Tag: pubmed

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4522.

ABSTRACT

Reciprocal peer teaching is a prominent pedagogical approach utilized across medical education to counteract reduction in gross anatomy contact hours. Traditionally, the roles of peer teacher and peer learner are alternated among students within a dissection group. This instance of reciprocal peer teaching was examined during Covid protocol, which prompted a third role, non-participants. Non-participants were students not present during peer teaching sessions due to enforced limitations on the number of students present at a table at a given time for social distancing. The purpose of this study was to examine the impact of student role (teacher, learner, or non-participant) during reciprocal peer teaching on performance of 1^st year medical students (n=34). The context of the study was a 10 week Human Gross Anatomy course taken first in the 1^st year medical student curriculum. Twenty-two peer teaching sessions were video recorded across the 4 blocks of anatomical content which resulted in (n=131) instances of reciprocal peer teaching. Peer teaching videos were cross-referenced to track student role during a given session and whether or not an anatomical structure was taught or not by cross-referencing the associated dissection structure list. Medical students throughout the course took 4 block laboratory practical exams which were collected and coded for student role, whether a question was answered correct or not, and if it was taught or not during the recorded peer teaching session. A GEE (generalized estimating equation) was used to determine if student role during reciprocal peer teaching sessions had a statistically significant effect on their likelihood to correctly answer lab practical questions, i.e., their performance. The factor role in the model was statistically significant (Wald χ² = 34.95 (2), p<0.0001) and indicated that those in the role of peer teacher had 4.14 times more likelihood to correctly answer lab practical questions. In practicality, this equated to an average increase in mean lab practical answers correct of 13% for peer teachers compared to peer learners, whereas peer learners only had a 3% increase in mean lab practical answers correct compared to non-participants. Given that peer teachers had to be involved in the hands-on dissection of the anatomical content for their given peer teaching session, the boost to their performance is not surprising. What is surprising is the marginal difference between peer learners and non-participants. These results may indicate that even though reciprocal peer teaching is premised as an active learning pedagogy, just because it is implemented doesn’t mean the peer learners are participating actively during teaching sessions and were largely passively being taught structures. A suggestion to increase peer learner benefit would be to allocate time for them to have an opportunity to identify and teach structures back to the peer teacher to increase their own retrieval practice. Future directions may incorporate the role of peer teacher as a facilitator rather than a passive lecturer, allowing the peer learners opportunities to become more actively involved in their own learning during reciprocal peer teaching sessions.

PMID:35557289 | DOI:10.1096/fasebj.2022.36.S1.R4522

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R4298.

ABSTRACT

SAMP1/YitFC (SAMP) mice exhibit spontaneous ileitis as they age with morphological and functional epithelial abnormalities mimicking human Crohn’s disease, a chronic disease characterized by ileal inflammation. Indole-3-carbinole (I3C), found in broccoli and Brussel sprouts, plays a crucial role in the anti-inflammatory processes by activating the aryl hydrocarbon receptor (AhR), a transcription factor vital for epithelial and immune cell functions. The impact of I3C diet on disease progression and epithelial integrity in SAMP model of ileitis is not known. METHODS: 6-week-old male and female (n=8 per group) SAMP and control AKR/J mice (Jackson) were fed for 14 weeks either a standard chow diet or a purified diet supplemented with 200 ppm with indole-3-carbinole (+I3C diet), or purified diet depleted of AhR ligands (-I3C diet). Ileum samples were collected for qPCR and histological analyses. Statistical analysis was performed by Tukey’s multiple comparison test for all three diets. To detect changes between +I3C vs. -I3C, delta values (Δ +/-I3C = SAMP-AKR) were analyzed by unpaired T-test. RESULTS: As expected, H&E staining for the ileum of SAMP mice fed chow diet, showed thickening of the muscle layer, neutrophil infiltration, and epithelial tufting vs. AKR mice. Severity of inflammation in SAMP mice, as assessed by fecal calprotectin ELISA, mRNA expression of cytokines, and histological analysis was not significantly impacted by dietary depletion or supplementation of I3C. With respect to epithelial abnormalities, Periodic Acid Schiff staining showed increased number of goblet cells per villi (~47-75%) in SAMP mice on all three diets. While mRNA levels of the major goblet cell secretory proteins, mucin2 (Muc2) and intestinal trefoil factor (ITF), were dramatically decreased in SAMP mice vs. AKR, supplementation of I3C attenuated this decrease in Muc2 and ITF by ~35% and 51% (p<.001), respectively, indicating defective synthesis or secretion. Similarly, I3C diet significantly (p<.01) attenuated the decrease in Paneth cell markers lysozyme C-1 (LYZ1) alpha defensin 5 (Def5α) and regenerating islet-derived protein 3 alpha (Reg3α) in SAMP mice by ~65%, 60%, and 24%, respectively. A decrease in fibroblast growth factor 15 (FGF15) and the epithelial ion transporters serotonin transporter (SERT) and organic solute transporter (OST) were observed in ileal mucosa of SAMP mice vs. AKR, and the supplementation of I3C mitigated these decreases by 30-58% (p<.01). There were no significant changes in the expression of tryptophan hydroxylase 1 (tph-1), C-X-C motif chemokine ligand 2 (CXCL2), or AhR by I3C diet in SAMP mice. In summary, I3C supplementation significantly attenuated the goblet cell, Paneth cell, and epithelial-specific abnormalities seen in SAMP mice. These data imply that dietary supplementation of AhR ligands may be a viable therapeutic strategy for Crohn’s patients to restore epithelial integrity.

