医学関連教育における対面学習と比較した遠隔学習の教育効果の整理

報告Practical report　本論文の目的は，医学関連教育において対面学習と比較した同期型遠隔学習と非同期型遠隔学習に関する文献を紹介し，対面学習と比較したそれぞれの遠隔学習の教育効果を整理することであった．同期型遠隔学習は，従来の対面学習と比較して知識と技能の教育効果に有意差を認めない可能性が示唆されたが，学習に対する満足度は高い可能性が示唆された．非同期型遠隔学習は，従来の対面学習と比較して知識の教育効果は，先行研究ごとに異なる結果であったが，技能の教育効果は高い可能性が示唆された．学習に対する満足度が高いかどうかは十分に検討されていなかった．同期型遠隔学習と非同期型遠隔学習は，対面学習に比べて教育効果に劣位性を認めていない先行研究が多かったことから，遠隔学習は対面学習を代替できる可能性があると考えられた．　Due to coronavirus disease 2019 (COVID-19), we are shifting from traditional learning to　distance learning. Distance learning is a learning method that has different advantages from traditional learning. Distance learning is divided into two types: synchronous and asynchronous. Previous studies reporting on the effectiveness of distance learning sometimes confuse synchronous distance learning with asynchronous distance learning, and it is necessary to organize the educational effect of each type of learning. The purpose of this paper was to introduce the literature on synchronous and asynchronous distance learning compared totraditional learning in medical related education, and to summarize the educational effects of each type of learning compared to traditional learning. Synchronous distance learning may not show any difference in the educational effectiveness of knowledge and skill compared to traditional learning, but the satisfaction with learning may be high. Compared to traditional learning, asynchronous distance learning yielded different results from article to article in terms educational effectiveness of knowledge, but suggested that educational effectiveness of skills may be higher. Satisfaction with learning was not fully explored. Many papers do not find that both synchronous and asynchronous distance learning are inferior traditional learning in terms of educational effect. As physical distance is now required due to COVID-19, synchronous and asynchronous distance learning can be considered as a supplementary learning method to traditional learning in medical education

大学生の午前と午後の授業中の眠気は夜間の睡眠状況と関連するか

研究論文Original Articles　本研究の目的は，大学生の授業中の眠気と夜間の睡眠状況の関連性を，午前と午後の授業時間帯別に明らかにすることであった．対象は，本学リハビリテーション学部に所属する学生137 名であった．方法は，自己記入によるアンケート調査であり，午前・午後の授業中の眠気の有無を目的変数，夜間の睡眠状況，性別，授業への興味や関心，服薬中の薬剤，うつ症状を説明変数としてロジスティック回帰分析を行った．結果，午前の授業中の眠気は，就床時間が遅く（p0.05）．授業中に眠気を感じる学生に対して，夜間の睡眠環境の整備を行うよう指導する場合があるが，午後の授業中の眠気の予防には，夜間の睡眠環境の整備のみでは効果が得られない可能性がある．　The purpose of this study was to identify the relationship between sleepiness during taking classes and the nighttime sleep in university students. This study focused on sleepiness in the morning class and the afternoon class. 137 students in Seirei Christopher University, School of Rehabilitation Sciences were participated in this study. The method of this study was a selfadministered questionnaire. The statistical analysis was used as a logistic regression analysis. The objective variables were analyzed sleepiness in the morning and afternoon classes. The explanatory variables were analyzed nighttime sleep situations, sex, interests in the class, medication, and depressive symptoms. The result showed that the students who felt sleepiness in the morning class went bed significantly later (p 0.05). The professors sometimes instruct to the students who feel sleepy in class for improvement their sleep in the night. However, it may not be solved it for their afternoon class

