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This communication records a series of obstructive behaviors not specified bibliographically detected in planners and/or executors from 2002 in a pioneering Argentine PBL medical curricular change. The results obtained were extracted mainly from the author's experience during his participation as a teacher in this process and from some related experiences recorded later in other Argentine medical schools that also develop curricular changes. In addition, he points to other design and implementation caveats not considered in a timely manner that negatively influenced that transformation. To date, unfortunately, all of this has contributed to the failure to meet the great expectations placed on it. This report may be useful for planners and implementers who pursue a successful PBL curriculum change by showing that, beyond the best intentions in this regard, particular behaviors, some of them linked to the human condition, can hinder its design and implementation. practice.
Esta comunicación registra una serie de conductas obstaculizadoras no especificadas bibliográficamente detectadas en planificadores y/o ejecutores a partir de 2002 en un cambio curricular médico PBL argentino pionero. Los resultados obtenidos se extrajeron principalmente de la experiencia del autor durante su participación como docente en este proceso y de algunas experiencias relacionadas registradas posteriormente en otras facultades de medicina argentinas que también desarrollan cambios curriculares. Además, señala otras advertencias de diseño e implementación no consideradas de manera oportuna que influyeron negativamente en esa transformación. Hasta la fecha, lamentablemente todo ello ha contribuido a que no se alcancen las grandes expectativas puestas en él. Este informe puede resultar útil para los planificadores e implementadores que persiguen un cambio curricular exitoso del ABP al evidenciar que, más allá de las mejores intenciones al respecto, comportamientos particulares, algunos de ellos vinculados a la condición humana, pueden dificultar su diseño y puesta en práctica.
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Humans , Behavior , Problem-Based Learning , Curriculum , Argentina , Schools, MedicalABSTRACT
Actin-binding proteins (ABPs) are important components of the F-actin cytoskeleton and affect the dynamics of F-actin by promoting the polymerization and depolymerization of actin. Numerous studies have shown that F-actin and actin-binding proteins are involved in all stages of carcinogenesis. Our analysis of esophageal carcinoma proteomic data showed that the actin-binding protein EHD2 (E p s l 5 homology domain-containing protein 2) is expressed at low levels in esophageal squamous cell carcinoma tissues and patients with lower EHD2 expression had poorer prognosis. Previous studies have revealed that EHD2 is involved in the regulation of glucose metabolism, autophagy and tumor cell migration. However, the role and mechanism of EHD2 in esophageal squamous cell carcinoma progression remain unclear. This study aimed to explore the effect of EHD2 on the proliferation of esophageal squamous cell carcinoma. Immunofluorescence and cell fractionation analysis showed that EHD2 was not only localized in the cell membrane and cytoplasm, but also in the nucleus. Colony formation, EdU labeling and flow cytometry were used to determine the effect of EHD2 on the proliferation of esophageal squamous cell carcinoma. The results showed that overexpression of EHD2 and EHD2-3×NLS (nuclear localization signal) inhibited proliferation, cell cycle G
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La introducción temprana del aprendizaje basado en la solución de problemas en la formación de grado pudiera contribuir a desarrollar habilidades de razonamiento clínico en estudiantes de ciencias de la salud. El aprendizaje basado en la solución de problemas brinda también una oportunidad de propiciar la integración interdisciplinar. El presente estudio tiene el objetivo de revisar un algoritmo creado para desarrollar habilidades de razonamiento clínico, mediante la imitación de los procederes de la toma de decisiones en el proceso de atención, al tiempo que se hace evidente la presencia de los contenidos de las ciencias básicas biomédicas. Cuando los casos-problemas se trabajan develando la situación del paciente de manera progresiva, se crea la posibilidad de abordar el método hipotético-deductivo como estrategia analítica de cognición. El algoritmo que se propone ayuda a que el estudiante desarrolle conscientemente su estrategia de razonamiento analítico en la búsqueda de la solución al problema; los diez pasos concebidos facilitan la ruta de este descubrimiento. Durante el proceso de investigación-búsqueda van emergiendo las necesidades de aprendizaje que se irán incorporando armónicamente al procedimiento general. Esta propuesta metodológica ha sido acogida favorablemente por los estudiantes, quienes argumentan que les ha propiciado una mejor comprensión de los casos y han logrado visualizar el vínculo entre los contenidos y las manifestaciones, de modo que comienzan a pensar en objetos de conocimiento más que en asignaturas independientes. La descomposición del todo en sus partes permite que el aprendizaje tenga significado para el estudiante y contrarresta, en alguna medida, la lentitud que a veces se produce al iniciar el caso(AU)
