Background The Gymkhana Room for Education and Evaluation in Nursing Studies (GREENS©) is a pedagogical model that can be used as a learning and assessment method in nursing training workshops. This model combines the advantages of gamification, the flipped classroom and the use of low-fidelity clinical simulation, also including self-reflection and peer evaluation of the situations experienced. Objectives To evaluate the students’ perception of the implementation of GREENS© as a learning and assessment tool in an academic course at the University of Almeria. Design A cross-sectional descriptive study. Settings Academic year 2018/2019, at the University of Almeria (UAL), Spain. Participants 77 students enrolled in their 2nd year of the Nursing Degree who attended the “Health Promotion and Safety” class. Methods After completing the GREENS© activity, the perception and anxiety of students were analyzed through an online ad hoc questionnaire composed of 17 questions. Data were collected in January 2019. Results All of the questions scored above 4 out of a maximum of 5 on a Likert scale. For all the questions, >50% of the students were in total agreement with the questions answered, showing a high acceptance of the GREENS© methodology implementation. The students reported that their anxiety decreased significantly, with a score of 4.7 points on average (95% CI 4.16 to 5.33, p less then 0.001), after knowing that the assessment would be through a gamification tool, not an oral one. More than 60% of the students answered “agree” or “strongly agree” with the idea that GREENS© is useful for improving motivation, teamwork, learning, fun and knowledge assessment. Conclusions The use of GREENS© has generated a high satisfaction and motivation of the students in their learning process, and as an assessment tool, it created a lower degree of anxiety as compared to an oral examination.Pregnancy represents an immunological challenge for the maternal immune system. Pregnancy augments innate immune responses, and particularly monocytes contribute to maintaining the balance between pro- and anti-inflammatory immune responses required for the successful sequence of distinct immunological phases throughout pregnancy. Nonetheless, studies that focus on the heterogeneity of monocytes and analyze the alteration of monocyte subsets in a longitudinal approach throughout healthy pregnancies have remained scarce. In this study, we characterized the gradual phenotypic changes of monocyte subsets and the secretory potential of bulk monocytes in peripheral blood mononuclear cells of healthy pregnant women from a population-based prospective birth cohort study. this website Blood samples at predefined time points were analyzed using flow cytometry for in-depth characterization of monocyte subsets, which confirmed a shift from classical towards intermediate monocytes throughout pregnancy. Principal component analysis revealed characteristic phenotypic changes on monocyte subsets, especially on the intermediate monocyte subset, throughout pregnancy. Pregnancy-related hormones were measured in serum and β-human chorionic gonadotropin levels were significantly associated with expression of CD11b, CD116 and CCR2 on monocyte subsets. TLR4 and TLR7/8 stimulation of monocytes furthermore showed reduced polycytokine production towards the end of pregnancy. These data provide a comprehensive overview of phenotypic changes and secretory potential of monocytes in healthy pregnant women and establish a selective contribution of different monocyte subsets to healthy pregnancy. The results from this study therefore build a basis for future comparisons and evaluation of women with adverse pregnancy outcomes.Background and objective In avascular or hypovascular tissues, elements required for maintaining tissue functions are recruited through diffusion, which is highly related with the permeability of the extracellular matrix in health and injury. Here, we investigate the effect of collagen fibril diameter distribution of bovine Anterior Cruciate Ligament (ACL) tissue on the hydraulic permeability of the matrix. Based on the fact that the diameter distribution is significantly different between healthy and injured ACL tissues, our study aims to investigate the effect of such variability on the hydraulic permeability. Methods Simulations are carried out in 3D geometries reconstructed from actual collagen filament/fibril diameter distributions obtained from healthy and injured tissue samples (n=3). The fluid flow through the fibrous tissue is modeled based on Eringen’s theory of micropolar fluid flow to determine the effects of vortex viscosity (m) and spin gradient viscosity (N) on hydraulic permeability. Results Computational results indicate that the hydraulic permeability of models which are replicates of healthy ACL tissues is higher than that of the injured, indicating that the filament size distribution might play an important role on fluid and nutrient transport through ligament tissues. Conclusions These findings underscore the need for increased attention on replicating the diameter distribution of healthy collagens in tissue engineering scaffolds and allowing adequate supply of elements through permeation during ACL reconstruction procedures.Background and objective Most healthcare institutions are reorganizing their healthcare delivery systems based on Clinical Pathways (CPs). CPs are novel medical management plans to standardize medical activities, reduce cost, optimize resource usage, and improve the quality of service. However, most CPs are still paper-based and not fully integrated with Health Information Systems (HIS). More CP computerization research is therefore needed to fully benefit from CP’s practical potentials. A major contribution of this research is the vision that CP systems deserve to be placed at the centre of HIS, because within CPs lies the very heart of medical planning, treatment and impressions, including healthcare quality and cost factors. Methods An important contribution to the realization of this vision is to fully standardize and digitize CPs so that they become machine-readable and smoothly linkable across various HIS. To achieve this goal, this research proposes a framework for (i) CP knowledge representation and sharing using ontologies, (ii) CP standardization based on SNOMED CT and HL7, and (iii) CP digitization based on a novel coding system to encode CP data.