Can Score Databanks Help Teaching?

Basic courses in most medical schools assess students' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students' grades. METHODOLOGY/PRINCIPAL FINDINGS: We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378-4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495-3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (p<0.0001 for both AUC). When scores conferred by single courses were compared over time, three time-trend patterns emerged: low variation, upward trend and erratic pattern. CONCLUSION/SIGNIFICANCE: An early identification of students with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student's performance

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Associação entre biomarcadores imunogenéticos e a gravidade ou resistência na malária por Plasmodium vivax

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2020-02-12T11:41:47Z No. of bitstreams: 1 Vitor Rosa Ramos de Mendonca Associação entre...2015.pdf: 19244771 bytes, checksum: 3515385e4ec8a9c978ecf452f16845c8 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2020-02-12T11:43:04Z (GMT) No. of bitstreams: 1 Vitor Rosa Ramos de Mendonca Associação entre...2015.pdf: 19244771 bytes, checksum: 3515385e4ec8a9c978ecf452f16845c8 (MD5)Made available in DSpace on 2020-02-12T11:43:04Z (GMT). No. of bitstreams: 1 Vitor Rosa Ramos de Mendonca Associação entre...2015.pdf: 19244771 bytes, checksum: 3515385e4ec8a9c978ecf452f16845c8 (MD5) Previous issue date: 2015Universidade Federal da Bahia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil.INTRODUÇÃO: A malária é uma das doenças infecto-parasitárias mais incidentes no mundo com grande morbimortalidade. Dentre as espécies infectivas ao ser humano, o Plasmodium vivax é a espécie predominante no Brasil, quase que exclusivamente na Região Amazônica. O espectro clínico da malária abrange desde uma infecção assintomática até casos moderados, com hiperbilirrubinemia isolada ou graves. A produção de mediadores inflamatórios pelo sistema imune, a via de metabolização do heme e os níveis sistêmicos de hepcidina são importantes mecanismos associados a fisiopatologia dos diferentes desfechos clínicos da malária. Além disso, coinfecções podem modular ou intensificar a resposta imune de indivíduos infectados pelo plasmódio. OBJETIVO: Neste ínterim, a identificação de biomarcadores confiáveis tanto de gravidade ou resistência são indispensáveis para o auxílio no seguimento, diagnóstico e terapêutica da malária. MATERIAL E MÉTODOS: Esta Tese reúne sete artigos com o objetivo de identificar biomarcadores plasmáticos e genéticos associados com a via do heme, hepcidina e resposta imune em indivíduos com diferentes manifestações clínicas da malária por P. vivax, assim como nos casos de coinfecção com dengue, da Amazônia Brasileira. RESULTADOS: Em primeiro lugar, foi descrito o estado da arte da diversidade genética humana que influencia o desfecho clínico da malária. Em outro estudo, alterações genéticas específicas e níveis plasmáticos elevados em moléculas na via de metabolização do heme estão associados com a malária vivax aguda. Em terceiro estudo, a interação entre biomarcadores imunoinflamatórios foi analisada por redes, e os participantes com malária assintomática tiveram várias correlações significativas envolvendo a IL-4. A resposta imune também foi influenciada por alterações genéticas e, em outro trabalho, foram identificados polimorfismos em genes relacionados ao sistema imune (DDX39B, TNF e IL6) que estão associados com risco maior de complicações na malária vivax, provavelmente, por influenciarem os níveis de mediadores inflamatórios. Verificou-se no quinto manuscrito que a resposta imune de indivíduos com malária e hiperbilirrubinemia isolada é parecida com aquela de indivíduos com malária não-complicada, sugerindo uma doença menos grave. Neste mesmo estudo, os níveis de hepcidina estão aumentados nos casos graves ou malária com hiperbilirrubinemia e este hormônio está positivamente correlacionado com IL-6, IL-10 e parasitemia no grupo de malária moderada, e com IFN-γ nos indivíduos graves. No sexto trabalho, um algoritmo clínico conseguiu distinguir os indivíduos monoinfectados daqueles com coinfecção dengue e P. vivax, e o perfil imune dos casos coinfectados foi marcada por uma assinatura molecular envolvendo as citocinas TNF, IL-6 e IFN-γ. Por fim, é descrito o estado da arte dos fatores imunoreguladores humanos relacionados à malária assintomática. CONCLUSÕES: O conjunto dos dados desta Tese ajuda no entendimento dos mecanismos imunopatológicos na infecção pelo P. vivax e podem guiar e auxiliar estudos futuros sobre métodos diagnósticos, terapêuticas e vacinas na malária vivax.INTRODUCTION: Malaria is one of the most frequent infectious diseases in the world with high morbidity and mortality. Among the infective species to humans, Plasmodium vivax is the most predominant species in Brazil, with disease incidence almost exclusively observed in the Amazon Region. The clinical spectrum of malaria can range from asymptomatic infection to mild cases, malaria with isolated hyperbilirubinaemia or severe infection. The immune system production of inflammatory mediators, the heme metabolism pathway and systemic levels of hepcidin are important mechanisms associated with pathophysiology of different malaria clinical outcomes. In addition, co-infections can modulate or enhance the immune response of individuals infected with P. vivax. OBJECTIVE: In this context, the identification of reliable biomarkers for disease severity and resistance are essential for the diagnosis, treatment and follow-up of malaria. MATERIAL AND METHODS: This work, composed of seven articles, aims to better explain genetic and plasma biomarkers associated with the heme pathway, hepcidin and immune response occurring in P.vivax infection. Subjects have been sampled from the Brazilian Amazon, with different clinical manifestations of P. vivax malaria, as well as co-infected with dengue. RESULTS: Firstly, it is described the state of the art regarding human genetic diversity, which affects malaria outcomes. In another study, specific genetic alterations and high levels of heme metabolism pathway biomarkers are associated with acute vivax malaria. In the third report, interactions between immunoinflammatory networks were analyzed, and subjects with asymptomatic malaria had significant correlations with increased IL-4 levels. The immune response is also influenced by genetic factors. Towards it, a study has identified polymorphisms in certain immune system genes (DDX39B, TNF and IL-6) that are associated with an increased risk of complications in vivax malaria infection. The fifth manuscript shows that the immune response of subjects with malaria with hyperbilirubinemia is similar to patients with uncomplicated malaria, suggesting it as a less severe disease. Next, a clinical algorithm was shown to distinguish between monoinfected subjects from those co-infected with dengue and P. Vivax; and an immune signature composed by TNF, IL-6 and IFN-γ was found in co-infected subjects. Finally, it is described new human immunoregulatory factors related to asymptomatic malaria. CONCLUSIONS: Together, the data presented here contribute to better understanding the immunopathological mechanisms occurring throughout P. vivax infection, in order to guide and assist future studies about diagnosis, therapeutics and vaccination for P. vivax malaria infection

Stimulating the Formation of the Physician-Scientist; Scientific Exposure during the Medical Course in Brazil

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-04T14:12:50Z No. of bitstreams: 1 Mendonça VRR Stimulating 2011.pdf: 209438 bytes, checksum: 3274474cbc0a298d35e47267be316749 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-04T14:29:33Z (GMT) No. of bitstreams: 1 Mendonça VRR Stimulating 2011.pdf: 209438 bytes, checksum: 3274474cbc0a298d35e47267be316749 (MD5)Made available in DSpace on 2018-10-04T14:29:33Z (GMT). No. of bitstreams: 1 Mendonça VRR Stimulating 2011.pdf: 209438 bytes, checksum: 3274474cbc0a298d35e47267be316749 (MD5) Previous issue date: 2011Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilDespite major advances in medical research, there is a decline in the number of physician-scientists. It is necessary to stimulate the involvement of MDs in the scientific endeavor. Brazil has a national program which stimulates the participation of undergraduate students, including medical students, in research projects as a regular academic activity. Herewith we analyze the introductory scientific program and the involvement of MDs in research in Brazil. The program to promote early scientific exposure during the undergraduate or medical course has the objective of recognizing students with aptitude for scientific research. Brazilian research groups in the area of medicine show a continuous increase, and the health sciences represent a sizable part of graduate students who receive scientific initiation fellowships. An important part of students who participated in introductory scientific programs continued in scientific activities in graduate programs. This finding supports the importance of basic scientific research in stimulating students to follow a scientific career

