地方医学人才培养中过程性评价和教学科研互动的实践与探索

在新时代“高教改革22条”的实施背景下，医学本科教育要求严格教育教学管理、改革教育教学制度、引导教师潜心育人。然而，教学资源相对不足、评价机制不够健全及教学科研互动不够等问题均会影响地方高等医学院校的人才培养质量。为深化医学教育教学改革，通过在探索创新性地方医学人才培养模式的实践过程中，构建了课堂教学、网络教学和线下考试三位一体的多元化过程性评价体系，分别从理论课、实验课和创新实训3个角度实施了教学科研互动式的医学人才培养方案，取得了一定成效，以期探索出地方高等医学院校卓越医学人才培养的新路径。     

Investigating attention in young adults with autism spectrum disorder (ASD) using change blindness and eye tracking

BackgroundSocial interaction at its core entails allocating attention to relevant stimuli. As such, the perception of change requires attention, but studies have suggested that the social impairment in people with autism spectrum disorder (ASD) occurs at the attentual level of "on-line" social cognition.MethodForty-four young adults—22 with autism spectrum disorder (ASD) and 22 with typical development (TD)—participated in two experiments. The first used a change blindness (CB) paradigm where attention was investigated through the detection of changed items with central and marginal levels of interest when viewing images of everyday scenarios. Eye-tracking was used to compare response times, first fixations and total fixation time on changes. The second used social films with eye tracking of gaze fixations.ResultsParticipants with ASD were slower in response time and first fixation than were participants with TD. Participants with TD showed longer fixation on items with marginal (compared to central) levels of interest. The social-film experiment showed that participants with ASD were slower to orient their gazes towards the characters’ faces and looked at speaking characters for less time than did the group with TD. This result correlates with less use of mental verbs in their narratives and less time spent looking at marginal items in the CB experiment.ConclusionsResults suggest reduced processing speed in young adults with ASD, which is associated with enhanced processing of local details. Clinically, these results imply that teaching strategies (e.g., cognitive cues) to process social context efficiently could benefit individuals with ASD.     

Predict Blood Pressure by Photoplethysmogram with the Fluid-Structure Interaction Modeling

Blood pressure (BP) has been identified as one of the main factors in cardiovascular disease and other related diseases. Then how to accurately and conveniently measure BP is important to monitor BP and to prevent hypertension. This paper proposes an efficient BP measurement model by integrating a fluid-structure interaction model with the photoplethysmogram (PPG) signal and developing a data-driven computational approach to fit two optimization parameters in the proposed model for each individual. The developed BP model has been validated on a public BP dataset and has shown that the average prediction errors among the root mean square error (RMSE), the mean absolute error (MAE), the systolic blood pressure (SBP) error, and the diastolic blood pressure (DBP) error are all below 5 mmHg for normal BP, stage I, and stage II hypertension groups, and, prediction accuracies of the SBP and the DBP are around 96% among those three groups.     

The Impact of Patient Access to Their Electronic Health Record on Medication Management Safety: A Narrative Review

IntroductionAs the American’s Federal Health Insurance Portability and Accountability Act (HIPAA) stated that patients should be allowed to review their medical records, and as information technology is ever more widely used by healthcare professionals and patients, providing patients with online access to their own medical records through a patient portal is becoming increasingly popular. Previous research has been done regarding the impact on the quality and safety of patients’ care, rather than explicitly on medication safety, when providing those patients with access to their electronic health records (EHRs).AimThis narrative review aims to summarise the results from previous studies on the impact on medication management safety concepts of adult patients accessing information contained in their own EHRs.ResultA total of 24 studies were included in this review. The most two commonly studied measures of safety in medication management were: (a) medication adherence and (b) patient-reported experience. Other measures, such as: discrepancies, medication errors, appropriateness and Adverse Drug Events (ADEs) were the least studied.ConclusionThe results suggest that providing patients with access to their EHRs can improve medication management safety. Patients pointed out improvements to the safety of their medications and perceived stronger medication control. The data from these studies lay the foundation for future research.     

