ABSTRACT
BackgroundMedical school assessments, clinical placements and teaching have been disrupted by the COVID-19 pandemic. The ADAPT consortium was formed to document and analyse the effects of the pandemic on medical education in the United Kingdom (UK), with the aim of capturing current and future snapshots of disruption to inform trends in the future performance of cohorts graduating during COVID-19. MethodsMembers of the consortium were recruited from various national medical student groups to ensure representation from medical schools across the UK. The groups involved were: Faculty of Medical Leadership and Management Medical Students Group (FMLM MSG); Neurology and Neurosurgery Interest Group (NANSIG); Doctors Association UK (DAUK); Royal Society of Medicine (RSM) Student Members Group and Medical Student Investigators Collaborative (MSICo.org). In total, 29 medical schools are represented by the consortium. Our members reported teaching postponement, examination status, alternative teaching provision, elective status and UK Foundation Programme Office (UKFPO) educational performance measure (EPM) ranking criteria relevant to their medical school during a data collection window (1st April 14:00 to 2nd April 23:59). ResultsAll 29 medical schools began postponement of teaching between the 11th and 17th of March 2020. Changes to assessments were highly variable. Final year examinations had largely been completed before the onset of COVID-19. Of 226 exam sittings between Year 1 and Year 4 across 29 schools: 93 (41%) were cancelled completely; 14 (6%) had elements cancelled; 57 (25%) moved their exam sitting online. 23 exam sittings (10%) were postponed to a future date. 36% of cohorts with cancelled exams and 74% of cohorts with online exams were granted automatic progression to the next academic year. There exist 19 cohorts at 9 medical schools where all examinations (written and practical) were initially cancelled and automatic progression was granted. ConclusionsThe approaches taken by medical schools have differed substantially, though there has been universal disruption to teaching and assessments. The data presented in this study represent initial responses, which are likely to evolve over time. In particular, the status of future elective cancellations and UK Foundation Programme Office (UKFPO) educational performance measure (EPM) decile calculations remains unclear. The long-term implications of the heterogeneous disruption to medical education remains an area of active research. Differences in specialty recruitment and performance on future postgraduate examinations may be affected and will be a focus of future phases of the ADAPT Study.
ABSTRACT
Estrogens act through binding to estrogen receptor α (ERα) and ß (ERß). Studies in knockout mice have shown that the absence of ERα leads to the polycystic ovary syndrome (PCOS) phenotype. Furthermore, the expression of ERß gene is lower in follicles derived from women with PCOS compared with healthy women. The aim of this study was to investigate the importance of ERα and ERß gene polymorphisms in PCOS. A cohort of 180 women with PCOS and 140 healthy controls were recruited, and the PvuII and XbaI polymorphisms of ERα, as well as, the AluI and RsaI polymorphisms of ERß were genotyped. No difference was found in the distribution of these polymorphisms between patients and healthy controls. However, in PCOS women, carriers of TC and TT genotypes of PvuII polymorphism had lower fasting glucose to insulin ratio compared with carriers of CC genotype (p = 0.029). In addition, the presence of AA genotype of XbaI polymorphism was associated with lower levels of follicle-stimulating hormone (FSH) compared with the presence of AG and GG genotypes (p = 0.03). The association of ERα polymorphisms with insulin resistance indices and FSH levels emphasizes the importance of ERα as a genetic modifier of the PCOS phenotype.
Subject(s)
Estrogen Receptor alpha/genetics , Estrogen Receptor beta/genetics , Follicle Stimulating Hormone, Human/blood , Insulin Resistance , Polycystic Ovary Syndrome/genetics , Polymorphism, Single Nucleotide , Adolescent , Adult , Blood Glucose/analysis , Cohort Studies , Estrogen Receptor alpha/metabolism , Estrogen Receptor beta/metabolism , Female , Genetic Association Studies , Genetic Predisposition to Disease , Greece , Heterozygote , Homozygote , Humans , Insulin/blood , Leukocytes/metabolism , Polycystic Ovary Syndrome/blood , Polycystic Ovary Syndrome/metabolism , Young AdultABSTRACT
Pregnancies achieved by assisted reproduction technologies, particularly by intracytoplasmic sperm injection (ICSI) procedures, are susceptible to genetic risks inherent to the male population treated with ICSI and additional risks inherent to this innovative procedure. The documented, as well as the theoretical, risks are discussed in the present review study. These risks mainly represent that consequences of the genetic abnormalities underlying male subfertility (or infertility) and might become stimulators for the development of novel approaches and applications in the treatment of infertility. In addition, risks with a polygenic background appearing at birth as congenital anomalies and other theoretical or stochastic risks are discussed. Recent data suggest that assisted reproductive technology might also affect epigenetic characteristics of the male gamete, the female gamete, or might have an impact on early embryogenesis. It might be also associated with an increased risk for genomic imprinting abnormalities.