Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

Lean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p < 5 x 10(-8)) or suggestively genome wide (p < 2.3 x 10(-6)). Replication in 63,475 (47,227 of European ancestry) individuals from 33 cohorts for whole body lean body mass and in 45,090 (42,360 of European ancestry) subjects from 25 cohorts for appendicular lean body mass was successful for five single-nucleotide polymorphisms in/ near HSD17B11, VCAN, ADAMTSL3, IRS1, and FTO for total lean body mass and for three single-nucleotide polymorphisms in/ near VCAN, ADAMTSL3, and IRS1 for appendicular lean body mass. Our findings provide new insight into the genetics of lean body mass

Tablet computer enhanced training improves internal medicine exam performance.

BACKGROUND:Traditional teaching concepts in medical education do not take full advantage of current information technology. We aimed to objectively determine the impact of Tablet PC enhanced training on learning experience and MKSAP® (medical knowledge self-assessment program) exam performance. METHODS:In this single center, prospective, controlled study final year medical students and medical residents doing an inpatient service rotation were alternatingly assigned to either the active test (Tablet PC with custom multimedia education software package) or traditional education (control) group, respectively. All completed an extensive questionnaire to collect their socio-demographic data, evaluate educational status, computer affinity and skills, problem solving, eLearning knowledge and self-rated medical knowledge. Both groups were MKSAP® tested at the beginning and the end of their rotation. The MKSAP® score at the final exam was the primary endpoint. RESULTS:Data of 55 (tablet n = 24, controls n = 31) male 36.4%, median age 28 years, 65.5% students, were evaluable. The mean MKSAP® score improved in the tablet PC (score Δ + 8 SD: 11), but not the control group (score Δ- 7, SD: 11), respectively. After adjustment for baseline score and confounders the Tablet PC group showed on average 11% better MKSAP® test results compared to the control group (p<0.001). The most commonly used resources for medical problem solving were journal articles looked up on PubMed or Google®, and books. CONCLUSIONS:Our study provides evidence, that tablet computer based integrated training and clinical practice enhances medical education and exam performance. Larger, multicenter trials are required to independently validate our data. Residency and fellowship directors are encouraged to consider adding portable computer devices, multimedia content and introduce blended learning to their respective training programs

Statistically significant improvement of MKSAP^® scores in the tablet but not the control group.

<p>Control group (n = 31) mean MKSAP^® score Δ — 7 (SD: 11). Tablet group (n = 24) mean MKSAP^® score Δ + 8 (SD: 11). The overall result is also reflected in the MKSAP^® median initial and final score change distribution by grouped by medical subject categories. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0172827#pone.0172827.g003" target="_blank">Fig 3</a>.</p

MKSAP^® score distribution.

<p>Initial and final score change distribution by subject categories in the control (n = 31) and tablet groups (n = 24) Error bars denote 95% CI.</p

Multiple regression for final MKSAP^® score (stepwise variable selection procedure using only significant variables in final model, adjusted for baseline score value), n = 55, R² = 0.58.

<p>Multiple regression for final MKSAP^® score (stepwise variable selection procedure using only significant variables in final model, adjusted for baseline score value), n = 55, R² = 0.58.</p

Participant flow.

<p>Participant flow.</p