Future of medical research in Sri Lanka: amidst economic chaos

Sri Lanka is facing an economic crisis and medical research is significantly affected at present with researchers facing many obstacles. Urgent remedial measures are required to overcome the current situation if medical research is to continue in Sri Lanka.

Effect of sex and combat employment on musculoskeletal injuries and medical downgrading in trained military personnel: an observational cohort study

INTRODUCTION

Following the opening of all combat roles to women across the UK Armed Forces, there is a requirement to understand the risk of injury to these female personnel. Women injure at a higher rate than men during basic military training, but fewer data are published from individuals who have passed military training.

METHODS

A bespoke survey was designed to investigate differences in injury prevalence and medical downgrading between sexes and career employment groups (ie, job roles) in the UK Armed Forces.

RESULTS

Questionnaire data were evaluated from 847 service personnel (87% men) employed in combat roles (Royal Marines, Infantry, Royal Armoured Corps, Royal Air Force Regiment (all men)) and non-combat roles (Royal Regiment of Artillery, Corps of Royal Engineers, Royal Logistic Corps and Combat Service Support Corps who were attached to one of the participating units (men and women)). Women reported more total (OR 1.64 (95% CI: 1.03 to 2.59), p=0.035), lower limb (OR 1.92 (95% CI: 1.23 to 2.98), p=0.004) and hip (OR 2.99 (95% CI: 1.59 to 5.62), p<0.001) musculoskeletal injuries in the previous 12 months than men, but there were no sex differences in the prevalence of current or career medical downgrading due to musculoskeletal injury (both p>0.05). There were no differences in 12-month musculoskeletal injury prevalence between men in combat roles and men in non-combat roles (all p>0.05), but men in non-combat roles were more likely to be currently medically downgraded (OR 1.88 (95% CI: 1.27 to 2.78), p=0.001) and medically downgraded during their career (OR 1.49 (95% CI: 1.11 to 2.00), p=0.008) due to musculoskeletal injury than men in combat roles. More time in service and quicker 1.5-mile run times were associated with increased prevalence of total musculoskeletal injuries, and female sex was a predictor of hip injury.

CONCLUSIONS

Although women are at greater risk of injury than men, we have no evidence that combat employment is more injurious than non-combat employment. The prevention of hip injuries should form a specific focus of mitigation efforts for women.

Effect of Covid-19 on Eye Banks and Corneal Transplantations: Current Perspectives

The coronavirus disease 2019 (COVID-19) pandemic exerted a great impact on medical practice, which was reframed according to the actual needs. Ophthalmological services and procedures including corneal transplantation did not represent an exception. The adoption and implementation of new standard operating procedures as well as of new technologies for remote consultation and smart-working reshaped daily activities of both eye bankers, physicians, researchers, and patients. Regulatory restrictions were issued redefining corneal donor eligibility criteria, as well as handling and harvesting procedures of donor ocular tissues. Surgical schedules underwent an abrupt contraction with prioritization of urgent procedures. Local lockdowns and confinement strategies resulted in both a reduction and redirection of research activities. The evaluation of SARS-CoV-2 colonization of ocular tissues, long-term corneal storage techniques, new disinfection strategies, split corneal transplants and cell-based therapies for the treatment of corneal disease peaked in the pipeline. Aim of this article is to summarizes the overall impact of the pandemic on the corneal transplantation machinery, and the current and future perspectives for the corneal transplant community.

Impact of test-enhanced learning as a study strategy: An exploratory study with first-year dental students

PURPOSE

Research has demonstrated that learners who practice self-testing have superior long-term retention compared to those rereading the material alone, a phenomenon called test-enhanced learning. This testing effect can be leveraged by spacing out the testing practice over time, a technique called spaced repetition. In 2017, we provided dental students at the school with access to Osmosis, a web-based platform that supports test-enhanced learning and spaced repetition through flashcards. This exploratory study examined students' adoption of self-testing with flashcards and its impact on learning performance in basic sciences.

METHODS

Participants were 143 first-year predoctoral students at a dental school in the US. The platform analytics revealed the number of flashcards students answered throughout the first academic year (2019-2020). Regression analyses examined how self-testing with flashcards impacted students' exam scores in basic sciences. Analysis of variance (ANOVA) tests examined the difference in students' exam performance among the non, minimal, occasional, and regular flashcard users who answered 0, 1-99, 100-499, and over 500 flashcards, respectively.

