International Journal of Applied and Basic Medical Research最新文献

Background: Spinal cord injury (SCI) results in severe physical impairments and significant lifestyle disruptions, including paralysis, increased dependence on caregivers, and a tendency toward social isolation. These challenges deeply affect the psychological health and overall quality of life (QOL) of those impacted, especially in younger patients. Investigating the psychological and QOL outcomes in individuals with stable SCIs is crucial for developing tailored rehabilitation strategies.

Aim: The study aimed to investigate the psychological health and QOL in patients with stable SCIs.

Materials and methods: This observational cross-sectional study involved patients with stable traumatic SCIs recruited through WhatsApp support groups from two major centers in India. Eligible participants were adults who were at least 1-year postinjury. Those with severe head injuries or nontraumatic spinal injuries were excluded. Participants provided sociodemographic information and injury history and completed assessments evaluating psychological health and QOL. Data were analyzed using IBM SPSS software, and statistical significance was determined through Chi-square tests.

Results: Psychological distress was identified in 26.2% of the participants. Younger participants exhibited significantly poorer QOL in the psychological domain (P = 0.02). Employment status showed a significant association with the physical domain (P = 0.037) and overall QOL scores (P = 0.046). Socioeconomic status was significantly correlated with both the psychological (P = 0.004) and social domains (P = 0.009).

Conclusions: The study underscores the considerable impact of SCI on psychological health and overall QOL, with younger individuals disproportionately affected. Healthcare providers should prioritize the integration of psychological support and counseling in SCI rehabilitation programs.

Background: ROS1, a proto-oncogene, drives cancer through chromosomal fusions. The G2032R and D2033N mutations, common in ROS1-rearranged non-small cell lung cancer, hinder crizotinib treatment. We investigate these mutations' impact on ROS1 structure through molecular dynamics (MD) simulations, revealing destabilization. Our findings shed light on how these mutations contribute to cancer development.

Materials and methods: The crystal structure of human ROS1 (PDB ID: 7z5x) served as the template for homology modeling and further mutation insertion of G2032R and D2033N substitutions introduced using Swiss-PdbViewer. The MD simulations were conducted on the wild-type (WT) and mutant ROS1 kinase domains to explore the structural changes and interactions.

Results: The initial model of the human ROS1 crystal structure was constructed, incorporating missing loop residues and then utilized for the MD simulation studies. The examination of conformational changes in WT, G2032R, and D2033N mutant ROS1 proteins involved observing alterations in the C-alpha protein. We observed that the mutations resulted in deviations in the MD trajectory over the 500 ns period. Consequently, the MD simulations unveiled significant conformational changes induced by the G2032R and D2033N mutations, affecting protein stability and dynamics, particularly in regions such as the ATP binding and active sites.

Conclusion: Our study constructed an initial model of the human ROS1 and used it for MD simulation studies to examine the conformational changes in ROS1 mutants. Notably, our observations revealed that the mutations caused deviations in the MD trajectory. The G2032R and D2033N mutations significantly alter ROS1 structure, affecting its stability and dynamics, offering key insights into their role in cancer disease development.

Introduction: Rheumatoid arthritis (RA) is a systemic, chronic, and inflammatory autoimmune disease with a strong genetic component. ARL15 gene variant rs255758 has been reported as a candidate for RA susceptibility. A replication study was performed on this variant by taking 188 RA cases and 310 healthy non-RA controls from northwest India in a case-control association study design.

Materials and methods: DNA isolated from collected blood samples was analyzed by genotyping of the variant on real-time polymerase chain reaction using TaqMan Allele Discrimination Assay and statistically analyzed.

Results: The variant was found to follow Hardy-Weinberg Equilibrium (P = 0.079) in the control group. The variant was significantly associated with RA susceptibility in the present studied population cohort (P = 0.024) with C as a risk allele and increased risk in the recessive model (CC vs. CA + AA; P = 0.004).

Conclusion: The present study corroborates the earlier findings on the role of ARL15 gene variant rs255758 in RA and further contributes to its genetic etiology.

Background: A portfolio is a specific collection of student work and achievements in various areas. E-portfolio is an electronic collection that serves the purpose of storage and showcase with the ease of access for both students and evaluators. The knowledge and skills regarding immunization in medical students are of utmost importance for the successful implementation and conduction of the Universal Immunization Program in the country. Hence, this study proposed to use e-portfolio for learning and assessment of immunization in medical undergraduates.