PMID:35557290 | DOI:10.1096/fasebj.2022.36.S1.R4298

FASEB J. 2022 May;36 Suppl 1. doi: 10.1096/fasebj.2022.36.S1.R2685.

ABSTRACT

INTRODUCTION: Retrieval practice through testing can strengthen long-term memory. Experimentally, this concept known as the “testing effect” has often been demonstrated using word pairs. As many health science students quiz with flashcards to enhance recall, can the testing effect be detected within the more complex study of anatomy? It was hypothesized that participants utilizing flashcards for review would score higher on tests than those restudying a handout.

METHODS: Students were recruited from Pacific Northwest University of Health Sciences (PNWU). On day 1 of the study, subjects were given 3 memory tests (assessing memory of printed words, pictures, and spoken words), the scores of which were combined and used to assign participants to groups with approximately equal “memory.” Participants studied a handout on ruminant digestive anatomy, a topic novel to most students. After the initial study session, subjects were divided into a “flashcard group” (FG) or a “handout group” (HG) and reviewed the learned material via their assigned method. Participants then took a 15-question test, indicating whether they were confident or not for each answer, and took a similar test 1 and 3 weeks later. Participants completed surveys on demographics, existing knowledge of ruminants and anatomical terms, wellness, and study behaviors on day 1 of the study. Data were analyzed using Mann Whitney U test, Fischer’s exact test, Pearson Correlation Coefficient, and repeated measures ANOVA using SPSSv25.0 software with p<0.05 considered statistically significant. This study was deemed exempt by PNWU IRB (#2021-015).

RESULTS: Though not statistically so, mean scores were higher in the FG than in the HG for each of the ruminant digestive anatomy assessments. For day 1 test score means (FG 10.67 ± 1.50 vs HG 9.00 ± 2.68), a large effect size (η_p² =0.16) was detected. While the FG started with more experience with anatomical terms (p=0.046), this experience was not significantly correlated with day 1 test scores (n=17). Though the FG tended to perform better on day 1 tests, the HG was more confident in their answer choices (mean confidence scores HG 10.00 ± 1.10 vs FG 7.78 ± 1.72), with a large effect size present (η_p² =0.38). Memory scores were not significantly different between the FG and the HG. Though not significant, most memory scores were negatively correlated with age. Sleep was negatively correlated with memory scores, which was significant for memory of printed words (r=-0.56; p=0.019). Female memory scores consistently ranked higher than male scores.

CONCLUSIONS: Participants who restudied with flashcards tended to outperform those restudying handouts on tests covering a novel anatomy topic, suggesting that the testing effect may have occurred. Interestingly, the opposite pattern was seen in confidence, with those studying handouts seemingly more confident in their test answers. Utilizing memory test scores resulted in evenly distributed groups with respect to memory, and some intriguing potential differences were seen related to sleep on the night before day 1 of the study, age, and gender. This study was limited by a small sample size and should be expanded to further investigate the effect of various restudy techniques, such as using flashcards or handouts while learning anatomy.

PMID:35557288 | DOI:10.1096/fasebj.2022.36.S1.R2685

Reprod Health. 2022 May 12;19(1):117. doi: 10.1186/s12978-022-01422-w.

