Medical education assessment

Um dos aspectos mais críticos na educação em medicina é a avaliação de novos conhecimentos e habilidades. Essa avaliação deve testar memórias curta, longa e de recuperação. Quando o aluno obtiver todas essa etapas, a memória perdurará por anos permitindo a realização de atividades cirúrgicas eficientes e seguras a longo prazo. A maioria das avaliações são subjetivas, embora difícil de se realizar a avaliação objetiva é modalidade de ensino ideal.  Esse artigo descreveu algumas opções de avaliações objetiva como OSAST, destreza e escala de taxa global. Além disso, foi abordado os valores da avaliação somativa e formativa no processo de aprendizado do estudante de medicina.One of the most critical steps for medical education is the assessment. The assessment can be divided into short-term memory, long-term memory, and retrieval memory. If the student acquires all these memories steps, the surgical skill will be mind incorporate for years. As a healthcare provider, the medical community needs to transform training and learning to a valid and reliable activity. Most of the medical evaluations are subjective; an objective assessment is difficult but most desirable. The authors described some objective surgical skill assessment based on OSAST, dexterity and global rating scale. Moreover, we discussed the formative and summative assessment roles to the medical learning process

Learning methodology in surgical training

This manuscript aimed to review the literature data related to the surgical training program. This review showed some of the requirements to perform effective surgical training were direct supervision, predetermined repetitions according to surgical skill complexity, valid simulator models, number of students per model. This manuscript discussed how the surgical program could achieve competence using a critical thinking framework, integrated curriculum based on the rationale behind simulation training program.Esse manuscrito tem como objetivo revisar dados da literatura relacionados ao treinamento cirúrgico para  alunos de graduação me medicina.  Essa revisão demostrou que  alguns  pré requesitos são necessários para se realizar treinamento cirúrgico de maneira eficaz: supervisão direta, repetições  pré-determinadas de acordo com a complexidade  da atividade a ser ensinada, modelos de simuladores válidos, número de alunos por modelo. Esse manuscrito também  discutiu como o programa cirúrgico pode levar a competência  pelo desenvolvimento do pensamento crítico e pela integração curricular baseado no racional da  utilização de um programa de treinamento por  simuladores

Representações sobre o patrimônio na imprensa escrita de Joinville – o caso do Bar Tigre e da Casa Amarela

Neste artigo propomos uma refl exão sobre representações sociais e imprensa, com base nas pesquisas sobre representações sociais de Serge Moscovici (2003), Roger Chartier (1988) e Sandra Jovchelovitch (2000) e sobre comunicação social de Pedrinho Guareschi (1991). A metodologia utilizada constou de pesquisa e análise das inserções publicadas nos jornais sobre o caso denominado popularmente de Bar Tigre e Casa Amarela, assim como de revisão bibliográfica, revisão da documentação oficial sobre o processo e realização de seis entrevistas orais com profissionais de imprensa e gestores do patrimônio. Observou-se como, com seu discurso, os veículos de comunicação contribuíram para a formação e a disseminação de representações sobre os imóveis. Nessas representações, patrimônio e história estavam relacionados, e as edificações foram apresentadas como sem valor histórico, “velharias” e obstáculos ao desenvolvimento proporcionado pelo supermercado que seria construído no local. Tal debate possibilitou a reflexão sobre temas amplos, como o que é patrimônio, sua ligação com a cidade e a necessidade de estabelecer novas regras para mediar essa relação

Extracellular Matrix-Derived Hydrogels to Augment Dermal Wound Healing:A Systematic Review

