Medical students as medical educators: opportunities for skill development in the absence of formal training programs

All physicians, at some point in their career, are responsible for the education of their peers and junior colleagues. Although medical students are expected to develop clinical and research skills in preparation for residency, it is becoming clear that a student should also be expected to develop abilities as a teacher. A handful of institutions have student-as-teacher programs to train medical students in education, but most students graduate from medical school without formal training in this area. When such a program does not exist, medical students can gain experience in education through participation in peer teaching, course design, educational committees, and medical education scholarship. In doing so, they attain important skills in the development, implementation, and evaluation of educational programs. These skills will serve them in their capacity as medical educators as they advance in their careers and gain increasing teaching responsibility as residents, fellows, and attending physicians.     

Antisense oligodeoxynucleotides: useful tool for search and assessment of new targets for anti-malarial drugs.

We investigated about targeting for new antimalarial drugs using antisense (AS) oligodeoxynucleotides (ODNs). Synthetic nuclease-resistant ODNs (phosphorothioate (PS) ODNs and ODNs containing 4'alpha-C-(2-aminoethyl)thymidines (4'-amino ODNs)) which target mitochondrial succinate dehydrogenase (SDH) iron-sulfur subunit (IP), had antimalarial activity (EC50; about 1.0 microM). Furthermore we showed that intra-parasitic SDH IP mRNA levels, which were detected using quantitative RT-PCR assay, were decreased 13% of control after the 24 h expose to SDH IP AS. From the results, we conclude that SDH has potential as the target for novel antimalarials, and AS ODNs is effective for search and assessment of targets for new antimalarial drugs.     

构建培养新型医学人才的医学遗传学课程体系改革

传统的医学课程体系已经远不能适应信息时代新知识技术所带来的巨大冲击.因此,构建新型课程体系,培养适应21世纪社会发展需要的新型医学人才,是人才培养模式改革的主要落脚点,也是教学改革的重点和难点.医学遗传学是遗传学与医学相互渗透、相互结合的边缘学科,是一门横跨基础医学和临床医学的桥梁课程,是现代医学的重要组成部分.近年来,随着现代生物学和现代遗传学研究技术的蓬勃发展,医学遗传学突飞猛进.医学遗传学作为专业性较强的基础学科,内容比较抽象,不易理解,一直是教学难点.针对医学遗传学迅猛发展的现状和难以理解的特点,进行医学遗传学课程体系改革和实践,进一步尝试建立新型课程体系,培养新型医学人才意义深远.本文探讨了医学遗传学课程体系改革的必要怀,过程及其意义.     

The Hirsch-index: a simple, new tool for the assessment of scientific output of individual scientists

In this brief paper we explore the Hirsch-index together with a couple of other bibliometric parameters for the assessment of the scientific output of 29 Dutch professors in clinical cardiology. It appears that even within such a homogeneous group there is large interindividual variability. Although the differences are quite remarkable, it remains undetermined what they mean; at least it is premature to interpret them as differences in scientific quality. It goes without saying that even more prudence is required when different fields of medicine and life sciences are compared (for example within University Medical Centres). Recent efforts to produce an amalgam of scientific ‘productivity’, ‘relevance’ and ‘viability’ as a surrogate parameter for the assessment of scientific quality, as for example performed in the AMC in Amsterdam, should be discouraged in the absence of a firm scientific base. Unfortunately for politicians and ‘managers of science’ only reading papers and studying are suitable for quality assessment of scientific output. Citations analyses can't substitute that. (Neth Heart J 2009;17:145–54.)     

Immuno-PCR--a new tool for paleomicrobiology: the plague paradigm

Background

The cause of past plague pandemics was controversial but several research teams used PCR techniques and dental pulp as the primary material to reveal that they were caused by Yersinia pestis. However, the degradation of DNA limits the ability to detect ancient infections.

Methods

We used for the first time immuno-PCR to detect Yersinia pestis antigens; it can detect protein concentrations 70 times lower than the standard ELISA. After determining the cut-off value, we tested 34 teeth that were obtained from mass graves of plague, and compared previous PCR results with ELISA and immuno-PCR results.

