Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum

Background

Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics.

Methods

This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013–14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course.

Results

Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001).

Conclusion

This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics.     

Protein reutilisation in corms of Colchicum autumnale

Colchicum autumnale L. is a monocotyledonous geophyte with hysteranthous leaves, i.e. flowering and leaf growth occur in different time periods. Because after the starch, the second prominent storage compound of corm is represented by proteins, we were interested in nitrogen remobilisation during the annual life cycle of C. autumnale. In this context the content of soluble and insoluble proteins were measured in parallel with determination of some exo-and endopeptidase activities. Our results indicate that the continual proteolysis occurs in both mother and new daughter corms during the whole life-cycle of the plant. L-Ala-aminopeptidase and trypsin-like endopeptidase were the most active peptidases in both mother and daughter corms. As the protein level of mother corm did not change significantly during the development of the future above-ground part under the soil surface (the first, autumnal developmental stage), the developmental profile of nitrate reductase activity was estimated followed by evaluation of total nitrogen and amino acid contents. Significant activity of root nitrate reductase was detected in the roots only in the second, vernal stage. Our results showed that the stored proteins constituted a relevant nitrogen source partly required by the growth processes of the late autumnal stage, but mainly by the intensive growth of leaves and reproductive structures during the second, photosynthetically active stage of the life-cycle.     

An improved procedure for root surface disinfection suitable for observations of proliferation of intraradical hyphae of arbuscular mycorrhizal fungusGlomus fistulosum

A disinfection procedure for mycorrhizal root segment surface was improved using neomycin and polymyxin B besides sodium hypochlorite, streptomycin and penicillin G, to obtain clean material for observation of proliferation of hyphae of arbuscular mycorrhizal (AM) fungi. The procedure of surface disinfection is more efficient, in terms of incidence of contamination, compared to the original procedure involving only sodium hypochlorite, streptomycin and penicillin G. A further decrease of visually detectable contamination can be achieved using bacteriostatic concentrations of rolitetracycline which cause a decrease of hyphal growth of the AM fungusGlomus fistulosum. The technique was used in experiment studying the uptake ofU-¹⁴C-glucose by proliferating hyphae. An active uptake of glucose occurred even in the presence of all four antibiotics at concentrations of 500 mg/L.     

X-Chromosomal recessive microcephaly with epilepsy,spastic tetraplegia and absent abdominal reflexes. New variety of “Paine syndrome”?

Summary Two brothers (7 years of age and 8 months respectively) are reported. They both suffered from a combination of severe microcephaly, spastic tetraplegia, clonic epileptic fits, absent abdominal cutaneous reflexes and severe mental retardation. This syndrome shows an X-chromosomal mode of inheritance. Dermatoglyphic patterns were characteristic. There was no change in aminoacids in CSF and the birth weight was high (4000g, in contrast to the cases described by Warkany et al.).

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Zusammenfassung Es wird über zwei Brüder (7 Jahre bzw. 8 Monate alt) berichtet. Beide litten an einer Kombination von schwerer Mikrocephalie, spastischer Tetraplegie, klonischen epileptischen Anf?llen, fehlenden abdominalen Hautreflexen und schwerem Schwachsinn. Es fand sich ein X-chromosomaler Erbgang. Die Dermatoglyphen zeigten einen charakteristischen Befund. Die Aminos?uren waren im Liquor cerebrospinalis nicht ver?ndert, und das Geburtsgewicht war hoch im Gegensatz zu den F?llen von Warkany et al.

     

Fish Oil Supplementation Alters the Plasma Lipidomic Profile and Increases Long-Chain PUFAs of Phospholipids and Triglycerides in Healthy Subjects

Background

While beneficial health effects of fish and fish oil consumption are well documented, the incorporation of n-3 polyunsaturated fatty acids in plasma lipid classes is not completely understood. The aim of this study was to investigate the effect of fish oil supplementation on the plasma lipidomic profile in healthy subjects.

