Factors predicting rural location employment intent and choice among medical students and graduates

Purpose Workforce shortage is a contributing cause of health inequality in rural Australia. There is inconclusive evidence demonstrating which factors cause doctors to choose rural practice. This study’s objective is to determine predictive factors for medical students’ intent to work rurally and for graduates’ current rural employment location choice. Methods This prospective cohort study, utilized data gathered from the University of New South Wales about students and graduates who had spent one or more years in a Rural Clinical School. Participants were final year students and graduates already working in Australia. Stepwise logistic regression was used to determine predictive factors for the two outcomes. Results Predictors for student intent to work rurally are rural background (odds ratio [OR], 7.16; 95% confidence interval [CI], 2.59–19.53), choosing to study at the Rural Clinical School (OR, 8.72; 95% CI, 1.32–57.63), and perceiving rural areas as opportunistic for career advancement (OR, 1.69; 95% CI, 1.15–2.49). Predictors for graduates currently working in a rural location are Bonded Medical Program participation (OR, 6.40; 95% CI, 1.15–35.59) and personal altruism (OR, 1.91; 95% CI, 1.02–3.57). Conclusion While intent is predicted by having a rural background, choosing to study at the Rural Clinical School and perception of rural areas as having positive career opportunities, a current rural workplace location among graduates is predicted by holding a bonded medical position and a desire to serve an under-resourced population. Maintaining the Bonded Medical Program and clear communication regarding training pathways may increase numbers of rural doctors

InGaN-based light-emitting diodes with an embedded conical air-voids structure

The conical air-void structure of an InGaN light-emitting diode (LEDs) was formed at the GaN/sapphire interface to increase the light extraction efficiency. The fabrication process of the conical air-void structure consisted of a dry process and a crystallographic wet etching process on an undoped GaN layer, followed by a re-growth process for the InGaN LED structure. A higher light output power (1.54 times) and a small divergent angle (120o) were observed, at a 20mA operation current, on the treated LED structure when compared to a standard LED without the conical air-void structure. In this electroluminescence spectrum, the emission intensity and the peak wavelength varied periodically by corresponding to the conical air-void patterns that were measured through a 100nm-optical-aperture fiber probe. The conical air-void structure reduced the compressed strain at the GaN/sapphire interface by inducing the wavelength blueshift phenomenon and the higher internal quantum efficiency of the photoluminescence spectra for the treated LED structure

Konsep Demokrasi Politik Dalam Islam

Coexistence of chronic rhinosinusitis (CRS) with asthma appears to impair asthma control. Type-2 innate lymphoid cells (ILC2s) respond to the cytokines of thymic stromal lymphopoietin (TSLP), interleukin (IL)-25 and IL-33, thus contributing to airway diseases such as CRS and asthma. We investigate whether the augmented Th2-cytokines in CRS might be related to sinonasal tract ILC2s corresponding to enhanced IL-25, IL-33 and TSLP release in severe asthmatics, and be involved in asthma control. Twenty-eight asthmatics (12 non-severe and 16 severe) with CRS receiving nasal surgery were enrolled. The predicted FEV1 inversely associated with CRS severity of CT or endoscopy scores. Higher expression of Th2-driven cytokines (IL-4, IL-5, IL-9, and IL-13), TSLP, IL-25 and IL-33 in nasal tissues was observed in severe asthma. Severe asthmatics had higher ILC2 cell counts in their nasal tissues. ILC2 counts were positively correlated with Th2-cytokines. Nasal surgery significantly improved asthma control and lung function decline in severe asthma and CRS. The higher expression of IL-33/ILC2 axis-directed type 2 immune responses in nasal tissue of CRS brought the greater decline of lung function in severe asthma. ILC2-induced the upregulated activity of Th2-related cytokines in asthmatics with CRS may contribute to a recalcitrant status of asthma control

Berberine chloride can ameliorate the spatial memory impairment and increase the expression of interleukin-1beta and inducible nitric oxide synthase in the rat model of Alzheimer's disease

