Standardized patients (SPs) have been one of the popular assessment methods in clinical teaching for decades, although they are resource intensive. Nowadays, simulated virtual patients (VPs) are increasingly used because they are permanently available and fully scalable to a large audience. However, empirical studies comparing the differential effects of these assessment methods are lacking. Similarly, the relationships between key variables associated with diagnostic competences (ie, diagnostic accuracy and evidence generation) in these assessment methods still require further research.
 
  The aim of this study is to compare perceived authenticity, cognitive load, and diagnostic competences in performance-based assessment using SPs and VPs. This study also aims to examine the relationships of perceived authenticity, cognitive load, and quality of evidence generation with diagnostic accuracy.
 
  We conducted an experimental study with 86 medical students (mean 26.03 years, SD 4.71) focusing on history taking tal to performance, both types of cognitive load must be monitored and manipulated systematically in the assessment. Diagnostic accuracy was higher for SPs than for VPs, which could potentially negatively affect students' grades with VPs. We identify and discuss possible reasons for this performance difference between both assessment methods.
  Previous studies provide evidence for the effectiveness of web-based interventions for panic disorder with and without agoraphobia. Smartphone-based technologies hold significant potential for further enhancing the accessibility and efficacy of such interventions.
 
  This randomized controlled trial aims to evaluate the efficacy of a guided, hybrid web-based training program based on cognitive behavioral therapy for adults with symptoms of panic disorder.
 
  Participants (N=92) with total scores in the Panic and Agoraphobia Scale ranging from 9 to 28 were recruited from the general population and allocated either to a hybrid intervention (GET.ON Panic) or to a wait-list control group. The primary outcome was the reduction in panic symptoms, as self-assessed using a web-based version of the Panic and Agoraphobia Scale.
 
  Analysis of covariance-based intention-to-treat analyses revealed a significantly stronger decrease in panic symptoms posttreatment (F=9.77; P=.002; Cohen d=0.66; 95% CI 0.24-1.08) in the intervention group than in the wait-list control group. Comparisons between groups of the follow-up measures at 3 and 6 months yielded even stronger effects (3-month follow-up F=17.40, P<.001, Cohen d=0.89, 95% CI 0.46-1.31; 6-month follow-up F=14.63, P<.001, Cohen d=0.81, 95% CI 0.38-1.24).
 
  Hybrid web-based training programs may help reduce the symptoms of panic disorder and hence play an important role in improving health care for patients with this debilitating disorder.
 
  German Clinical Trial Register DRKS00005223; https//tinyurl.com/f4zt5ran.
 
  RR2-10.1186/1745-6215-15-427.
 RR2-10.1186/1745-6215-15-427.
  Novel wearable biosensors, ubiquitous smartphone ownership, and telemedicine are converging to enable new paradigms of clinical research. A new generation of continuous glucose monitoring (CGM) devices provides access to clinical-grade measurement of interstitial glucose levels. Adoption of these sensors has become widespread for the management of type 1 diabetes and is accelerating in type 2 diabetes. In parallel, individuals are adopting health-related smartphone-based apps to monitor and manage care.
 
  We conducted a proof-of-concept study to investigate the potential of collecting robust, annotated, real-time clinical study measures of glucose levels without clinic visits.
 
  Self-administered meal-tolerance tests were conducted to assess the impact of a proprietary synbiotic medical food on glucose control in a 6-week, double-blind, placebo-controlled, 2×2 cross-over pilot study (n=6). The primary endpoint was incremental glucose measured using Abbott Freestyle Libre CGM devices associated with a smartp; http//clinicaltrials.gov/ct2/show/NCT04424888.
 ClinicalTrials.gov NCT04424888; http//clinicaltrials.gov/ct2/show/NCT04424888.
  The development, review, and approval process of therapeutic biological products in the United States presents two primary challenges time and cost. Advancing a biotherapeutic from concept to market may take an average of 12 years, with costs exceeding US $1 billion, and the product may still fail the US Food and Drug Administration (FDA) approval process. Despite the FDA's practices to expedite the approval of new therapies, seeking FDA approval remains a long, costly, and risky process.
 
  The objective of this paper is to explore the factors and gaps related to the FDA review and approval process that contribute to process inefficiencies and complexities as well as proposed methods and solutions to address such gaps. This paper also aims to investigate the available modeling efforts for the FDA approval process of therapeutic biological products.
 
  A narrative review of literature was conducted to understand the scope of published knowledge about challenges, opportunities, and specific methods to address stigative purposes identify influential sources of variability that cause major delays, including individual, team, and organizational decision making; identify the human-system bottlenecks; identify areas of opportunity for design-driven improvements; study the effect of induced changes in the system; and assess the robustness of the structure of the FDA approval process in terms of enforcement and information symmetry.Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed.  https://www.selleckchem.com/products/trastuzumab.html  Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging.