Factors affecting medical students' satisfaction with online learning: a regression analysis of a survey.

BACKGROUND: Medical education requires the implementation of different teaching methods and strategies for future doctors to achieve broad learning objectives. This wide range of methods and strategies includes the use of Information Technologies. For a long time, there was a call for a change in medical education for blending new teaching approaches to lessen medical students' class time. The COVID-19 pandemic then sped up the transition to the new way of medical education and classroom lectures were quickly moved to a virtual environment. We expect that these changes will continue, and online learning will be one of the main teaching strategies in medical education. Therefore, educational experiences during the COVID-19 pandemic will improve our understanding of online learning and will help to develop blended medical school curricula in the future. For this reason, we aimed to determine students' overall satisfaction with their online learning experience and to define the main factors affecting students' satisfaction with their online learning program at Cerrahpasa Medical Faculty. METHODS: A cross-sectional survey study was conducted to determine medical students' overall satisfaction with online learning methods and to identify factors associated with positive and negative satisfaction levels. A questionnaire, consisting of 24 questions to collect demographic characteristics, factors associated with online education experience and overall satisfaction levels was developed and distributed to 1600 medical students. Multivariable linear regression analysis was used to determine the factors associated with positive and negative satisfaction levels. RESULTS: Regression analysis showed that being familiar with online teaching techniques (ß = 0.19, 95% CI [0.07, 0.30], faculty members' higher online teaching skill levels (ß = 0.42, 95% CI [0.32, 0.51], interactive online teaching approaches (ß = 0.54, 95% CI [0.41, 0.67], having a personal workspace (ß = 0.43, 95% CI [0.19, 0.67], and a self-reported longer attention span (ß = 0.75, 95% CI [0.57, 0.92] were associated with higher overall satisfaction with online learning. The occurrence of technical problems (ß = -0.19, 95% CI [-0.26, -0.12] was associated with lower overall satisfaction. CONCLUSIONS: Higher online teaching skills of faculty members, use of interactive approaches, students' familiarity with online teaching techniques, provision of a personal workspace, and self-reported longer attention spans positively contributed to higher levels of student satisfaction with online learning. Considering the increasing significance of online educational methods, our study identified key components that affect students' level of satisfaction. This information might contribute to the development of online educational programs in the future.

Aortic ischemia-reperfusion injury and potency of fluoxetine.

Objectives: Due to cross-clamping of the aorta during aortic aneurysm surgeries, ischemia-reperfusion (IR) develops, and it may cause damage to the aorta itself or even to remote organs by oxidative stress or inflammation. Fluoxetine (FLX) which might be used in the preoperative period for its tranquilizing effect also has antioxidant effects in short-term use. The purpose of our study is to examine whether FLX protects aorta tissue, against the damage caused by IR. Materials and Methods: Three groups of Wistar rats were formed randomly. 1) Control group (sham-operated), 2) IR group (60 min ischemia+120 min perfusion), and 3) FLX+IR group (FLX dose was 20 mg/kg for 3 days IP before IR). At the end of each procedure, aorta samples were collected, and oxidant-antioxidant, anti-inflammatory, and anti-apoptotic status of the aorta were evaluated. Histological examinations of the samples were provided. Results: Levels of LOOH, MDA, ROS, TOS, MPO, TNFα, IL-1ß, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA were found to be significantly increased in the IR group compared with control (P<0.05) and SOD, GSH, TAS, and IL-10 levels were significantly lower (P<0.05). FLX significantly decreased LOOH, MDA, ROS, TOS, MPO, TNFα, IL-1ß, IL-6, NF-kB, MMP-9, caspase-9, 8-OHdG, NO, and HA levels in the FLX+IR group compared with IR group (P<0.05) and increased IL-10, SOD, GSH, and TAS (P<0.05). FLX administration prevented the deterioration of aortic tissue damage. Conclusion: Our study is the first study that demonstrates FLX-mediated suppression of IR injury in the infrarenal abdominal aorta by antioxidant, anti-inflammatory, and anti-apoptotic properties.