ABSTRACT

BACKGROUND: Lifestyle modification (diet, exercise, and behavioral interventions) is the first-line treatment for polycystic ovary syndrome (PCOS). The benefits of face-to-face lifestyle modification intervention in a short time have been demonstrated. However, few studies have investigated the mobile technology effects on lifestyle modification in PCOS. Therefore, we examined the effect of transtheoretical model-based mobile health application intervention program for PCOS.

METHODS: A randomised controlled, single-blind trial, was carried out from October 2018 to March 2019, which included 122 participants recruited from gynecology outpatient clinics of affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention (n = 61) and control groups (n = 61). Participants in the intervention group undertook a TTM-based mobile health application program in addition to routine care, and participants in the control group received only routine care.

RESULTS: Fifty-one participants in the intervention group and 49 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant decrease for BMI (P < 0.05), WC (P < 0.05), SAS (P < 0.05), and SDS (P < 0.05) scores at 6-month and 12-month, respectively. Behavior stage change of exercise and diet among paticipants with PCOS was significant at 6 months (c² = 43.032, P < 0.05) and 12th months (c² = 49.574, P < 0.05) between the intervention and control groups.

CONCLUSIONS: This study showed that the TTM-based mobile health application program can decrease BMI, WC, anxiety, and depression, and improve exercise and diet adherence in patients with PCOS in the long term. The TTM-based mobile health application program can be applied for lifestyle modification in women with PCOS. Trial registration This study was approved by the ethics committee NO.[2019]1-028 in March 2018 and was registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn , registry number: ChiCTR2000034572).

PMID:35549736 | DOI:10.1186/s12978-022-01422-w

Anaesth Intensive Care. 2022 May 12:310057X211053644. doi: 10.1177/0310057X211053644. Online ahead of print.

ABSTRACT

Dantrolene is currently the only drug known to specifically treat malignant hyperthermia (MH) crises. Although dantrolene attenuates Ca²⁺ disorders by acting mainly on the ryanodine receptor type 1 (RYR1), some patients who manifest MH without RYR1 variants have also been successfully treated with dantrolene. Thus, dantrolene appears to have an inhibitory effect on patients with and without RYR1 variants. This study aimed to investigate whether the effects of dantrolene differed depending on the presence or absence of RYR1 variants using muscle cells from MH-predisposed individuals. The study participants were individuals diagnosed with MH predisposition by the Ca²⁺-induced Ca²⁺ release rate test. They were genetically tested and divided into two groups: with and without RYR1 variants. We investigated whether these two groups showed differences in the changes in the half-maximal effective concentration (EC₅₀) for caffeine and the resting intracellular Ca²⁺ concentration ([Ca²⁺]_i) before and after dantrolene administration. Dantrolene administration significantly increased the EC₅₀ (P < 0.0001) and decreased the resting [Ca²⁺]_i (P < 0.0001). The inhibitory effects of dantrolene and the presence of RYR1 variants showed no statistically significant interactions related to the EC₅₀ (P = 0.59) and resting [Ca²⁺]_i (P = 0.21). In conclusion, the presence or absence of RYR1 variants does not appear to influence the effect of dantrolene.

PMID:35549722 | DOI:10.1177/0310057X211053644

Malar J. 2022 May 12;21(1):146. doi: 10.1186/s12936-022-04164-z.

ABSTRACT

BACKGROUND: Malaria is widespread in Ethiopia and has been a major cause of illness and death in that country. Therefore, Ethiopia has been exerting enormous efforts towards eliminating malaria by 2030. In the context of comprehensive malaria control, the malaria vaccine is used for the prevention of Plasmodium falciparum malaria in children living in regions with moderate- to-high malaria transmission.

METHODS: A community-based cross-sectional study was conducted among caregivers of children under the age of five throughout the months of September 2021. A structured interviewer-administered questionnaire was designed for data collection, and binary logistic regression analysis was used. The final result of the association was determined based on an adjusted odds ratio (AOR) at a 95% confidence interval (CI) level, and p < 0.05 indicated statistical significance.

RESULTS: A total of 406 caregivers of children under the age of 5 were interviewed. Overall, 131 (32.3%) respondents were willing to vaccinate their children. Marital status (AOR = 1.243; 95% CI 1.021-3.897), knowledge (AOR = 3.120; 95% CI 1.689-5.027), and previous experience with childhood vaccination (AOR = 2.673; 95% CI 1.759-4.101) were found to be significantly associated with willingness to accept a malaria vaccine for their children, at p < 0.05.

