5-day Challenge Research Articles

A Challenge-Based Learning Intensive Course for Competency Development in Undergraduate Engineering Students: Case Study on UAVs

Accelerated advances in science and technology drive the need for professionals with flexible problem-solving abilities towards a collaborative working environment. The advances pose a challenge to educational institutions about how to develop learning environments that contribute to meeting the aforementioned necessity. Additionally, the fast pace of technology and innovative knowledge are encouraging universities to employ challenge-based-learning (CBL) approaches in engineering education supported by modern technology such as unmanned aerial vehicles (UAVs) and other advanced electronic devices. Within the framework of competency-based education (CBE) and CBL are the design, implementation, and evaluation of an intensive 40 h elective course which includes a 5-day challenge to promote the development of disciplinary and transversal competencies in undergraduate engineering students whilst relying on UAVs as the medium where the teaching–learning process takes place. Within this credit course, a case study was carried out considering the framework of an exploratory mixed-methods educational research approach that sought a broad understanding of the studied phenomena using various data collection instruments with quantitative and qualitative characteristics. An innovative academic tool was introduced, namely a thematic UAV platform that systematically exposed students to the principles underlying robotic systems and the scientific method, thereby stimulating their intellectual curiosity as a trigger to solve the posed challenge. Moreover, students came up with innovative teamwork-based solutions to a designed challenge while having an enjoyable and motivating time flying drones on an indoor obstacle course arranged by themselves. The preliminary findings may contribute to the design of other CBL experiences, supported by technology applied for educational purposes, which could promote the development of more disciplinary and transversal competencies in future engineers.

The Kidney Diet Challenge: An Experiential Educational Experience.

Health care providers who care for patients with CKD must be able to provide effective counseling about a kidney-friendly diet. Nutrition is underemphasized in medical curricula, and the kidney diet is one of the most challenging diets. We hypothesized that participation in an experiential educational program in kidney diet would result in improved knowledge of the underlying principles behind it and provide concrete examples of how to explain this diet to patients. The first part of this study was a knowledge assessment administered to all US nephrology fellows during the 2020 National Board of Medical Examiners Nephrology In-Training Examination. We later opened the assessment to a broader, global audience via social media. Respondents included trainees, practicing nephrologists, dieticians, and other health professionals. Participants self-identified willingness to participate in the second part of the study, the Kidney Diet Challenge (KDC). The 5-day challenge included daily webinars by experts in nutrition. Daily surveys captured self-reported adherence to the diet. Social media was used to engage with participants. All participants received a follow-up knowledge assessment. Among the nephrology fellows (n=317), the median pretest score was 2 out of 5 (40%) questions correct, and results did not differ by year of training (P=0.31). Of the participants (n=70) who completed the 5-day challenge and responded to the post-challenge survey, the distribution of the number of correct answers improved after the KDC (median [25th, 75th percentile]: 3 [2, 3] versus 3 [2, 4]; P<0.001). Statistics from our official hashtag for this study (#kidneydietchallenge) showed that we achieved 406,241 reaches and 1,004,799 impressions, with a total of 974 posts using this hashtag. The KDC is an immersive, experiential educational tool that enabled a global population to learn how to counsel their patients better about adherence to a complex kidney diet.

Dietary effects of a low-molecular weight fraction (

Aquaculture by-products have been of great interest for producing protein hydrolysates with multiple biological activities. The present experiment was carried out to evaluate dietary effects of a low-molecular fraction (<10 kDa) from shrimp waste hydrolysate in forms of unprotected and nanocapsulated on growth and immunity of rainbow trout. Therefore, six diets were designed including a control diet (no supplementation), D1 (1 g kg−1 of unprotected fraction), D2 (1 g kg−1 chitosan nanocapsules), D3 (1 g kg−1 liposome nanocapsules), D4 (1 g kg−1 of fraction-loaded chitosan nanocapsules), D5 (1 g kg−1 of fraction-loaded liposome nanocapsules). Fish (0.91 ± 0.15 g) were fed with experimental diets until apparent satiation for six weeks followed by a 5-day experimental challenge with Streptococcus iniae. Results revealed that growth is strongly affected in fish receiving the fraction with D4 treatment showing the highest weight gain, SGR, final weight and the lowest FCR (p < 0.05). Nanocapsules without fraction did not show remarkable effects when compared to control group. In terms of serum and mucus immune parameters of lysozyme, complement activity, myeloperoxidase activity, and total protease, fish from D4 group showed the highest measured values followed by D5 (p < 0.05). Key immune related genes of IL-6 and TNF-α were noticeably up-regulated in fish from D1, D4, and D5 groups, which were consistent with survival rate after 5 days challenge with Streptococcus iniae. All together, the present findings highlighted the application of chitosan and liposome nanocarriers in aquaculture and potential of low-molecular weight fraction (<10 kDa) from shrimp wastes hydrolysate to improve growth performance and immune status of rainbow trout.

Multidimensional Approach for Investigating the Effects of an Antibiotic-Probiotic Combination on the Equine Hindgut Ecosystem and Microbial Fibrolysis.

