SUMMARY[18F]-Fluoro-D-deoxyglucose positron emission tomography (FDG-PET) is used in the complex presurgical evaluation of patients with medically intractable temporal lobe epilepsy (TLE) (Debets et al

Patients who were considered to be well-controlled proved to report an unexpectedly high number of subjective complaints. Both medication and aspects of personality contributed to the level of complaints. Our study illustrates that subjective side-effects are easily overlooked in everyday clinical practice, possibly because in practice a generally phrased question is used to detect side-effects.

A B S T R A C TThis study is focused on how peer feedback in SPOCs (Small Private Online Courses) can effectively lead to deep learning. Promoting deep learning in online courses, such as SPOCs, is often a challenge. We aimed for deep learning by reinforcement of 'feedback dialogue' as scalable intervention.Students provided peer feedback as a dialogue, both individually and as a group. They were instructed to rate each other's feedback, which was aimed at deep learning. Data from questionnaires from 41 students of a master epidemiology course were used to measure for each feedback assignment to what extent deep learning was perceived. The feedback received by students who scored extremely high or low on the questionnaire was analyzed in order to find out which features of the feedback led to deep learning. In addition, students were interviewed to retrieve information about the underlying mechanisms.The results support the view that peer feedback instruction and peer feedback rating lead to peer feedback dialogues that, in turn, promote deep learning in SPOCs. The value of peer feedback appears to predominantly result from the dialogue it triggers, rather than the feedback itself. Especially helpful for students is the constant attention to how one provides peer feedback: by instruction, by having to rate feedback and therefore by repeatedly having to reflect. The dialogue is strengthened because students question feedback from peers in contrast to feedback from their instructor. As a result, they continue to think longer and deeper, which enables deep learning.

Study design: An experimental cross-sectional design. Objectives: To evaluate whether training of the innervated respiratory muscles in individuals with a (partial) cervical spinal cord injury will improve the strength and endurance capacity of these muscles and the exercise performance in these individuals. Setting: Department of Physiology and Pulmonary diseases, Nijmegen, The Netherlands. Method: In this study nine individuals with tetraplegia (C3 ± C7) performed a target¯ow endurance training of the inspiratory muscles, twice a day for 15 min. First, the subjects performed a`sham' training for 6 weeks with no appreciable resistance, after that they performed a`real' training for 6 weeks with a resistance of 70% of the maximal endurance capacity of the inspiratory muscles. The training was evaluated at 0, 6 and 12 weeks by the following tests: (1) the slow Inspiratory Vital Capacity (IVC) and the Forced Inspiratory and Expiratory Volumes over 1 s (FIV 1 and FEV 1 ); (2) the Maximal Inspiratory Mouth Pressure (P imax ) and the Endurance Pressure (P endu ) and (3) a maximal arm-cranking exercise test. Results: After the sham training, the P endu was increased from 3.98 to 4.71 kPa with a Pvalue of 0.05. The sham training had no in¯uence on any of the other variables. The real training had no eect on the IVC, FIV 1 , FEV 1 and P imax , however, increased the P endu from 4.71 to 6.16 kPa (P=0.01), representing the respiratory muscle-endurance capacity. The oxygen consumption (V . O 2 peak) in the maximal exercise test improved from 0.87 to 0.98 l/ min (P=0.05). Conclusion:The results of the study indicate that training of the respiratory muscles results in an enhanced endurance capacity of these muscles and a concomitant increase in the aerobic exercise performance.

Introduction Social interaction is key in educational success. In online education, the creation of social interaction may be a challenge. This observational study evaluated to what extent social interactions occur during small private online courses (SPOCs). Methods Discussion forums of four courses of the UMC Utrecht's international Master's Program Epidemiology were assessed and posts were categorized as either content specific, functional/technical, or social. Results SPOCs at University Medical Center Utrecht showed substantial social interaction, creating involvement and student coherence, combined with students discussing and explaining content to each other. Interactions play a major role in SPOCs. Our results show that 43% of all discussion posts were social; 90% of social posts were initiated by students; and 94% was aimed at students. Conclusion SPOCs appear to provide a sustainable answer to the increased demand for online higher education, with an environment suitable for students to learn, in agreement with the need for social interaction in higher education.