RESULTS

Students answered 82,766 flashcards during the year. Additionally, they created 17,973 flashcards using the platform's flashcard authoring tool. Regression analyses showed that self-testing with flashcards correlated positively with students' exam performance in anatomy, biochemistry, nutrition, and physiology. ANOVA results revealed a statistically significant difference in students' exam performance in anatomy, biochemistry, and nutrition among the four groups.

CONCLUSIONS

This study is the first in dental education to examine students' self-testing on the Osmosis platform. Results revealed that there was widespread adoption of self-testing with flashcards. The study provided additional evidence to support the value of self-testing for dental students. It has practical implications of how test-enhanced learning can be incorporated into dental education to support student learning. The study contributed to the test-enhanced learning literature in dental education, an area that has been underexplored.

Aerobic fitness predicted by demographics, anthropometrics, health behaviour, physical activity and muscle fitness in male and female recruits entering military service

INTRODUCTION

The physical and mental training load can be high during military service. Therefore, tailored preconditioning programmes based on assessment of physical fitness could increase readiness for military service, especially among those ones with lower baseline fitness level. The purpose of present study was to investigate how self-assessed health behaviour, physical activity and muscle fitness can predict physical fitness in young male and female military cohorts.

METHODS

Demographics, health behaviour and daily physical activity preceding military service were surveyed by a questionnaire. Thereafter, physical fitness was assessed during the military service by the tests of 12 min running, 1 min push-ups and sit-ups. Explosive power of the lower extremities was studied by maximal standing long jump. Measurements of body anthropometry consisted of body mass, height, and waist circumference.

RESULTS

The two strongest individual predictors of objectively measured running distance in 12 min were self-reported physical activity and physical readiness in both men and women. Self-reported physical activity, readiness for military service, sitting time, education, smoking and body anthropometrics together explained 52% of the variance in the 12 min running test result (R2=0.52, mean absolute percentage error (MAPE) 8.8%, mean absolute error (MAE) 207 m) in men, while for women the predictive values were weaker. Addition of muscle fitness results to the adjusted regression model further improved the model, which explained 59% of the variance in the 12 min running tests result of male conscripts (R2=0.59, MAPE 7.8%, MAE 181 m).

CONCLUSION

In the present study, self-reported physical activity, muscle fitness, physical readiness for military service, sitting time, education, smoking and body anthropometrics predicted inadequately the measured endurance capacity among recruits. The present questionnaire-based variables do not accurately predict physical fitness of recruits and thus, they are not either suitable for practical use for preconditioning programmes or preselection before entering the military service.

Basic Medical Sciences Knowledge Retention for Clinical Practice

BACKGROUND

The basis for studying the clinical sciences is the recall and comprehension of basic medical science facts. Do not, however, directly alter clinical information and as studies revealed that there are basic sciences knowledge retention of medical students gaps in clinical practice. The purpose of this study was to assess medical students' basic medical sciences knowledge retention and a relevance of basic sciences knowledge for clinical for practice.

METHODS

An institutional-based descriptive cross-section epidemiological study design was carried out in the University of Gondar from April to May of 2021. A total of 15 basic and clinical sets of questions were used for data collection. The data were entered and analyzed using SPSS version 20 to analyze data.

RESULTS

A total of 191 medical students participated with response rate of 100%. Of these, 48.6% were male. Of all participant students, 69 (36.1%) have had the academic status of excellent with a commutative grade point average greater that 3.6 out of 4.0. Students who correctly responded for all categories of questions for basic and clinical sciences were 8.6±2.7 and 5±2.8 of second years, 5.5±2.3 and 7.1±1.2 of fourth years, 6.5±1.4 and 6.7±1.0 of fifth years, 5.3±0.8 and 8.4±2.5 of sixth years, respectively. As a representative year, the score of second year students' performance for the basic sciences is a statistically significant with overall impact of the basic sciences (6.49±2.5, F=12.51, P≤0.001) and clinical sciences (4.0±1.9, F=14.73, P≤0.001).

CONCLUSION

It is proposed that basic sciences knowledge should be aligned with clinical sciences preparation so that students may grasp disease diagnosis and treatment concepts in an integrated manner.

Association of Osteopontin gene single nucleotide polymorphism with lupus nephritis

AIM

To determine the association of single nucleotide polymorphism at 9250 C/T in exon 7 of the Osteopontin (OPN) gene among Egyptian patients with lupus nephritis (LN) and healthy controls and assess its relation with clinical and laboratory features in addition to both activity and chronicity indices in these patients.

