Sound pollution is known as an annoying phenomenon in modern life. Especially, development of organisms during fetal life is more sensitive to environmental tensions. To address a link between the behavioral and electrophysiological aspects of brain function with action of hypothalamus-pituitary-adrenal (HPA) axis in stressed animals, this study was carried out on the male Wistar rats prenatally exposed to sound stress. Groups of pregnant rats were exposed to noise stress for 1, 2, and 4 hour(s). The degree of anxiety and the spatial memory were evaluated by elevated plus maze and Morris water maze, respectively. Basic synaptic activity and long-term potentiation (LTP) induction were assessed in the CA3-CA1 pathway of hippocampus. The serum level of corticosterone was measured in the pregnant mothers and the offspring. The behavioral experiments appeared that the stressed animals performed considerably weaker than the control rats. The prenatal stress negatively affected the basic synaptic responses and led to a lower level of LTP. The pregnant animals showed an increased serum corticosterone in comparison with the nonpregnant females. Also the offspring exposed to the noise stress had a more elevated level of corticosterone than the control rats. Our findings indicate that the corticosterone concentration changes markedly coincides the results of behavioral and electrophysiological experiments. We conclude that, similar to other environmental stresses, the sound stress during fetal life efficiently disturbs both cognitive abilities and synaptic activities. The changes in action of HPA axis may contribute to problems of the brain function in the prenatally stress exposed animals.

This study reviews articles published in the last two decades to determine the pros and cons of virtual outpatient education for undergraduate medical students and residents. A review of articles published between 2001 and 2021 in PubMed, Scopus, ERIC, and google scholar databases. Keywords for this search were: Ambulatory care/Outpatient clinics and education, and medical/internship and residency. The emphasis of this study was on the implementation of any kind of E-learning in outpatient clinics. Out of 5100 in the initial monitoring, 168 articles were reviewed based on the full text. Finally, information on 11 articles was extracted. Results were summarized in 4 areas: methods and tools used in e-learning, benefits of e-learning, challenges and limitations of e-learning, and student support. The main methods used were telemedicine via video conferencing and telephone calls, especially for residents. Other were virtual clinics with a simulated patient, as well as online educational modules. The main preponderances were: increasing knowledge and skills of telemedicine, improving medical knowledge and skills, access to educational resources even during patients visit, the possibility of learning at any time and place, and betterment of the quality of care. The main challenges were lack of technological literacy and lack of Internet access for some patients, time-consuming entry of patient information for students, reduction of clinical experiences, the unfeasibility of acquiring full skills in performing physical examinations, or some technical and procedural skills and hardware/software technological problems. Regarding student support, the main activity includes holding orientation sessions on new approaches for trainees. Due to the urgency of using virtual outpatient education in the corona era, it is predicted that in the post-corona era, we will see a tendency to use this method by stakeholders. Certainly, citing the results of original articles and reviewing them, similar to the present study, can make it possible to implement qualified E-learning innovation in clinics with quality in the future.

Social stress affects brain function. Trier social stress test (TSST) is a standard test to assess it. The study aimed to analyze the electroencephalographic (EEG) recording during and after TSST in healthy subjects. The EEG signals of 44 healthy men participating in the study were recorded in the control condition, during and after TSST and after 30 min of recovery. Salivary cortisol (SC) and the Emotional Visual Analog Scale (EVAS) score were measured in the control condition, after TSST, and after the recovery period. The false discovery rate correction was used to control the false positive of significance in EEG. In the comparison control condition, the SC and EVAS levels significantly increased after TSST. The relative Delta band frequency significantly increased during TSST. On the other hand, the Beta bands and, in less amount, the Theta and Gamma 1 (30–40 Hz) oscillations decreased, especially in the frontal region. The nonlinear features such as, approximate and spectral entropy, Katz fractal dimension behaved like Beta band oscillation. All changes returned to baseline after TSST except the increase of Katz in the F3 channel after the recovery period. Thus, stress on EEG increased low frequency (1–4 Hz), decreased high frequency (13–40 Hz), and complexity indices during TSST.