St. Thomas and del Nido cardioplegia are superior to Custodiol cardioplegia in a rat model of donor heart.

OBJECTIVES: Cardiac transplantation is an effective treatment for advanced heart disease and protection of the donor organ is directly associated with post-transplantation outcomes. Cardioplegic strategies intend to protect the donor heart against ischemic injury during transplantation procedures. In our study, the effects of three different cardioplegia solutions were evaluated in a rat heart donor model in terms of cellular base. Design. Cardioplegia solutions as St. Thomas, del Nido or Custodiol were administered to male Wistar albino rats until cardiac arrest. Arrested hearts were excised and incubated in cold cardioplegia solutions for 4 h. Organ bath experiments were performed using the right ventricular free wall strips of the heart tissues. ATP, sialic acid, TNF-α levels and MMP-9 activities were measured in heart tissues. Incubation media were also used to measure TNF-α and troponin-I levels following organ baths experiments. Results. Custodiol administration led to reduced myocardial contraction (p < .05), decreased ATP levels (p < .001) and increased both TNF-α levels (p < .05), and MMP-9 activity (p < .05). Additionally, troponin-I and TNF-α levels in media were significantly increased (p < .05), TNF-α levels were positively correlated with MMP-9 activities (r = .93, p = .007) and negatively correlated with ATP levels (r = -.91, p = .01) in the Custodiol group. Also, MMP-9 activities were negatively correlated with ATP levels (r = -.90, p = .01) Conclusion. Custodiol cardioplegia cannot prevent functional and cellular damage in donor heart tissue. St. Thomas or del Nido cardioplegia could result in superior functional and biochemical improvement during transplantation procedures. In this respect, these cardioplegic solutions may be more advantageous as cellular and functional.

The effects of fluoxetine on circulating oxidative damage parameters in rats exposed to aortic ischemia-reperfusion.

Oxidative stress and reperfusion injury may develop in different ischemia-reperfusion (IR) models. Growing evidence links altered lipid protein redox-homeostasis with IR. The effect of fluoxetine (FLX; N-methyl-3-[4-(trifluoromethyl) phenoxy] benzenepropanamine), on the lipid protein redox-homeostasis mechanisms in the rats exposed to aortic IR is unclear. We aimed to investigate the effects of FLX on circulating protein oxidation and lipid peroxidation parameters, such as ischemia modified albumin (IMA), lipid hydroperoxide (LOOH), prooxidant antioxidant balance (PAB), erythrocyte glutathione (GSH), CuZn-superoxide dismutase (CuZn-SOD), ferric reducing antioxidant power (FRAP), as potential IR biomarkers. Wistar rats were randomized into three groups (n=7/group): 1) Control (sham laparotomy); 2) IR without FLX, (60min ischemia and 120min reperfusion); 3) IR with FLX (FLX+IR) (FLX 20mg/kg/day, i.p. for three days before surgery). All of the aforementioned parameters (IMA, LOOH, PAB, GSH, CuZn-SOD, and FRAP) were measured spectrophotometrically. IMA, LOOH, and PAB levels in IR group were significantly higher than the control (P<0.01 respectively) and fluoxetine groups (P<0.01, P<0.01, and P<0.05 respectively), whereas CuZn-SOD activities, GSH and FRAP were significantly lower in IR groups. Fluoxetine group significantly reduced IMA when compared to IR group (P<0.001) and control group (P<0.01). With respect to IMA, LOOH and PAB, impaired redox homeostasis is substantially more prominent in aortic IR. The antidepressant FLX has profitable effects on circulating redox status in rats exposed to aortic IR. FLX administration before IR might decrease the surgery-enhanced free radical production; taken together, the antioxidant effects of FLX supplementation should be considered in future studies.