MATERIALS AND METHOD

The study population includes 100 patients with LN and 100 age- and gender-matched controls. OPN gene 9250 C/T polymorphism was detected by polymerase chain reaction and restriction fragment length polymorphism.

RESULTS

We observed a significant difference in the frequencies of the OPN gene 9250 T allele between the patients with LN and the controls (74.5% vs 57.5%, P < .001); also, TT and CT + TT genotypes showed significant differences in frequencies between LN patients versus controls (59% vs 35% P = .005 and 90% vs. 80% P = .048, respectively). We also observed a non-significant association between OPN gene 9250 genotypes and each of the laboratory data and clinical features in addition to activity and chronicity indices in all studied LN patients. There were no statistically significant increased TT and CT + TT genotypes and T allele frequencies in LN patients with renal failure compared to those without renal failure. Logistic regression analysis revealed that only OPN (CT + TT) genotype could predict LN development in Egyptian patients.

CONCLUSION

TT and CT + TT genotypes and T alleles of OPN 9250 are considered risk factors for LN development in Egyptian systemic lupus erythematosus patients. However, these genotypes showed no association with each laboratory data and clinical feature or activity and chronicity indices in these patients. OPN 9250 (CT + TT) genotype could be used to predict LN development in SLE.

Towards the optimal use of video recordings to support the flipped classroom in medical school basic sciences education

The use of recorded video in medical education is increasing. Video material may be assigned before scheduled sessions to create a flipped classroom. Here, the instructor may lead a session that is organized for discussion, interpretation, and reflection of the previewed content. We established conditions that lead to increased student participation and engagement with prerecorded content for a medical genetics section in a first-year medical school basic sciences integrated course. Preliminary analysis of an asynchronous video-based pre-professional program directed the design of video material to support a first semester medical genetics course. We compared student participation in, and opinion of, a flipped-classroom session based on written vs. video presentation of material. Student opinion was surveyed with audience response devices (clickers). Shorter videos that were created specifically for the course were preferred by students compared to recordings of previously delivered lectures. Students preferred videos to assigned reading material and consistent scheduling throughout the teaching semester increased student participation. Presentation of medical school content with previously recorded video material can be a useful teaching tool if properly implemented.

Twelve tips for UK medical students undertaking laboratory-based intercalated research projects

This article was migrated. The article was marked as recommended. Laboratory-based intercalated research projects are a popular undertaking for medical students in the UK. Such projects can provide students with a wealth of valuable experiences and the chance to develop new skills that will be highly beneficial to their future careers. Laboratory-based intercalated research projects however represent a very different challenge to other aspects of medical education, with distinct expectations and requirements of students in order for success to be achieved. In this article, the author compiled twelve tips based on current literature and their experiences carrying out a laboratory-based intercalated research project as a UK medical student. These tips will help ensure UK medical students are well prepared before commencing their intercalated research project, in order to maximise the benefits of the opportunities presented to them. Although focused on a UK perspective, many of the tips will similarly be applicable to medical students in other countries conducting laboratory-based projects, albeit in slightly different contexts.

Acupuncture inhibits mammalian target of rapamycin, promotes autophagy and attenuates neurological deficits in a rat model of hemorrhagic stroke

BACKGROUND

Intracerebral hemorrhage (ICH) accounts for approximately 15% of all stroke cases. Previous studies suggested that acupuncture may improve ICH-induced neurological deficits. Therefore, we investigated the effects of acupuncture on neurological deficits in an animal model of ICH.

METHODS

Adult male Sprague-Dawley rats were injected with autologous blood (50 μL) into the right caudate nucleus. Additional rats underwent sham surgery as controls. ICH rats either received acupuncture (GV20 through GB7 on the side of the lesion) or sham acupuncture (1 cm to the right side of the traditional acupuncture point locations). Some ICH rats received acupuncture plus rapamycin injection into the right lateral ventricle. Neurological deficits in the various groups were assessed based on composite neurological score. The perihemorrhagic penumbra was analyzed by histopathology following hematoxylin-eosin staining. Levels of autophagy-related proteins light chain (LC)3 and p62 as well as of mammalian target of rapamycin (mTOR)-related proteins, and phosphorylated (p)-mTOR and p-S6K1 (ribosomal protein S6 kinase beta-1), were assessed by Western blotting.