Results

The immuno-PCR technique was the most sensitive (14 out of 34) followed by the PCR technique (10 out of 34) and ELISA (3 out of 34). The combination of these three methods identified 18 out of 34 (53%) teeth as presumably being from people with the plague.

Conclusion

Immuno-PCR is specific (no false-positive samples were found) and more sensitive than the currently used method to detect antigens of ancient infections in dental pulp. The combination of three methods, ELISA, PCR and immuno-PCR, increased the capacity to identify ancient pathogens in dental pulp.     

Lung ultrasound: a new tool for the cardiologist

Background

We have previously reported strain dyssynchrony index assessed by two-dimensional speckle tracking strain, and a marker of both dyssynchrony and residual myocardial contractility, can predict response to cardiac resynchronization therapy (CRT). A newly developed three-dimensional (3-D) speckle tracking system can quantify endocardial area change ratio (area strain), which coupled with the factors of both longitudinal and circumferential strain, from all 16 standard left ventricular (LV) segments using complete 3-D pyramidal datasets. Our objective was to test the hypothesis that strain dyssynchrony index using area tracking (ASDI) can quantify dyssynchrony and predict response to CRT.

Methods

We studied 14 heart failure patients with ejection fraction of 27 ± 7% (all≤35%) and QRS duration of 172 ± 30 ms (all≥120 ms) who underwent CRT. Echocardiography was performed before and 6-month after CRT. ASDI was calculated as the average difference between peak and end-systolic area strain of LV endocardium obtained from 3-D speckle tracking imaging using 16 segments. Conventional dyssynchrony measures were assessed by interventricular mechanical delay, Yu Index, and two-dimensional radial dyssynchrony by speckle-tracking strain. Response was defined as a ≥15% decrease in LV end-systolic volume 6-month after CRT.

Results

ASDI ≥ 3.8% was the best predictor of response to CRT with a sensitivity of 78%, specificity of 100% and area under the curve (AUC) of 0.93 (p < 0.001). Two-dimensional radial dyssynchrony determined by speckle-tracking strain was also predictive of response to CRT with an AUC of 0.82 (p < 0.005). Interestingly, ASDI ≥ 3.8% was associated with the highest incidence of echocardiographic improvement after CRT with a response rate of 100% (7/7), and baseline ASDI correlated with reduction of LV end-systolic volume following CRT (r = 0.80, p < 0.001).

Conclusions

ASDI can predict responders and LV reverse remodeling following CRT. This novel index using the 3-D speckle tracking system, which shows circumferential and longitudinal LV dyssynchrony and residual endocardial contractility, may thus have clinical significance for CRT patients.     

Lipolysis index: evaluation of a new tool for metabolic assessment in epidemiological studies on obesity

Lipid mobilization through adipocyte lipolysis is central for energy metabolism and is decreased in obesity. However, the factors of importance for lipolytic activity in the general population are not known. To further examine this we performed a cross-sectional study on teenagers and adults. We constructed and evaluated a simple index of lipolytic activity (ratio of fasting p-glycerol and body fat %) in population based samples in 316 teenagers (BMI 16-51 kg/m (2)) and 3,039 adults (BMI 16-70 kg/m (2)). In the adults, multiple regression analysis showed that waist and BMI but not age, plasma insulin, plasma noradrenaline or waist-to-hip ratio contributed independently and inversely to lipolytic activity (partial r=-0.37 and -0.28, respectively, p<0.0001). Together waist and BMI explained about 45% of the variability of lipolysis. Waist was a stronger factor than BMI in stepwise regression. The same analysis in teenagers showed that only BMI contributed independently and inversely to lipolytic activity (partial r=-0.90, p<0.0001) and explained about 55% of lipolysis variation. BMI had the strongest effect on lipolysis in lean teenagers. The results were the same for men and women. At all levels of lipolytic activity plasma fatty acid levels were elevated in obese subjects (p<0.0001). We conclude that during adolescence BMI is the major factor negatively influencing lipolytic activity, in particular among lean young subjects. In adulthood central fat accumulation together with increasing BMI decreases lipolysis. In spite of low lipolytic activity circulating fatty acid levels are increased in obesity, probably due to an adipose mass effect.     

