Exploring HTML5 Package Interactive Content in Supporting Learning Through Self-Paced Massive Open Online Courses on Healthy Aging: Mixed Methods Study.

BACKGROUND: The rapidly aging population and the growth of geriatric medicine in the field of internal medicine are not supported by sufficient gerontological training in many health care disciplines. There is rising awareness about the education and training needed to adequately prepare health care professionals to address the needs of the older adult population. Massive open online courses (MOOCs) might be the best alternative method of learning delivery in this context. However, the diversity of MOOC participants poses a challenge for MOOC providers to innovate in developing learning content that suits the needs and characters of participants. OBJECTIVE: The primary outcome of this study was to explore students' perceptions and acceptance of HTML5 package (H5P) interactive content in self-paced MOOCs and its association with students' characteristics and experience in using MOOCs. METHODS: This study used a cross-sectional design, combining qualitative and quantitative approaches. Participants, predominantly general practitioners from various regions of Indonesia with diverse educational backgrounds and age groups, completed pretests, engaged with H5P interactive content, and participated in forum discussions and posttests. Data were retrieved from the online questionnaire attached to a selected MOOC course. Students' perceptions and acceptance of H5P interactive content were rated on a 6-point Likert scale from 1 (strongly disagree) to 6 (strongly agree). Data were analyzed using SPSS (IBM Corp) to examine demographics, computer literacy, acceptance, and perceptions of H5P interactive content. Quantitative analysis explored correlations, while qualitative analysis identified recurring themes from open-ended survey responses to determine students' perceptions. RESULTS: In total, 184 MOOC participants agreed to participate in the study. Students demonstrated positive perceptions and a high level of acceptance of integrating H5P interactive content within the self-paced MOOC. Analysis of mean (SD) value across all responses consistently revealed favorable scores (greater than 5), ranging from 5.18 (SD 0.861) to 5.45 (SD 0.659) and 5.28 (SD 0.728) to 5.52 (SD 0.627), respectively. This finding underscores widespread satisfaction and robust acceptance of H5P interactive content. Students found the H5P interactive content more satisfying and fun, easier to understand, more effective, and more helpful in improving learning outcomes than material in the form of common documents and learning videos. There is a significant correlation between computer literacy, students' acceptance, and students' perceptions. CONCLUSIONS: Students from various backgrounds showed a high level of acceptance and positive perceptions of leveraging H5P interactive content in the self-paced MOOC. The findings suggest potential new uses of H5P interactive content in MOOCs, such as interactive videos with pop-up questions, to substitute for synchronous learning. The study underscores the significance of tailored educational strategies in supporting the professional development of health care professionals.

In vitro antiviral activity of NanB bacterial sialidase against avian influenza H9N2 virus in MDCK cells.

The avian influenza virus is an infectious agent that may cause global health problems in poultry and is potentially zoonotic. In the recent decades, bacterial-derived sialidases have been extensively studied for their ability to inhibit avian influenza virus infections. In this study, the antiviral activity of NanB sialidase from Pasteurella multocida was investigated through in vitro analysis using Madin-Darby canine kidney (MDCK) cells. NanB sialidase was purified from P. multocida to test its toxicity and its ability to hydrolyse its sialic acid receptors on MDCK cells. The H9N2 challenge virus was propagated in MDCK cells until cytopathic effects appeared. Antiviral activity of NanB sialidase was tested using MDCK cells, and then observed based on cell morphology, viral copy number, and expression of apoptosis-mediating genes. NanB sialidase effectively hydrolysed Neu5Acα(2,6)-Gal sialic acid at a dose of 129 mU/ml, while at 258 mU/ml, it caused toxicity to MDCK cells. Antiviral activity of sialidase was evident based on the significant decrease in viral copy number at all doses administered. The increase of p53 and caspase-3 expression was observed in infected cells without sialidase. Our study demonstrates the ability of NanB sialidase to inhibit H9N2 virus replication based on observations of sialic acid hydrolysis, reduction in viral copy number, and expression of apoptosis-related genes. The future application of sialidase may be considered as an antiviral strategy against avian influenza H9N2 virus infections. RESEARCH HIGHLIGHTSNanB sialidase effectively hydrolyses Neu5Acα(2,6)-Gal at a dose of 129 mU/ml.NanB sialidase from Pasteurella multocida can inhibit the entry of H9N2 virus into cells.NanB sialidase of Pasteurella multocida prevents infection-induced cell apoptosis.NanB sialidase reduces the H9N2 viral copy number in MDCK cells.