BACKGROUND: Berberine is the major alkaloidal component of Rhizoma coptidis, and has multiple pharmacological effects including inhibiting acetylcholinesterase, reducing cholesterol and glucose, lowering mortality in patients with chronic congestive heart failure and anti-inflammation etc. Thus berberine is a promising drug for diabetes, hyperlipemia, coronary artery disease and ischemic stroke etc. The present study was carried out to investigate the effect of berberine chloride on the spatial memory, inflammation factors interleukin-1 beta (IL-1beta) and inducible nitric oxide synthase (iNOS) expression in the rat model of Alzheimer's disease (AD) which was established by injecting Abeta (1–40) (5 microgram) into the rats hippocampuses bilaterally. RESULTS: The rats were given berberine chloride (50 mg/kg) by intragastric administration once daily for 14 days. The spatial memory was assayed by Morris water maze test, IL-1beta and iNOS in the hippocampus were assayed by immunohistochemistry and real time polymerase chain reaction (PCR). Intragastric administration of berberine significantly ameliorated the spatial memory impairment and increased the expression of IL-1beta, iNOS in the rat model of AD. CONCLUSION: Berberine might be beneficial to AD by intragastric administration though it might exaggerate the inflammation reaction

Diosgenin, a Steroidal Saponin, Inhibits Migration and Invasion of Human Prostate Cancer PC-3 Cells by Reducing Matrix Metalloproteinases Expression

BACKGROUND: Diosgenin, a steroidal saponin obtained from fenugreek (Trigonella foenum graecum), was found to exert anti-carcinogenic properties, such as inhibiting proliferation and inducing apoptosis in a variety of tumor cells. However, the effect of diosgenin on cancer metastasis remains unclear. The aim of the study is to examine the effect of diosgenin on migration and invasion in human prostate cancer PC-3 cells. METHODS AND PRINCIPAL FINDINGS: Diosgenin inhibited proliferation of PC-3 cells in a dose-dependent manner. When treated with non-toxic doses of diosgenin, cell migration and invasion were markedly suppressed by in vitro wound healing assay and Boyden chamber invasion assay, respectively. Furthermore, diosgenin reduced the activities of matrix metalloproteinase-2 (MMP-2) and MMP-9 by gelatin zymography assay. The mRNA level of MMP-2, -9, -7 and extracellular inducer of matrix metalloproteinase (EMMPRIN) were also suppressed while tissue inhibitor of metalloproteinase-2 (TIMP-2) was increased by diosgenin. In addition, diosgenin abolished the expression of vascular endothelial growth factor (VEGF) in PC-3 cells and tube formation of endothelial cells. Our immunoblotting assays indicated that diosgenin potently suppressed the phosphorylation of phosphatidylinositide-3 kinase (PI3K), Akt, extracellular signal regulating kinase (ERK) and c-Jun N-terminal kinase (JNK). In addition, diosgenin significantly decreased the nuclear level of nuclear factor kappa B (NF-κB), suggesting that diosgenin inhibited NF-κB activity. CONCLUSION/SIGNIFICANCE: The results suggested that diosgenin inhibited migration and invasion of PC-3 cells by reducing MMPs expression. It also inhibited ERK, JNK and PI3K/Akt signaling pathways as well as NF-κB activity. These findings reveal new therapeutic potential for diosgenin in anti-metastatic therapy

