Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms un...Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.展开更多
Simulation-based training is a promising way to train a carrier flight deck crew because of the complex and dangerous working environment. Quantitative evaluation of simulation-based training quality is vital to make ...Simulation-based training is a promising way to train a carrier flight deck crew because of the complex and dangerous working environment. Quantitative evaluation of simulation-based training quality is vital to make simulation-based training practical for aircraft carrier marshalling.This paper develops a personal computer-based aircraft carrier marshalling simulation system and a cave automatic virtual environment（CAVE）-based immersive environment. In order to compare the training effectiveness of simulation-based training and paper-based training, a learning cubic model is proposed and a contrast experiment is carried out as well. The experimental data is analyzed based on a simplified Kirkpatrick＇s model. The results show that simulation-based training is better than paper-based training by 26.80% after three rounds of testing, which prove the effectiveness of simulation-based aircraft carrier marshalling training.展开更多
Background: Simulation-based training is a new strategy in teaching that gives the students good opportunities to learn and apply what they learn in nursing care safely. Aim: This study conducted to evaluate the effec...Background: Simulation-based training is a new strategy in teaching that gives the students good opportunities to learn and apply what they learn in nursing care safely. Aim: This study conducted to evaluate the effects of simulation-based training on nursing students’ communication skill, self-efficacy and clinical competence in practice. Subjects and Methods: Quiz-experimental design was used in this study (pre-posttest intervention), it was carried out on 100 nursing students first semester in 2019 using low and high-fidelity simulators. This study was carried out at College of Applied Medical Sciences-Bshia University. Data Collection: demographic data, communication skill, self-efficacy and clinical competence questionnaires. Analysis is done by SPSS version 20 software. Results: Participants who received the simulation-based training, showed statistical significant improvement in communication skill, self-efficacy, and clinical competence scores after participation in the simulation program (t = −32.64, p = 0.001;t = −19.9, p = 0.001;16.4, p = 0.001). Also, there are significant relation between gender and clinical competency (t = 2.768, p Conclusion: Simulation-based training in medical courses is effective in enhancing communication skill, self-efficacy and clinical competence. Multiple-patient simulations as a teaching-learning strategy in the nursing curriculum are highly recommended.展开更多
BACKGROUND: Low-frequency and high-risk situations, such as neonatal resuscitation, are the ideal targets for simulation-based learning. The aim of this paper is to present the structure of our internal neonatal resus...BACKGROUND: Low-frequency and high-risk situations, such as neonatal resuscitation, are the ideal targets for simulation-based learning. The aim of this paper is to present the structure of our internal neonatal resuscitation training program, using a realistic, simulated delivery room, and to present the participants' opinions about teamwork, emotional stress, and their subjective ability to face a resuscitation. METHODS: We administered a training course to 24 doctors and midwives. One of the simulation classrooms was modified to appear similar to a real delivery room. Four scenarios were conducted using a previously designed checklist of primary and secondary goals. Upon completion, all students participated in a debriefing session with the help of a video review. RESULTS: Students rated the achievement of their previously defined goals on a scale of 1 to 5. Grouping together the percentages of the highest ratings (Categories 4 and 5), 83.4% (20/24) of the students considered the course useful for acquiring clinical skills. For 87.5% (21/24) of the students, the scenarios simulated real clinical situations, the room properly simulated a real delivery room, and the course improved the students' ability to work in a team. For 66.6% (16/24) of the students, the course improved their stress in confronting neonatal resuscitation. Initially, only 33.3% (8/24) of the students considered themselves very capable or fully able to cope with a resuscitation. After the course, that percentage rose to 62.5% (15/24). CONCLUSIONS: The incorporation of simulation-based learning into neonatal resuscitation teaching programs, using realistic scenarios, is useful and offers the possibility of acquiring technical skills, but it also allows for the improvement of teamwork and the adoption of different roles and positive attitudes towards emotional stress.展开更多
Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental...Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental retardation who received rehabilitation intervention in our hospital from January 2022 to December 2025 were selected and divided into a control group and an experimental group,with 60 children in each group.The control group adopted a conventional rehabilitation training program;the experimental group adopted a combined sensory integration training and cognitive training program.The sensory integration ability,cognitive function,and daily living skills of children in the two groups were compared.Results:The sensory integration ability score of the experimental group(85.3±6.2)was significantly higher than that of the control group(72.1±7.5)(p<0.05);the cognitive function score(88.7±5.8)was significantly improved compared with that of the control group(76.4±6.9)(p<0.05);the daily living skills score(90.2±4.7)was significantly higher than that of the control group(80.5±5.3)(p<0.05).The social interaction ability of the experimental group reached 92.5%,which was significantly higher than that of the control group(81.3%)(p<0.05).Conclusion:Sensory integration training combined with cognitive training demonstrates favorable outcomes in the rehabilitation treatment of children with mental retardation,exhibiting a notable neurofunctional remodeling effect.It can optimize the multidimensional rehabilitation process,effectively enhance the comprehensive developmental potential of children,and hold significant clinical application value.展开更多
