Assesing teaching assistant programmes as a tool facilitating the learning process of Physiology / Avaliação do modelo de monitoria como ferramenta facilitadora para o processo de aprendizagem em Fisiologia

A teaching assistant programme is an extracurricular activity in which an advanced student (the assistant) is guided and supervised by the lecturer to provide support to the curricular unit. The aim of the present study was to asses the contribution of teaching assistant programmes based on problem cases towards the acquisition of a medicine course content. The study was cross-sectional and involved 153 students divided into two groups: the present and the absent at teaching assistant sessions. All the participants responded to standardised questionnaires that have been used to analyse their perception of content acquisition, their active participation in learning and the contribution of teaching assistant sessions. The results showed that the perception of complete content acquisition among the present group was at 38.4%, while for the absent group only at 29.7%. The negative perception of content acquisition was at 13.6 % for the absent group and at 6.1% for the present group. Within the present group 73.5% of the students studied the topics covered in lectures within two weeks. For the absent group this number fell to 49.4%. In addition, 86% of the present group said that the teaching assistant sessions contributed towards their learning. As the main reason they pointed to the opportunity to answer questions. On the whole, the results suggest that teaching assistant programmes based on problem cases can be effective in facilitating the perception of learning. The reason appears to be a more intense involvement of the participants in a more active study routine.

Father absence and trajectories of offspring mental health across adolescence and young adulthood: findings from a UK-birth cohort

Background: High prevalence of parental separation and resulting biological father absence raises important questions regarding its impact on offspring mental health across the life course. However, few studies have examined prospective associations between biological father absence in childhood and risk of offspring depression and depressive symptoms trajectories across adolescence and young adulthood. We specifically examined whether these relationships vary by sex and the timing of exposure to father absence (early or middle childhood). Methods: This study is based on up to 8,409 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants provided self-reports of depression (Clinical Interview Schedule-Revised) at age 24 years and depressive symptoms (Short Mood and Feelings Questionnaire) between the ages of 10 and 24 years. Biological father absence in childhood was assessed through maternal questionnaires at regular intervals from birth to 10 years. We used logistic regression to examine the association between biological father absence and depression/depressive symptoms at age 24. We estimated the association between biological father absence and trajectories of depressive symptoms using multilevel growth-curve modelling. Results: Early but not middle childhood father absence was strongly associated with increased odds of offspring depression and greater depressive symptoms at age 24 years. Early childhood father absence was associated with higher trajectories of depressive symptoms during adolescence and early adulthood compared with father presence. Differences in the level of depressive symptoms between middle childhood father absent and father present groups narrowed into early adulthood. Girls whose father was absent in early childhood, compared with present, manifested higher levels of depressive symptoms throughout adolescence, but this difference narrowed by early adulthood. In contrast, boys who experienced father absence in early childhood had similar trajectories of depressive symptoms compared to the father present group but experienced a steep increase in early adulthood. Girls whose fathers were absent in middle childhood manifested higher trajectories across middle adolescence into young adulthood compared to the father present group. Conclusions: We found evidence that father absence in childhood is persistently associated with offspring depression in adolescence and early adulthood and that this relationship varies by sex and timing of father's departure. Further research is needed to examine whether this relationship is causal and to identify mechanisms that could inform preventative interventions to reduce the risk of depression in children who experience father absence.

TO STUDY CORRELATION OF SERUM VITAMIN D LEVEL WITH OSTEOARTICULAR INFECTION

Background: To study correlation of serum vitamin D level with osteoarticular infection Methods: All patients (5 to 65 years of age) were presented with pain and raised local temperature of osteoarticular joint or prosthetic joint in the Orthopaedic department of S.M.S. Medical college and attached hospitals, were included in the study. Results: The mean (SD) of S. Vitamin D (ng/mL) in the Osteoarticular Infection: Present group was 19.08 (8.41). The mean (SD) of S. Vitamin D (ng/mL) in the Osteoarticular Infection: Absent group was 18.53 (9.26). The median (IQR) of S. Vitamin D (ng/mL) in the Osteoarticular Infection: Present group was 17.7 (14.15-23.3). The median (IQR) of S. Vitamin D (ng/mL) in the Osteoarticular Infection: Absent group was 14.85 (11.6-23.3). The S. Vitamin D (ng/mL) in the Osteoarticular Infection: Present ranged from 8.2 -38. The S. Vitamin D (ng/mL) in the Osteoarticular Infection: Absent ranged from 9.2 - 46. Conclusion: Our study result were similar in respect to other authors but statistically not significant, therefore requires reopening of the debate on correlation of serum vitamin D with osteoarticular infections. Keywords: Osteoarticular Infection, Vitamin D, Joint