The early introduction of problem solving-based learning in undergraduate formation could contribute to develop clinical reasoning skills in health science students. Problem solving-based learning also provides an opportunity to foster interdisciplinary integration. The present study aims to review an algorithm created to develop clinical reasoning skills, through the imitation of decision-making procedures in the care process, while the presence of the contents of the basic biomedical sciences is evident. When the problem cases are analyzed and solved revealing the patient's situation progressively, the possibility is created for addressing the hypothetical-deductive method as an analytical strategy of cognition. The proposed algorithm helps the student develop consciously his/her analytical reasoning strategy in the search for the solution to the problem; the ten steps conceived facilitate the route to this discovery. During the research-search process, the learning needs that will be harmoniously incorporated into the general procedure emerge. This methodological proposal has been favorably received by the students, who argue that it has given them a better understanding of the cases and have managed to visualize the association between the contents and the manifestations, so that they begin to think about objects of knowledge rather than independent subjects. The decomposition of the whole into its parts allows for learning to have a meaning for the student and counteracts, to some extent, the slowness that sometimes occurs when the case starts(AU)
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Humans , Algorithms , Knowledge , Health Sciences , LearningABSTRACT
Resumen: La educación médica se enfrenta a nuevos retos para el desarrollo y adquisición de competencias en los estudiantes de medicina, y aunque existen diversas estrategias didácticas que pueden permitir enfrentar dichos retos, el aprendizaje basado en problemas (ABP) es una de las más eficaces para lograrlo; sin embargo, con el fin de aplicarlo de la mejor manera, es necesario entender el método y las diversas formas en que se ha implementado, así como identificar las dificultades y desventajas que se presentan. El presente artículo tiene como objetivo realizar una revisión sobre el método del ABP, sus ventajas y desventajas, así como algunos errores comunes al momento de implementarlo, haciendo hincapié en el contexto mexicano.
Abstract: Medical education faces new challenges in the development and acquisition of competencies in medical students, and although there are teaching strategies that can be helpful to reach this goal, PBL is one of the best strategies. In order to take advantage of PBL, it is important to understand the method and the various ways in which it has been implemented, as well as to identify the difficulties and disadvantages of PBL. The objective of this article is to review the PBL method, its advantages and disadvantages, and some frequent mistakes in its implementation, emphasizing the Mexican context.
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RESUMO A pancreatite aguda é doença frequente nas enfermarias de hospitais gerais, tem etiologia multifatorial e pode levar a alterações graves dos diversos aparelhos e sistemas corpóreos. O internato, em geral, é o momento em que os alunos de Medicina sedimentam os conhecimentos adquiridos de maneira fracionada durante as etapas básicas do curso. Atualmente, com a mudança do modelo pedagógico em vários cursos de Medicina, a Aprendizagem Baseada em Problemas (ABP) vem sendo adotada. O objetivo deste estudo foi avaliar a efetividade do método ABP na aquisição de conhecimentos de alunos do internato médico sobre pancreatite aguda, em comparação ao método tradicional. Trata-se de estudo descritivo, de abordagem quantitativa e caráter transversal. A amostra foi composta por 40 alunos que cursavam a décima primeira etapa do curso de Medicina de uma instituição de ensino superior privada do interior paulista no segundo semestre de 2015. Foi realizada avaliação entre os sujeitos do grupo pesquisa e do grupo controle quanto à diferença no nível de conhecimento sobre o tema. Como teste estatístico foi utilizado o teste paramétrico t de Student para dois grupos independentes. Como resultado, obteve-se que os alunos que participaram das sessões tutoriais pelo método ABP tiveram maior rendimento nas respostas às questões do instrumento de avaliação, com p = 0,013. Assim, ratifica-se que, além dos ganhos já sabidos em relação à formação de um profissional médico proativo, atento para sentir seu ambiente de trabalho, seus pares e os usuários, o método é também eficiente para a continuidade do processo ensino-aprendizagem durante o internato médico. Desse modo, recomenda-se utilizar a ABP no processo ensino-aprendizagem da Clínica Cirúrgica na universidade do estudo. Propõe-se também a continuidade de pesquisas com médicos residentes para avaliar a aquisição do conhecimento de outras patologias em outras clínicas, comparando-se os métodos ABP e o tradicional com vistas a mais subsídios para adoção da ABP nesse estágio de formação.