Vitamin D supplementation alleviates insulin resistance in prediabetic rats by modifying IRS-1 and PPARγ/NF-κB expressions.

Background: Prediabetes is a condition of intermediate hyperglycemia that may progress to type 2 diabetes. Vitamin D deficiency has been frequently linked to insulin resistance and diabetes. The study aimed to investigate the role of D supplementation and its possible mechanism of action on insulin resistance in prediabetic rats. Method: The study was conducted on 24 male Wistar rats that were randomly divided into 6 rats as healthy controls and 18 prediabetic rats. Prediabetic rats were induced with a high-fat and high-glucose diet (HFD-G) combined with a low dose of streptozotocin. Rats with the prediabetic condition were then randomized into three groups of 12-week treatment: one group that received no treatment, one that received vitamin D3 at 100 IU/kg BW, and one group that received vitamin D3 at 1000 IU/kg BW. The high-fat and high-glucose diets were continuously given throughout the twelve weeks of treatment. At the end of the supplementation period, glucose control parameters, inflammatory markers, and the expressions of IRS1, PPARγ, NF-κB, and IRS1 were measured. Results: Vitamin D3 dose-dependently improves glucose control parameters, as shown by the reduction of fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated albumin, insulin levels, and markers of insulin resistance (HOMA-IR). Upon histological analysis, vitamin D supplementation resulted in a reduction of the islet of Langerhans degeneration. Vitamin D also enhanced the ratio of IL-6/IL-10, reduced IRS1 phosphorylation at Ser307, increased expression of PPAR gamma, and reduced phosphorylation of NF-KB p65 at Ser536. Conclusion: Vitamin D supplementation reduces insulin resistance in prediabetic rats. The reduction might be due to the effects of vitamin D on IRS, PPARγ, and NF-κB expression.

Clostridium perfringens sialidase interaction with Neu5Ac α-Gal sialic acid receptors by in-silico observation and its impact on monolayers cellular behavior structure.

Objective: This study aims to evaluate the effect of Clostridium perfringens sialidase treatment on monolayer cell behavior using computational screening and an in vitro approach to demonstrate interaction between enzyme-based drugs and ligands in host cells. Materials and Methods: The in silico study was carried out by molecular docking analysis used to predict the interactions between atoms that occur, followed by genetic characterization of sialidase from a wild isolate. Sialidase, which has undergone further production and purification processes exposed to chicken embryonic fibroblast cell culture, and observations-based structural morphology of cells compared between treated cells and normal cells without treatment. Results: Based on an in silico study, C. perfringens sialidase has an excellent binding affinity with Neu5Acα (2.3) Gal ligand receptor with Gibbs energy value (∆G)-7.35 kcal/mol and Ki value of 4.11 µM. Wild C. perfringens isolates in this study have 99.1%-100% similarity to the plc gene, NanH, and NanI genes, while NanJ shows 93.18% similarity compared to the reference isolate from GenBank. Sialidase at 750 and 150 mU may impact the viability, cell count, and cell behavior structure of fibroblast cells by significantly increasing the empty area and perimeter of chicken embryo fibroblast (CEF) cells, while at 30 mU sialidase shows no significant difference compared with mock control. Conclusion: Sialidase-derived C. perfringens has the capacity to compete with viral molecules for attachment to host sialic acid based on in silico analysis. However, sialidase treatment has an impact on monolayer cell fibroblasts given exposure to high doses.

The effect of simvastatin-Acalypha indica Linn. combination on the improvement of fatty pancreas in rats induced with a high fructose and cholesterol diet.

Objective: The study aimed to determine the effect of Acalypha indica Linn. (AI) root extract and a combination of simvastatin-AI on improving the fatty pancreas in Sprague-Dawley rats induced with a high fructose and cholesterol diet. Materials and Methods: Twenty-four male Sprague-Dawley rats were induced with a high fructose and cholesterol diet for 4 weeks before being divided into four groups. Each group receiving treatments consisting of simvastatin only, A. indica extracts only, or simvastatin-A. indica extract combination. A histological examination was conducted to determine the effect of each treatment. Also, one-way analysis of variance (ANOVA) and post-hoc Bonferroni test were conducted to assess the comparison of groups from the histological examination. Results: Significant improvement was found in fatty pancreas between rats without therapy and rats treated with simvastatin therapy (p = 0.024, 95% CI: 0.038-0.696), and also between rats without treatment and rats treated with simvastatin-A. indica extract combination therapy (p = 0.000, 95% CI: 0.241-0.873) using one-way ANOVA and the post-hoc Bonferroni test. Conclusions: The results of the combination of simvastatin-A. indica Linn. root extracts treatment showed a synergistic effect on the improvement of fatty pancreas, but further research is needed to find potential adverse effects on the interaction of these two substrates to confirm the safe use of this treatment.