The Cymbidium genome reveals the evolution of unique morphological traits

The marvelously diverse Orchidaceae constitutes the largest family of angiosperms. The genus Cymbidium in Orchidaceae is well known for its unique vegetation, floral morphology, and flower scent traits. Here, a chromosomescale assembly of the genome of Cymbidium ensifolium (Jianlan) is presented. Comparative genomic analysis showed that C. ensifolium has experienced two whole-genome duplication (WGD) events, the most recent of which was shared by all orchids, while the older event was the τ event shared by most monocots. The results of MADS-box genes analysis provided support for establishing a unique gene model of orchid flower development regulation, and flower shape mutations in C. ensifolium were shown to be associated with the abnormal expression of MADS-box genes. The most abundant floral scent components identified included methyl jasmonate, acacia alcohol and linalool, and the genes involved in the floral scent component network of C. ensifolium were determined. Furthermore, the decreased expression of photosynthesis-antennae and photosynthesis metabolic pathway genes in leaves was shown to result in colorful striped leaves, while the increased expression of MADS-box genes in leaves led to perianth-like leaves. Our results provide fundamental insights into orchid evolution and diversification.The National Key Research and Development Program of China, the National Natural Science Foundation of China, the Outstanding Young Scientific Research Talent Project of Fujian Agriculture and Forestry University, the Key Laboratory of National Forestry and Grassland Administration for Orchid Conservation and Utilization Construction Funds, and the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program.https://www.nature.com/hortresam2022BiochemistryGeneticsMicrobiology and Plant Patholog

The Impact of Cultural Attributes on Perceived Clinical Teaching

The quality of clinical teaching is important to ensure medical students are well taught, and that learning resources and teaching time are used efficiently.The quality of clinical teaching can be indirectly assessed by student outcomes. It is difficult, however, to link student outcomes to the quality of specific teaching practices. It is more common, therefore, to assess teaching practices directly using techniques such as self-reported questionnaires, peer review, and most popularly, student teaching evaluations.Most student evaluations seek feedback from students on teacher and teaching satisfaction. However, mere satisfaction may not adequately reflect teaching quality, since students may focus on the “niceness” of the teacher, or the grades they received, rather than the long-term outcomes resulting from their learning experience.In addition, student personal attributes, beyond demographic factors such as age and gender, are rarely considered in student evaluations of teaching in general. This omission may compromise the validity of teaching evaluation since students’ personal attributes impact on their judgment and the responses to questionnaires, which are normally used for teaching evaluations. This is particularly pertinent to clinical teaching which has unique features, such as frequent workplace interactions with different health professionals as well as crucial patient involvement.The objective of the research presented in this thesis was, therefore, to establish a framework and tools for effective and valid assessment of clinical teaching within a diverse student population. This has been achieved by identifying the impact of clinical teaching practices, devising a valid scale for assessing teaching practices observed in clinical teaching sessions, and identifying the impact of individual cultural attributes on student evaluation of the clinical teaching practices they had experienced.To identify the effectiveness of clinical teaching practices, a meta-analysis was undertaken. It identified 16 teaching practices with effect sizes (ES) ranging from 0.06 to 1.49. The most effective teaching practices are: mastery learning (ES=1.49), small group learning (ES=0.95), goal setting (ES=0.86), worked examples (ES=0.61), play programmes (ES=0.61), questioning (ES=0.59), concept mapping (ES=0.47), meta-cognitive strategies (ES=0.44), visual-perception programmes (ES=0.44), and teaching strategies (ES=0.40).Based on the results from the meta-analysis an empirical study was undertaken to devise a tool for assessing the quality of clinical teaching. The tool, entitled Student Ratings in Clinical Teaching – Three Teaching Practices (STRICT-3TP), uses student reports of the frequency of teaching practices identified as effective in the meta-analysis.A battery of three valid scales for assessing the quality of clinical teaching was validated and then applied in conjunction with other scales measuring individual cultural attributes (specifically, individualism, collectivism, power distance, and uncertainty avoidance) to identify the impact of cultural attributes on student evaluation of clinical teaching. The results demonstrate that cultural attributes accounted for 7.2 to 8.4% of the variance in the reported scores, representing the frequency of teaching practices observed by students.Overall, this thesis found that 1) different effective teaching practices share many common traits; 2) students are able to identify those practices utilising student-centred teaching approaches in particular; and 3) cultural attributes such as collectivism, individualism, power distance, and uncertainty avoidance affect students’ perceptions of clinical teaching practices related to active learning, problem-solving learning, and visual technology. In conclusion, student cultural attributes should be considered when student evaluation of teaching data is interpreted