The detection of gravitational waves by the LIGO-Virgo-KAGRA collaboration has ushered in a new era of observational astronomy,emphasizing the need for rapid and detailed parameter estimation and population-level anal...The detection of gravitational waves by the LIGO-Virgo-KAGRA collaboration has ushered in a new era of observational astronomy,emphasizing the need for rapid and detailed parameter estimation and population-level analyses.Traditional Bayesian inference methods,particularly Markov chain Monte Carlo,face significant computational challenges when dealing with the high-dimensional parameter spaces and complex noise characteristics inherent in gravitational wave data.This review examines the emerging role of simulation-based inference methods in gravitational wave astronomy,with a focus on approaches that leverage machine-learning techniques such as normalizing flows and neural posterior estimation.We provide a comprehensive overview of the theoretical foundations underlying various simulation-based inference methods,including neural posterior estimation,neural ratio estimation,neural likelihood estimation,flow matching,and consistency models.We explore the applications of these methods across diverse gravitational wave data processing scenarios,from single-source parameter estimation and overlapping signal analysis to testing general relativity and conducting population studies.Although these techniques demonstrate speed improvements over traditional methods in controlled studies,their model-dependent nature and sensitivity to prior assumptions are barriers to their widespread adoption.Their accuracy,which is similar to that of conventional methods,requires further validation across broader parameter spaces and noise conditions.展开更多
Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,f...Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,function,and mobility in individuals with knee osteoarthritis(OA)?Among 3192 participants,those classified as“Lifelong ST”(n=142)demonstrated superior 4-year patient-reported outcomes and exhibited the lowest incidence of mobility disability(0.8%vs 2.3%–4.1%).Notably,they also maintained the fastest walking speeds at Year 4.展开更多
Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effec...Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effect of high-fat feeding on cardiac morphology and mitochondrial function,alongside the mitigating effects of voluntary exercise training.Methods Six-week-old male C57Bl/6 J mice commenced a high fat diet(HFD)or chow diet and were randomized to receive locked(sedentary)or unlocked(voluntary exercise training(VET))running wheels at 10 weeks of age.Mice were monitored until 30 weeks of age and euthanized for collection of tissues.Magnetic resonance imaging was performed to assess body composition,and echocardiography was performed to assess cardiac function.Results Compared with chow-fed animals,the HFD increased body weight and adiposity and decreased cardiolipins(CL)in the heart,which are required for maintaining adequate mitochondrial respiration.Importantly,VET reversed these effects and induced physiological cardiac hypertrophy.Cardiac mitochondrial respiratory chain analysis revealed decreased complexes II and IV activity following high fat feeding,while VET enhanced complex I activity,emphasizing the cardioprotective effect of exercise training in obesity.Conclusion This study uncovers mechanisms by which obesity and exercise impact cardiac mitochondrial health and suggests the mitochondria is a therapeutic target in obesity-related cardiovascular diseases.展开更多
Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from...Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from the Osteoarthritis Initiative(n=3192)were grouped by ST engagement during ages 12–18 years,19–34 years,35–49 years,and 50+years.Participants were categorized as:No ST(no ST at any point;61.7±9.0 years(mean±SD)),Some ST(engaged in ST during 1–3 life stages;58.9±8.7 years),and Lifelong ST(consistently engaged in ST across all life stages;55.6±8.1 years).Measures were collected at baseline and Year 4:Western Ontario and McMaster Universities Osteoarthritis Index Scores(WOMAC;pain,daily activities),Knee Injury and Osteoarthritis Outcome Score(KOOS;sports,recreation),Physical Activity Score for the Elderly(PASE),Short Form-12 Physical Component Score(SF-12 PCS),mobility disability,chair rise time,and walking speed(20 m and 400 m).Results At Year 4,the Lifelong ST group reported better WOMAC activity scores in the right knee along with better WOMAC pain,KOOS sports/recreation,and PASE scores compared to other groups(p<0.05).The Lifelong ST group had the lowest incidence of mobility disability of all groups(0.8%vs.2.3%–4.1%;p=0.015)and maintained the fastest walking speeds in Year 4.Conclusion For those with knee OA,ST throughout life may help preserve function and mobility,allowing for greater physical activity engagement while keeping pain levels relatively lower.展开更多
Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of...Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of dementia. Despite networked cognitive training has been demonstrated to enhance cognitive function in MCI, its effectiveness for negative emotions is still unknown. This review aimed to exam the influences of networked cognitive training on negative emotions and quality of life in people with MCI. Methods: Searches for eligible studies were conducted using PubMed, Web of Science, EMBASE, Cochrane Library, Psyc INFO, CNKI, Wanfang database, VIP database, and Sinomed. The retrieval time limit was set from their inception to 17 December 2025. The articles were reviewed and extracted by two researchers, and their quality was evaluated using the Cochrane risk-of-bias assessment tool. Subsequently, a meta-analysis was carried out utilizing RevMan 5.4 software. Results: The review comprised 13 randomized controlled trials with 626 individuals. The meta-analysis demonstrated that networked cognitive training significantly improved depression (SMD = -0.36;95% CI [-0.73, -0.00];p = .050), anxiety (SMD = -0.32;95% CI [-0.57, -0.06];p < .050), and quality of life (MD = 2.54;95% CI [0.98, 4.10];p < .001). In terms of the comparison of apathy, the effect of intervention was unclear. Conclusions: From these meta-analysis results, networked cognitive training may help patients for MCI with their anxiety, depression, and overall quality of life. However, because there are so few randomized controlled trials available, the evidence regarding apathy is still ambiguous. More thorough randomized controlled trials with larger samples are necessary to verify the significance of networked cognitive training on apathy and to consolidate the findings.展开更多
Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for long...Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for longitudinal hypertrophy.Methods:We included studies that satisfied the following criteria:(1)be a resistance training intervention with a comparison of LML vs SML-RT;(2)assess both fascicle length(FL)and muscle size pre-and post-intervention;(3)involve healthy adults aged≥18 years;(4)be published in an English-language journal,and;(5)have a minimum training intervention duration of 4 weeks.Three databases were searched in February 2024(Google Scholar,PubMed/Medline,Scopus)for relevant articles,alongside'forward'and'backward'citation searching of articles included and additions via authors'personal knowledge.The results of studies were described narratively,compared,and contrasted.Eight studies met the inclusion criteria,totaling a sample size of 120.Results:Our results suggest that both muscle size and fascicle length increases may be greater following LML-RT versus SML-RT,suggesting LML-RT may lead to greater longitudinal hypertrophy than SML-RT.Notably,evidence is largely mixed;no studies to date have attempted to estimate serial sarcomere number changes from LML versus SML-RT,and all but one study used linear extrapolation methods to estimate FL,which has questionable validity.Therefore,the structural adaptations underlying hypertrophy from LML-RT remain undetermined.Conclusion:In conclusion,results suggest that LML-RT may be superior to SML-RT for inducing muscle hypertrophy and,more specifically,longitudinal growth,though evidence is mixed.展开更多
Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(...Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.展开更多
[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized c...[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid adv...Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.展开更多
Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain an...Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain and muscles work together during this type of training.To address this,we conducted a cross-sectional study at The Seventh Affiliated Hospital,Sun Yat-sen University in China,where we observed the connection between brain and muscle activity during bilateral upper limb training in 21 stroke patients and 17 healthy controls.We used functional near-infrared spectroscopy and surface electromyography to measure changes in cerebral cortex oxygenation and upper limb muscle contraction signals,respectively.The results showed that,compared with the healthy control group,stroke patients had reduced functional connectivity and more irregular muscle activity in the affected flexor muscle during bilateral upper limb training.Moreover,we found a significant correlation between the surface electromyographic signal characteristics of upper limb muscles and cerebral oxygenation indicators of multiple brain regions in stroke patients.These findings indicate that bilateral upper limb training is an effective rehabilitation method that improves upper limb motor function in stroke patients by promoting brain functional connectivity and improving muscle activity patterns.展开更多
[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rot...[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rotator cuff injuries managed conservatively.[Methods]Eighty patients diagnosed with rotator cuff injury were selected and randomly assigned to either the control group or the experimental group,each comprising 40 individuals.The control group received conventional rehabilitation treatment,whereas the experimental group underwent phased rehabilitation training in addition to the conventional treatment for 6 weeks.Assessments were conducted prior to treatment,6 weeks following treatment,and 8 weeks after the completion of treatment(follow-up period).The visual analogue scale(VAS)was employed to evaluate pain intensity,the Constant-Murley score was utilized to assess shoulder joint function,and the shoulder joint range of motion was measured.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups across all measured indicators(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups exhibited significant reductions in VAS scores compared to baseline measurements,alongside improvements in Constant-Murley scores and shoulder joint range of motion(P<0.05).Furthermore,the magnitude of improvement in the experimental group was significantly greater than that in the control group(P<0.05).[Conclusions]Phased rehabilitation training can enhance shoulder joint function and alleviate pain in patients with rotator cuff injuries beyond the effects of conventional rehabilitation treatment,demonstrating notable clinical application value.展开更多
Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip f...Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip fracture admitted to our hospital from January 2023 to January 2024 were selected and divided into the observation group(25 cases)and the control group(25 cases)by random number table method.The control group received routine nursing,while the observation group received early rehabilitation training on the basis of routine nursing.The balance ability(Berg Balance Scale,BBS)and quality of life(SF-36)of the two groups were compared.Results:The BBS scores of the observation group at all postoperative time points were significantly higher than those of the control group(p<0.05),and the quality-of-life scores of the observation group were also significantly higher than those of the control group(p<0.05).Conclusion:Early postoperative rehabilitation training for elderly patients with hip fracture can improve their balance ability,enhance their quality of life,and reduce the incidence of postoperative complications,which is worthy of clinical promotion.展开更多
文摘Objective:Self-directed training represents a challenge in simulation-based training as low cognitive effort can occur when learners overrate their own level of performance.This study aims to explore the mechanisms underlying the positive effects of a structured self-assessment intervention during simulation-based training of mastoidectomy.Methods:A prospective,educational cohort study of a novice training program consisting of directed,self-regulated learning with distributed practice(5x3 procedures)in a virtual reality temporal bone simulator.The intervention consisted of structured self-assessment after each procedure using a rating form supported by small videos.Semi-structured telephone interviews upon completion of training were conducted with 13 out of 15 participants.Interviews were analysed using directed content analysis and triangulated with quantitative data on secondary task reaction time for cognitive load estimation and participants’self-assessment scores.Results:Six major themes were identified in the interviews:goal-directed behaviour,use of learning supports for scaffolding of the training,cognitive engagement,motivation from self-assessment,selfassessment bias,and feedback on self-assessment(validation).Participants seemed to self-regulate their learning by forming individual sub-goals and strategies within the overall goal of the procedure.They scaffolded their learning through the available learning supports.Finally,structured self-assessment was reported to increase the participants’cognitive engagement,which was further supported by a quantitative increase in cognitive load.Conclusions:Structured self-assessment in simulation-based surgical training of mastoidectomy seems to promote cognitive engagement and motivation in the learning task and to facilitate self-regulated learning.
基金supported by the Fundamental Research Funds for the Central Universities of China
文摘Simulation-based training is a promising way to train a carrier flight deck crew because of the complex and dangerous working environment. Quantitative evaluation of simulation-based training quality is vital to make simulation-based training practical for aircraft carrier marshalling.This paper develops a personal computer-based aircraft carrier marshalling simulation system and a cave automatic virtual environment（CAVE）-based immersive environment. In order to compare the training effectiveness of simulation-based training and paper-based training, a learning cubic model is proposed and a contrast experiment is carried out as well. The experimental data is analyzed based on a simplified Kirkpatrick＇s model. The results show that simulation-based training is better than paper-based training by 26.80% after three rounds of testing, which prove the effectiveness of simulation-based aircraft carrier marshalling training.
文摘Background: Simulation-based training is a new strategy in teaching that gives the students good opportunities to learn and apply what they learn in nursing care safely. Aim: This study conducted to evaluate the effects of simulation-based training on nursing students’ communication skill, self-efficacy and clinical competence in practice. Subjects and Methods: Quiz-experimental design was used in this study (pre-posttest intervention), it was carried out on 100 nursing students first semester in 2019 using low and high-fidelity simulators. This study was carried out at College of Applied Medical Sciences-Bshia University. Data Collection: demographic data, communication skill, self-efficacy and clinical competence questionnaires. Analysis is done by SPSS version 20 software. Results: Participants who received the simulation-based training, showed statistical significant improvement in communication skill, self-efficacy, and clinical competence scores after participation in the simulation program (t = −32.64, p = 0.001;t = −19.9, p = 0.001;16.4, p = 0.001). Also, there are significant relation between gender and clinical competency (t = 2.768, p Conclusion: Simulation-based training in medical courses is effective in enhancing communication skill, self-efficacy and clinical competence. Multiple-patient simulations as a teaching-learning strategy in the nursing curriculum are highly recommended.