Neural training for quick strength gains in the elderly: strength as a learned skill

A sample of 20 older adults (76 +/- 6 years) participated in a two-session training intervention with the goal of eliciting rapid and functionally meaningful strength gains in the ankle plantarflexors. Tests were conducted on a Monday-Wednesday-Friday schedule with two training sessions after tests one and two. During each test, subjects performed five maximal explosive force production contractions (MVCs) from which maximal voluntary torque (MVT) and peak rates of torque development (RTDs) were obtained. To augment the quick strength gains typically observed in response to serial strength measurements, these MVCs were supplemented with exercises consisting of high-velocity, low-force movements at the ankle joint. These exercises were chosen to elicit high rates of neural stimulation without high resistance. Maximal voluntary torque increased by 15% from 53.9 +/- 36 to 62.2 +/- 36.2 N x m (p = 0.02). There was a parallel trend toward increases in RTD based on RTD measures computed over various timescales (0.11 < p < 0.21). The nonsignificant increase in RTD was from 223.9 +/- 153.6 to 248.4 +/- 147.8 N x m x s(-1). This preliminary study has determined that rapid strength gains of functional magnitude are possible in the plantarflexors of the elderly. Subsequent work is necessary to test the translation of such gains to function in the frail elderly and to determine the specific contributions of the selected low-resistance exercises to overall gains.     

Portable optical fiber probe-based spectroscopic scanner for rapid cancer diagnosis: a new tool for intraoperative margin assessment

There continues to be a significant clinical need for rapid and reliable intraoperative margin assessment during cancer surgery. Here we describe a portable, quantitative, optical fiber probe-based, spectroscopic tissue scanner designed for intraoperative diagnostic imaging of surgical margins, which we tested in a proof of concept study in human tissue for breast cancer diagnosis. The tissue scanner combines both diffuse reflectance spectroscopy (DRS) and intrinsic fluorescence spectroscopy (IFS), and has hyperspectral imaging capability, acquiring full DRS and IFS spectra for each scanned image pixel. Modeling of the DRS and IFS spectra yields quantitative parameters that reflect the metabolic, biochemical and morphological state of tissue, which are translated into disease diagnosis. The tissue scanner has high spatial resolution (0.25 mm) over a wide field of view (10 cm × 10 cm), and both high spectral resolution (2 nm) and high spectral contrast, readily distinguishing tissues with widely varying optical properties (bone, skeletal muscle, fat and connective tissue). Tissue-simulating phantom experiments confirm that the tissue scanner can quantitatively measure spectral parameters, such as hemoglobin concentration, in a physiologically relevant range with a high degree of accuracy (<5% error). Finally, studies using human breast tissues showed that the tissue scanner can detect small foci of breast cancer in a background of normal breast tissue. This tissue scanner is simpler in design, images a larger field of view at higher resolution and provides a more physically meaningful tissue diagnosis than other spectroscopic imaging systems currently reported in literatures. We believe this spectroscopic tissue scanner can provide real-time, comprehensive diagnostic imaging of surgical margins in excised tissues, overcoming the sampling limitation in current histopathology margin assessment. As such it is a significant step in the development of a platform technology for intraoperative management of cancer, a clinical problem that has been inadequately addressed to date.     

XRate: a fast prototyping, training and annotation tool for phylo-grammars

Background  

Recent years have seen the emergence of genome annotation methods based on the phylo-grammar, a probabilistic model combining continuous-time Markov chains and stochastic grammars. Previously, phylo-grammars have required considerable effort to implement, limiting their adoption by computational biologists.     

