Integrating an Evidence Based Medicine Module Presentation into the Ob-Gyn Clerkship

Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills. Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness of the curriculum addition, students were administered a survey to rate their knowledge of EBM before and after completing the EBM project. Results: One full academic year of clerkship cohorts (n=103) were surveyed. Regardless of EBM knowledge before the project, comparison of self-reported knowledge increased to above-average level of understanding as a result of the project (mean=4.0, SD=1.07, CI=3.75-4.19). Furthermore, student presentation percentage scores using the rubric showed an above average understanding of EBM (mean=96, SD=4.40). Conclusion: It is important for students to integrate EBM into their practice early in their training. This curriculum addition was effective and could be utilized in other clerkships

An original phylogenetic approach identified mitochondrial haplogroup T1a1 as inversely associated with breast cancer risk in BRCA2 mutation carriers

Introduction: Individuals carrying pathogenic mutations in the BRCA1 and BRCA2 genes have a high lifetime risk of breast cancer. BRCA1 and BRCA2 are involved in DNA double-strand break repair, DNA alterations that can be caused by exposure to reactive oxygen species, a main source of which are mitochondria. Mitochondrial genome variations affect electron transport chain efficiency and reactive oxygen species production. Individuals with different mitochondrial haplogroups differ in their metabolism and sensitivity to oxidative stress. Variability in mitochondrial genetic background can alter reactive oxygen species production, leading to cancer risk. In the present study, we tested the hypothesis that mitochondrial haplogroups modify breast cancer risk in BRCA1/2 mutation carriers. Methods: We genotyped 22,214 (11,421 affected, 10,793 unaffected) mutation carriers belonging to the Consortium of Investigators of Modifiers of BRCA1/2 for 129 mitochondrial polymorphisms using the iCOGS array. Haplogroup inference and association detection were performed using a phylogenetic approach. ALTree was applied to explore the reference mitochondrial evolutionary tree and detect subclades enriched in affected or unaffected individuals. Results: We discovered that subclade T1a1 was depleted in affected BRCA2 mutation carriers compared with the rest of clade T (hazard ratio (HR) = 0.55; 95% confidence interval (CI), 0.34 to 0.88; P = 0.01). Compared with the most frequent haplogroup in the general population (that is, H and T clades), the T1a1 haplogroup has a HR of 0.62 (95% CI, 0.40 to 0.95; P = 0.03). We also identified three potential susceptibility loci, including G13708A/rs28359178, which has demonstrated an inverse association with familial breast cancer risk. Conclusions: This study illustrates how original approaches such as the phylogeny-based method we used can empower classical molecular epidemiological studies aimed at identifying association or risk modification effects.Peer reviewe

Integrating an Evidence Based Medicine Module Presentation into the Ob-Gyn Clerkship

Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills. Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness of the curriculum addition, students were administered a survey to rate their knowledge of EBM before and after completing the EBM project. Results: One full academic year of clerkship cohorts (n=103) were surveyed. Regardless of EBM knowledge before the project, comparison of self-reported knowledge increased to above-average level of understanding as a result of the project (mean=4.0, SD=1.07, CI=3.75-4.19). Furthermore, student presentation percentage scores using the rubric showed an above average understanding of EBM (mean=96, SD=4.40). Conclusion: It is important for students to integrate EBM into their practice early in their training. This curriculum addition was effective and could be utilized in other clerkships

Integrating an Evidence Based Medicine Module Presentation into the Ob-Gyn Clerkship

Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills. Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness of the curriculum addition, students were administered a survey to rate their knowledge of EBM before and after completing the EBM project. Results: One full academic year of clerkship cohorts (n=103) were surveyed. Regardless of EBM knowledge before the project, comparison of self-reported knowledge increased to above-average level of understanding as a result of the project (mean=4.0, SD=1.07, CI=3.75-4.19). Furthermore, student presentation percentage scores using the rubric showed an above average understanding of EBM (mean=96, SD=4.40). Conclusion: It is important for students to integrate EBM into their practice early in their training. This curriculum addition was effective and could be utilized in other clerkships