文摘BACKGROUND: Low-frequency and high-risk situations, such as neonatal resuscitation, are the ideal targets for simulation-based learning. The aim of this paper is to present the structure of our internal neonatal resuscitation training program, using a realistic, simulated delivery room, and to present the participants' opinions about teamwork, emotional stress, and their subjective ability to face a resuscitation. METHODS: We administered a training course to 24 doctors and midwives. One of the simulation classrooms was modified to appear similar to a real delivery room. Four scenarios were conducted using a previously designed checklist of primary and secondary goals. Upon completion, all students participated in a debriefing session with the help of a video review. RESULTS: Students rated the achievement of their previously defined goals on a scale of 1 to 5. Grouping together the percentages of the highest ratings (Categories 4 and 5), 83.4% (20/24) of the students considered the course useful for acquiring clinical skills. For 87.5% (21/24) of the students, the scenarios simulated real clinical situations, the room properly simulated a real delivery room, and the course improved the students' ability to work in a team. For 66.6% (16/24) of the students, the course improved their stress in confronting neonatal resuscitation. Initially, only 33.3% (8/24) of the students considered themselves very capable or fully able to cope with a resuscitation. After the course, that percentage rose to 62.5% (15/24). CONCLUSIONS: The incorporation of simulation-based learning into neonatal resuscitation teaching programs, using realistic scenarios, is useful and offers the possibility of acquiring technical skills, but it also allows for the improvement of teamwork and the adoption of different roles and positive attitudes towards emotional stress.
基金Baoding Science and Technology Plan Project(Project No.:2541ZF307)。
文摘Objective:To analyze the clinical effect of sensory integration training combined with cognitive training in the rehabilitation treatment of children with mental retardation.Methods:A total of 120 children with mental retardation who received rehabilitation intervention in our hospital from January 2022 to December 2025 were selected and divided into a control group and an experimental group,with 60 children in each group.The control group adopted a conventional rehabilitation training program;the experimental group adopted a combined sensory integration training and cognitive training program.The sensory integration ability,cognitive function,and daily living skills of children in the two groups were compared.Results:The sensory integration ability score of the experimental group(85.3±6.2)was significantly higher than that of the control group(72.1±7.5)(p<0.05);the cognitive function score(88.7±5.8)was significantly improved compared with that of the control group(76.4±6.9)(p<0.05);the daily living skills score(90.2±4.7)was significantly higher than that of the control group(80.5±5.3)(p<0.05).The social interaction ability of the experimental group reached 92.5%,which was significantly higher than that of the control group(81.3%)(p<0.05).Conclusion:Sensory integration training combined with cognitive training demonstrates favorable outcomes in the rehabilitation treatment of children with mental retardation,exhibiting a notable neurofunctional remodeling effect.It can optimize the multidimensional rehabilitation process,effectively enhance the comprehensive developmental potential of children,and hold significant clinical application value.
基金supported by the National Key Research and Development Program of China(2021YFC2203004)the National Natural Science Foundation of China(NSFC)(12405076,12247187,and 12147103)+1 种基金the National Astronomical Data Center(NADC2023YDS-01)the Fundamental Research Funds for the Central Universities.
文摘The detection of gravitational waves by the LIGO-Virgo-KAGRA collaboration has ushered in a new era of observational astronomy,emphasizing the need for rapid and detailed parameter estimation and population-level analyses.Traditional Bayesian inference methods,particularly Markov chain Monte Carlo,face significant computational challenges when dealing with the high-dimensional parameter spaces and complex noise characteristics inherent in gravitational wave data.This review examines the emerging role of simulation-based inference methods in gravitational wave astronomy,with a focus on approaches that leverage machine-learning techniques such as normalizing flows and neural posterior estimation.We provide a comprehensive overview of the theoretical foundations underlying various simulation-based inference methods,including neural posterior estimation,neural ratio estimation,neural likelihood estimation,flow matching,and consistency models.We explore the applications of these methods across diverse gravitational wave data processing scenarios,from single-source parameter estimation and overlapping signal analysis to testing general relativity and conducting population studies.Although these techniques demonstrate speed improvements over traditional methods in controlled studies,their model-dependent nature and sensitivity to prior assumptions are barriers to their widespread adoption.Their accuracy,which is similar to that of conventional methods,requires further validation across broader parameter spaces and noise conditions.