Technology-mediated writing: It’s not how much, but the thought that counts

Struggling writers including students with disabilities (SWD) need instructional strategies to support their ability to write independently. Integrating technology-mediated instruction to support student writing can mitigate students' challenges throughout the writing process and personalize instruction. In the present group design study, teachers taught 11 to 12 year olds in sixth grade with varying abilities to use a technology-based graphic organizer (TBGO) when digitally planning and composing a persuasive paragraph. Results indicated that the writing quality of the paragraph and use of transition words by typical and struggling writers was significantly better when the TBGO was used as compared to students who wrote without the TBGO. Additionally, when the TBGO was removed, students in the treatment group maintained gains. Student participants and teachers in this study identified features that were especially supportive to students’ writing behaviors. Implications for practice and future research are discussed.

Cytoplasmic String Between ICM and mTE Is a Positive Predictor of Clinical Pregnancy and Live Birth Outcomes in Elective Frozen-thawed Single Blastocyst Transfer Cycles: A Time-lapse Study

Background: In this study, we aim to investigate whether cytoplasmic string between inner cell mass (ICM) and mural trophectoderm (mTE) is a positive predictor of clinical pregnancy and live birth outcomes.Methods: 1,267 elective frozen-thawed single blastocyst transfer (eSBT) cycles cultured in time-lapse incubation system from January 2018 to May 2019 were involved in the study. Blastocysts were grouped according to the appearance of cytoplasmic strings between ICM and mTE cells, and identified as “Present” and “Absent” groups. In Present group, they were further categorized according to the quantity of cytoplasmic strings between ICM and mTE cells. Clinical pregnancy and live birth outcomes of blastocysts were used to evaluate the effect of cytoplasmic strings between ICM and mTE.Results: The baseline demographic and laboratory features were similar between the Present and Absent groups of cytoplasmic strings between ICM and mTE (P>0.05). According to the time-lapse analysis, cytoplasmic strings between ICM and mTE were more visible among good quality blastocysts. Furthermore, blastocysts with cytoplasmic strings showed a higher clinical pregnancy and live birth rates (P<0.05), and no significant differences were observed in abortion rate and birth weight (P>0.05).Conclusions: Although the previous conclusions of cytoplasmic strings were controversial, the present time-lapse analysis provides the evidence for the first time that cytoplasmic strings between ICM and mTE cells would be a positive predictor of clinical pregnancy and live birth outcomes in elective frozen-thawed single blastocyst transfer cycles.

Mere Presence of a Cell Phone: Effects on Academic Ability

Prior research has suggested that cell phone use in the classroom and during learning-related tasks is detrimental to academic performance. Recently, the mere presence of a cell phone has been found to negatively affect relationships and to impair performance on learning and cognitive tasks. This study explored whether the presence (visibility without use) of a cell phone negatively impacts one’s performance on tests measuring preexisting academic ability. The study evaluated 45 participants; some were enrolled in an introductory psychology course, and others were members of the public. Three subtests from the Wide Range Achievement Test (WRAT-4) were completed: spelling, sentence comprehension, and mathematics. During testing, half of the participants had cell phones, and the other half did not. Statistical analyses revealed no significant difference between the cell phone-present and cell phone-absent group on the sentence comprehension (p=.52), spelling (p=.07), and mathematics subtest (p=.11). Unexpectedly, a non-significant trend was observed in the opposite direction; that is, the cell phone-present group outperformed the cell phone-absent group on all subtests. Therefore, the original hypothesis suggesting that the cell phone-present group would be significantly poorer at demonstrating preexisting skills on tests of academic ability in comparison to the cell phone-present group was not supported.