Integrating an Evidence Based Medicine Module Presentation into the Ob-Gyn Clerkship

Introduction: During the preclinical curriculum, students are introduced to EBM principles, however structured application to clinical medicine varies throughout clinical experiences. Application of EBM in a clinical educational environment affords students opportunities to practice required skills. Methods: Students selected a patient case and formulated a question related to diagnosis ortreatment using the PICO framework. Students selected research publications related to the patient case, critically appraised their validity and generalization, and developed a comprehensive presentation involving a case summary and related EBM topics, which were evaluated by a faculty member using a rubric developed for the project. To assess the effectiveness of the curriculum addition, students were administered a survey to rate their knowledge of EBM before and after completing the EBM project. Results: One full academic year of clerkship cohorts (n=103) were surveyed. Regardless of EBM knowledge before the project, comparison of self-reported knowledge increased to above-average level of understanding as a result of the project (mean=4.0, SD=1.07, CI=3.75-4.19). Furthermore, student presentation percentage scores using the rubric showed an above average understanding of EBM (mean=96, SD=4.40). Conclusion: It is important for students to integrate EBM into their practice early in their training. This curriculum addition was effective and could be utilized in other clerkships

Producción social del hábitat y políticas en el Área Metropolitana de Buenos Aires: historia con desencuentros

This document analyzes some specific policies implemented in the Buenos Aires Metropolitan Area (AMBA) in the aftermath of the crisis. Departing from a theoretical framework that defines the concept of social production of habitat, it reflects on the current conditions of political and territorial insertion of popular sectors in the area, their degrees of organization and the results that the interaction between social organizations and government agencies produce on policy-making.Partiendo de una elaboración teórico conceptual acerca de la producción social del hábitat y del análisis de algunas políticas sectoriales implementadas en la post crisis en el AMBA, el documento analiza y reflexiona sobre las condiciones de inserción socio política y territorial de los sectores populares en áreas centrales y periféricas del AMBA, sobre sus niveles de organización, el papel jugado por el Estado y los significados que asume su interacción en el plano de las políticas

Determination of DNA Content of Aquatic Bacteria by Flow Cytometry

The distribution of DNA among bacterioplankton and bacterial isolates was determined by flow cytometry of DAPI (4′,6′-diamidino-2-phenylindole)-stained organisms. Conditions were optimized to minimize error from nonspecific staining, AT bias, DNA packing, changes in ionic strength, and differences in cell permeability. The sensitivity was sufficient to characterize the small 1- to 2-Mb-genome organisms in freshwater and seawater, as well as low-DNA cells (“dims”). The dims could be formed from laboratory cultivars; their apparent DNA content was 0.1 Mb and similar to that of many particles in seawater. Preservation with formaldehyde stabilized samples until analysis. Further permeabilization with Triton X-100 facilitated the penetration of stain into stain-resistant lithotrophs. The amount of DNA per cell determined by flow cytometry agreed with mean values obtained from spectrophotometric analyses of cultures. Correction for the DNA AT bias of the stain was made for bacterial isolates with known G+C contents. The number of chromosome copies per cell was determined with pure cultures, which allowed growth rate analyses based on cell cycle theory. The chromosome ratio was empirically related to the rate of growth, and the rate of growth was related to nutrient concentration through specific affinity theory to obtain a probe for nutrient kinetics. The chromosome size of a Marinobacter arcticus isolate was determined to be 3.0 Mb by this method. In a typical seawater sample the distribution of bacterial DNA revealed two major populations based on DNA content that were not necessarily similar to populations determined by using other stains or protocols. A mean value of 2.5 fg of DNA cell(−1) was obtained for a typical seawater sample, and 90% of the population contained more than 1.1 fg of DNA cell(−1)