文摘Kiehl and colleagues1 utilized data from the Osteoarthritis Initiative(OAI)to address a clinically significant question:Is lifetime participation in strength training(ST)associated with improved trajectories of pain,function,and mobility in individuals with knee osteoarthritis(OA)?Among 3192 participants,those classified as“Lifelong ST”(n=142)demonstrated superior 4-year patient-reported outcomes and exhibited the lowest incidence of mobility disability(0.8%vs 2.3%–4.1%).Notably,they also maintained the fastest walking speeds at Year 4.
基金MAF is supported by an NHMRC Investigator Grant(APP1194141)Research in his laboratory was supported by project grants from the NHMRC(APP1042465,APP1041760,and APP1156511).
文摘Background Obesity is a risk factor for developing cardiometabolic disease.Exercise training is pivotal in the treatment of obesity and is associated with reduced cardiovascular mortality.This study examined the effect of high-fat feeding on cardiac morphology and mitochondrial function,alongside the mitigating effects of voluntary exercise training.Methods Six-week-old male C57Bl/6 J mice commenced a high fat diet(HFD)or chow diet and were randomized to receive locked(sedentary)or unlocked(voluntary exercise training(VET))running wheels at 10 weeks of age.Mice were monitored until 30 weeks of age and euthanized for collection of tissues.Magnetic resonance imaging was performed to assess body composition,and echocardiography was performed to assess cardiac function.Results Compared with chow-fed animals,the HFD increased body weight and adiposity and decreased cardiolipins(CL)in the heart,which are required for maintaining adequate mitochondrial respiration.Importantly,VET reversed these effects and induced physiological cardiac hypertrophy.Cardiac mitochondrial respiratory chain analysis revealed decreased complexes II and IV activity following high fat feeding,while VET enhanced complex I activity,emphasizing the cardioprotective effect of exercise training in obesity.Conclusion This study uncovers mechanisms by which obesity and exercise impact cardiac mitochondrial health and suggests the mitochondria is a therapeutic target in obesity-related cardiovascular diseases.
文摘Background This study compared knee osteoarthritis(OA)outcomes specific to pain,physical function,and quality of life in later life based on strength training(ST)participation over a lifetime.Methods Participants from the Osteoarthritis Initiative(n=3192)were grouped by ST engagement during ages 12–18 years,19–34 years,35–49 years,and 50+years.Participants were categorized as:No ST(no ST at any point;61.7±9.0 years(mean±SD)),Some ST(engaged in ST during 1–3 life stages;58.9±8.7 years),and Lifelong ST(consistently engaged in ST across all life stages;55.6±8.1 years).Measures were collected at baseline and Year 4:Western Ontario and McMaster Universities Osteoarthritis Index Scores(WOMAC;pain,daily activities),Knee Injury and Osteoarthritis Outcome Score(KOOS;sports,recreation),Physical Activity Score for the Elderly(PASE),Short Form-12 Physical Component Score(SF-12 PCS),mobility disability,chair rise time,and walking speed(20 m and 400 m).Results At Year 4,the Lifelong ST group reported better WOMAC activity scores in the right knee along with better WOMAC pain,KOOS sports/recreation,and PASE scores compared to other groups(p<0.05).The Lifelong ST group had the lowest incidence of mobility disability of all groups(0.8%vs.2.3%–4.1%;p=0.015)and maintained the fastest walking speeds in Year 4.Conclusion For those with knee OA,ST throughout life may help preserve function and mobility,allowing for greater physical activity engagement while keeping pain levels relatively lower.