RESULTS

Acupuncture significantly improved composite neurological scores 7 days after ICH (17.7 ± 1.49 vs 14.8 ± 1.32, p < 0.01). Acupuncture augmented autophagosome and autolysosome accumulation based on transmission electron microscopy. Acupuncture significantly increased expression of LC3 (p < 0.01) but decreased expression of p62 (p < 0.01). Acupuncture also reduced levels of p-mTOR and p-S6K1 (both p < 0.01).

CONCLUSION

Acupuncture improved neurological deficits in a rat model of ICH, possibly by inhibiting the mTOR pathway and activating autophagy.

What Use is Anatomy in First Opinion Small Animal Veterinary Practice? A Qualitative Study

Despite the uncontested importance of anatomy as one of the foundational aspects of undergraduate veterinary programs, there is still limited information available as to what anatomy knowledge is most important for the graduate veterinarian in their daily clinical work. The aim of this study was therefore to gain a deeper understanding of the role that anatomy plays in first opinion small animal veterinary practice. Using ethnographic methodologies, the authors aimed to collect rich qualitative data to answer the question "How do first opinion veterinarians use anatomy knowledge in their day-to-day clinical practice?" Detailed observations and semi-structured interviews were conducted with five veterinarians working within a single small animal first opinion practice in the United Kingdom. Thematic analysis was undertaken, identifying five main themes: Importance; Uncertainty; Continuous learning; Comparative and dynamic anatomy; and Communication and language. Anatomy was found to be interwoven within all aspects of clinical practice; however, veterinarians were uncertain in their anatomy knowledge. This impacted their confidence and how they carried out their work. Veterinarians described continually learning and refreshing their anatomy knowledge in order to effectively undertake their role, highlighting the importance of teaching information literacy skills within anatomy curricula. An interrelationship between anatomy use, psychomotor, and professional skills was also highlighted. Based on these findings, recommendations were made for veterinary anatomy curriculum development. This study provides an in-depth view within a single site small animal general practice setting: further work is required to assess the transferability of these findings to other areas of veterinary practice.

Developing a blended learning postgraduate teaching programme in anaesthesia: pandemic and beyond

One of the many challenges facing doctors in training during the COVID-19 pandemic was a significant reduction in postgraduate medical education in the form of formal teaching. Consequently, we sought to provide a blended and asynchronous teaching programme that would be delivered to anaesthetic trainees preparing for their postgraduate examinations. Six sessions of 90-minute duration were delivered during the months July, August and September 2020. Each of the six sessions was delivered live using a variety of online educational tools in addition to traditional didactic-style teaching by the presenters. Participants submitted requests for topics to be covered by the presenters in the final of the six sessions. The sessions were recorded and later uploaded onto an online educational learning platform for viewing at the participants' discretion. The live nature of the sessions ensured participant interaction and a sense of community that trainees had come to expect from previous face-to-face teaching sessions prior to the COVID-19 pandemic.Evaluation was via qualitative and quantitative means using preset questions using the Likert scale and a free-text comments box. The results demonstrated positive feedback across all sessions with particular relevance to the interactive element of the course, the content and delivery.This article describes the requirement for a method of continuing postgraduate medical education in an era where traditional face-to-face teaching is not possible and how the introduction of various innovative educational applications and resources can be used to further postgraduate medical education in the future.

Interprofessional team-based learning in basic sciences: students' attitude and perception of communication and teamwork

OBJECTIVES

To explore whether a team-based learning strategy applied to an interprofessional course on basic science changes students' perception of communication and teamwork skills and attitudes as related to interprofessional learning.

METHODS

A mixed-methods approach was utilized. The participants were selected through an opportunity sample of 33 first-semester anatomy students from occupational therapy and orthoptics programs. Students completed an interprofessional questionnaire before and after the course. The data were analyzed descriptively. Fourteen students were selected randomly for group interviews. Qualitative data was interpreted using thematic analyses.

RESULTS

The pre-test scores for 'communication and teamwork skills' and 'interprofessional learning' were high with mean values of 26.58 and 34.24, respectively. The post-test scores were 27.30 and 34.27, respectively, indicating no relevant changes in students' perception and attitudes. Qualitative data suggested that team-based learning represents a valid strategy to encourage communication and teamwork skills but revealed a lack of interprofessional exchange during the course. Students reported that classroom activities must require the professional knowledge of all participating groups in order to prevent a negative attitudinal shift towards interprofessional education in the later years of their studies.

