Showing papers by "Ashutosh Kumar published in 2019"

Building Professionalism in Human Dissection Room as a Component of Hidden Curriculum Delivery: A Systematic Review of Good Practices.

Abstract: The core values in medical practice which are essential for the humane outlook of a physician are clubbed within the domain of medical professionalism. Professionalism along with other discipline-independent skills (human skills) is propagated implicitly in medical schools as components of a "hidden curriculum." Evidence suggests a strong association between "hidden curriculum" delivery and development of professionalism in the human dissection room. In this review article, the authors have tried to highlight a few exclusive practices adopted by medical schools which enhance the implementation of the "hidden curriculum" within the practice of human dissection and successfully inculcate the key components of professionalism such as integrity, respect, and compassion among students. These distinctive concepts are aimed at humanizing the experience of anatomical dissection by revealing the identity of the donors along with their personal details either through display of video clips of donor interviews, interactions with the family members of the donor over a meal or recognition of the donor as a mentor and organizing memorial services in honor of donors after conclusion of the dissection in the presence of their family members. The resounding success of these good practices in building professionalism among medical students from the onset of the academic curriculum has signaled a new chapter in anatomical sciences education. It has become imperative to recognize the visionary efforts of a select few medical educators and begin incorporating these recent trends into the delivery of the "hidden curriculum" within the evolving gross anatomy education model.

Giberellic Acid-Stimulated Transcript Proteins Evolved through Successive Conjugation of Novel Motifs and Their Subfunctionalization

Abstract: Gibberellic Acid Stimulated Transcript (GAST)-like genes encode small polypeptides, some of which have been implicated in diverse biological processes regulating plant growth and development. However, the occurrence of GASTs among plants, their protein structures, and the mechanisms by which they evolved remain elusive. Here, using a customized workflow, we report genes encoding GAST proteins, identify novel motifs and evolutionary patterns contributing to the subfunctionalization of GAST domains, and explore functional conservation across diverse plant groups. We show that GAST-like sequences evolved initially in the vascular plant Selaginella moellendorffii, after the divergence from bryophytes, and later emerged in gymnosperms and angiosperms. GASTs in angiosperms are characterized by four conserved novel motifs; however, relatively fewer conserved motifs exist in pteridophytes and gymnosperms. Phylogenetic analysis revealed that the GAST-Cysteine Rich1 motif evolved early in the S. moellendorffii GAST, which further acquired subfunctionalization through successive conjugation of other motifs and remained conserved across plants, as supported by their collinearity. Functional characterization of two orthologs from the dicot Arabidopsis (Arabidopsis thaliana; Gibberellic Acid-Stimulated Arabidopsis 10) and the monocot rice (Oryza sativa; Gibberellic Acid Stimulated Transcript-Related 9) suggests hormonal regulation, novel roles in seed germination, and functional conservation among diverse plant groups. Computational modeling predicts that these GAST genes are regulated by several factors, including the phytohormones gibberellin and abscisic acid, through conserved cis-motifs present in their promoters, and that they might act as signaling molecules in a complex feedback loop. Thus, our study identifies GASTs and their encoded proteins, uncovers their structure, novel motifs, and evolutionary pattern among plants, and suggests their functional conservation.

The rich heritage of anatomical texts during Renaissance and thereafter: a lead up to Henry Gray's masterpiece.

Abstract: The practice of modern human anatomy was started by Vesalius in sixteenth century Europe during the Renaissance. His exploits are documented in his legendary anatomical text De humani corporis fabrica. Remarkable success of De humani encouraged noted anatomists to publish their own texts over the years. Such a cascading effect started an ongoing process of refining the text based presentation of anatomical details that eventually led to the emanation of Gray's Anatomy, the masterpiece from Henry Gray. In this review article we have tried to revisit the journey from De humani to Gray's Anatomy and have also highlighted on other anatomical texts that form important landmarks in this journey. The article attempts to focus on the rectification of Galenic errors, description of new discoveries in human anatomy, introduction of the concept of clinical anatomy, emergence of surgical anatomy and the advent of sectional anatomy. The article also put emphasis on the efforts to make anatomical illustrations used in texts more scientific and in tune with the printed matter. We noted with interest that luminary anatomists over the years have contributed in their own individual manner towards the development of text based anatomy and from cumulative perspective their visionary efforts have shaped the outlook of anatomical texts in present times.

Altered Expression of a Unique Set of Genes Reveals Complex Etiology of Schizophrenia.

Abstract: Background: The etiology of schizophrenia is extensively debated, and multiple factors have been contended to be involved. A panoramic view of the contributing factors in a genome-wide study can be an effective strategy to provide a comprehensive understanding of its causality. Materials and Methods: GSE53987 dataset downloaded from GEO-database, which comprised mRNA expression data of post-mortem brain tissue across three regions from control (C) and age-matched subjects (T) of schizophrenia (N = Hippocampus [HIP]: C-15, T-18, Prefrontal cortex [PFC]: C-15, T-19, Associative striatum [STR]: C-18, T-18). Bio-conductor-affy-package used to compute mRNA expression, and further t-test applied to investigate differential gene expression. The analysis of the derived genes performed using the PANTHER Classification System and NCBI database. Further, a protein interactome analysis of the derived gene set was performed using STRING v10 database (https://string-db.org/) Results: A set of 40 genes showed significantly altered (p < 0.01) expression across all three brain regions. The analyses unraveled genes implicated in biological processes and events, and molecular pathways relating basic neuronal functions. Conclusions: The aberrant expression of genes maintaining basic cell machinery explains compromised neuronal processing in SCZ.