Chronic, non-healing, dermal wounds form a worldwide medical problem with limited and inadequate treatment options and high societal burden and costs. With the advent of regenerative therapies exploiting extracellular matrix (ECM) components, its efficacy to augment wound healing is to be explored. This systematic review was performed to assess and compare the current therapeutic efficacy of ECM hydrogels on dermal wound healing. The electronic databases of Embase, Medline Ovid, and Cochrane Central were searched for in vivo and clinical studies on the therapeutic effect of ECM-composed hydrogels on dermal wound healing (April 13, 2021). Two reviewers selected studies independently. Studies were assessed based on ECM content, ECM hydrogel composition, additives, and wound healing outcomes, such as wound size, angiogenesis, and complications. Of the 2102 publications, 9 rodent-based studies were included while clinical studies were not published at the time of the search. Procedures to decellularize tissue or cultured cells and subsequently generate hydrogels were highly variable and in demand of standardization. ECM hydrogels with or without additives reduced wound size and also seem to enhance angiogenesis. Serious complications were not reported. To date, preclinical studies preclude to draw firm conclusions on the efficacy and working mechanism of ECM-derived hydrogels on dermal wound healing. The use of ECM hydrogels can be considered safe. Standardization of decellularization protocols and implementation of quality and cytotoxicity controls will enable obtaining a generic and comparable ECM product. Impact statementExtracellular matrix (ECM)-based hydrogels are biocompatible and harbor growth factors that can instruct tissue healing. Their application is a novelty in (pre)clinical wound healing treatment. This systematic review provides an overview of the current evidence for ECM hydrogels in enhancing wound healing and an extensive overview of the decellularization procedures used. Lastly, challenges and future directions to standardize decellularization procedures and implement quality controls are proposed

A muscological view upon archaeology: “Regional Prehistory” of Joinville exhibition (Santa Catarina State).

A exposição "Pré-história Regional" foi planejada e montada em 1991 no Museu Arqueológico de Sambaqui de Joinville (Estado de Santa Catarina, Brasil). Apresenta a cultura dos grupos sambaquianos da região de Joinville enfocando sua distribuição espacial, suas características bio-cüllurais e o processo de trabalho desencadeado pelos arqueólogos para a obtenção desses conhecimentos. O projeto foi desenvolvido por profissionais de várias instituições: Museu Arqueoló­ gico de Sambaqui de Joinville, Museu de Arqueologia e Etnologia/USP e Museu Paraense Emílio Goeldi/CNPq.The "Regional Prehistory" exhibition was planned and put together in 1991, at the Museu Arqueológico do Sambaqui de Joinville (Santa Catarina Stale, Brazil). This exhibition presents the culture of the Joinville shell-mounds past inhabitants, the spatial distribution of these groups and their biocultural characteristics. Besides, it shows the sort of work done by archaeologists in order to acquire a belter understanding of their lives. The project was accomplished by professionals of three distinct institutions: Museu Arqueológico do Sambaqui de Joinvillc, Museu de Arqueología e Etnologia/USP e Museu Paracnsc Emilio Goeldi/CNPq

VAChT overexpression increases acetylcholine at the synaptic cleft and accelerates aging of neuromuscular junctions

Background: Cholinergic dysfunction occurs during aging and in a variety of diseases, including amyotrophic lateral sclerosis (ALS). However, it remains unknown whether changes in cholinergic transmission contributes to age-and disease-related degeneration of the motor system. Here we investigated the effect of moderately increasing levels of synaptic acetylcholine (ACh) on the neuromuscular junction (NMJ), muscle fibers, and motor neurons during development and aging and in a mouse model for amyotrophic lateral sclerosis (ALS). Methods: Chat-ChR2-EYFP (VAChTHyp) mice containing multiple copies of the vesicular acetylcholine transporter (VAChT), mutant superoxide dismutase 1 (SOD1G93A), and Chat-IRES-Cre and tdTomato transgenic mice were used in this study. NMJs, muscle fibers, and a-motor neurons\u27 somata and their axons were examined using a light microscope. Transcripts for select genes in muscles and spinal cords were assessed using real-time quantitative PCR. Motor function tests were carried out using an inverted wire mesh and a rotarod. Electrophysiological recordings were collected to examine miniature endplate potentials (MEPP) in muscles. Results: We show that VAChT is elevated in the spinal cord and at NMJs of VAChTHyp mice. We also show that the amplitude of MEPPs is significantly higher in VAChTHyp muscles, indicating that more ACh is loaded into synaptic vesicles and released into the synaptic cleft at NMJs of VAChTHyp mice compared to control mice. While the development of NMJs was not affected in VAChTHyp mice, NMJs prematurely acquired age-related structural alterations in adult VAChTHyp mice. These structural changes at NMJs were accompanied by motor deficits in VAChTHyp mice. However, cellular features of muscle fibers and levels of molecules with critical functions at the NMJ and in muscle fibers were largely unchanged in VAChTHyp mice. In the SOD1G93A mouse model for ALS, increasing synaptic ACh accelerated degeneration of NMJs caused motor deficits and resulted in premature death specifically in male mice. Conclusions: The data presented in this manuscript demonstrate that increasing levels of ACh at the synaptic cleft promote degeneration of adult NMJs, contributing to age-and disease-related motor deficits. We thus propose that maintaining normal cholinergic signaling in muscles will slow degeneration of NMJs and attenuate loss of motor function caused by aging and neuromuscular diseases