CONCLUSIONS AND RECOMMENDATIONS: The willingness to accept a malaria vaccine for children among caregivers of children under the age of five was low in the study area. Thus, health education and communication are crucial for alleviating poor knowledge about malaria vaccines.

PMID:35549710 | DOI:10.1186/s12936-022-04164-z

Hum Resour Health. 2022 May 12;20(1):40. doi: 10.1186/s12960-022-00729-w.

ABSTRACT

BACKGROUND: The 2014-2016 Ebola virus disease outbreak in West Africa revealed weaknesses in the health systems of the three most heavily affected countries, including a shortage of public health professionals at the local level trained in surveillance and outbreak investigation. In response, the Frontline Field Epidemiology Training Program (FETP) was created by CDC in 2015 as a 3-month, accelerated training program in field epidemiology that specifically targets the district level. In Guinea, the first two FETP-Frontline cohorts were held from January to May, and from June to September 2017. Here, we report the results of a cross-sectional evaluation of these first two cohorts of FETP-Frontline in Guinea.

METHODS: The evaluation was conducted in April 2018 and consisted of interviews with graduates, their supervisors, and directors of nearby health facilities, as well as direct observation of data reports and surveillance tools at health facilities. Interviews and site visits were conducted using standardized questionnaires and checklists. Qualitative data were coded under common themes and analyzed using descriptive statistics.

RESULTS: The evaluation revealed a significant perception of improvement in all assessed skills by the graduates, as well as high levels of self-reported involvement in key activities related to data collection, analysis, and reporting. Supervisors highlighted improvements to systematic and quality case and summary reporting as key benefits of the FETP-Frontline program. At the health facility level, staff reported the training had resulted in improvements to information sharing and case notifications. Reported barriers included lack of transportation, available support personnel, and other resources. Graduates and supervisors both emphasized the importance of continued and additional training to solidify and retain skills.

CONCLUSIONS: The evaluation demonstrated a strongly positive perceived benefit of the FETP-Frontline training on the professional activities of graduates as well as the overall surveillance system. However, efforts are needed to ensure greater gender equity and to recruit more junior trainee candidates for future cohorts. Moreover, although improvements to the surveillance system were observed concurrent with the completion of the two cohorts, the evaluation was not designed to directly measure impact on surveillance or response functions. Combined with the rapid implementation of FETP-Frontline around the world, this suggests an opportunity to develop standardized evaluation toolkits, which could incorporate metrics that would directly assess the impact of equitable field epidemiology workforce development on countries’ abilities to prevent, detect, and respond to public health threats.

PMID:35549712 | DOI:10.1186/s12960-022-00729-w

Breastfeed Med. 2022 May 12. doi: 10.1089/bfm.2021.0326. Online ahead of print.

ABSTRACT

Background: The second stage of lactation with copious milk production occurs after birth regardless of the infant’s survival. Previous research indicates that milk donation following a perinatal loss may help some bereaved mothers come to terms with their loss. The purpose of this study was to explore the experience of women choosing to continue to express milk after a perinatal loss specifically for donation to a nonprofit milk bank governed by the Human Milk Banking Association of North America (HMBANA). Materials and Methods: Participants were recruited through HMBANA’s milk bank directors’ listserv, their bereavement committee, and through their website. Participants were eligible if they donated to an HMBANA milk bank and specifically continued to pump milk for the purpose of milk donation following a perinatal loss. Qualitative interviews were conducted with each participant using a secured web-based platform. Data collection and analysis occurred concurrently using qualitative content analysis until there was acknowledged informational redundancy. Participants’ demographic and lactation data were collected and analyzed using descriptive statistics. Results: Over 10 months, 21 participants were interviewed. Donating after perinatal loss has been described as a positive, valuable, and nurturing experience. Diminished grieving, enhanced connection to the infant, establishment of legacy, and creation of a positive from a negative are highlighted in several themes that illuminate the phenomena of bereaved donation. Discussion: The findings of this research are consistent with published literature, but in this study, two subgroups were formed. This enabled the researchers to compare the experience of those with previous breastfeeding experience and those without, which adds to the knowledge about the phenomenon. It provides information for health care professionals (HCPs) to understand the experience of bereaved milk donors and serves as a call to action for HCPs to develop best practices and incorporate lactation management in enhanced, individualized bereavement care for these women.