Transcriptomic Analysis of the Neurogenesis Signature suggests Continued but Minimal Neurogenesis in the Adult Human Hippocampus

Abstract: Purpose Since immunohistological investigations have given rise to divergent perspectives about continued hippocampal neurogenesis in adult humans, a comprehensive transcriptomic analysis of the neurogenesis signature markers supplemented with insights from gliogenesis and apoptotic markers (in context to the developmental stages across age) may discern important aspects and may well be the appropriate methodology for resolving this conflict. Materials and Methods RNA expression data for the salient neurogenesis, gliogenesis, and apoptotic marker genes in post-mortem human hippocampal tissue of the Prenatal (n=15), Infant/Early childhood (n= 5), Adolescence (n=4), and Adulthood (n=6) ages were downloaded from Allen Brain Atlas database (http://www.brainspan.org/rnaseq). Gene expression data was categorized, median values were computed, and age group specific differential expression was statistically analyzed (the confidence level of 95%, p value ≤ 0.05 is used). Results A sharp fall in prenatal to infant/early childhood expression was observed for all studied neurogenesis markers, except that for the post-mitotic late maturation (CALB1, CALB2, MAP2, NEUN, STMN2) which showed no significant differences in expression profiles. A continued post childhood decrease across advancing age was observed in the neural stem cells and progenitor markers with insignificant differences across close age groups. Uniquely, the postnatal sharp fall of KI67 and TBR2 continued across advancing age groups, reached near baseline until adolescent age. The immature granule cell, post mitotic early maturation, and late maturation markers showed a maintained or slightly increased (albeit insignificant) post childhood expression. The gliogenesis markers mostly showed a significant downregulation between prenatal and infant /early childhood age groups; this decline was persistent thereafter with insignificant differences between close age groups. A continued postnatal decrease occurred in apoptotic markers with observable, but insignificant, differences between adolescent and adult age. Conclusions Our findings indicate a possibility of continued but minimal neurogenesis in the adult human hippocampus. A significant part of the newborn cells in the neurogenic niche may be glial cells. (Findings of this study were first presented at the Annual Meeting of Society for Neuroscience (SFN), 3rd-7th November, 2018, San Diego, USA.https://abstractsonline.com/pp8/#!/4649/presentation/37213) Highlights A varying but continued fall in expression was observed for all studied neurogenesis markers across advancing age groups, except that for the immature granule cells, early and post-mitotic late neuronal maturation markers. A continued postnatal sharp fall of progenitor markers KI67 and TBR2 reached near baseline until adolescent age. Gliogenesis markers showed continued but insignificant fall in expression post infant/early childhood. Apoptotic markers showed continued post infant/early childhood downfall but changes were negligible between adolescent and adult age.

Establishing the Identity from the Skeletal Remains of Alum Bheg, a Martyr from the 1857 Indian Freedom Struggle

Abstract: Introduction The present study was undertaken to analyze the morphological features of a skull supposed to be that of Alum Bheg, a martyr from the 1857 Indian Freedom Struggle (also called the Sepoy Mutiny), using established methods to validate identity with regards to age and height as available in the note found with the skull (∼ 32 years old and 5 feet 7½ inch tall). Materials and Methods Identification of the gender of the skull was performed based on established criteria. Analysis for closure of skull sutures (cranial and facial) and measurement of orbitomedial (OM) and maxillomedial (MM) facial anthropometric lines were undertaken to provide an estimated age against each examined suture, as well as against a group of sutures through established scoring systems. Furthermore, the approximate height of the individual was estimated from the skull length using regression equations from a reference adult Indian male population. All of the measurements were made on the digital images of the skull using a digital image analyzer (Image J software, National Institutes of Health, Bethesda, MD, USA). Results Established criteria confirmed that the skull was of a male individual, and the skull sutures and age related morphological changes in the bones indicate that it belonged to an individual in an age range between 20 and 50 years old, with an average of 30 years old, and an approximate height between 5 feet 8.2 inches to 6 feet 1.3 inches. Conclusion The observed values are in approximation with those mentioned in historical notes, and slight differences may be attributed to gross reporting of the original values or limitations of anthropometric analysis. Further biological tests will be required to validate the identity beyond reasonable doubt.

Comparison of cardiovascular, cognitive and stress parameters in presence and in absence of examination among medical students: An observational and prospective study

Abstract: Introduction: Medical student during undergraduate course of 4=1/2 years including 1-year internship study hard, tirelessly for longer periods of day or night and often work beyond their mental threshold and physical strength resulting in stress. The present study was designed to evaluate and compare the stress status among first and second year MBBS students. Materials and Methods: 160 (62 males and 98 females) first (n=90) and second (n=70) year healthy MBBS students were enrolled for this study. Cardiovascular parameters like pulse rate (PR), systolic blood pressure (SBP), diastolic blood pressure (DBP), Cognitive function tests like auditory reaction time (ART) and visual reaction time (VRT) and Stress score (by stress questionnaire) was evaluated and compared in presence of examination (pre-examination) and during absence examination (post-examination, 10-15 days after pre-examination). Data obtained from this study was analysed by Instat Graph Pad using paired t-test. Results: All parameters studied in this study were increased in almost all students during pre-examination. In females compared to males all parameters were significantly less in pre-examination except PR (i.e. less SBP, DBP, less cognition function that means high ART & VRT and less stress score). During postexamination study comparison between males and females, difference of means of parameters were not significant except VRT (Visual reaction time was high in females). Cognition function was less in females as compared to males in both pre as well post examination. Conclusion: Students were in stress with increased all cardiovascular parameters, cognitive parameters and stress score. This may affect the performance and can produce anxiety and/or depression subsequently. Students who are at risk of excessive stress should be identified and faculties should help them to deal the examination stress, anxiety or depression effectively and the earliest. Keywords: Cardiovascular parameters, Cognit