Molecular dynamics simulation as a tool for assessment of drug binding property of human serum albumin

Human serum albumin (HSA) is a major plasma protein and binding of drugs with this plasma protein has a great importance. It possess esterase activity which can cleave the drugs containing ester bond and thus, can regulate the effect of drugs. Till date no systematic study has been done to analyse binding of such drugs and to compare the results with the drugs which do not have ester bond. Therefore, in the present study two different categories—ester and non-ester drugs have been considered to analyse their interaction with HSA at two principle drug binding sites using molecular modelling tools. It is observed that the drugs irrespective of ester or non-ester nature prefer either Sudlow site I or II by hydrogen bond and hydrophobic interactions. The information obtained from the study can assist to study pharmacokinetics of the drugs and that in turn will help in noval drug discoveries.     

Jane: a new tool for the cophylogeny reconstruction problem

Background  

This paper describes the theory and implementation of a new software tool, called Jane, for the study of historical associations. This problem arises in parasitology (associations of hosts and parasites), molecular systematics (associations of orderings and genes), and biogeography (associations of regions and orderings). The underlying problem is that of reconciling pairs of trees subject to biologically plausible events and costs associated with these events. Existing software tools for this problem have strengths and limitations, and the new Jane tool described here provides functionality that complements existing tools.     

Split-seed: a new tool for maize researchers

Until recently, immature embryos have been a choice tissue for manipulation in culture for regeneration and production of transgenic maize plants. The utility of this explant has been compromised by low output, genotype dependence and time-consuming incubation in tissue culture. We have developed a new explant, the split-seed, which addresses these limitations by formally treating each seed as though it were a “dicot”. By splitting maize seed longitudinally, three different tissues: the scutellum, the coleoptilar-ring and the shoot apical meristems are simultaneously exposed. The cells of these tissues can be made competent to enhance the regeneration, given that the molecular networks resulting from exposure of the split-seed to hormones is likely to be different from whole seed and, in turn, affects the in vitro response. Using this explant, callus induction frequency exceeded 92% and the regeneration frequency was 76%. The mean number of shoots regenerated via callus was 11 shoots per callus clump and 28 shoots per explant at first sub-culture. All of the regenerated plants survived and were 95% fertile. The large numbers of fertile plants produced were regenerated in 6–8 weeks. Finally, the incidence of regenerated plants varies as a function of growth regulator profile.Electronic Supplementary Material Supplementary material is available for this article at and is accessible for authorized users.     

A new tool for biotechnology: AdoMet-dependent methyltransferases

AdoMet-dependent methyltransferases catalyze highly specific methyl group transfers from the ubiquitous cofactor S-adenosyl-L-methionine to a multitude of biological targets in the cell. Recently, DNA methyltransferases have been used for the sequence-specific, covalent attachment of larger chemical groups to plasmid and bacteriophage DNA using two classes of synthetic AdoMet analogs. These synthetic cofactors, in combination with the myriad AdoMet-dependent methyltransferases available in nature, provide new molecular tools for precise, targeted functionalization and labeling of large natural DNAs and, in all likelihood, RNAs and proteins. This paves the way for numerous novel applications in the functional analysis of biological methylation, biotechnology and medical diagnostics.     

Survival regression analysis: a powerful tool for evaluating fighting and assessment

Theoretical models of animal contests frequently generate predictions about how asymmetries (e.g. differences in size, residence status) between contestants affect fight duration. Linear regression and nonparametric correlation analyses are commonly used to test the fit of data to such models. We show how survival regression analysis (SRA) is a powerful technique for studying the effect of asymmetries on the duration of contests. SRA, which is under-utilized by students of animal behaviour, offers several advantages over more frequently used procedures. It provides unbiased parameter estimates even when including censored data (i.e. results of contests that have not ended at the time when observations are stopped). The analysis of hazard functions, which is a component of SRA, is an easy way to test for consistency with predictions of the sequential assessment game model. These and other advantages of SRA are illustrated by using SRA and more conventional methods to analyse the effect of asymmetries on contest duration for encounters between female Mediterranean tarantulas, Lycosa tarentula (L.). It is hoped that this example of the advantages of SRA will encourage more widespread use of this powerful technique. Copyright 2000 The Association for the Study of Animal Behaviour.