Relationship matters: a qualitative study of medical students' experiences in a learner-driven research program in South Korea

Background Although research experience is important for medical students, it is difficult to develop research skills only through a formal curriculum. To develop research programs that address the authentic needs of students and align with the entirety of the medical school curriculum, a learner-centered approach may be more effective than an instructor-centered approach. This study investigates medical student perspectives on factors that help them develop research competency. Methods Hanyang University College of Medicine in South Korea operates the Medical Scientist Training Program (MSTP) as a supplement to its formal curriculum. Semi-structured interviews were held with 18 students (20 cases) in the program, and qualitative content analysis was performed using the software tool MAXQDA20. Results The findings are discussed in relation to three domains: learner engagement, instructional design, and program development. The students were more engaged when they perceived the program as a new experience, had prior research experience, wanted to make a good impression, and felt a sense of contribution. In terms of instructional design, they positively participated in research when their supervisors respected them, set clear tasks, provided constructive feedback, and invited them into the research community. In particular, the students highly valued relationships with their professors, and these relationships served not only as a main motivating factor in their research participation but also affected their college lives and careers. Conclusions The longitudinal relationship between students and professors has newly emerged in the Korean context as a factor that strengthens student engagement in research and the complementary relationship between formal curriculum and MSTP was highlighted to encourage student engagement in research

Engineering integrin signaling for promoting embryonic stem cell self-renewal in a precisely defined niche

We present development and use of a 3D synthetic extracellular matrix (ECM) analog with integrin- specific adhesion ligands to characterize the microenvironmental influences in embryonic stem cell (ESC) self-renewal. Transcriptional analysis of 24 integrin subunits followed by confirmation at the trans- lational and functional levels suggested that integrins a5b1, avb5, a6b1 and a9b1 play important roles in maintenance of stemness in undifferentiated mouse ESCs. Using the well-defined matrix as a tool to activate integrins a5b1 plus avb5, a6b1 and a9b1, individually and in combination, differential integrin activation was demonstrated to exert exquisite control over ESC fate decisions. Simultaneous ligation of these four integrin heterodimers promoted self-renewal, as evidence by prolonged SSEA-1, Oct4 and Nanog expression, and induced Akt1 kinase signaling along with translational regulation of other stemness-related genes. The biofunctional network we have designed based on this knowledge may be useful as a defined niche for regulating ESC pluripotency through selective cell–matrix interactions, and the method we present may be more generally useful for probing matrix interactions in stem cell self- renewal and differentiation

Baseline Renal Function Predicts Hyponatremia in Liver Cirrhosis Patients Treated with Terlipressin for Variceal Bleeding

Objectives. Terlipressin is safely used for acute variceal bleeding. However, side effects, such as hyponatremia, although very rare, can occur. We investigated the development of hyponatremia in cirrhotic patients who had acute variceal bleeding treated with terlipressin and the identification of the risk factors associated with the development of hyponatremia. Design and Methods. This retrospective, case-control study investigated 88 cirrhotic patients who developed hyponatremia and 176 controls that did not develop hyponatremia and were matched in terms of age and gender during the same period following terlipressin administration. Results. The overall change in serum sodium concentration and the mean lowest serum sodium concentration were 3.44 ± 9.55 and 132.44 ± 8.78 mEq/L during treatment, respectively. Multivariate analysis revealed that baseline serum sodium was an independent positive predictor, and the presence of baseline serum creatinine, HBV, DM, creatinine, and shock on admission was independent negative predictors of hyponatremia (P<0.05). Conclusion. The presence of HBV, DM, the baseline serum sodium, shock on admission, and especially baseline creatinine may be predictive of the development of hyponatremia after terlipressin treatment. Therefore, physicians conduct vigilant monitoring associated with severe hyponatremia when cirrhotic patients with preserved renal function are treated with terlipressin for variceal bleeding

Efficient and Accurate Conservative Schemes for Homogeneous Equilibrium Two-Phase Flow Computations

For efficient and accurate computations of compressible/incompressible gas-liquid two-phase flows, the two conservative schemes, named AUSMPW+ and RoeM, are extended to two-phase flows at all speeds. In order to maintain the merits of these schemes even in two-phase flows, a new shock discontinuity sensing term suitably scaled for two-phase flows is derived. Also, Multigrid and LU-SGS techniques are implemented for more efficient computation, after being modified adequate for two-phase flows. The numerical results show the accurate and robust behavior of the proposed schemes for all speed two-phase flows

Computation of Multiphase Mixture Flows using RoeM and AUSMPW+ Schemes

RoeM[1] and AUSMPW+[2] schemes, originally developed for the robust and accurate simulation of single phase gas dynamics, are extended to the compressible gas-liquid two-phase flows. We adopted homogeneous equilibrium model(HEM) using mass fraction to describe different two phases. In the Eulerian-Eulerian framework, HEM assumes dynamic and thermal equilibrium of the two phases in the same computational mesh. We derived new pressure weighting function from the mixture equation of state(EOS) to construct the new shock discontinuity sensing term(SDST), which is commonly used in RoeM and AUSMPW+ for the stable numerical flux calculation. The developed two-phase versions of RoeM and AUSMPW+ are applied on several air-water two-phase test problems. In spite of the large discrepancy of material properties such as density, enthalpy, and speed of sound, the numerical results show that both schemes provide very satisfactory solutions

Development of a Novel Diagnostic Biomarker Set for Rheumatoid Arthritis Using a Proteomics Approach

Background. Rheumatoid arthritis (RA) is an autoimmune disease that starts with inflammation of the synovial membrane. Studies have been conducted to develop methods for efficient diagnosis of RA and to identify the mechanisms underlying RA development. Blood samples can be useful for detecting disturbance of homeostasis in patients with RA. Nanoliquid chromatography-tandem mass spectrometry (LC-MS/MS) is an efficient proteomics approach to analyze blood sample and quantify serum proteins. Methods. Serum samples of 18 healthy controls and 18 patients with RA were analyzed by LC-MS/MS. Selected candidate biomarkers were validated by enzyme-linked immunosorbent assay (ELISA) using sera from 43 healthy controls and 44 patients with RA. Results. Thirty-eight proteins were significantly differentially expressed by more than 2-fold in healthy controls and patients with RA. Based on a literature survey, we selected six candidate RA biomarkers. ELISA was used to evaluate whether these proteins effectively allow distinguishing patients with RA from healthy controls and monitoring drug efficacy. SAA4, gelsolin, and vitamin D-binding protein were validated as potential biomarkers of RA for screening and drug efficacy monitoring of RA. Conclusions. We identified a panel of three biomarkers for RA which has potential for application in RA diagnosis and drug efficacy monitoring. Further, our findings will aid in understanding the pathogenesis of RA