Estimation of efficiency of complex cytoprotective therapy of pregnant women with fetal growth delay

The objective: estimate efficiency and influence of complex, cytoprotective therapy of pregnant women with fetal growth delay on biochemical indexes and results of delivery. Materials and methods. 93 women with monocyesis at term of 28-34 gestation weeks took part in the research. Group І includes 30 pregnant women with fetal growth delay (FGD). The pregnant women of the present group were prescribed with complex, cytoprotective therapy. It includes prescription of thiotriazolin in complex with L-arginine and diosmin. Group ІІ is presented by 33 pregnant women with FGD whose management of pregnancy and delivery is provided by valid orders of Ministry of Healthcare of Ukraine. Group ІІІ (the control one) consists of 30 pregnant women without FGD. Research of protein oxidative modification (POM) markers and level of stable nitrogen oxide metabolites (NO) were estimated in blood serum with spectrophotometric method. Reduced glutathione (GSH) was determined with calculation of its level according to the calibration curve. Results. Primary estimation of their content showed statistically valid (p < 0.05) lower GSH and NO in comparison of indexes of pregnant women without FGD (ІІІ group) with indexes of pregnant women with FGD (both І and ІІ groups). This fact indicates decrease of antioxidant protection and deficit of the main vessel dilator in the present group. Further estimation of biochemical indexes in dynamics of pregnancy permitted to determine considerable progress of imbalance between oxidants and antioxidants and absence of significant changes of NO level among pregnant women of II group. In pregnant women of I group who got the proposed complex cytoprotective therapy, on contrary, statistically valid (p < 0.05) decrease of POM indexes together with increase of GSH and NO level that indicates its positive influence were found. By means of analysis of special features of the pregnancy course in research group there was stated that the rate of habitual pregnancy non-carrying (HPN) in group II made 39.4% and considerably exceeded relevant indexes of І (20.0%) and ІІІ (16.7%) groups. Hypertensive disorders during pregnancy and labour are diagnosed only in pregnant women of І (6.7%) and ІІ (9.1%) groups. Average index of giving birth in І and ІІІ groups made 38.5±0.6 weeks and 39.4 ± 0.5 weeks correspondingly and in group ІІ it was lower 37.2±0.6 weeks. Index of preterm delivery (PD) rate in І group made 3.3% and was 6 times lower than appropriate index of ІІ group (21.2%). PD rate was absent in ІІІ group. Rate of the fetus distress in ІІ group (18.2%) was 2.7 times higher than the relevant index of І group (6.7%) and in ІІІ group it made 3.3%. Condition of newborns in research groups was estimated under Apgar scale. Both at the 1-st and 5-th minute the general index under appropriate scale was statistically valid (p < 0.05) and lower than in ІІ group as compared to indexes of І and ІІІ groups. During description of perinatal complications there was stated considerable percentage of neonatal encephalopathy and jaundice in ІІ group, namely 33.3% and 36.4% correspondingly. In І group their rate made 10.0% and 3.3%, correspondingly. In structure of perinatal pathology prematurity was in 21.2% of newborns of ІІ group that is 6 times higher than appropriate index of І group (3.3%). Mentioned complications were not determined in ІІІ group. In calculation under weight and height parameters of newborns the rate of FGD in ІІ group was the highest and made 88.6%. Mentioned index in І and ІІІ groups made 60.0% and 10.0%, correspondingly. Conclusion. The proposed complex cytoprotective therapy including combined use of thiotriazolin, L-arginine and diosmin (that considerably increases anti-ischemic, antioxidant and endothelium protective action of complex therapy) in women with fetal growth delay has the positive effect on oxidative-reductive hemeostasis and thiol-disulfide balance of mother-placenta-fetus system. Obstetric and perinatal results of delivery in the present group of pregnant women are characterized by statistically valid (р < 0.05) prevalence of estimation indexes under Apgar scale and correspondingly processes of adaptation as well as results of anthropomorphic measurements of newborns, their weight and height parameters and lower rate of neonatal encephalopathy and delivery of premature babies. Keywords: pregnancy, fetus growth inhibition, protein oxidative modification, antioxidant defense system, oxidative stress, obstetric and perinatal complications, cytoprotective therapy.