PMID:35549706 | DOI:10.1089/bfm.2021.0326

BMC Health Serv Res. 2022 May 12;22(1):632. doi: 10.1186/s12913-022-08055-6.

ABSTRACT

BACKGROUND: Late antenatal care initiation is linked to a higher risk of maternal death. Women who do not start ANC at an early stage may experience the effects of pregnancy-related health difficulties, as well as long-term health issues and pregnancy complications. Therefore, our study aimed to determine the prevalence of late initiation of antenatal care and associated factors among pregnant women in Jimma Zone public Hospitals.

METHODS: A facility-based cross-sectional study design was employed in Jimma zone public hospitals from February 1 up to 30 March 2020 and 409 pregnant women were participated in the study by using a systematic random sampling method. Structured questionnaire was used to collect data that contain socio demographic variables, socio cultural variables, pregnancy related factors and predisposing factor related variables. The data was entered into EPI data version 3.1 and exported to SPSS version 20 for statistical analysis. Binary and multivariable logistic regression analysis were performed by using 95%CI and significance was declared at P < 0.05.

RESULT: Forty-eight percent of pregnant women were initiated their first ANC late. Primary education (AOR = 0.242; 95% CI, 0.071-0.828) and college diploma and above was (AOR = 0.142; 95% CI, 0.040- 0.511), mothers with an unplanned pregnancy (AOR = 11.290; 95%CI, 4.109-31.023), time taken to arrive the health facility greater than sixty (60) minutes (AOR = 8.285; 95% CI, 2.794-24.564) and inadequate knowledge about ANC service (AOR = 4.181; 95%CI, 1.693-10.348) were associated with late first Antenatal care initiating.

CONCLUSION: The prevalence of late initiation of ANC still remains a major public health concern in the study area. Level of education, unplanned pregnancy, distance from house to health facility, and lack of understanding about ANC services were all found to be significant variables in late ANC starting. As a result, healthcare workers can provide ongoing health education on the need of starting antenatal care visits early to avoid unfavorable pregnancy outcomes by considering all identified factors.

PMID:35549700 | DOI:10.1186/s12913-022-08055-6

BMC Musculoskelet Disord. 2022 May 12;23(1):447. doi: 10.1186/s12891-022-05394-7.

ABSTRACT

BACKGROUND: Surgical treatment of displaced distal radius fractures (DRF) in older patients has increased, despite lacking evidence of its superiority over non-operative treatment. How treatment choice affects these patients after the initial 12-month period remains unknown. This study presents a clinical and radiographic follow up at an average of 3 years after treatment in the context of a randomized clinical trial comparing outcomes in patients aged ≥70 years, with a dorsally displaced distal radius fracture treated either surgically with volar locking plate or non-operatively.

METHODS: Between 2009 and 2017, 140 patients aged ≥70 years with dorsally displaced DRF were randomized to surgery with volar locking plate (VLP) or non-operative treatment. At an average of 3 years after inclusion the participants were invited to an additional follow-up. The primary outcome was Patient Rated Wrist Evaluation (PRWE). Secondary outcomes included additional Patient Reported Outcome Measures (PROM), grip strength, range of motion, complications and radiological results.

RESULTS: Sixty six patients were available for a 3 year follow-up, 33 in the non-operatively treated group and 33 in the VLP-group. The mean age at injury was 77 years. At 3 years the median PRWE was better (0 points) in the VLP-group than in the non-operative treatment group (9 points) p-value: 0.027. No statistically significant difference was found in Disabilities of the Arm, Hand, and Shoulder (DASH), EuroQol 5 Dimensions (EQ-5D) or grip strength. Total arc of range of motion was larger in the operatively treated group. No significant difference in osteoarthritis was found. Both groups had regained grip strength. The complication rate was similar. Outcomes improved from the 1 year to the 3 year follow-up.

CONCLUSIONS: Surgery with volar locking plate gave less long-term disability compared to non-operative treatment for severely displaced distal radius fractures in patients aged ≥70 years. Our findings were statistically significant but in the lower range of clinical importance.

TRIAL REGISTRATION: The study was registered at : NCT02154620 03/06/2014 and NCT01268397 30/12/2010. Ethical approval was obtained from Ethical Committee in Stockholm, Sweden (2009/37-31/3, 2013/105-31/2, 2014/1041-32, 2017/611-32).

PMID:35549696 | DOI:10.1186/s12891-022-05394-7