Antitumor Activity of Choerospondias axillaris Fruit Extract by Regulating the Expression of SNCAIP and SNCA on MDA-MB-231 Cells

Objective: Cancer is a huge problem of disease globally. Today, the percentage of people die from cancer is more than a combination of various diseases. In females, most common types of malignancies that occur are breast and cervical. The present focus has been shifted on medicinal plants as a form of therapy and there is a constant need to identify new therapeutic agents. Choerospondias axillaris (C. axillaris), an underutilized fruit, has been used in the remedy of various diseases. In the present communication, we evaluated the molecular mechanism of C. axillaris methanol extract in regulating cell death in human breast cancer cells (MDA-MB-231). Methods: Methanol extract of C. axillaris was prepared and compounds were screened by Gas chromatography-mass spectrometry. The effect of fruit extract was determined on MDA-MB-231 cells by MTT ((3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay and to analyse the molecular mechanism of human breast cancer cells after treating with fruit extract, protein profiling study was performed by two-dimensional gel electrophoresis. Results: A total 9 differentially expressed proteins were identified by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS/MS) analysis. Among 9 identified proteins, synphilin-1 protein was found to be significantly downregulated, validated by western blot and RT-qPCR analysis. Possible interacting partners of synphilin-1 (SNCAIP) were analyzed for their possible role in cancer by the in-silico method. Conclusion: Our data implicate that the presence of bioactive compound(s) in C. axillaris fruits might play an important role in inhibiting the proliferation of breast carcinoma cells and Synphilin-1 protein may play a role of apoptotic function.     

Interactions médicamenteuses des inhibiteurs de tyrosine kinase dans le traitement du cancer bronchique non à petites cellules

The development of tyrosine kinase inhibitors has revolutionized the treatment strategy in patients with non-small cell lung cancer with activating EGFR mutations, ALK or ROS-1 gene rearrangements. The Food and Drug Administration and European Medicines Agency have approved several inhibitors for the treatment of non-small cell lung cancer : five tyrosine kinase inhibitors targeting EGFR (erlotinib, gefitinib, afatinib, osimertinib and dacomitinib) and six tyrosine kinase inhibitors targeting ALK (crizotinib, céritinib, alectinib, brigatinib, lorlatinib and entrectinib). Interestingly, these tyrosine kinase inhibitor treatments are administered orally. While this route of administration improves the treatment flexibility and provides a comfortable and preferable option for patients, it also increases the risk of drug-drug interactions. The latter may result in changes in pharmacokinetics or pharmacodynamics of the tyrosine kinase inhibitors or their concomitant treatments, with subsequent risks of increasing their toxicity and/or reducing their effectiveness. This review provides an overview of drug-drug interactions with tyrosine kinase inhibitors targeting EGFR and ALK, as well as practical recommendations to guide oncologists and clinical pharmacists in the process of managing drug-drug interactions during the treatment of non-small cell lung cancer with tyrosine kinase inhibitors.     

Developing the Intergenerational Community Survey for older adults: Assessing neighborhood environments,social and physical activities,and health

Many survey instruments have been developed to assess neighborhood environments for their impacts on people's health and daily activities. However, no instruments are available for capturing social interactions with different age groups among older populations. This study introduces a four-phase process of developing a comprehensive Intergenerational Community Survey (ICS) covering six domains: (1) physical activities, walking, and sedentary activities; (2) mental health and quality of life; (3) social activities (e.g. intergenerational and peer interactions) in and outside the neighborhood; (4) neighborhood environments (e.g. safety, streets and sidewalks); (5) supportive services or programs (e.g. intergenerational programs, transportation services); and (6) personal characteristics. Test-retest reliability assessments among 38 community-dwelling older adults (aged 65+) showed fair to good reliability results. ICS can serve as a useful tool to facilitate future research on intergenerational communities and interactions for older adults.     

The Effect of Ambient Illumination on Handheld Display Image Quality

Handheld devices such as smartphones and tablets are becoming useful in the medical field, as they allow physicians, radiologists, and researchers to analyze images with the benefit of mobile accessibility. However, for handheld devices to be effective, the display must be able to perform well in a wide range of ambient illumination conditions. We conducted visual experiments to quantify user performance for testing the image quality of two current-generation devices in different ambient illumination conditions while measuring ambient light levels with a real-time illuminance meter. We found and quantified that due to the high reflectivity of handheld devices, performance deteriorates as the user moves from dark areas into environments of greater ambient illumination. The quantitative analysis suggests that differences in display reflection coefficients do not affect the low illumination performance of the device but rather the performance at higher levels of illumination.