Livestreaming clinical experience to remotely located learners: A critical narrative review.

CONTEXT: Medical education relies on real patient learning (RPL) to provide medical students with essential clinical experience. However, growing demand for clinical placements continues to be a challenge in providing sufficient RPL opportunities. The COVID-19 pandemic forced academic institutions to rethink the delivery of traditional clinical training and innovations in online clinical learning experiences, specifically livestreamed clinical experiences, have emerged which show promise in addressing the capacity limitations of traditional placements. Although previous reviews have explored the use of livestreamed clinical experiences during the pandemic, there is a lack of rigorous theoretical framing to support these innovations. OBJECTIVES: The aim of this review is two-fold: to examine the effectiveness of livestreamed clinical experiences through an experience-based learning (ExBL) theory perspective and to provide practical recommendations to optimise and implement these innovations. METHODS: A review of literature was conducted to identify journal articles published between September 2019 and January 2023 reporting on innovations relating to livestreamed clinical experiences. The search focused on undergraduate and postgraduate medical education but relevant evidence from other healthcare professions were also included due to a limited evidence base. Strengths and weaknesses were derived from the literature and analysed in relation to ExBL components. RESULTS: Principal strengths of livestreamed clinical experiences included expanded access to RPL opportunities and medical specialties, enhanced standardisation of learning experiences and positive perceptions from students regarding convenience. Clinical educators found these innovations enabled teaching at scale. Patients did not perceive such innovations to negatively impact their standard of care. Limitations included the inability to practice physical examination skills, challenges in ensuring learner engagement and connectivity issues. CONCLUSION: Livestreamed clinical experiences have the potential to effectively expand placement capacity and provide high-quality educational experiences for medical students. Although certain limitations exist, technological and pedagogical adaptations can help overcome these challenges. The application of theoretical frameworks to future online innovations will be fundamental to ensure effective clinical learning.

Small Noncoding RNAs in Reproduction and Infertility.

Infertility has been reported as one of the most common reproductive impairments, affecting nearly one in six couples worldwide. A large proportion of infertility cases are diagnosed as idiopathic, signifying a deficit in information surrounding the pathology of infertility and necessity of medical intervention such as assisted reproductive therapy. Small noncoding RNAs (sncRNAs) are well-established regulators of mammalian reproduction. Advanced technologies have revealed the dynamic expression and diverse functions of sncRNAs during mammalian germ cell development. Mounting evidence indicates sncRNAs in sperm, especially microRNAs (miRNAs) and transfer RNA (tRNA)-derived small RNAs (tsRNAs), are sensitive to environmental changes and mediate the inheritance of paternally acquired metabolic and mental traits. Here, we review the critical roles of sncRNAs in mammalian germ cell development. Furthermore, we highlight the functions of sperm-borne sncRNAs in epigenetic inheritance. We also discuss evidence supporting sncRNAs as promising biomarkers for fertility and embryo quality in addition to the present limitations of using sncRNAs for infertility diagnosis and treatment.

Mosquitoes associated with US Department of Agriculture managed wetlands on Maryland's DelMarVa Peninsula.

Mosquito faunal studies were carried out 2004-2005 in Maryland's Eastern Shore wetlands managed by the US Department of Agriculture. The wetlands included flooded fields, inundated woodlands, and tidal salt marshes. Sampling methods included larval collections, adult landing counts, and CDC light and oviposition traps. A total of 1,186 larvae and 1,363 adults identified represented 14 species. Temporary pools were found to have the highest potential for rapid mosquito colonization with Psorophora columbiae the predominant species. Aedes vexans, Culex territans/pipiens, Ps. ciliata/howardii, and Anopheles crucians were collected primarily from pond and flooded woodlands. Ochlerotatus sollicitans larvae were sampled from tidal pools. The predominant daytime landing count species was Oc. sollicitans with Ps. ciliata, Ae. vexans, and Cx. territans also identified. Light traps collected An. crucians, the principal crepuscular species from flooded wooded areas. Aedes atlanticus, An. quadrimaculatus, Coquillettidia perturbans, Cx. restuans, Oc. sollicitans, Ps. ciliata, Ps. columbiae, and Uranotaenia sapphirina were also identified. Oviposition traps collected small numbers of An. crucians at the tidal marsh, 1 Ae. albopictus, and 1 each of Cx. territans/pipiens from the flooded woodlands. As a result of this study, it was recommended that abatement strategies be implemented during and after wetland construction to minimize the creation of temporary pool breeding sites.

A prospective case control study of the benefits of electronic discharge summaries.

A system of electronic discharge summaries was developed. It replaced conventional discharge prescriptions and dictated discharge summaries. We conducted a prospective case-control study of 102 consecutive patients admitted to our hospital under the care of one consultant physician. Patients discharged after 1 December 2004 were discharged using the new computerised system (50 patients) while patients admitted under the same medical team, but to another ward were discharged using the conventional paper discharge system (52 patients). Patients in the electronic group and the conventional group were similar in age (mean 67 years versus 58 years, P>0.05) and duration of hospital stay (6 days versus 1 day, P>0.05). The mean time taken to produce an electronic discharge summary was immediate (0 days) which was significantly (P<0.0001) less than the mean time taken to produce a conventional discharge summary (80 days). Combining electronic discharge prescriptions with electronic summaries appears promising and merits further study.

