A study on the impact of simulation-based training, on retention of knowledge and skills of medical interns, for patient care, during the COVID-19 pandemic

Background: During the pandemic of COVID-19, the highly transmissible novel coronavirus can easily affect medical interns who are a part of frontline health-care providers. They are required to have adequate knowledge and skills, to protect themselves from getting infected with COVID-19 and also care for patients, effectively. Aims and Objectives: This study aims to evaluate the impact of simulation-based training on retention of knowledge and skills of medical interns, for patient care, during the COVID-19 pandemic. Materials and Methods: A total of 122 medical interns, aged between 21 and 25 years, of which 47.5% (58) were male and 52.5% (64) female, were included as study participants. A simulation-based training was conducted, based on knowledge and skills required in providing patient care during the COVID-19 pandemic such as donning and doffing of personal protective equipment, triage of COVID-19 patients, and airway management. A pre-tested pre-test questionnaire was used before training and simulation-based practical test along with post-test was conducted 6 months after the training. Results: The pre-test and post-test theory and simulation-based practical scores were analyzed and compared using paired t-test and P = 0.05 was considered to be statistically significant. There was a significant difference between total scores, both theory and practical pre-test and post-test scores, using paired t test with t = 28.441 (P = 0.001). Conclusion: During the current COVID-19 pandemic, simulation-based training has a significant impact on retention of knowledge and skills of the medical interns in patient care, during the COVID-19 pandemic.

Oculocutaneous albinism in southern Africa: Historical background, genetic, clinical and psychosocial issues

Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programs are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalization and stigmatization of people with albinism and to improve their quality of life.

Oculocutaneous albinism in southern Africa: Historical background, genetic, clinical and psychosocial issues

Albinism is an inherited condition associated with significant depigmentation of the skin, hair and eyes. It occurs in every population with varying frequency, and narratives of people with albinism have been recorded since 200 BC. In southern Africa albinism is common, about 1 in 4000 people are affected, but it remains a poorly understood condition surrounded by myths and superstition. This article provides a historical background on oculocutaneous albinism (OCA) in southern Africa and presents relevant information from the literature regarding epidemiology, genetics and genetic counselling, health, psychosocial and cultural issues, and medical care. There are several recessively inherited types of OCA and a mutation, responsible for about 80%of South African variants, has been identified in OCA type 2. The physical characteristics associated with albinism, that is, sun-sensitive skin and low vision, can be managed. However, people with OCA in Africa also experience psychosocial issues, such as discrimination, because of the various superstitious beliefs and attitudes held in the community. Management should include medical care for health problems, appropriate adjustment of the schooling context and genetic counseling. In addition, widespread public awareness programmes are required to increase the knowledge of the genetic causes of OCA and of the nature of genetic counselling, to address the negative attitudes in the community, to reduce the marginalisation and stigmatization of people with albinism and to improve their quality of life

Comprimento de isquiotibiais, função motora grossa e marcha em crianças e adolescentes com paralisia cerebral / Tamaño de los isquiotibiales, función motora gruesa y marcha en niños y adolescentes con parálisis cerebral / Hamstring length, gross motor function and gait in children and adolescents with cerebral palsy

RESUMO O objetivo desse estudo é verificar se há relação entre o comprimento dos isquiotibiais, função motora grossa e marcha em crianças e adolescentes com paralisia cerebral (PC). Os participantes, entre 6 e 18 anos, foram classificados pelo Sistema de Classificação da Função Motora Grossa (GMFCS) nos níveis I, II e III através da escala Tardieu modificada, para avaliar o comprimento dos músculos isquiotibiais, sendo identificados em: R1 (primeira resistência da extensão da perna), R2 (segunda resistência da extensão da perna) e R2-R1 (diferença entre R1 e R2) do membro inferior esquerdo e direito. Para avaliar a função motora grossa, foi utilizado o teste gross motor function measure (GMFM-88), e a escala physicians rating scale modificada (PRS) foi utilizada para avaliar a marcha. Vinte e três participantes foram incluídos e os resultados evidenciaram correlações moderadas entre R1, R2 e PRS do membro inferior esquerdo e GMFM. As demais variáveis apresentaram uma correlação fraca.