Conhecimento científico na graduação do Brasil: comparação entre estudantes de Medicina e Direito

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2016-08-10T12:17:48Z No. of bitstreams: 1 Reis Filho Research knowledge....pdf: 1168889 bytes, checksum: 9c6ba437258598b6c544cd0cf9554b45 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2016-08-10T12:28:36Z (GMT) No. of bitstreams: 1 Reis Filho Research knowledge....pdf: 1168889 bytes, checksum: 9c6ba437258598b6c544cd0cf9554b45 (MD5)Made available in DSpace on 2016-08-10T12:28:36Z (GMT). No. of bitstreams: 1 Reis Filho Research knowledge....pdf: 1168889 bytes, checksum: 9c6ba437258598b6c544cd0cf9554b45 (MD5) Previous issue date: 2010-09Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilNIH. Laboratory of Parasitic Diseases. Bethesda, MD, United StatesFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, BrasilHipotetizamos que o impacto da experiência na pesquisa obtida durante a graduação varia entre os currículos profissionais e entre os cursos de graduação. Métodos: Um questionário validado de múltipla escolha sobre conceitos científicos foi dado aos alunos do primeiro e quarto anos das faculdades de Medicina e Direito em uma instituição pública brasileira de ensino. Resultados: Os estudantes de Medicina participaram com mais frequência de programas de iniciação científica em relação aos estudantes de Direito, e essa tendência aumentou do primeiro ao quarto ano de faculdade. Em ambos os currículos, os alunos do quarto ano apresentaram uma maior porcentagem de acertos que os alunos do primeiro ano. A maior proporção de alunos do quarto ano definiu corretamente os conceitos de hipótese científica e teoria científica. Nas áreas de interpretação e escrita de artigos científicos, os alunos do quarto ano, em ambos os currículos, se sentiram mais confiantes do que os estudantes do primeiro ano. Embora os estudantes de Medicina tenham se sentido menos confiantes no planejamento e na realização de projetos de pesquisa que os estudantes de Direito, eles estavam mais envolvidos em atividades de pesquisa. Conclusão: A graduação em Medicina parece favorecer o desenvolvimento da maturidade crítica científica do que a graduação em Direito. A existência de políticas específicas nas escolas médicas é uma explicação razoável para a participação de estudantes de Medicina em mais atividades científicas.Exposure to science education during college may affect a student’s profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. Methods: A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Results: Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Conclusion: Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students’ participation in more scientific activities

Research knowledge in undergraduate school in Brazil: a comparison between medical and law students

Objective: Exposure to science education during college may affect a student’s profile, and research experience may be associated with better professional performance. We hypothesized that the impact of research experience obtained during graduate study differs among professional curricula and among graduate courses. Methods: A validated multiple-choice questionnaire concerning scientific concepts was given to students in the first and fourth years of medical and law school at a public Brazilian educational institution. Results: Medical students participated more frequently in introductory scientific programs than law students, and this trend increased from the first to the fourth years of study. In both curricula, fourth-year students displayed a higher percentage of correct answers than first-year students. A higher proportion of fourth-year students correctly defined the concepts of scientific hypothesis and scientific theory. In the areas of interpretation and writing of scientific papers, fourth-year students, in both curricula, felt more confident than first-year students. Although medical students felt less confident in planning and conducting research projects than law students, they were more involved in research activities. Conclusion: Medical graduation seems to favor the development of critical scientific maturity than law graduation. Specific policy in medical schools is a reasonable explanation for medical students’ participation in more scientific activities