文摘Purpose: Individuals with mild cognitive impairment (MCI) frequently experience negative emotions, which are closely correlated with an accelerated rate of cognitive decline and the subsequent transition to a state of dementia. Despite networked cognitive training has been demonstrated to enhance cognitive function in MCI, its effectiveness for negative emotions is still unknown. This review aimed to exam the influences of networked cognitive training on negative emotions and quality of life in people with MCI. Methods: Searches for eligible studies were conducted using PubMed, Web of Science, EMBASE, Cochrane Library, Psyc INFO, CNKI, Wanfang database, VIP database, and Sinomed. The retrieval time limit was set from their inception to 17 December 2025. The articles were reviewed and extracted by two researchers, and their quality was evaluated using the Cochrane risk-of-bias assessment tool. Subsequently, a meta-analysis was carried out utilizing RevMan 5.4 software. Results: The review comprised 13 randomized controlled trials with 626 individuals. The meta-analysis demonstrated that networked cognitive training significantly improved depression (SMD = -0.36;95% CI [-0.73, -0.00];p = .050), anxiety (SMD = -0.32;95% CI [-0.57, -0.06];p < .050), and quality of life (MD = 2.54;95% CI [0.98, 4.10];p < .001). In terms of the comparison of apathy, the effect of intervention was unclear. Conclusions: From these meta-analysis results, networked cognitive training may help patients for MCI with their anxiety, depression, and overall quality of life. However, because there are so few randomized controlled trials available, the evidence regarding apathy is still ambiguous. More thorough randomized controlled trials with larger samples are necessary to verify the significance of networked cognitive training on apathy and to consolidate the findings.
文摘Background:This paper aimed to systematically review the literature regarding the effects of resistance training(RT)performed at longer-muscle length(LML)versus shorter-muscle length(SML)on proxy measurements for longitudinal hypertrophy.Methods:We included studies that satisfied the following criteria:(1)be a resistance training intervention with a comparison of LML vs SML-RT;(2)assess both fascicle length(FL)and muscle size pre-and post-intervention;(3)involve healthy adults aged≥18 years;(4)be published in an English-language journal,and;(5)have a minimum training intervention duration of 4 weeks.Three databases were searched in February 2024(Google Scholar,PubMed/Medline,Scopus)for relevant articles,alongside'forward'and'backward'citation searching of articles included and additions via authors'personal knowledge.The results of studies were described narratively,compared,and contrasted.Eight studies met the inclusion criteria,totaling a sample size of 120.Results:Our results suggest that both muscle size and fascicle length increases may be greater following LML-RT versus SML-RT,suggesting LML-RT may lead to greater longitudinal hypertrophy than SML-RT.Notably,evidence is largely mixed;no studies to date have attempted to estimate serial sarcomere number changes from LML versus SML-RT,and all but one study used linear extrapolation methods to estimate FL,which has questionable validity.Therefore,the structural adaptations underlying hypertrophy from LML-RT remain undetermined.Conclusion:In conclusion,results suggest that LML-RT may be superior to SML-RT for inducing muscle hypertrophy and,more specifically,longitudinal growth,though evidence is mixed.
基金supported by Joint Program on Health Science&Technology Innovation of Hainan Province(WSJK2024QN093)Discipline Leader Development Program for Outstanding Talents of Hainan West Central Hospital.
文摘Objectives:Postmenopausal women with stress urinary incontinence(SUI)exhibit low androgen expression.This study aimed to evaluate the efficacy and safety of vaginal androgen combined with pelvic floor muscle training(PFMT)in the treatment of SUI in postmenopausal women.Methods:Postmenopausal women with SUI were recruited from Hainan West Central Hospital between January 2024 and March 2025.Participants were randomly assigned in a double-blind manner to receive either vaginal androgen cream combined with PFMT(treatment group)or a visually identical placebo cream(without androgens)combined with PFMT(control group).The vaginal cream was applied to the vaginal wall at a dose of 0.5 g per application,twice weekly for a total of 10 applications,while PFMT was conducted for 8 weeks.The clinical efficacy and safety were compared between the two groups.Results:A total of 61 patients were finally enrolled,with 31 in the treatment group and 30 in the control group.At both 3-month and 6-month follow-ups,the treatment group demonstrated significantly lower values in daily pad usage(p<0.05),24-h pad test scores(p<0.05),and ICIQ-UI SF scores(p<0.05)compared to the control group.The improvement rate of urinary incontinence was significantly higher in the treatment group(p<0.05).Compared to baseline,the treatment group showed statistically significant reductions in all three outcome measures(all p<0.05).No severe adverse events were reported in either group during the treatment period.Conclusions:Androgen therapy combined with PFMT significantly improved the urinary incontinence remission rate in postmenopausal women with SUI,with no severe adverse effects observed.These findings suggest that androgen therapy may represent a novel therapeutic approach for SUI management in postmenopausal women.