RESUMEN El presente estudio tuvo como objetivo verificar si existe una relación entre el tamaño de los isquiotibiales, la función motora gruesa y la marcha en niños y adolescentes con parálisis cerebral (PC). Los participantes con edades entre 6 y 18 años fueron clasificados en el Sistema de Clasificación de la Función Motora Gruesa (GMFCS) en los niveles I, II y III utilizando la escala Tardieu modificada para evaluar el tamaño de los músculos isquiotibiales, y que los identificaron en: R1 (primera resistencia de extensión de la pierna), R2 (segunda resistencia de extensión de la pierna) y R2-R1 (diferencia entre R1 y R2) de la extremidad inferior izquierda y derecha. Para evaluar la función motora gruesa, se utilizó la prueba Gross Motor Function Measure (GMFM-88); y para evaluar la marcha, la escala Physicians Rating Scale modificada (PRS). Se incluyeron 23 participantes, y los resultados mostraron correlaciones moderadas entre R1, R2 y PRS del miembro inferior izquierdo y GMFM. Las otras variables tuvieron una correlación débil.

ABSTRACT This study aims at assessing the relationship between hamstring length, gross motor function, and gait in children with spastic cerebral palsy (CP). Children and adolescents aged between 6 and 18 years, were classified as levels I, II or III according to the Gross Motor Function Classification System. Participants were assessed using a modified Tardieu Scale to determine hamstring length, evaluating: R1 (first leg extension resistance), R2 (second leg extension resistance) and R2-R1 (difference between R1 and R2) of the left and right lower limbs. The Gross Motor Function Measure (GMFM) was used to evaluate gross motor function and the modified Physicians Rating Scale (PRS) for gait. Twenty-three participants were included in the study and the results showed a moderate correlation between R1, R2, and PRS of the left leg and the GMFM. All other variables exhibited a weak correlation. Hamstring length was weakly to moderately related to gross motor function and gait in children and adolescents with CP.

Identification of SNP-containing regulatory motifs in the myelodysplastic syndromes model using SNP arrays and gene expression arrays / 癌症

Myelodysplastic syndromes have increased in frequency and incidence in the American population, but patient prognosis has not significantly improved over the last decade. Such improvements could be realized if biomarkers for accurate diagnosis and prognostic stratification were successfully identified. In this study, we propose a method that associates two state-of-the-art array technologies--single nucleotide polymor-phism(SNP) array and gene expression array--with gene motifs considered transcription factor-binding sites (TFBS). We are particularly interested in SNP-containing motifs introduced by genetic variation and mutation as TFBS. The potential regulation of SNP-containing motifs affects only when certain mutations occur. These motifs can be identified from a group of co-expressed genes with copy number variation. Then, we used a sliding window to identify motif candidates near SNPs on gene sequences. The candidates were filtered by coarse thresholding and fine statistical testing. Using the regression-based LARS-EN algorithm and a level-wise sequence combination procedure, we identified 28 SNP-containing motifs as candidate TFBS. We confirmed 21 of the 28 motifs with ChIP-chip fragments in the TRANSFAC database. Another six motifs were validated by TRANSFAC via searching binding fragments on co-regulated genes. The identified motifs and their location genes can be considered potential biomarkers for myelodysplastic syndromes. Thus, our proposed method, a novel strategy for associating two data categories, is capable of integrating information from different sources to identify reliable candidate regulatory SNP-containing motifs introduced by genetic variation and mutation.

Influência da porção extensora do músculo glúteo máximo sobre a inclinação da pelve antes e depois da realização de um protocolo de fadiga / Influences of the extensor portion of the gluteus maximus muscle on pelvic tilt before and after the performance of a fatigue protocol

INTRODUÇÃO: Há carência na literatura de dados que determinem qual a influência da porção extensora do músculo glúteo máximo na inclinação da pelve no plano sagital e, portanto, na estabilidade lombar. OBJETIVOS: Verificar a influência da porção extensora do músculo glúteo máximo sobre a inclinação da pelve. MÉTODOS: Foram recrutadas 10 voluntárias jovens, saudáveis, com índices de massa corpórea (IMC's) menores que 24,9 kg/m² e com dismetria real de membros inferiores (MMII) inferior a 1 cm. Foram avaliados o IMC, o perímetro pélvico e o comprimento dos MMII e, posteriormente, os graus de inclinação das hemipelves e a assimetria entre elas pela análise de uma fotografia em perfil ortostático usando o SAPO (Software para Avaliação Postural). Em seguida, a porção extensora do músculo glúteo máximo do lado dominante foi induzido à fadiga, após a qual foram determinadas novamente a inclinação das hemipelves e a assimetria entre elas. Testes de Pearson r e teste t de student foram realizados no nível de significância α=0,05. RESULTADOS: Não houve correlação entre as variáveis de confusão e a assimetria dos ângulos das hemipelves. O ângulo da hemipelve apresentou modificação significativa do lado dominante (t=3,760; p=0,004). CONCLUSÕES: A fadiga da porção extensora do músculo glúteo máximo pode gerar um aumento do ângulo de inclinação da pelve homolateral.

INTRODUCTION: There is a lack of data in the literature for determining the influences of the extensor portion of the gluteus maximus muscle on pelvic tilting and, thus, on lumbar stability. OBJECTIVES: To assess the influences of the extensor portion of the gluteus maximus muscle on pelvic tilt. METHODS: Ten healthy young subjects were recruited, with a body mass index (BMI) below 24.9 kg/m² and leg length discrepancy below 1 cm. The BMI, pelvic perimeter and lower-limb lengths were assessed and, subsequently, the degrees of hemi-pelvic tilt and asymmetry between them were analyzed using lateral view photographs of the subjects in a standing position, using SAPO (Software for Postural Assessment). Next, fatigue was induced in the extensor portion of the gluteus maximus muscle on the dominant side, and after that the hemi-pelvic tilt and the asymmetry between the hemi-pelvises were reassessed. The Pearson r and Student t tests were conducted at the significance level of α=0.05. RESULTS: There were no significant correlations between the confounding variables and asymmetry of the hemi-pelvic angles. There were significant changes in the hemi-pelvic angle of the dominant side (t=3.760; p=0.004). CONCLUSIONS: Fatigue in the extensor portion of the gluteus maximus muscle can generate increases in the tilt angle of the ipsilateral pelvis.

Clinical utility of telangiectasia of hands in scleroderma and other rheumatic disorders.

Telangiectasia of the hands were observed in 76% of patients with scleroderma (n = 53) as compared with 12% of patients with other rheumatic disorders (n = 100) and in 13% of healthy subjects (n = 30). In scleroderma, telangiectasia of the hands were commonly multiple (mean number +/- SD = 22.9+/-30.1) with 7.3% being >1 mm in size. They were found in greater numbers in those patients with the limited subtype. The distribution of telangiectasia was observed on all but 4 of 158 sectors of the hand with significant higher numbers on the ventral surface of the digits. Significant associations of telangiectasia of the hands were also observed with numbers of telangiectasia on face and lips (p = 0.001), disease duration (p = 0.002), surface area of digital calcinosis (p = 0.03) and with the presence of the centromere antibody (p = 0.005). Possible associations were observed with prior gastrointestinal bleeds (particularly with telangiectasia >1 mm) and with isolated pulmonary hypertension. No significant correlation was found between number of telangiectasia and with nailfold capillary size or density. In conclusion, multiple telangiectasia of the hands were most commonly observed in patients with the centromere positive, limited subtype of scleroderma of long duration. Their pathogenesis is unknown.