ABSTRACT Acute pancreatitis is a frequent disease in general hospitals wards; it has a multifactorial etiology and can lead to severe alterations of the various corporeal systems. The internship generally represents the time when medical students consolidate the knowledge they have gradually acquired during the initial stages of their course. Several medical courses are currently undergoing a change in pedagogical focus, with the adoption of Problem-Based Learning (PBL). The objective of this study was to evaluate the effectiveness of the Problem-Based Learning (PBL) method in relation to knowledge about acute pancreatitis among medical intern students from a private university in the interior of São Paulo state, compared to the traditional learning method. It is a descriptive and transversal study with a quantitative approach. The sample consisted of 40 sixth-year medicine students of a private higher education institution in São Paulo state, in the second semester of 2015. A comparative evaluation was made between the knowledge about the matter among the study group and the control group. The Student t parametric test was applied to two independent groups, resulting in the finding that the students who participated in the PBL tutorial sessions performed better in the assessment test, with p = 0.013. Hence, in addition to the advantages already known in relation to the preparation of proactive medical professionals, in tune with the feelings of their working environment, their peers and patients, the method is also proven to be efficient in continuing the teaching-learning process during medical internship. It is therefore concluded that this teaching-learning method be employed at the medical school in the study. It is also proposed that the research be continued with resident physicians, to evaluate the acquisition of knowledge of other pathologies and other specialties, comparing PBL to traditional methods in order to achieve greater support for the adoption of the PBL method in this stage of medical training.
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Humans , Problem-Based Learning/methods , Internship and Residency , Pancreatitis , BrazilABSTRACT
OBJECTIVE To explore the immunity-enhancing effect of ABP-AW1, a low-molecular-mass polysaccharides isolated from Agaricus blazei Murill, on immunosuppressive mice. METHODS ICR mice were ip injected cyclophosphamide 80 mg · kg-1, once daily for 3 d, to establish an immuno?suppressive mouse model. Then, ABP-AW1125, 250 and 500 mg · kg-1 were ig given to the immuno?suppressive mice,respectively, once daily for 7 d. The mouse thymus index and spleen index were calcu?lated, and the phagocytic function of phagocytes was determined using carbon clearance test. Splenic lym?phocyte proliferation was measured by MTT method. The interleukin 2 (IL-2) and interferon γ (IFN-γ) production from splenic lymphocytes was examined by ELISA. The splenic lymphocyte CD4+/CD8+ratio was determined by flow cytometric analysis. RESULTS Compared with normal control group, the thymus index, spleen index and phagocytic index of phagocytes in the immunosuppressive model mice declined (P<0.05). ABP-AW1250 and 500 mg·kg-1 treatment significantly increased the thymus index, spleen index and phagocytic index in immunosuppressive mice (P<0.05). Compared with normal control group, concanavalin A (Con A) and lipopolysaccharide (LPS) induced T and B lymphocyte proliferation, respectively, and IL-2 and IFN-γproduction from splenic lymphocytes in the immunosuppressive model mice was lower (P<0.05). Compared with model group, ABP-AW1250 and 500 mg·kg-1 promoted Con A and LPS induced T and B lymphocyte proliferation (P<0.05) , and elevated IL-2 and IFN-γ production from splenic lymphocytes (P<0.05). In addition, ABP-AW1250 and 500 mg·kg-1 reversed the decreased splenocyte CD4+/CD8+ratio in immunosuppressive model mice (P<0.05). CONCLUSION ABP-AW1 has immuneity-enhancing effect on cyclophosphamide-induced immunosuppressive mice.
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El objetivo del presente estudio fue develar factores que facilitan u obstaculizan el proceso tutorial del aprendizaje basado en problemas (ABP) en grupo pequeño, según los destacan los estudiantes de la Facultad de Medicina de la Universidad de La Frontera. Se desarrolló la investigación bajo el paradigma cualitativo mediante un estudio de caso. La muestra estuvo constituida por 15 estudiantes informantes claves de los dos últimos niveles curriculares. La información se obtuvo mediante seis entrevistas y un grupo focal. Se hizo triangulación por investigador, juicio de experto y comprobación con participantes en el estudio. Se identificaron 574 unidades de significado, de las cuales 542 se agruparon en 22 categorías. Se destacan entre ellas: Desarrollo del tutorial, Tutor experto en la metodología, Manejo del grupo, Características personales del estudiante y Responsabilidad del estudiante. Emergieron cuatro macro categorías: Competencias propias del tutor, Relaciones humanas y ambiente de aprendizaje, Características y participación de los estudiantes y Aspectos organizacionales. Los estudiantes consideraron relevantes en el proceso tutorial las características del tutor y su experiencia y responsabilidad; también le dieron importancia a las características personales, la experiencia en la metodología, el trabajo colaborativo, las relaciones interpersonales y el ambiente de aprendizaje. Asimismo, a los aspectos administrativos y de gestión que influyen en el desarrollo del ABP...