Hematological indices and their correlation with glucose control parameters in a prediabetic rat model.

Background and Aim: Chronic hyperglycemia in prediabetic individuals would progress to diabetes and lead to several systemic disruptions, including hematological parameters. This study aimed to investigate the correlation between prediabetes and hematological indices in a prediabetic rat model. Materials and Methods: Eighteen male rats were randomly divided into two groups of nine. Prediabetes was induced in nine rats by a 3-week high-fat and high-glucose diet, followed by low-dose streptozotocin (STZ) injection (30 mg/kg body weight). The oral glucose tolerance test was performed, and the fasting blood glucose (FBG) and insulin levels were measured 72 h after STZ administration. The control group of nine rats was given standard diets. At the end of the 3rd week, the animals fasted overnight before blood collection. Blood samples were drawn and used for the analysis of the FBG and fasting insulin levels and glycated albumin to define prediabetes criteria before hematology analysis. Results: We found a significant increase in the FBG and insulin levels in the prediabetic versus the control group. There were decreases in red blood cells, hemoglobin, and hematocrit levels and red cell distribution in prediabetic rats versus the control. At the same time, a significant increase in the platelet count was observed in the prediabetic group. There was a positive correlation between FBG and lymphocytes and neutrophil-lymphocyte ratio in prediabetic rats. On the other hand, we found a negative correlation between white blood cell count and glycated albumin. Conclusion: Correlations were found in several hematological parameters in the prediabetic rat models. The changes in hematological indices in prediabetic rats may be further used as a valuable indicator of glycemic control.

Supporting newly graduated medical doctors in managing COVID-19: An evaluation of a Massive Open Online Course in a limited-resource setting.

INTRODUCTION: Newly graduated medical doctors in their internships are positioned to strengthen the front line in combating COVID-19. We developed a Massive Open Online Course (MOOC) to equip them with adequate knowledge for COVID-19 management. This paper aims to analyze the MOOC and evaluate participant satisfaction and increase in knowledge after completing the course. METHODS: An observational study was conducted. Quantitative data were obtained from questionnaires and pre- and post-tests. Responses to open-ended questions of the questionnaires were collected. Analysis using the Quality Reference Framework was also completed. RESULTS: The MOOC consisted of fundamental knowledge of COVID-19 (Part A) and further enrichment (Part B), and the content was written in the Indonesian language. A total of 3,424 and 2,462 participants completed the course in August and November 2020, respectively. Most participants agreed that the platform was easy to navigate, the design was interesting, and the content was aligned with their needs. Pre- and post-test scores in Part A's subjects increased significantly. Factors contributing to and inhibiting usability and areas for improvement were further highlighted. DISCUSSION: The use of a specific quality framework facilitated a comprehensive evaluation of the MOOC's strengths, weaknesses, and areas for future improvements. The participants' satisfaction and pre- and post-test results showed that the current MOOC holds great potential benefit for continuing education for medical interns joining the frontliners during the pandemic. Future implementation should consider increasing the quality of learning resources, scaling up the platform and its technical supports, and enhancing organizational supports.

Drug Efflux Transporters Are Overexpressed in Short-Term Tamoxifen-Induced MCF7 Breast Cancer Cells.

Tamoxifen is the first line drug used in the treatment of estrogen receptor-positive (ER+) breast cancer. The development of multidrug resistance (MDR) to tamoxifen remains a major challenge in the treatment of cancer. One of the mechanisms related to MDR is decrease of drug influx via overexpression of drug efflux transporters such as P-glycoprotein (P-gp/MDR1), multidrug resistance associated protein (MRP), or BCRP (breast cancer resistance protein). We aimed to investigate whether the sensitivity of tamoxifen to the cells is maintained through the short period and whether the expressions of several drug efflux transporters have been upregulated. We exposed MCF7 breast cancer cells with tamoxifen 1 µM for 10 passages (MCF7 (T)). The result showed that MCF7 began to lose their sensitivity to tamoxifen from the second passage. MCF7 (T) also showed a significant increase in all transporters examined compared with MCF7 parent cells. The result also showed a significant increase of CC50 in MCF7 (T) compared to that in MCF7 (97.54 µM and 3.04 µM, resp.). In conclusion, we suggest that the expression of several drug efflux transporters such as P-glycoprotein, MRP2, and BCRP might be used and further studied as a marker in the development of tamoxifen resistance.