CONCLUSIONS

Implementing team-based learning in basic sciences can encourage communication and teamwork among students. Mixed classes can help socialize students of different professional groups, although they carry a risk of a negative attitudinal shift towards interprofessional education. Whether, and in what ways, effective interprofessional exchange during the teaching of basic sciences can be achieved needs further investigation.

Effects of pretreatment with terazosin and valsartan on intraoperative haemodynamics in patients with phaeochromocytoma

OBJECTIVE

Surgery is the primary strategy for treating phaeochromocytoma (PCC), but it can lead to severe hypertension and heart failure. Although valsartan is effective in reducing high blood pressure, clinical data on the potential role of valsartan in PCC are currently limited. Therefore, the aim of this study was to investigate the effects of pretreatment with terazosin and valsartan on patients with PCC.

METHODS

In this retrospective cohort study, 50 patients who underwent laparoscopic resection of PCC were enrolled. During preoperative preparation, the patients (n=25) in the control group were treated with terazosin, while those (n=25) in the combination treatment group were treated with terazosin and valsartan. The levels of catecholamine hormones before and after surgery were determined, and the intraoperative blood pressure and the incidence of complications were compared between the two groups.

RESULTS

The results showed no significant differences in baseline patient characteristics or surgical conditions between the two groups (p>0.05). However, on the third day after surgery, the levels of catecholamine hormones in the two groups were significantly lower than those before surgery (p<0.05), while the levels in the combination treatment group were notably lower than those in the control group (p<0.05). The patients in the combination treatment group showed lower intraoperative blood pressure fluctuations and incidence of perioperative complications compared with the control group (p<0.05).

CONCLUSIONS

Terazosin combined with valsartan can effectively improve perioperative haemodynamic instability and reduce postoperative complications in the preoperative management of PCC.

Transfer of basic science knowledge in a problem-based learning curriculum

AIM

The aim of this study was to evaluate transfer of basic science knowledge for clinical application in our BDS programme by exploring the correlations between student performance in integrated dental science (IDS) examinations and applied dental knowledge (ADK) tests.

METHODS

Numeric test scores were drawn from summative IDS and ADK assessments undertaken by BDS students spanning six academic years (2013-14 to 2018-19) for two cohorts (2013 and 2014). The data included a total of 13 test scores for each cohort with four IDS tests, taken in Years 1 and 2, and nine ADK tests taken in Years 3, 4 and 5.

RESULTS

The sample included 120 students across both cohorts with 65 females (54%) and 55 males (46%). The correlation coefficients between the successive tests and the combinations of IDS and ADK scores were positive, all being greater than 0.48, and all being significantly correlated (P < .001). Regarding correlation between standardised averages across all IDS tests and all ADK tests, performance remained significantly correlated: (2013 cohort: r (53) = .667, P < .001; 2014 cohort: r (50) = .700, P < .001).

CONCLUSIONS

The results of this study show that the students' knowledge of basic sciences correlates with their applied dental knowledge and may offer a predictive value. These findings may be attributed to a PBL curriculum and student-led learning at our school.

Neuroanatomical relationship between Jingbi and the brachial plexus

BACKGROUND

This study examined the stratified anatomy of the traditional acupuncture point Jingbi and the neuroanatomical relationship between Jingbi and the brachial plexus, and investigated neural pathways that could be affected by acupuncture stimulation at Jingbi.

METHODS

Twelve dissected specimens were used to study the pathway of an acupuncture needle inserted at Jingbi. The stratified anatomy and the neuroanatomical relationship between Jingbi and the brachial plexus were studied. Our samples were grouped by gender and cause of death for comparative analysis.

RESULTS

All needles (n = 24, on both sides of a total of 12 cadavers) punctured the anterior scalene muscle medial to the brachial plexus and external jugular vein, lateral to the phrenic nerve and internal jugular vein, and superior to the clavicle and subclavian artery/vein. The depth of needle insertion at Jingbi on the right side of male samples was 28.0 (interquartile range (IQR), 22.5-30.8) mm, which was approximately 8 mm deeper than for female subjects (p < 0.05). The needle was 3.0 (IQR, 2.0-5.0) mm and 7.0 (IQR, 5.5-8.0) mm medial to the brachial plexus on the left and right sides, respectively.

