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Healthcare practice and education are highly emotional endeavors. While this is recognized by educators and researchers seeking to develop interventions aimed at improving wellness in health professionals and at providing them with skills to deal with emotional interpersonal situations, the field of health professions education has largely ignored the role that emotions play on cognitive processes. The purpose of this review is to provide an introduction to the broader field of emotions, with the goal of better understanding the integral relationship between emotions and cognitive processes. Individuals, at any given time, are in an emotional state. This emotional state influences how they perceive the world around them, what they recall from it, as well as the decisions they make. Rather than treating emotions as undesirable forces that wreak havoc on the rational being, the field of health professions education could be enriched by a greater understanding of how these emotions can shape cognitive processes in increasingly predictable ways.

The increase in global average temperature, mainly due to the high rate of greenhouse gas emissions, has triggered severe global warming and climate change. In Europe, the building sector accounts for a significant portion of emissions and energy consumption, prompting attention on nearly-zero-energy buildings (nZEBs) and zero-carbon buildings, as they play a pivotal role in reaching the goal of climate neutrality by 2050. Passive systems offer a promising solution, optimizing energy usage by better adapting buildings to their local climates. This paper reviews the state-of-the-art of passive heating and cooling techniques, exploring their contributions to contemporary architecture and showcasing their features and adaptability across different climates. Furthermore, the link between traditional and bioclimatic architecture is assessed. Recent years have witnessed a surge in publications on bioclimatic solar passive strategies, reflecting an intensified debate on climate change. Europe leads research in this area, aligned with initiatives like the Green Deal and Fit for 55. While dynamic simulation software is widely utilized for energy efficiency analysis, there remains limited integration of Building Information Modeling (BIM) and life cycle analysis (LCA) tools, which could enhance holistic assessments.

ABSTRACT BACKGROUND An experimenter controlled form of reflection has been shown to improve the detection and correction of diagnostic errors in some situations; however, the benefits of participant-controlled reflection have not been assessed. OBJECTIVE The goal of the current study is to examine how experience and a self-directed decision to reflect affect the accuracy of revised diagnoses. DESIGN Medical residents diagnosed 16 medical cases (pass 1). Participants were then given the opportunity to reflect on each case and revise their diagnoses (pass 2). PARTICIPANTS Forty-seven medical Residents in post-graduate year (PGY) 1, 2 and 3 were recruited from Hamilton Health Care Centres. MAIN MEASURES Diagnoses were scored as 0 (incorrect), 1 (partially correct) and 2 (correct). Accuracies and response times in pass 1 were analyzed using an ANOVA with three factors—PGY, Decision to revise yes/no, and Case 1–16, averaged across residents. The extent to which additional reflection affected accuracy was examined by analyzing only those cases that were revised, using a repeated measures ANOVA, with pass 1 or 2 as a within subject factor, and PGY and Case or Resident as a between-subject factor. KEY RESULTS The mean score at pass 1 for each level was PGY1, 1.17 (SE 0.50); PGY2, 1.35 (SE 0.67) and PGY3, 1.27 (SE 0.94). While there was a trend for increased accuracy with level, this did not achieve significance. The number of residents at each level who revised at least one diagnosis was 12/19 PGY1 (63 %), 9/11 PGY2 (82 %) and 8/17 PGY3 (47 %). Only 8 % of diagnoses were revised resulting in a small but significant increase in scores from Pass 1 to 2, from 1.20/2 to 1.22 /2 ( t  = 2.15, p  = 0.03). CONCLUSIONS Participants did engage in self-directed reflection for incorrect diagnoses; however, this strategy provided minimal benefits compared to knowing the correct answer. Education strategies should be directed at improving formal and experiential knowledge.

To mitigate greenhouse gas emissions responsible for global warming and climate change, governments have undertaken concerted efforts and established goals to restructure production and consumption patterns within the current global economy. The construction sector, which in Europe has significant energy use and related greenhouse gas emissions, recognizes adopting passive heating and cooling systems for buildings as a viable solution. The revival of vernacular passive solar strategies emerges as opportune within this context. Through dynamic simulations, this study aims to analyze and quantify the potential contribution of glazed balconies, a traditional passive heating system, to improve contemporary constructions’ thermal behavior and comfort conditions in mild temperate climates, such as in northern Portugal. Results indicate that this system can significantly enhance a building’s energy efficiency, reducing energy needs for heating and cooling by up to 47% while extending periods of thermal comfort indoors by nearly 900 h per year compared to buildings with non-glazed balconies. Proper use of natural ventilation and shading devices is essential to ensure optimal system performance and prevent overheating. This research underscores the potential of glazed balconies as a sustainable solution for enhancing contemporary buildings’ thermal-energy performance and comfort, contributing to the transition towards carbon-neutral constructions.