The objective of the study was to explore factors that facilitate or make difficult the tutorial process in problem-based learning (PBL) in small groups, atthe Faculty of Medicine, University of La Frontera. Research was done under the qualitative paradigm through a case study. The sample consisted of 15 key informant students of the last two curricular levels. Information was collected through six interviews and a focus group. Triangulation was conducted by researcher, expert judgment and verification with study participants. We identified 574 meaning units, out of which 542 were grouped in 22 categories, among them: Tutorial group development, Tutor as an expert in methodology, Group management, Personal characteristics of the student, and Student responsibility. Four macro-categories emerged, namely: Competences of the tutor, Human relationships and learning environment, Characteristics and participation of the students and Organizational aspects. Students considered that the characteristics of the tutor and his/her experience and responsibility are relevant in the tutorial process. They also emphasized on collaborative work, interpersonal relationships, learning environment, and the administrative aspects that may influence the development of PBL...
O objetivo do presente estudo foi detectar os fatores que facilitam ou dificultam o processo tutorial de aprendizagem baseada em problemas (ABP) em pequeño grupo, de acordó com o suporte aos alunos da Faculdade de Medicina da Universidad de la Frontera. A pesquisa é desenvolvimento no âmbito do paradigma qualitativo por meio de um estudo de caso. A amostra constituiu-se de 15 alunos informanteschave no último dois níveis curriculares. As informaçõesb foram obtidas através de seis entrevistas e um focus group. Triangulação foi feita pelo pesquisador, o julgamento dos peritos e os testes com os participantes do estudo. Foram identificados 574 unidades de significado, das quais 542 foram agrupados em 22 categorias. Se destaca estre elas: Desenvolvimento do tutorial, especialista tutor da metodologia, a gestão do grupo, características pessoais do aluno e a responsabilidade do aluno. Quatro macrocategorias surgiram: competências próprias do tutor, relações humanas, e um ambiente de aprendizagem, características e a participação dos alunos e os aspectos organizacionais. Os Estudantes considerados relevantes no proceso tutor características e sua experiência eresponsabilidade; também deram importância para as características pessoais, a experiência da metodologia,trabalho colaborativo, o relacionamento interpessoal e o ambiente de aprendizagem. Além disso,aspectos administrativos e gerenciais que influenciam o desenvolvimento da ABP...
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Young Adult , Problem-Based Learning , Area Health Education CentersABSTRACT
Glutamate acting on AMPA-type ionotropic glutamate receptor (AMPAR) mediates the majority of fast excitatory synaptic transmission in the mammalian central nervous system. Dynamic regulation of AMPAR by post-translational modifications is one of the key elements that allow the nervous system to adapt to environment stimulations. S-palmitoylation, an important lipid modification by post-translational addition of a long-chain fatty acid to a cysteine residue, regulates AMPA receptor trafficking, which dynamically affects multiple fundamental brain functions, such as learning and memory. In vivo, S-palmitoylation is controlled by palmitoyl acyl transferases and palmitoyl thioesterases. In this review, we highlight advances in the mechanisms for dynamic AMPA receptors palmitoylation, and discuss how palmitoylation affects AMPA receptors function at synapses in recent years. Pharmacological regulation of S-palmitoylation may serve as a novel therapeutic strategy for neurobiological diseases.
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[Objective]To discuss the clinical effect of laparoscopic common bile duct exploration(LCBDE)on acute biliary pancreatitis(ABP)induced by treating cholelithiasis. [Method] Select 68 cases of ABP having LCBDE induced with cholelithiasis as experimental group, and other 87 cases of open choledocholitho tomy T-tube drainage(OCTD) as control group;both had routine treatment before operation. Compare their operational time, bed time, post-operation gastro-intestinal recovery time, drainage tube removing time, time of leaving hospital, results of calculus removal and complications. [Result] In experimental group, the operational time was 115~205min,(143.62 ±28.73)min in average, both successful y finishing LCBDE, without conversion to open laparotomy. Calculus removal result: 61 cases were al removed the calculus in the bile duct, the T tube was removed 4w after operation; the remained calculus in 7 cases were removed completely after 6w through T tube sinus tract choledochoscope. In the control groups: the operation time was 120~150min,(135.07 ±15.01)min in average;79 cases had successful OCTD, other 8 cases ended the operation in advance over constitution and much bleeding in operation, and finished the calculus removal after 6w. On post-operational complication, the experimental group had no severe complications, however, there’re 10 cases with complications in control group; in fol owing up, the experimental group had no complications, but there’re 3 cases with complications in control one. Both groups had no statistical meaning for difference on operational time; on bed time, post-operational gastro-intestinal recovery time, drainage removal time, time leaving hospital and complications, the experimental group was markedly better than control one.[Conclusion] LCBDE phase-1 treating ABP induced by cholelithiasis is safe and available, with little trauma, quick recovery and good cure effect.
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Tor2 is an activator of the Rom2/Rho1 pathway that regulates α-factor internalization. Since the recruitment of endocytic proteins such as actin-binding proteins and the amphiphysins precedes the internalization of α-factor, we hypothesized that loss of Tor function leads to an alteration in the dynamics of the endocytic proteins. We report here that endocytic proteins, Abp1 and Rvs167, are less recruited to endocytic sites not only in tor2 but also tor1 mutants. Furthermore, we found that the endocytic proteins Rvs167 and Sjl2 are completely mistargeted to the cytoplasm in tor1Δtor2ts double mutant cells. We also demonstrate here that the efficiency of endocytic internalization or scission in all tor mutants was drastically decreased. In agreement with the Sjl2 mislocalization, we found that in tor1Δtor2ts double mutant cells, as well as other tor mutant cells, the overall PIP2 level was dramatically increased. Finally, the cell wall chitin content in tor2ts and tor1Δtor2ts mutant cells was also significantly increased. Taken together, both functional Tor proteins, Tor1 and Tor2, are essentially required for proper endocytic protein dynamics at the early stage of endocytosis.
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Las ciencias de la salud están en la búsqueda de nuevas estrategias para el proceso de enseñanza-aprendizaje, incluyendo cambios notables en sus programas. En la Universidad Central de Venezuela (UCV) y en la Facultad de Medicina se están implementando propuestas innovadoras para los estudios de pregrado y posgrado. De esta búsqueda se origina el modelo propuesto que permite integrar varias disciplinas como anatomía, fisiología, histología, fisiopatología y clínica de los síndromes clásicos infecciosos. La modalidad incluye dos fases con tres modelos: i. sistema gastrointestinal; ii. sistema renal y iii. sistema cardiorrespiratorio. La primera fase corresponde al proceso de enseñanza-aprendizaje y actividades docentes de la asignatura microbiología. La segunda fase, consistirá en la aplicación y evaluación del modelo
The teaching-learning process in health sciences is undergoing changes in the search for new strategies. At the "Universidad Central de Venezuela" in its Faculty of Medicine curricular changes are taking place and proposals are being made for improving the undergrade and postgraduate courses. The proposed model is product of this search intending to integrate several disciplines such as anatomy, physiology, histology, physiopathology and the classic infectious syndromes. The model includes two phases and three models, gastrointestinal, renal and cardio-respiratory. The first instance includes its application in the microbiology course and the second moment the evaluation of the results
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Humans , Competency-Based Education/methods , Universities , Histology/education , Models, Educational , UniversitiesABSTRACT
Objective To investigate the biological function of NS5ABP37 and to look for proteins interacting with NS5ABP37 protein in hepatocytes. Methods We constructed bait plasmid expressing NS5ABP37 protein of hepatitis C virus (HCV) by cloning the gene of NS5ABP37 protein into pGBKT7, then the recombinant plasmid DNA was transformed into yeast AH109 (α type). The transformed yeast AH109 was mated with yeast Y187 (α type) containing liver cDNA library plasmid in 2×YPDA medium. Diploid yeast was plated on synthetic dropout nutrient medium (SD/-Trp-Leu-His-Ade) containing X-α-gal for selection and screening. After extracting and sequencing of plasmids from positive (blue) colonies, we made a sequence analysis by bioinformatics. Results We screened twenty-five proteins binding to NS5ABP37, including Homo sapiens cyclin Ⅰ (CCNI) gene, Homo sapiens matrix metallopeptidase 25 (MMP25) and Homo sapiens talin 1. Conclusion The yeast-two hybrid system is an effective method for identifying hepatocyte proteins interacting with NS5ABP37 of HCV. And the biological function of NS5ABP37 may be associated with glycometabolism, lipid metabolism and apoptosis.
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Ambulatory blood pressure monitor (ABPM) was done on 103 hypertensive patients according to clinical stages and left ventricular measure (LVM) was randomly done on a portion of the patients. The results showed that the variability of stage-Ⅱ-group's 24 hour systolic pressure and stage-Ⅲ-group's systolic and diastolic pressures was significantly higher than that of stage-Ⅰ-group (P