Aim and objectives: The aims of this study were as follows: to develop an e-portfolio for learning and assessment in community medicine, to improve the knowledge of immunization schedules of undergraduates using e-portfolio, to improve the vaccination and counseling skills of undergraduates using e-portfolio, and to obtain feedback regarding the e-portfolio from students and faculty.

Methodology: This interventional educational study was conducted at a tertiary care medical college including 48 students of Phase III MBBS after informed consent was signed. Prevalidated questionnaire and checklist were used for data collection. Students wrote reflections and uploaded their videos of immunization skills and counseling on the e-portfolio and 5 faculty members assessed the students and provided feedback to students. Feedback on the e-portfolio was taken at the end, and descriptive and qualitative analysis was done. Ethical approval for the study was obtained from the institutional ethics committee.

Results: The e-portfolio was found to be effective in showcasing the progress and learning of the students. E-portfolio improved knowledge, skills, self-directed learning, and reflective writing. The competency of immunization improved after the use of e-portfolio (P < 0.001). Faculty and students had high satisfaction with the e-portfolio and found the e-portfolio to be innovative, convenient to use, and easily accessible.

Conclusions: E-portfolio is user-friendly and effective in imparting and assessing immunization competency. The use of this intervention for other topics is recommended.

Background: Active learning strategies (ALSs) in medical education are valued for their effectiveness but face adoption challenges among educators, underscoring the need for a deeper understanding of their implementation and impact.

Aim: The aim of the study was to investigate the perceptions of medical educators regarding the effectiveness and challenges of ALS through mentor-learner (ML) web-based discussions.

Settings and design: The retrospective cross-sectional study analyzed data from 32 medical educators enrolled in the Foundation for Advancement of International Medical Education Research course at Christian Medical College, Ludhiana. It utilized a mixed-method approach, gathering both quantitative and qualitative data through ML web discussions.

Materials and methods: The study used a "dual-method" approach, combining traditional online discussions with a "role-reversal" method on an ML web platform, promoting experiential learning. Participant responses on ALS implementation tasks were collected and analyzed within these discussions.

Results: Participants shared various ALS for collaborative learning (20), classroom engagement (26), assessing prior knowledge (12), and note-taking during lectures (10). Further, among the 11 ALS examined, the ease of implementation varied significantly among participants (P < 0.0001). Challenges in ALS implementation included inadequate faculty training (91%), motivation (84%), resource constraints (81%), student (75%), and administrative resistance (69%). Four themes emerged as recommendations for effective ALS implementation: empowering educators, engaging students, streamlining support systems, and monitoring impact.

Conclusion: The study highlights a mixed perspective of medical educators on ALS. Although ALS was perceived as effective in fostering critical thinking and developing collaborative learning among students, various challenges, such as a lack of skilled faculty and resources, necessitated robust faculty development initiatives.

Background: Delivering feedback to students who have just joined a new course is relevant for it may help them to understand their subject better and hence enhance their performance.

Aim: The present study aimed to provide feedback to students using two different techniques: the sandwich method and the Ask-Tell-Ask method. It also evaluated students' perceptions of the feedback and assessed the quality of the feedback provided.

Materials and methods: The present study was a prospective randomized study conducted in the department of biochemistry with 1^st-year MBBS students from August 2022 to November 2022. Students were divided into two groups based on their midterm marks: 58 students who scored more than 50% received collective feedback, while 41 students who scored <50% received feedback individually.

Results: The difference in midterm marks obtained by students of the group which was provided feedback individually compared to the other group which received collective feedback was statistically significant (P ˂ 0.000). After applying the intervention, the mean marks obtained by the group who received the individual feedback increased by 12.35 ± 17.57. This lead to a decreased difference in the mean marks between both the groups although it still remained statistically significant (P = 0.0004). However, no statistical difference has been observed in the mean increment of marks based on which faculty provided the feedback as determined by the one-way analysis of variance (P = 0.8). The perceptions of students regarding the provided feedback and the quality of the feedback taken with the help of two different questionnaires revealed that 75.5% of students felt that the feedback provided was relevant and related to the topic. The feedback was provided within 2 weeks (75.3%) of conducting the test. About 75.6% of students felt that they got motivated for working hard. About 65.9% of students feel that providing feedback should be made a norm in the institute.

