonate platform: Lower member of the Alwa Formation (Ba'id Exotic), Oman Mountains

- The lower member of the Alwa Formation (Lower Olenekian), found within the Ba'id Exotic in the Oman Mountains (Sultanate of Oman), consists of ammonoid-bearing, pelagic limestones that were deposited on an isolated, drowned carbonate platform on the Neotethyan Gondwana margin. The strata contain a variety of unusual carbonate textures and features, including thrombolites, Frutexites-bearing microbialites that contain synsedimentary cements, matrix-free breccias surrounded by isopachous calcite cement, and fissures and cavities filled with large botryoidal cements. Thrombolites are found throughout the study interval, and occur as 0.5-1.0 m thick lenses or beds that contain laterally laterally-linked stromatactis cavities. The Frutexites-bearing microbialites occur less frequently, and also form lenses or beds, up to 30 cm thick; the microbialites may be laminated, and often developed on hardgrounds. In addition, the Frutexites-bearing microbialites also contain synsedimentary calcite cement crusts and botryoids (typically <1 cm thick) that harbour layers or pockets of what appear to be bacterial sheaths and coccoids, and are indicative of biologically mediated precipitation of the cement bodies. Slumping following lithification led to fracturing of the limestone and the precipitation of large, botryoidal aragonite cements in fissures that cut across the primary fabric. Environmental conditions, specifically palaeoxygenation and the degree of calcium carbonate supersaturation, likely controlled whether the thrombolites (high level of calcium carbonate supersaturation associated with vertical mixing of water masses and dysoxic conditions) or Frutexites-bearing microbialites (low level of calcium carbonate supersaturation associated with anoxic conditions and deposition below a stable chemocline) formed. The results of this study point to continued environmental stress in the region during the Early Triassic that likely contributed to the uneven recovery from the Permian-Triassic mass extinction.

Cross-species and cross-platform gene expression studies with the Bioconductor-compliant R package 'annotationTools'.

Background: The variety of DNA microarray formats and datasets presently available offers an unprecedented opportunity to perform insightful comparisons of heterogeneous data. Cross-species studies, in particular, have the power of identifying conserved, functionally important molecular processes. Validation of discoveries can now often be performed in readily available public data which frequently requires cross-platform studies.Cross-platform and cross-species analyses require matching probes on different microarray formats. This can be achieved using the information in microarray annotations and additional molecular biology databases, such as orthology databases. Although annotations and other biological information are stored using modern database models ( e. g. relational), they are very often distributed and shared as tables in text files, i.e. flat file databases. This common flat database format thus provides a simple and robust solution to flexibly integrate various sources of information and a basis for the combined analysis of heterogeneous gene expression profiles.Results: We provide annotationTools, a Bioconductor-compliant R package to annotate microarray experiments and integrate heterogeneous gene expression profiles using annotation and other molecular biology information available as flat file databases. First, annotationTools contains a specialized set of functions for mining this widely used database format in a systematic manner. It thus offers a straightforward solution for annotating microarray experiments. Second, building on these basic functions and relying on the combination of information from several databases, it provides tools to easily perform cross-species analyses of gene expression data.Here, we present two example applications of annotationTools that are of direct relevance for the analysis of heterogeneous gene expression profiles, namely a cross-platform mapping of probes and a cross-species mapping of orthologous probes using different orthology databases. We also show how to perform an explorative comparison of disease-related transcriptional changes in human patients and in a genetic mouse model.Conclusion: The R package annotationTools provides a simple solution to handle microarray annotation and orthology tables, as well as other flat molecular biology databases. Thereby, it allows easy integration and analysis of heterogeneous microarray experiments across different technological platforms or species.

Decoding sequence learning from single-trial intracranial EEG in humans.

We propose and validate a multivariate classification algorithm for characterizing changes in human intracranial electroencephalographic data (iEEG) after learning motor sequences. The algorithm is based on a Hidden Markov Model (HMM) that captures spatio-temporal properties of the iEEG at the level of single trials. Continuous intracranial iEEG was acquired during two sessions (one before and one after a night of sleep) in two patients with depth electrodes implanted in several brain areas. They performed a visuomotor sequence (serial reaction time task, SRTT) using the fingers of their non-dominant hand. Our results show that the decoding algorithm correctly classified single iEEG trials from the trained sequence as belonging to either the initial training phase (day 1, before sleep) or a later consolidated phase (day 2, after sleep), whereas it failed to do so for trials belonging to a control condition (pseudo-random sequence). Accurate single-trial classification was achieved by taking advantage of the distributed pattern of neural activity. However, across all the contacts the hippocampus contributed most significantly to the classification accuracy for both patients, and one fronto-striatal contact for one patient. Together, these human intracranial findings demonstrate that a multivariate decoding approach can detect learning-related changes at the level of single-trial iEEG. Because it allows an unbiased identification of brain sites contributing to a behavioral effect (or experimental condition) at the level of single subject, this approach could be usefully applied to assess the neural correlates of other complex cognitive functions in patients implanted with multiple electrodes.

El ocio terapéutico y educativo en los centros penitenciarios. Aprenentatge i Servei en el Centre Penitenciari de Lledoners

El Aprendizaje y Servicio (APS) es una propuesta educativa que combina procesos de aprendizaje y de servicio a la comunidad en un solo proyecto. El Aprenentatge i Servei en el Centre Penitenciari de Lledoners nace de la voluntad de estudiantes y docentes de la Facultad de Educación Social y Trabajo Social Pere Tarrés (URL) y del Grupo 33, una Plataforma Ciudadana de Sensibilización y Movilización, formada por más de 7.000 personas de todos los sectores de la sociedad civil, que trabaja para conseguir la reinserción real de las personas privadas de libertad. El proyecto pretende hacer frente al actual modelo de prisiones de Cataluña y promover cambios hacia un modelo rehabilitador.

Analysis and evaluation of techniques for the extraction of classes in the ontology learning process

This paper analyzes and evaluates, in the context of Ontology learning, some techniques to identify and extract candidate terms to classes of a taxonomy. Besides, this work points out some inconsistencies that may be occurring in the preprocessing of text corpus, and proposes techniques to obtain good terms candidate to classes of a taxonomy.

Impairment of mossy fiber long-term potentiation and associative learning in pituitary adenylate cyclase activating polypeptide type I receptor-deficient Mice

The pituitary adenylate cyclase activating polypeptide (PACAP) type I receptor (PAC1) is a G-protein-coupled receptor binding the strongly conserved neuropeptide PACAP with 1000-fold higher affinity than the related peptide vasoactive intestinal peptide. PAC1-mediated signaling has been implicated in neuronal differentiation and synaptic plasticity. To gain further insight into the biological significance of PAC1-mediated signaling in vivo, we generated two different mutant mouse strains, harboring either a complete or a forebrain-specific inactivation of PAC1. Mutants from both strains show a deficit in contextual fear conditioning, a hippocampus-dependent associative learning paradigm. In sharp contrast, amygdala-dependent cued fear conditioning remains intact. Interestingly, no deficits in other hippocampus-dependent tasks modeling declarative learning such as the Morris water maze or the social transmission of food preference are observed. At the cellular level, the deficit in hippocampus-dependent associative learning is accompanied by an impairment of mossy fiber long-term potentiation (LTP). Because the hippocampal expression of PAC1 is restricted to mossy fiber terminals, we conclude that presynaptic PAC1-mediated signaling at the mossy fiber synapse is involved in both LTP and hippocampus-dependent associative learning.

Dialogic learning and interactive groups: an IMS LD template integrated in runtime systems

Dialogic learning and interactive groups have proved to be a useful methodological approach appliedin educational situations for lifelong adult learners. The principles of this approach stress theimportance of dialogue and equal participation also when designing the training activities. This paperadopts these principles as the basis for a configurable template that can be integrated in runtimesystems. The template is formulated as a meta-UoL which can be interpreted by IMS Learning Designplayers. This template serves as a guide to flexibly select and edit the activities at runtime (on the fly).The meta-UoL has been used successfully by a practitioner so as to create a real-life example, withpositive and encouraging results