Clinical reasoning is considered a crucial concept in reaching medical decisions. This paper reviews the reasoning processes involved in clinical reasoning from the perspective of cognitive psychology. To properly use clinical reasoning, one requires not only domain knowledge but also structural knowledge, such as critical thinking skills. In this paper, two types of reasoning process required for critical thinking are discussed: inductive and deductive. Inductive and deductive reasoning processes have different features and are generally appropriate for different types of tasks. Numerous studies have suggested that experts tend to use inductive reasoning while novices tend to use deductive reasoning. However, even experts sometimes use deductive reasoning when facing challenging and unfamiliar problems. In clinical reasoning, expert physicians generally use inductive reasoning with a holistic viewpoint based on a full understanding of content knowledge in most cases. Such a problem-solving process appears as a type of recognition-primed decision making only in experienced physicians’ clinical reasoning. However, they also use deductive reasoning when distinct patterns of illness are not recognized. Therefore, medical schools should pursue problem-based learning by providing students with various opportunities to develop the critical thinking skills required for problem solving in a holistic manner.
HighlightsEthanol extract of Kummerowia striata is a potent antioxidant.It inhibits melanin synthesis by downregulating tyrosinase and related proteins.It may be used in cosmetics for skin whitening and reducing wrinkles.
UVB radiation changes several photoaging pathway in the body, thereby prompting skin injury. Besides, chronic UVB radiation leads to photoaging, sustained immunosuppression, and photocarcinogenesis. We investigated the protective effect of Timosaponin AIII (TA-III), a naturally occurring steroidal saponin separated from Anemarrhena asphodeloides, against UVB-induced invasive properties of human epidermal keratinocytes (HEKs) and human dermal fibroblasts (HDF). No cytotoxicity was observed up to 50 nM concentration of TA-III. Similarly, TA-III inhibited UVB-induced cyclooxygenase-2 (COX-2), matrix metalloproteinase-9 (MMP-9) transcription level and protein expression in a dose-dependent manner at non-cytotoxic dose. Further, TA-III decreased UVB-induced invasion in primary skin cells. Additionally, TA-III suppressed UVB-stimulates mitogen-activated protein kinase (MAPK) signaling, activator protein-1 (AP-1) and nuclear factor kappa B (NF-κB) activation, thereby preventing the overexpression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and COX-2 in human epidermal keratinocytes cells. Furthermore, TA-III prevented UVB-mediated formation of 8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxo-dG) and activation of DNA repair enzymes and, cell cycle arrest genes like as proliferating cell nuclear antigen (PCNA), structural maintenance of chromosomes protein 1 (SMC1). This results support that understanding into the molecular action of TA-III, which can be useful for developing photoprotective agents.
Background: Immersive VR is still rarely used as an intervention for meeting the affective end goals of student learning despite its positive impact on affection. Also, studies regarding the use of immersive VR as an intervention for affective achievement in broader educational contexts are still lacking. Objectives: This study aimed to examine the effect of immersive VR and perspective-taking on presence and empathy.Methods: A total of 148 pre-service teachers participated in experiments, using either a head-mounted display or a flat screen device to view two VR videos with different perspective-taking affordances. This study used a mixed design with one between-subject variable of immersion level and one within-subject variable of perspective-taking to explore how immersive VR experiences influenced participants' perceived level of presence and empathy.
Results and Conclusions:The results showed that the level of immersion affects perceived presence, but it was the type of perspective-taking that affects empathetic reactions. We also found an interaction effect between immersion levels and perspective-taking. The direct embodiment in VR combined with high immersion produced stronger empathy than with low immersion, while the perspective of an observer was better in evoking empathy when experienced with low immersion.Implications: This study gives a guidance on how to take advantage of this new technology in educational settings, and apply it to instructional activities to enhance students' empathy. In addition, it could serve as a reference when developing or introducing educational contents with respect to the types of contents that are more effective in educational settings.
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