Characteristics of Facial Asymmetry in Congenital Superior Oblique Palsy according to Trochlear Nerve Absence

Background/Aims. Facial asymmetry is affected by various developmental factors, and congenital superior oblique palsy (SOP) is one of the most common causes of asymmetric development of the face. The presence of facial symmetry is usually assessed subjectively, which varies with the examiner. We aimed to objectively assess facial asymmetry in patients with unilateral congenital SOP according to the presence or absence of the trochlear nerve on high-resolution magnetic resonance imaging (MRI). Methods. A total of 287 consecutive patients diagnosed with congenital SOP and 82 control subjects were included. Congenital SOP patients were grouped according to the presence (present group) or absence (absent group) of the trochlear nerve using thin-section high-resolution MRI of cranial nerves. We developed a computer-aided detection (CAD) system that could automatically analyze objective indices of facial asymmetry using frontal face photographs. Results. Of the 287 patients with congenital SOP, 60% of patients had ipsilateral trochlear nerve absence and superior oblique muscle (SO) hypoplasia (absent group), while the remaining 40% had a normal SO and trochlear nerve (present group). All but one objective indices related to facial asymmetry were significantly different between congenital SOP patients and controls (all P < 0.05 ). Among these features, the angle of nose deviation was significantly larger in the absent group compared to the present group ( P < 0.001 ). Conclusion. Objective analysis of facial asymmetry using our novel CAD system was useful for identifying distinct features of congenital SOP. Deviation of the nose was more prominent in congenital SOP patients with trochlear nerve absence.

Cytoplasmic String Between ICM and mTE Is a Positive Predictor of Clinical Pregnancy and Live Birth Outcomes in Elective Frozen-thawed Single Blastocyst Transfer Cycles: a Time-lapse Study

Background: In this study, we aim to investigate whether cytoplasmic string between inner cell mass (ICM) and mural trophectoderm (mTE) is a positive predictor of clinical pregnancy and live birth outcomes.Methods: 1,267 elective frozen-thawed single blastocyst transfer (eSBT) cycles cultured in time-lapse incubation system from January 2018 to May 2019 were involved in the study. Blastocysts were grouped according to the appearance of cytoplasmic strings between ICM and mTE cells, and identified as “Present” and “Absent” groups. In Present group, they were further categorized according to the quantity of cytoplasmic strings between ICM and mTE cells. Clinical pregnancy and live birth outcomes of blastocysts were used to evaluate the effect of cytoplasmic strings between ICM and mTE.Results: The baseline demographic and laboratory features were similar between the Present and Absent groups of cytoplasmic strings between ICM and mTE (P>0.05). According to the time-lapse analysis, cytoplasmic strings between ICM and mTE were more visible among good quality blastocysts. Furthermore, blastocysts with cytoplasmic strings showed a higher clinical pregnancy and live birth rates (P<0.05), and no significant differences were observed in abortion rate and birth weight (P>0.05).Conclusions: Although the previous conclusions of cytoplasmic strings were controversial, the present time-lapse analysis provides the evidence for the first time that cytoplasmic strings between ICM and mTE cells would be a positive predictor of clinical pregnancy and live birth outcomes in elective frozen-thawed single blastocyst transfer cycles.

A Clinical Practice Comparison of Overall Survival, Time-to-Next-Treatment, and Time-to-Treatment-Discontinuation Among CLL/SLL Patients Receiving First-Line Ibrutinib with and without a Del(17p) Mutation