Foundation Programme doctors as teachers.

BACKGROUND: Teaching is a core competency outlined in the Foundation Programme curriculum in the UK. This article reports data from a larger postal questionnaire study asking general practitioner (GP) trainers and GP programme directors in the Yorkshire & Humber Deanery whether Foundation Year 2 (FY2) doctors were undertaking teaching roles during primary care posts. We also aimed to explore their attitudes towards FY2s as teachers. METHODS: A questionnaire was designed asking whether FY2s had been present in the practice, and if so what teaching methods they had undertaken. The responder was then asked how comfortable they would feel with an FY2 doctor undertaking certain teaching roles. Responses were prompted using a nine-point Likert scale. RESULTS: The response rate was 74 per cent (216/291). Of the respondents, 37 per cent (80/216) stated that FY2s had been present in their surgery in the last 12 months; 16 per cent (13/80) went on to say that those FY2 doctors had undertaken teaching roles. Respondents felt more comfortable with FY2s undertaking the teaching of practical skills (median score 6, interquartile range 5-7, on the Likert scale) and giving one-to-one tutorials to medical students (median score 6, interquartile range range 4-7), but were uncomfortable with them clinically supervising medical students (median score 3, interquartile range 2-5) and giving one-to-one tutorials to fellow FY2s (median 4, interquartile range 2-5). DISCUSSION: With reduced hours resulting in a decrease in exposure to teaching experience during hospital rotations, it is important that these doctors are given adequate opportunities during primary care placements to improve skills in this area.

Six new recombinant inbred populations for the study of quantitative traits in Arabidopsis thaliana.

Quantitative approaches are now widely used to study the genetic architecture of complex traits. However, most studies have been conducted in single mapping populations, which sample only a fraction of the natural allelic variation available within a gene pool and can identify only a subset of the loci controlling the traits. To enable the progress towards an understanding of the global genetic architecture of a broad range of complex traits, we have developed and characterised six new Arabidopsis thaliana recombinant inbred populations. To evaluate the utility of these populations for integrating analyses from multiple populations, we identified quantitative trait loci (QTL) controlling flowering time in vernalized plants growing in 16 h days. We used the physical positions of markers to align the linkage maps of our populations with those of six existing populations. We identified seven QTL in genomic locations coinciding with those identified in previous studies and in addition a further eight QTL were identified.

Accelerated throughput metabolic route screening in early drug discovery using high-resolution liquid chromatography/quadrupole time-of-flight mass spectrometry and automated data analysis.

The resource investment required to characterise the metabolic fate of a compound is relatively large, meaning that within a drug discovery environment relatively few compounds are characterised in depth. Rate-limiting steps include the setting up of a complex array of mass spectrometry experiments and the subsequent analysis of the large data sets produced. We describe here a strategy for the evaluation of metabolic routes using full-scan high-resolution liquid chromatography/quadrupole time-of-flight mass spectrometry (LC/QToFMS) with automated data analysis using Metabolynx, a commercially available software package. Data from several structurally diverse compounds taken from the literature illustrate that, with careful setting of key parameters, this approach is able to indicate the presence of a wide range of metabolites with only a limited requirement for manual intervention.

Genetic diversity of the Novi Sad Wheat Core Collection revealed by microsatellites.

In recent years, considerable emphasis has been placed on the development of microsatellites to be used for a variety of objectives. Parental genetic diversity is a crucial requisition to derive desirable and superior progenies from crossing and selection. In order to determine desirable genotypes for hybridization, 710 wheat genotypes from the Novi Sad Core Collection, originating from 38 countries, have been evaluated during the 1993-2000 period. During those seven growth seasons, 54 agronomical, morphological, physiological and other traits have been evaluated in field and controlled conditions. In each year, the field experiment comprised 3-7 replications, while for each field replication the plot size was 1.2 m(2). Based on the results from this evaluation, 96 genotypes with the highest phenotypic variation for 26 of the very important traits for wheat breeding programmes in Yugoslavia and the UK, were identified for screening with microsatellites. A set of 36 microsatellite markers was used, covering all three wheat genomes and all 42 chromosomes. For the 36 microsatellites, a total of 46 loci and 366 alleles were detected, with the average number of 7.96 alleles per locus. For 35 loci, null alleles were detected. The association of microsatellite data with phenotypic data, for 6 important traits for wheat breeding (stem height, earliness, resistance to leaf rust and powdery mildew, sedimentation value and protein content), as well as the potential for their implementation in marker assisted selection (MAS) in wheat breeding programmes for both Yugoslavia and UK are discussed.