CONCLUSION

Deep needle insertion at Jingbi can puncture the anterior scalene muscle. The mechanism of action of acupuncture stimulation at Jingbi might be related to its close relationship with the brachial plexus. Significant differences in needling depth were observed when our samples were grouped by gender. More studies are needed.

Systematic survey of the causal language use in systematic reviews of observational studies: a study protocol

INTRODUCTION

Sometimes, observational studies may provide important evidence that allow inferences of causality between exposure and outcome (although on most occasions only low certainty evidence). Authors, frequently and perhaps usually at the behest of the journals to which they are submitting, avoid using causal language when addressing evidence from observational studies. This is true even when the issue of interest is the causal effect of an intervention or exposure. Clarity of thinking and appropriateness of inferences may be enhanced through the use of language that reflects the issue under consideration. The objectives of this study are to systematically evaluate the extent and nature of causal language use in systematic reviews of observational studies and to relate that to the actual intent of the investigation.

METHODS AND ANALYSIS

We will conduct a systematic survey of systematic reviews of observational studies addressing modifiable exposures and their possible impact on patient-important outcomes. We will randomly select 200 reviews published in 2019, stratified in a 1:1 ratio by use and non-use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Teams of two reviewers will independently assess study eligibility and extract data using a standardised data extraction forms, with resolution of disagreement by discussion and, if necessary, by third party adjudication. Through examining the inferences, they make in their papers' discussion, we will evaluate whether the authors' intent was to address causation or association. We will summarise the use of causal language in the study title, abstract, study question and results using descriptive statistics. Finally, we will assess whether the language used is consistent with the intention of the authors. We will determine whether results in reviews that did or did not use GRADE differ.

ETHICS AND DISSEMINATION

Ethics approval for this study is not required. We will disseminate the results through publication in a peer-reviewed journals.

REGISTRATION

Open Science Framework (osf.io/vh8yx).

Integrating the basic sciences in medical curricula: focus on the basic scientists

Basic science educators are not trained as clinicians, yet are expected to adjust their content to mesh appropriately with its clinical application. While achievable, this is a challenge that requires intentional effort on the part of the basic science educators. A practical solution to facilitate curricular integration is to create experiential opportunities for basic scientists to observe the clinical application of their content and to pair these initiatives with training in effective medical education practices.

What Is the Educational Value of a Student-Led Conference in Dental Education?

Student-led conferences are a type of inquiry learning and student-led pedagogy. They have the potential to foster learning across many of the domains required for professional dental practice including communication and interpersonal skills, adaptive capability, professional attitude and ethical judgment, entrepreneurship, and a social and community orientation. A student-led conference, which provided a framework for students studying oral biosciences to create and host a conference focused on contemporary issues in oral biosciences, was introduced into the Bachelor of Oral Health program at the University of Sydney in Australia in 2017 and 2018. The aim of this qualitative study was to examine the educational purposes that the student-led conference satisfied. Data were collected from the 2017 cohort of students in the form of reflective essays. In 2018, students' experience of the conference was recorded from a focus group discussion. In both years, reflective accounts written by attendees were collected. The thematic analysis generated four themes: integration of learning, personal learning, student resourcefulness through peer relationships, and deep commitment to delivering an excellent conference. The learning project served as a platform for students to display their professionalism and skills gained in entrepreneurship, communication, and adaptive capability. This study provided an example of a participatory curriculum approach with the potential to help students generate a working understanding of knowledge structures and how knowledge is created and circulates in the discipline.

Ballistic gelatin calibration standardisation

INTRODUCTION

A review of ballistic gelatin calibration standards has highlighted that data used from studies with different calibrations methods may not be able to be compared. Calibration of ballistic gelatin did not occur until the mid-1980s when Fackler recognised the deficiencies of uncalibrated gelatin. He determined that the calibration standard should be 85±5 mm of ball bearing penetration for a 180 m/s impact velocity. This study looks to improve on and optimise current ballistic gelatin calibration standards METHODS: Nine 0.177 cal (4.5 mm) spheres were fired using a Daisy Powerline air rifle at velocities between 134 m/s and 224 m/s at 25 gelatin blocks (n=225). Velocities were measured using an Oehler Model 36 Chronograph with three Model 57 screens. Depth of penetration (DoP) was measured from the entry surface to the back end of the sphere via a Mitutoyo Absolute vernier calliper.