文摘[Objectives]To investigate the clinical efficacy of core stability training combined with conventional rehabilitation in the functional recovery of patients suffering from chronic low back pain.[Methods]A randomized controlled trial design was employed in this study.Ninety patients with chronic low back pain were recruited and randomly assigned to either a control group(n=45),which received conventional rehabilitation,or an experimental group(n=45),which received conventional rehabilitation combined with core stability training.Both groups underwent treatment for 6 weeks.Assessments were conducted using the visual analogue scale(VAS),Oswestry disability index(ODI),and finger-to-floor test prior to treatment,6 weeks following treatment,and during the follow-up period,respectively.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups in terms of general information and various baseline measurements(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups demonstrated significant improvements in VAS scores,ODI scores,and lumbar anteflexion range of motion compared to baseline measurements(P<0.05).Notably,the magnitude of improvement in the experimental group exceeded that of the control group,with this inter-group difference reaching statistical significance(P<0.05).No serious adverse reactions were reported during the treatment process.[Conclusions]Core stability training combined with conventional rehabilitation can significantly enhance the alleviation of pain and functional impairments in patients suffering from chronic low back pain.This approach holds valuable implications for the optimization of rehabilitation treatment protocols.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金Supported by the Key Special Project of“Cutting-Edge Biotechnology”in the National Key Research and Development Program of China(No.2024YFC3406200)Sanming Project of Medicine in Shenzhen(No.SZSM202411007)Shenzhen Science and Technology Program(No.JCYJ20240813152704006).
文摘Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.
文摘Stroke patients experience varying degrees of upper limb functional impairment.Although bilateral arm training can help stroke patients recover movement after stroke,little is known about the way in which the brain and muscles work together during this type of training.To address this,we conducted a cross-sectional study at The Seventh Affiliated Hospital,Sun Yat-sen University in China,where we observed the connection between brain and muscle activity during bilateral upper limb training in 21 stroke patients and 17 healthy controls.We used functional near-infrared spectroscopy and surface electromyography to measure changes in cerebral cortex oxygenation and upper limb muscle contraction signals,respectively.The results showed that,compared with the healthy control group,stroke patients had reduced functional connectivity and more irregular muscle activity in the affected flexor muscle during bilateral upper limb training.Moreover,we found a significant correlation between the surface electromyographic signal characteristics of upper limb muscles and cerebral oxygenation indicators of multiple brain regions in stroke patients.These findings indicate that bilateral upper limb training is an effective rehabilitation method that improves upper limb motor function in stroke patients by promoting brain functional connectivity and improving muscle activity patterns.
文摘[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rotator cuff injuries managed conservatively.[Methods]Eighty patients diagnosed with rotator cuff injury were selected and randomly assigned to either the control group or the experimental group,each comprising 40 individuals.The control group received conventional rehabilitation treatment,whereas the experimental group underwent phased rehabilitation training in addition to the conventional treatment for 6 weeks.Assessments were conducted prior to treatment,6 weeks following treatment,and 8 weeks after the completion of treatment(follow-up period).The visual analogue scale(VAS)was employed to evaluate pain intensity,the Constant-Murley score was utilized to assess shoulder joint function,and the shoulder joint range of motion was measured.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups across all measured indicators(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups exhibited significant reductions in VAS scores compared to baseline measurements,alongside improvements in Constant-Murley scores and shoulder joint range of motion(P<0.05).Furthermore,the magnitude of improvement in the experimental group was significantly greater than that in the control group(P<0.05).[Conclusions]Phased rehabilitation training can enhance shoulder joint function and alleviate pain in patients with rotator cuff injuries beyond the effects of conventional rehabilitation treatment,demonstrating notable clinical application value.
基金Chongqing Education Science Planning Project.Project Name:Research on Talent Training of Community Rehabilitation Major in Higher Vocational Colleges Based on OBE Concept(Project No.:K23ZG3420222)。
文摘Objective:To analyze the improvement effect of early postoperative rehabilitation training on balance ability and quality of life in elderly patients with hip fracture.Methods:A total of 50 elderly patients with hip fracture admitted to our hospital from January 2023 to January 2024 were selected and divided into the observation group(25 cases)and the control group(25 cases)by random number table method.The control group received routine nursing,while the observation group received early rehabilitation training on the basis of routine nursing.The balance ability(Berg Balance Scale,BBS)and quality of life(SF-36)of the two groups were compared.Results:The BBS scores of the observation group at all postoperative time points were significantly higher than those of the control group(p<0.05),and the quality-of-life scores of the observation group were also significantly higher than those of the control group(p<0.05).Conclusion:Early postoperative rehabilitation training for elderly patients with hip fracture can improve their balance ability,enhance their quality of life,and reduce the incidence of postoperative complications,which is worthy of clinical promotion.