Endosymbiosis in trypanosomatids: the genomic cooperation between bacterium and host in the synthesis of essential amino acids is heavily influenced by multiple horizontal gene transfers

Background Trypanosomatids of the genera Angomonas and Strigomonas live in a mutualistic association characterized by extensive metabolic cooperation with obligate endosymbiotic Betaproteobacteria. However, the role played by the symbiont has been more guessed by indirect means than evidenced. Symbiont-harboring trypanosomatids, in contrast to their counterparts lacking symbionts, exhibit lower nutritional requirements and are autotrophic for essential amino acids. To evidence the symbiont’s contributions to this autotrophy, entire genomes of symbionts and trypanosomatids with and without symbionts were sequenced here. Results Analyses of the essential amino acid pathways revealed that most biosynthetic routes are in the symbiont genome. By contrast, the host trypanosomatid genome contains fewer genes, about half of which originated from different bacterial groups, perhaps only one of which (ornithine cyclodeaminase, EC:4.3.1.12) derived from the symbiont. Nutritional, enzymatic, and genomic data were jointly analyzed to construct an integrated view of essential amino acid metabolism in symbiont-harboring trypanosomatids. This comprehensive analysis showed perfect concordance among all these data, and revealed that the symbiont contains genes for enzymes that complete essential biosynthetic routes for the host amino acid production, thus explaining the low requirement for these elements in symbiont-harboring trypanosomatids. Phylogenetic analyses show that the cooperation between symbionts and their hosts is complemented by multiple horizontal gene transfers, from bacterial lineages to trypanosomatids, that occurred several times in the course of their evolution. Transfers occur preferentially in parts of the pathways that are missing from other eukaryotes. Conclusion We have herein uncovered the genetic and evolutionary bases of essential amino acid biosynthesis in several trypanosomatids with and without endosymbionts, explaining and complementing decades of experimental results. We uncovered the remarkable plasticity in essential amino acid biosynthesis pathway evolution in these protozoans, demonstrating heavy influence of horizontal gene transfer events, from Bacteria to trypanosomatid nuclei, in the evolution of these pathways

Sexual dimorphism in the South American water snake Helicops polylepis (Serpentes: Dipsadidae)

Sexual selection, fecundity selection and ecological divergence have been the main explanations proposed for the origin and maintenance of sexual dimorphism. In this study we provide evidence of sexual dimorphism in the South American aquatic snake Helicops polylepis, which is mainly determined by body and head sizes. Males have longer tails and more subcaudal scales, and females have larger body and head and more ventral scales. The sexual dimorphism observed in different morphological characters of H. polylepis occurs in other species of xenodontine snakes and is interpreted as a consequence of sexual selection pressures. Data on growth rates associated with prey availability and female size-related offspring size are necessary to refine our analyzes and test specific hypotheses about the ecological and evolutionary bases of sexual dimorphism in H. polylepis