RESULTS

The R-squared regression model showed that all batches had a close fit to the regression line. Using the R-squared regression model, the equation y=0.584x - 20.02 (where x is the velocity) returned a DoP of 84.918 mm for a 180 m/s impact and therefore needed minimal adjustment to align with Fackler's 85 mm DoP. The equation can be adjusted to y=0.584x - 20.12 to return a DoP of 85 mm for 180 m/s.

CONCLUSIONS

We propose that the calibration standard of ballistic gelatin with 4.5 mm spheres is DoP=0.584x - 20.12 where DoP is the depth of penetration (mm) and x is the impact velocity (m/s), The measured DoP should be within 5% of the calculated DoP.

Searching the Literature: A Simple Step-Wise Process for Evidence-Based Medicine

Sifting and sorting through the literature and research on health care is an important skill for practicing pharmacists. It is vital for staying current and, most important, helping with the critical task of avoiding adverse drug events in the optimal care of patients. Today, searching this literature efficiently and effectively is increasingly difficult at a time when clinical knowledge is growing exponentially. This article aims to provide a systematic process for going through the literature in an evidence-based manner.

Perceived clinical relevance and retention of basic sciences across the medical education continuum

Medical programs are under pressure to maintain currency with scientific and technical advances, as well as prepare graduates for clinical work and a wide range of postgraduate careers. The value of the basic sciences in primary medical education was assessed by exploring the perceived clinical relevance and test performance trends among medical students, interns, residents, and experienced clinicians. A pilot study conducted in 2014 involved administration of a voluntary 60-item multiple-choice question test to 225 medical students and 4 interns. These participants and 26 teaching clinicians rated the items for clinical relevance. In 2016, a similarly constructed test (main study) was made a mandatory formative assessment, attempted by 563 students in years 2, 4, and 6 and by 120 commencing general practice residents. Test scores, performance trends, clinical relevance ratings, and correlations were assessed using relevant parametric and nonparametric tests. Rank order and pass-fail decisions were also reviewed. The mean test scores were 57% (SD 7.1) and 52% (SD 6.1) for the pilot and main studies, respectively. Highest scores were observed in pathology and social sciences. Overall performance increased with increasing year of study. Test scores were positively correlated with perceived relevance. There were moderate correlations (r = 0.50-0.63; P < 0.001) between participants' scores in the basic science and summative exams. Assessments may be key to fostering relevance and integration of the basic sciences. Benchmarking knowledge retention and result comparisons across topics are useful in program evaluation.

Approaches Towards Professional Studies and Spare-time Activities Among Preclinical and Clinical Year Medical Students

Objective This study aims at a recognition of the differences in the study habits, approach to teaching resources, and spare-time activities of medical students in the preclinical and clinical training periods at King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA). Methods Study sampling was carried out in 2017 at the Faculty of Medicine, KAU, Jeddah, SA. Students from both genders were included and further subdivided to preclinical (2^nd and 3^rd years) and clinical groups (4^th, 5^th, and 6^th years). Students were asked to respond to an online questionnaire. SPSS-Version 21 (IBM Corp., Armonk, NY, US) was utilized for statistical analysis of the collected data, Results Of the 347/500 (response rate 69.4%) medical students, 85 (24.5%) were from the preclinical students (2^nd and 3^rd years), and 262 (64.5%) were enrolled in the clinical group (4^th to 6^th years of MBBS). The majority of students 330 (94.1%) were unmarried, only 17 of them, i.e., 4.9%, were married. Analysis of the data revealed that medical textbooks, essential versions of basic medical books, online resources, and online version of books were used more frequently by the clinical group as compared to the preclinical students. Teacher-provided lecture handouts and lecture notes taken during classes were being equally used by both groups. There was a significant difference in the opinion on the usefulness of different resources between both groups. Students faced difficulty in understanding the English language, observed more in the pre-clinical years as compared to relatively groomed clinical students. The preclinical group could not understand the teaching material in books due to a weaker understanding of the English language. Social media software was used for keeping both groups busy, but clinical students also used social media for academic purposes. More than half of the participants from the preclinical and almost one-third from the clinical years admitted that their teachers recommended them for relevant medical textbooks. An encouraging trend was observed in most preclinical group students: they found teaching modalities, such as problem-based learning (PBL) and other academic activities, as a trigger to promote book reading. Conclusion Our results show that the students in the clinical phase had a more methodical approach to professional studies and a difference in spare-time activities.