臨床実習指導者が考えるクリニカル・クラークシップの問題点に関する文献検証

研究論文Original Articles　本研究の目的は，わが国のリハビリテーション専門職の臨床実習において，臨床実習指導者が考えるクリニカル・クラークシップの問題点を文献的に明らかにすることであった．対象論文は，医学中央雑誌とメディカルオンラインに掲載されており，キーワード検索に該当した原著論文であった．検索キーワードは，「クラークシップ」OR 「参加型」AND 「実習」とした．その結果，キーワード検索により 215 論文が抽出され，対象論文は，除外基準に該当した論文を除く5 論文であった．5 論文内の記載で多く認められたクリニカル・クラークシップの問題点は，「学生が患者の全体像を把握しにくい」，「臨床実習指導者が学生の理解度を把握しにくい」，「臨床実習指導者の負担が増加する」であった．臨床実習指導者が，なぜ上記の問題点をクリニカル・クラークシップの問題点と考えやすいのか，養成校の教員は原因を分析し，対策を講じる必要がある．　The purpose of this literature review was to clarify the issue of clinical clerkship on clinical practicum of rehabilitation professionals in Japan. The authors searched Centra Revuo Medicina Web and Medical Online. A literature review was conducted using the search term“Clerkship” OR “"On the Job Training” AND “Clinical Practicum”. In total, 215 studies were identified and 5 studies were selected and analyzed. The issue with the clinical clerkship were "It was difficult for students to understand the patients", "It was difficult for clinical educator to understand the students\u27 level of understanding”, "The burden on clinical educator increased”. The instructors in the training institutions for rehabilitation professionals need to analyze the issue of clinical clerkship and take their action

退院時の6 分間歩行距離は退院3 か月後の身体活動量に影響する : 軽症脳梗塞患者における前向きコホート研究

研究論文Original Articles　【目的】本研究の目的は，急性期病院退院後の軽症脳梗塞患者の身体活動量に影響する退院時の要因を明らかにすることであった．【方法】研究デザインは，前向きコホート研究である．軽症脳梗塞患者を対象に身体活動量に関連する要因を退院時に測定し，退院2 週後と3 か月後の身体活動量をオムロン活動量計Active style Pro HJA-750C を用いて測定し，退院後の身体活動量に影響する退院時の要因を検討した．【結果】重回帰分析の結果，退院3 か月後の身体活動量に影響する要因として6 分間歩行距離（β＝ 0.675，p ＜ 0.001）のみが抽出された（自由度調整済みR2 ＝ 0.432，p ＜ 0.001）．【結論】急性期病院退院後の軽症脳梗塞患者の身体活動量には，退院時の6 分間歩行距離が影響することが明らかになった．退院3 か月後の身体活動量の向上には，退院時の6 分間歩行距離を高めることが重要であることが示唆された．【Object】The purpose of this study was to clarify the factors at the time of discharge that affect the physical activity level in patients with minor ischemic stroke after discharge from the acute care hospital.【Methods】This is a prospective cohort study.　We measured factors related to physical activity level at the time of discharge for patients with minor ischemic stroke, and used OMRON\u27s Active Style Pro HJA-750C to measure physical activity level 2 weeks and 3 months after discharge.　We used multiple regression analysis to examine factors at discharge that affect physical activity level after discharge.【Result】As a result of multiple regression analysis, only 6-minute walking distance ( β = 0.675, p <0.001) was extracted as a factor affecting physical activity level 3 months after discharge.【Conclusion】It was clarified that the 6-minute walking distance at the time of discharge affected the physical activity level of patients with minor ischemic stroke after discharge from the acute hospital. These results suggest that it is important to increase the walking distance for 6 minutes at the time of discharge in order to improve physical activity level 3 months after discharge

