Generative AI versus Faculty-Facilitated Scenario-Based Simulation Design by Medical Students

Introduction: Interest in generative AI and its application to various disciplines, including medical education, has been exponentially growing. ChatGPT was released in 2022 and has garnered much attention due to its free public access. However, research exploring its use to design scenario-based simulations (SBSs) is limited. Rodgers’ Simulation in Healthcare article (2023) describes ChatGPT’s potential as a useful tool for simulationists to streamline instructional design. Yet, they underscore the crucial role of human intervention in addressing shortcomings related to errors, complexity, and formatting. A background in simulation educational design may be a prerequisite. Often when SBS design is undertaken by novice simulationists, the process can be overwhelming and the instructional design may be incomplete, especially without the guidance of experienced simulationists. The applicability of ChatGPT in aiding non-simulationists with SBS design in healthcare education has not been explored. Objective: To describe the instructional design process and outcomes of SBS created by medical students using ChatGPT and compare them to SBS created by medical students with simulation-expert faculty guidance. Methods: Five existing SBSs designed by medical student interest groups (SIG) with simulation faculty guidance were collected from simulation center archives, and scenario goals and patient synopsis were extracted. Medical students unfamiliar with the complete scenario details used the extracted goals and synopsis to create new scenarios using ChatGPT. A blank scenario design template outlining essential elements was used for reference. The ChatGPT conversation tool facilitated iterative refinement of missing elements, errors, or desired modifications. Five scenarios were produced in one session, with elapsed time recorded. The number of design elements and objectives were quantified and compared to the scenarios crafted by SIGs; analysis employed a two-tailed T-test. Results: On average (n=5), the ChatGPT scenarios design time was 37±11.8 minutes and 5.8±1.3 prompts were needed to produce the final scenario. In contrast, SBSs designed by SIGs with faculty input were created over months, and required multiple faculty-student meetings. ChatGPT produced an average of 4.0±0.7 learning objectives, compared to 3.2±1.6 when developed with faculty. ChatGPT’s objectives were often repetitions of the initial input goals. ChatGPT fulfilled an average of 11.8±0.8 out of 18 template elements, compared to 12.8±3.8 in faculty-guided scenarios. Discussion: The most notable difference between ChatGPT and faculty guided scenarios is substantial reduction in creation time. AI-assisted scenarios were created in mere minutes, while faculty guided scenarios took months to complete. Time efficiency could allow students to jumpstart the design process and time saved could support further simulation refinement under faculty guidance. There were no statistical differences between groups in the number of fulfilled elements (p=0.53) or objectives (p=0.35). However, the quality and accuracy of the ChatGPT scenarios have yet to be examined by simulation experts. Challenges experienced while using ChatGPT include the omission of requested scenario components, inadvertent removal of desired elements during the iterative process, and inconsistencies in formatting between scenarios. Target Audience: Novice and expert simulationists, medical students, faculty<p/

Phenothiazine-mediated rescue of cognition in tau transgenic mice requires neuroprotection and reduced soluble tau burden

Abstract Background It has traditionally been thought that the pathological accumulation of tau in Alzheimer's disease and other tauopathies facilitates neurodegeneration, which in turn leads to cognitive impairment. However, recent evidence suggests that tau tangles are not the entity responsible for memory loss, rather it is an intermediate tau species that disrupts neuronal function. Thus, efforts to discover therapeutics for tauopathies emphasize soluble tau reductions as well as neuroprotection. Results Here, we found that neuroprotection alone caused by methylene blue (MB), the parent compound of the anti-tau phenothiaziazine drug, Rember&#8482;, was insufficient to rescue cognition in a mouse model of the human tauopathy, progressive supranuclear palsy (PSP) and fronto-temporal dementia with parkinsonism linked to chromosome 17 (FTDP17): Only when levels of soluble tau protein were concomitantly reduced by a very high concentration of MB, was cognitive improvement observed. Thus, neurodegeneration can be decoupled from tau accumulation, but phenotypic improvement is only possible when soluble tau levels are also reduced. Conclusions Neuroprotection alone is not sufficient to rescue tau-induced memory loss in a transgenic mouse model. Development of neuroprotective agents is an area of intense investigation in the tauopathy drug discovery field. This may ultimately be an unsuccessful approach if soluble toxic tau intermediates are not also reduced. Thus, MB and related compounds, despite their pleiotropic nature, may be the proverbial "magic bullet" because they not only are neuroprotective, but are also able to facilitate soluble tau clearance. Moreover, this shows that neuroprotection is possible without reducing tau levels. This indicates that there is a definitive molecular link between tau and cell death cascades that can be disrupted.http://deepblue.lib.umich.edu/bitstream/2027.42/78314/1/1750-1326-5-45.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78314/2/1750-1326-5-45.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78314/3/1750-1326-5-45-S1.PDFPeer Reviewe

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Evaluation of Molluscs as Dietary Sources of Iron: Heme and Non-Heme Iron Content of Clams and Oysters Consumed in the Asia-Pacific Region

M.S. University of Hawaii at Manoa 2015.Includes bibliographical references.Iron deficiency is the most prevalent nutrient deficiency in the world. Limited bivalve data indicates discrepancies in iron and heme iron concentration. Therefore, fresh Manila clams, Pacific oysters, canned blood clams (A. granosa), canned akagai (A. broughtonii), and frozen blood clams were assayed and compared to beef liver as a reference food rich in heme iron. Heme iron ranged from 0.53 ± 0.08 to 5.77 ± 0.34 mg/100 g edible portion in Manila clams and blanched frozen blood clams, respectively. Non-heme iron ranged from 4.47 ± 0.44 to 9.81 ± 0.58 and total iron ranged from 4.35 ± 0.85 to 12.28 ± 0.44 mg/100 g EP in Manila clams and canned blood clams, respectively. Frozen blood clams had significantly more heme and total iron compared to the liver reference. Although these data indicate that clams could be a reasonable iron source, some samples contained potentially toxic amounts of cadmium

Oral History Interview with Seraphine Robello

Portuguese. "Slightly edited transcriptions of interviews conducted by the Ethnic Studies Oral History Project, University of Hawaii at Manoa.

Oral History Interview with Lucy Robello (LR)

Portuguese. "Slightly edited transcriptions of interviews conducted by the Ethnic Studies Oral History Project, University of Hawaii at Manoa.

Oral History Interview with Antone and Marry P. Camacho

Portuguese. "Slightly edited transcriptions of interviews conducted by the Ethnic Studies Oral History Project, University of Hawaii at Manoa.