Methodology/Principal Findings

In a double-blinded randomized controlled parallel-group study, healthy subjects received capsules containing either 8 g/d of fish oil (FO) (1.6 g/d EPA+DHA) (n = 16) or 8 g/d of high oleic sunflower oil (HOSO) (n = 17) for seven weeks. During the first three weeks of intervention, the subjects completed a fully controlled diet period. BMI and total serum triglycerides, total-, LDL- and HDL-cholesterol were unchanged during the intervention period. Lipidomic analyses were performed using Ultra Performance Liquid Chromatography (UPLC) coupled to electrospray ionization quadrupole time-of-flight mass spectrometry (QTOFMS), where 568 lipids were detected and 260 identified. Both t-tests and Multi-Block Partial Least Square Regression (MBPLSR) analysis were performed for analysing differences between the intervention groups. The intervention groups were well separated by the lipidomic data after three weeks of intervention. Several lipid classes such as phosphatidylcholine, phosphatidylethanolamine, lysophosphatidylcholine, sphingomyelin, phosphatidylserine, phosphatidylglycerol, and triglycerides contributed strongly to this separation. Twenty-three lipids were significantly decreased (FDR<0.05) in the FO group after three weeks compared with the HOSO group, whereas fifty-one were increased including selected phospholipids and triglycerides of long-chain polyunsaturated fatty acids. After seven weeks of intervention the two intervention groups showed similar grouping.

Conclusions/Significance

In healthy subjects, fish oil supplementation alters lipid metabolism and increases the proportion of phospholipids and triglycerides containing long-chain polyunsaturated fatty acids. Whether the beneficial effects of fish oil supplementation may be explained by a remodeling of the plasma lipids into phospholipids and triglycerides of long-chain polyunsaturated fatty acids needs to be further investigated.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01034423","term_id":"NCT01034423"}}NCT01034423     

Particulate 1,3-β-d-glucan, carboxymethylglucan and sulfoethylglucan—Influence of their oral or intraperitoneal administration on immunological respondence of mice

The effect of orally or intraperitoneally administered particulate 1,3-β-d-glucan (PBG), carboxymethylglucan (CMG) or sulfoethylglucan (SEG), obtained from the culture filtrate ofSaccharomyces cerevisiae, on the functions of murine peritoneal adherent cells (PC) (peroxidase activity, nitric oxide synthesis), on relative organ mass and on proliferation of splenocytes was determined. The modulating activities after parenteral and non-parenteral administration of these polysaccharides were compared. Significant enhancement of NO production was observed only afterin vitro cultivation of PC in the presence of lipopolysaccharide (LPS) in groups of mice treated repeatedly orally with CMG, PBG and SEG at a dose of 50 mg/kg body mass. Peroxidase activity increased significantly after repeated oral administration of CMG and PBG at doses 150 and 50 mg/kg, SEG 150 mg/kg body mass. The peroxidase activity and NO synthesis in mice given a single intraperitoneal injection of glucans (15 mg/kg body mass) were slightly higher than those after oral administration. Neither a significant enhancement of relative organ mass nor enhancement of the proliferative response of splenocytes toin vitro added stimuli (LPS, phytohemagglutinin) after repeated oral or single intraperitoneal administration of β-glucans was observed.     

Bivalve Wood Borings of the Ichnogenus Teredolites Leymerie from the Bohemian Cretaceous Basin (Upper Cretaceous,Czech Republic)

Finds of fossil wood with bivalve wood borings (Teredolites clavatus and T. longissimus) occur in various facies and presumed sedimentary settings of the platform, shallow-marine Bohemian Crectaceous Basin. The basin comprises areas with sandy-dominated sediments, with marl and clay-dominated sediments, areas with predominat sandy-marly rocks, and finally areas dominated by calcareous nearshore sediments. Teredolites clavatus is common in fossil wood of sandstones, originating in beach or deltaic settings; marl and clay-dominated rock frequently bear wood fragments densely bored by Teredolites longissimus. When accompanied by evidence of marine environments as body fossils, glauconite or typical trace fossils, most of the wood fragments are bored. The presence/absence of borings in wood fragments can be considered the most reliable and easily useable criterion of distinction of marine settings in sandy sediments of the margin of the Bohemian Cretaceous Basin.