Prediction of protein assemblies, the next frontier: The CASP14-CAPRI experiment

We present the results for CAPRI Round 50, the fourth joint CASP-CAPRI protein assembly prediction challenge. The Round comprised a total of twelve targets, including six dimers, three trimers, and three higher-order oligomers. Four of these were easy targets, for which good structural templates were available either for the full assembly, or for the main interfaces (of the higher-order oligomers). Eight were difficult targets for which only distantly related templates were found for the individual subunits. Twenty-five CAPRI groups including eight automatic servers submitted ~1250 models per target. Twenty groups including six servers participated in the CAPRI scoring challenge submitted ~190 models per target. The accuracy of the predicted models was evaluated using the classical CAPRI criteria. The prediction performance was measured by a weighted scoring scheme that takes into account the number of models of acceptable quality or higher submitted by each group as part of their five top-ranking models. Compared to the previous CASP-CAPRI challenge, top performing groups submitted such models for a larger fraction (70–75%) of the targets in this Round, but fewer of these models were of high accuracy. Scorer groups achieved stronger performance with more groups submitting correct models for 70–80% of the targets or achieving high accuracy predictions. Servers performed less well in general, except for the MDOCKPP and LZERD servers, who performed on par with human groups. In addition to these results, major advances in methodology are discussed, providing an informative overview of where the prediction of protein assemblies currently stands.Cancer Research UK, Grant/Award Number: FC001003; Changzhou Science and Technology Bureau, Grant/Award Number: CE20200503; Department of Energy and Climate Change, Grant/Award Numbers: DE-AR001213, DE-SC0020400, DE-SC0021303; H2020 European Institute of Innovation and Technology, Grant/Award Numbers: 675728, 777536, 823830; Institut national de recherche en informatique et en automatique (INRIA), Grant/Award Number: Cordi-S; Lietuvos Mokslo Taryba, Grant/Award Numbers: S-MIP-17-60, S-MIP-21-35; Medical Research Council, Grant/Award Number: FC001003; Japan Society for the Promotion of Science KAKENHI, Grant/Award Number: JP19J00950; Ministerio de Ciencia e Innovación, Grant/Award Number: PID2019-110167RB-I00; Narodowe Centrum Nauki, Grant/Award Numbers: UMO-2017/25/B/ST4/01026, UMO-2017/26/M/ST4/00044, UMO-2017/27/B/ST4/00926; National Institute of General Medical Sciences, Grant/Award Numbers: R21GM127952, R35GM118078, RM1135136, T32GM132024; National Institutes of Health, Grant/Award Numbers: R01GM074255, R01GM078221, R01GM093123, R01GM109980, R01GM133840, R01GN123055, R01HL142301, R35GM124952, R35GM136409; National Natural Science Foundation of China, Grant/Award Number: 81603152; National Science Foundation, Grant/Award Numbers: AF1645512, CCF1943008, CMMI1825941, DBI1759277, DBI1759934, DBI1917263, DBI20036350, IIS1763246, MCB1925643; NWO, Grant/Award Number: TOP-PUNT 718.015.001; Wellcome Trust, Grant/Award Number: FC00100

軽症脳梗塞患者に対するSedentary Behaviorの減少を促すアプローチに関する研究

聖隷クリストファー大学2021年

Relationship between thyroid tumor radiosensitivity and nuclear localization of DNA-dependent protein kinase catalytic subunit

Thyroid tumors are the most common types of endocrine malignancies and are commonly treated with radioactive iodine (RAI) to destroy remaining cancer cells following surgical intervention. We previously reported that the expression levels of double-stranded DNA-dependent protein kinase catalytic subunit (DNA-PKcs), which plays a key role in non-homologous end joining, are correlated with the radiosensitivity of cancer cells. Specifically, cells expressing high levels of DNA-PKcs exhibited radiation resistance, whereas cells expressing low levels were sensitive to radiation treatment. In this study, we observed full-length native DNA-PKcs (460 kDa) in radiation-resistant FRO and KTC-2 cells through western blot analysis using an antibody against the C-terminus of DNA-PKcs. In contrast, cleaved DNA-PKcs (175 kDa) were observed in radiation-sensitive TPC-1 and KTC-1 cells. Almost equal amounts of DNA-PKcs were observed in moderately radiation-sensitive WRO cells. We also describe a simple method for the prediction of radiation therapy efficacy in individual cases of thyroid cancers based on staining for DNA-PKcs in human cancer cell lines. Immunofluorescent staining showed that native DNA-PKcs was localized largely in the cytoplasm and only rarely localized in the nuclei of radiation-resistant thyroid cancer cells, whereas in radiation-sensitive cancer cells a 175-kDa cleaved C-terminal fragment of DNA-PKcs was localized mainly inside the nuclei. Therefore, DNA-PKcs moved to the nucleus after γ-ray irradiation. Our results suggest a new method for classifying human thyroid tumors based on their cellular distribution patterns of DNA-PKcs in combination with their radiosensitivity