The behavior of timber–concrete slab-type structures is not fully understood yet. This is the case of the transversal load distribution in composite floors under concentrated loads. Included in a broader investigation, this article presents the findings for the specific case of a timber–concrete composite floor under the action of a concentrated load. This article aims at studying such transversal load distribution by means of some theoretical methods, which were compared with experimental results. Different finite elements (FE) and analytical models were used. Numerical models using different types of FE were validated based on numerical and experimental results. The analytical model used distribution coefficients. From the study, it was possible to conclude that all the methods were able to detect a non-linear transversal distribution, but there were some deviations when comparing the methods with each other. The analytical method, based on several simplifications presented a larger deviation from the numerical ones. This is discussed in more detail within this article and some practical considerations were added.

Transplanted individuals in operational tolerance (OT) maintain long-term stable graft function after completely stopping immunosuppression. Understanding the mechanisms involved in OT can provide valuable information about pathways to human transplantation tolerance. Here we report that operationally tolerant individuals display quantitative and functional preservation of the B-cell compartment in renal transplantation. OT exhibited normal numbers of circulating total B cells, naive, memory and regulatory B cells (Bregs) as well as preserved B-cell receptor repertoire, similar to healthy individuals. In addition, OT also displayed conserved capacity to activate the cluster of differentiation 40 (CD40)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in Bregs, in contrast, with chronic rejection. Rather than expansion or higher activation, we show that the preservation of the B-cell compartment favors OT.

Chan et al asserts that the COVID-19 pandemic has disrupted the medical assessment system in Canada. Examinations delivered by The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) were delayed, cancelled or adapted. As these examinations are required for independent practice, this had a negative impact on trainees, supervisors and patients during a time of great stress within our health care system. Although disruptive, these challenges provided an opportunity for change by unfreezing the historical approach to medical licensure in Canada--an approach that can be characterized as arduous, expensive, logistically challenging, poorly aligned with clinical practice and potentially biased. The ongoing use of high-stakes examinations for licensure has numerous unintended consequences. Standardized exams test nonsalient variables and are at risk of biases (e.g., financial hardship from paying to write and attend examinations, structural racism affecting examination literacy and preparation) that may inhibit the movement of our health care institutions toward equity, diversity and inclusion.

Glyphosate-based herbicides (GBH) are the most used herbicides in the world, carrying potentially adverse consequences to the environment and non-target species due to their massive and inadequate use. This study aimed to evaluate the effects of acute exposure to a commercial formulation of glyphosate, Roundup® Flex (RF), at environmentally relevant and higher concentrations in zebrafish larvae through the assessment of the inflammatory, oxidative stress and cell death response. Transgenic Tg(mpxGFP)i114 and wild-type (WT) zebrafish larvae (72 h post-fertilisation) were exposed to 1, 5, and 10 µg mL−1 of RF (based on the active ingredient concentration) for 4 h 30 min. A concentration of 2.5 µg mL−1 CuSO4 was used as a positive control. Copper sulphate exposure showed effectiveness in enhancing the inflammatory profile by increasing the number of neutrophils, nitric oxide (NO) levels, reactive oxygen species (ROS), and cell death. None of the RF concentrations tested showed changes in the number of neutrophils and NO. However, the concentration of 10 µg a.i. mL−1 was able to induce an increase in ROS levels and cell death. The activity of antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx)), the biotransformation activity, the levels of reduced (GSH) and oxidised (GSSG) glutathione, lipid peroxidation (LPO), lactate dehydrogenase (LDH), and acetylcholinesterase (AChE) were similar among groups. Overall, the evidence may suggest toxicological effects are dependent on the concentration of RF, although at concentrations that are not routinely detected in the environment. Additional studies are needed to better understand the underlying molecular mechanisms of this formulation.

Heavily modified water bodies (HMWB) have been seriously affected by human activities and natural processes promoting their imbalance, and impacting their functioning and biodiversity. This study explores a new approach of monitoring and assessing water quality in Mediterranean reservoirs using phytoplankton communities across a disturbance gradient, according to water framework directive. Phytoplankton and environmental data were sampled in 34 reservoirs over 8 years. Two types of reservoirs were analyzed: Type1 “run-of-river reservoirs” (located in the main rivers, with a low residence time); and Type2 “true reservoirs” (located in tributaries, with high residence time). The transition from deeper and colder reservoirs (reference sites) to shallow and warmer (impaired sites) was clear in Type2, correlated to organic pollution and mineral gradients. Impaired sites from both types showed a higher richness of tolerant taxa. Principal response curve (PRC) provided a concise summary of phytoplankton temporal dynamics and assessed ecosystem health for Mediterranean HMWBs. PRC will provide a powerful tool for environmental quality assessment and be incorporated into monitoring and assessment programs. This approach can help policymakers to manage natural capital to achieve multiple objectives, mainly increasing ecosystem services, and improve readability and interpretation of spatial patterns in temporal changes.