Conclusions: The study found that providing individual feedback increased the mean marks of students with no statistical difference in the mean increment of marks based on which faculty member provided the feedback. The students perceived the feedback as relevant, timely (provided within 2 weeks of the test), and related to their performance. They felt that the culture of delivering feedback should be made an institutional norm.

Background: A competent dental undergraduate at the preclinical level will ensure a confident transition into clinics and quality treatment for patients. Cavity preparation of a tooth is one of the key competencies in dentistry. A preclinical training module was introduced to enhance the skill training and improve students' learning.

Aim: This study aims to develop and implement a preclinical operative dentistry module to enhance Class-II cavity preparation training.

Methodology: Feedback was taken from the 3^rd year undergraduate batch regarding the preclinical operative dentistry training. Based on the feedback, a training module was developed and implemented for Class-II cavity preparation for 2^nd year dental students. The three-stage intervention included a preparatory intervention with a Prebrief PowerPoint presentation, followed by a live demonstration of the Class-II cavity preparation and access to a video demonstration. In the third stage, formative assessments were conducted with the help of an assessment rubric. At the end, student and faculty perceptions were gathered using a feedback survey.

Results: Most students (98%) were satisfied with the training. All the faculty strongly agreed that the module should be part of future training. Video demonstration and rubric-based assessments were testified by 93% of students as the most helpful element of the module. Major themes after thematic analysis were a better understanding of the procedure, enhanced visualization, the ability to identify areas for improvement, and boosted confidence for final exams.

Conclusions: The preclinical training module successfully met the needs of the participating undergraduate students. Video demonstration proved a beneficial digital learning resource.

Background: Abundant literature signifies the imperative role of evidence-based research in the health sector which underpins the importance of training medical graduates in research skills early in their medical journey. Low awareness, less knowledge, and minimal practical involvement of undergraduates (UGs) in research have been identified all over India. The lack of structured delivery of research curriculum in the UG period has been the basis of uptaking this project with the aim of developing research competency in medical UGs.

Materials and methods: The study was conducted as a participatory action research with a mixed-method approach in the department of community medicine at a medical college. A structured validated module was developed by the core committee and then pilot tested. The 5 years' journey through module development, pilot testing, longitudinal delivery, and then adapting it into a value-added course program at the university curriculum level was attempted.

Results: "UG Medical Research" has been adopted as value-added course in the curriculum of MBBS in the university. The research program is being run in a longitudinal structured manner with all MBBS UGs being trained using the "Module for UG Medical Research" module followed by research mentoring by faculty and subsequently academic scholarships in Electives Research Block 1. Interdisciplinary voluntary faculty pool has been created for research mentoring of UG students. The research environment of the institute has improved in terms of the increase in the number of research projects being carried out by UG students, Short Term Studentship (STS) Indian Council of Medical Research (ICMR) research scholarships, conducting annual UG research exhibition/conferences in the campus, awards for best research works, and providing intramural research grant for UGs.

Conclusions: The longitudinal structured research program was successfully incorporated into the UG curriculum which enabled UG students to demonstrate acquisition of research competency.

Background: Although the curriculum has changed, assessment tools are not in alignment with the new types of teaching such as early clinical exposure (ECE) and self-directed learning. Both in summative and formative assessment most commonly used tools for assessment of cognitive domain are written formats including MCQ. However, these assessment tools such as MCQ and written essays cannot assess the higher order thinking skills and clinical reasoning skills.

Materials and methods: The present study was conducted in the department of physiology, in collaboration with medical simulation center, as a part of formative assessment for topics on pathophysiology of shock and obstructive and restrictive lung disorders taught during ECE using case scenarios. Two script concordance tests (SCTs) each on the topic of pathophysiological mechanism of different types of shock and obstructive and restrictive lung disorders each were prepared and administered to the students. Student perception to this assessment tools was obtained.

Results: The Cronbach's alpha of the 6-item SCT for respiratory and cardiovascular topic administered to the students (n = 107, 98) was 0.83 and 0.82, respectively. The inter-item correlation was respiratory and cardiovascular topic for 0.71, 0.69 suggesting that they are close and repetitive. Students were of the opinion that SCT are difficult to understand (75.8%), challenging to answer (47.2%), and it tested the clinical content better (71.4%).

Conclusions: In our study, students felt though SCT tested the clinical content better when compared to conventionally used MCQ, they still find it challenging to understand and are not in favor of its use in summative and formative assessments.