Introduction: Genetic risk factors play an important role in the prognosis of a patient with Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL). One of the strongest negative prognostic factors is the presence of a 17p deletion (del(17p)). While ibrutinib monotherapy has shown efficacy in the relapsed/refractory and treatment-naïve settings (Burger et al., 2015; Munir et al., 2019), evidence from clinical trials specifically concerning its use in patients with del(17p) is limited in the front line setting. The available limited evidence does suggest that its use in patients with del(17p) may result in shorter PFS and OS compared to patients without the deletion (Mato et al., 2018; O'Brien et al., 2018; Brown et al., 2018). Using real world data we addressed two objectives: (1) comparing baseline demographic and clinical characteristics of ibrutinib-treated patients with and without del(17p), and (2) assessing outcomes of overall survival (OS), time-to-next-treatment (TTNT), and time-to-treatment discontinuation (TTD) among CLL/SLL patients with and without del(17p) in the first-line setting. Methods: Data from the nationwide Flatiron Health EHR-derived de-identified database were abstracted. Patients included were those aged ≥18 years, diagnosed with CLL/SLL (ICD-9 codes: 204.1x or ICD-10: C91.1x, C83.0x), and who had at least two clinic encounters in the Flatiron Health network and received ibrutinib as first CLL directed therapy on or after January 1, 2011. Patients had documented CLL/SLL and a documented cytogenetic test performed prior to ibrutinib start date confirming the presence or absence of del(17p). The start of first-line ibrutinib was defined as the index date for all comparative analyses. Baseline characteristics between present or absent del(17p) groups were compared. OS, TTNT, TTD were estimated using Kaplan Meier method and survival outcomes were compared between the two groups using the Cox proportional hazards model. Adjustment for covariates was performed for gender, age at index date, practice type (academic or community), Rai stage at diagnosis, ECOG status year of index date, status of deletion 11q, 13q, Trisomy 12 and IgHV mutation status. Reasons for discontinuation of ibrutinib are being explored. Presence or absence of TP53 mutations were not captured. Results: There were 1,037 first-line ibrutinib treated patients included based on the above inclusion criteria, 24% of patients had del(17p) present. The majority (95%) of patients were treated in community practices and the median follow up period was 18 months. The two groups differed in their Rai stage distribution at diagnosis, with del(17p) present patients tending to be later stage at diagnosis than del(17p) absent. Del(17p) patients also started first-line therapy sooner after diagnosis.Median OS was shorter in the del(17p) present group at 57.54 months from initiation of treatment (p&lt;0.001), compared to the del(17p) absent group where median OS was not reached [Table 1, Figure 1].The Cox proportional hazards models were consistent with this finding, where HR for OS was 1.72 times greater in the del(17p) present group, and this difference was statistically significant in both the unadjusted (p&lt;0.001) [Table 1] and adjusted analyses (p=0.009) [Not shown].In parallel with OS findings, the del(17p) present group tended to have shorter median TTNT (50.23 months vs. NR, p=0.063). The TTD for all patients was 48.62 months, while the TTD was shorter in the del(17p) group (35.80 months vs. NR, p=0.117). These results were confirmed in the Cox proportional hazards models and similarly the difference between groups was not statistically significant [Table 1, Figure 2]. Conclusions: We present the largest study addressing outcomes of patients with del(17p) treated with ibrutinib monotherapy in the front line setting to address an important data gap that current clinical trials have not directly addressed. Since ibrutinib is now a standard of care for such high-risk patients, a deeper understanding if the presence of del(17p) impacts survival outcomes in patients treated with ibrutinib in the front line setting is needed. Based on the significant impact shown on OS, and to a lesser degree TTNT and TTD, these data confirm that del(17p) is a negative predictive factor in this setting. This reflects an ongoing unmet need among treatment naïve CLL/SLL patients with del(17p) status. Disclosures Mato: Janssen: Consultancy, Research Funding; Loxo: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; TG Therapeutics: Consultancy, Research Funding; AstraZeneca: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Adaptive: Consultancy, Research Funding. Tang:BeiGene, Ltd.: Current Employment, Current equity holder in publicly-traded company. Azmi:BeiGene, Ltd.: Current Employment, Current equity holder in publicly-traded company. Yang:BeiGene, Ltd.: Current Employment, Current equity holder in publicly-traded company. Stern:BeiGene, Ltd.: Current Employment, Current equity holder in publicly-traded company. Hedrick:BeiGene, Ltd: Current Employment, Current equity holder in publicly-traded company. Huang:BeiGene: Current Employment, Current equity holder in publicly-traded company, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company). Sharman:AbbVie: Consultancy, Research Funding; Bristol Meyers Squibb: Consultancy, Research Funding; BeiGene: Research Funding; Pfizer: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; AstraZeneca: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; TG Therapeutics: Consultancy, Research Funding; Acerta: Consultancy, Research Funding; Roche: Consultancy, Research Funding; Celgene: Consultancy, Research Funding.