The equine hindgut ecosystem is specialized in dietary fibers’ fermentation to provide horses’ energy and contribute to its health. Nevertheless, antibiotics are known to disrupt the hindgut microbiota, affecting the fibrolytic activity of bacteria and the intestinal immune balance, leading to diseases. This in vivo study used a general and comprehensive approach for characterizing the hindgut ecosystem of 9 healthy horses over 28 days in response to a 5-day challenge with oral trimethoprim-sulfadiazine (TMS), with a special emphasis on microbial fibrolytic activity and the host immune response. Horses were supplemented with two doses of Lactobacillus acidophilus, Ligilactobacillus salivarius (formerly L. salivarius), and Bifidobacterium lactis blend or a placebo in a 3 × 3 Latin square design. Changes in fecal microbiota were investigated using 16S rRNA sequencing. Clostridioides difficile was quantified in feces using quantitative polymerase chain reaction. Anaerobic microbiological culture was used to enumerate functional bacterial groups (cellulolytic, amylolytic, and lactic acid-utilizing). The environmental dimensions were assessed by measuring the concentrations of volatile fatty acids (VFAs) and lactic acid using biochemical methods, and changes in pH and dry matter weight. Systemic and local inflammation was evaluated by determination of cytokine and immunoglobulin (Ig)A concentrations in the serum and secretory IgA (SIgA) concentrations in the feces using immuno-enzymatic methods. Oral TMS treatment strongly altered the whole hindgut ecosystem by 2 days after the first administration. Bacterial diversity decreased in proportion to the relative abundance of fibrolytic genera, which coincided with the decrease in the concentration of cellulolytic bacteria. At the same time, the composition of microbiota members was reorganized in terms of relative abundances, probably to support the alteration in fibrolysis. C. difficile DNA was not found in these horses, but the relative abundances of several potential pathobiont genera increased. 2 days after the first TMS administration, fecal concentrations of VFAs and SIgA increased in parallel with fecal water content, suggesting an alteration of the integrity of the hindgut mucosa. Recovery in bacterial composition, functions, and immune biomarkers took 2–9 days after the end of TMS administration. Supplementation with this bacterial blend did not limit bacterial alteration but might have interesting mucosal immunomodulatory effects.

Prospective study of 5-day challenge with penicillins in children

ObjectivesTo examine if a 5-day challenge with penicillin improves the diagnostic sensitivity compared with a single full dose in children with mild skin reactions.DesignSubjects referred with suspected allergy to penicillin...

Efficacy and Safety of 5-Day Challenge for the Evaluation of Nonsevere Amoxicillin Allergy in Children

To determine if the use of a 5-day challenge with amoxicillin would not only be safe but also lead to an increase in future amoxicillin use in nonallergic patients compared with a single-dose graded drug provocation.The population included 130 consecutive children <18 years of age referred to the allergy unit with a history of amoxicillin or amoxicillin and clavulanate. Children with life-threatening reactions or severe non–immunoglobulin E–mediated reactions were excluded. A total of 57.7% presented with a maculopapular rash, 35.4% presented with hives.Initial evaluation included skin testing done in a blinded fashion and a graded drug provocation test (DPT) with 45 mg/kg amoxicillin in 3 steps (1/100, 1/10, and full dose) at 30-minute intervals, independent of skin test results. Patients with negative single-dose DPT results were sent home with a 4-day course of amoxicillin. Phone follow-up was done 2 years later.A total of 2.3% had an immediate reaction during the single-dose DPT, and all were mild. Three of the remaining 127 patients had a confirmed nonimmediate reaction during the 4-day challenge (1 on the second day, 1 on the third day, and 1 3 days after completion). All 3 reactions were a mild, isolated maculopapular rash. Three patients had equivocal reactions that were determined to be negative with reassessment. At 2 years, 65.8% had used antibiotics again, and 89.3% had used amoxicillin. Three patients (4.5%) had a mild delayed cutaneous reaction with later use of amoxicillin. In a previous study using a single-dose provocation, 18.3% of patients had refusal to use amoxicillin again compared with 1.3% of the current study.Five-day oral challenge with amoxicillin is safe and effective and greatly increases the compliance with future use of penicillin antibiotics.It is important to note that the majority of patients in the study presented with a maculopapular rash, which is usually not an immunoglobulin E–mediated reaction. In this largely low-risk population, DPT with a single-dose regimen would be safe without skin testing, and a subsequent 5-day challenge in those that passed the single-dose challenge is safe (with a small number of minor reactions) and does increase the chance that patients would be willing to use this class of antibiotics in the future.

Efficacy and Safety of 5-Day Challenge for the Evaluation of Nonsevere Amoxicillin Allergy in Children

Penicillin allergy is the most frequent drug allergy, among which aminopenicillins are reputed for causing delayed rashes in children, particularly in the context of viral infections. Despite a negative allergy evaluation, a significant proportion of individuals continue to avoid penicillin antibiotics for fear of an allergic reaction. To evaluate the safety and efficacy of a 5-day challenge to amoxicillin and the proportion of subsequent use of amoxicillin. Pediatric patients with a history of a reaction to amoxicillin were prospectively recruited in the study. All patients were challenged, and those with negative immediate challenges underwent an ambulatory 5-day challenge to amoxicillin to rule out nonimmediate reactions. Patients were called 2 years after their initial allergy evaluation to assess subsequent amoxicillin use and tolerance. One hundred thirty children with a history of amoxicillin allergy underwent a graded drug provocation test (DPT) to amoxicillin. Three patients had a positive immediate challenge, 3 had a positive nonimmediate challenge, and 2 were equivocal. Of the 122 patients with a negative challenge, 114 (93.4%) were reached 2 years after their initial allergy evaluation: 75 had used antibiotics since, of which only 1 (1.3%) had refused to reuse amoxicillin because of fear of an allergic reaction. Finally, the 5-day DPT resulted in a 24.1% decrease in future penicillin avoidance compared with classical single-dose graded DPT performed for 1 day in a historical cohort (P < .0001). The 5-day challenge is a safe and effective way to rule out nonimmediate amoxicillin allergy, and it ensures better compliance with future penicillin use.