Project description:Editor's Note: this Article has been retracted; the Retraction Note is available at https://www.nature.com/articles/s41598-020-71843-9.
Project description:In the medical field where the volume of information to be studied and reproduced is enormous, note taking and note making becomes an integral part of an effective learning process. Not only does it simplify the learning process, it also eases last minute revision and improves presentation skills in examinations. Knowing when and where to begin taking notes, which topics to take notes on, and how to take notes is crucial before investing one's quality time. Restructuring a content into a table, flowchart, or an illustrative figure depicts your understanding and hard work. It can fetch more marks and save time during examination. It becomes a prerequisite to attain guaranteed success.
Project description:BackgroundThis is the first randomized controlled trial evaluating the impact of note template design on note quality using a simulated patient encounter and a validated assessment tool.ObjectiveTo compare note quality between two different templates using a novel randomized clinical simulation process.DesignA randomized non-blinded controlled trial of a standard note template versus redesigned template.ParticipantsPGY 1-3 IM residents.InterventionsResidents documented the simulated patient encounter using one of two templates. The standard template was modeled after the usual outpatient progress note. The new template placed the assessment and plan section in the beginning, grouped subjective data into the assessment, and deemphasized less useful elements.Main measuresNote length; time to note completion; note template evaluation by resident authors; note evaluation by faculty reviewers.Key results36 residents participated, 19 randomized to standard template, 17 to new. New template generated shorter notes (103 vs 285 lines, p < 0.001) that took the same time to complete (19.8 vs 21.6 min, p = 0.654). Using a 5-point Likert scale, residents considered new notes to have increased visual appeal (4 vs 3, p = 0.05) and less redundancy and clutter (4 vs 3, p = 0.006). Overall template satisfaction was not statistically different. Faculty reviewers rated the standard note more up-to-date (4.3 vs 2.7, p = 0.001), accurate (3.9 vs 2.6, p = 0.003), and useful (4 vs 2.8, p = 0.002), but less organized (3.3 vs 4.5, p < 0.001). Total quality was not statistically different.ConclusionsResidents rated the new note template more visually appealing, shorter, and less cluttered. Faculty reviewers rated both note types equivalent in the overall quality but rated new notes inferior in terms of accuracy and usefulness though better organized. This study demonstrates a novel method of a simulated clinical encounter to evaluate note templates before the introduction into practice.Trial registrationClinicalTrials.gov ID: NCT04333238.
Project description:Neuritic retraction in the absence of overt neuronal death is a shared feature of normal aging and neurodegenerative disorders, but the intracellular mechanisms modulating this process are not understood. We propose that cumulative distal mitochondrial protein damage results in impaired protein import, leading to mitochondrial dysfunction and focal activation of the canonical apoptosis pathway in neurites. This is a controlled process that may not lead to neuronal death and, thus, we term this phenomenon "neuritosis." Consistent with our hypothesis, we show that in primary cerebrocortical neurons, mitochondrial distance from the soma correlates with increased mitochondrial protein damage, PINK1 accumulation, reactive oxygen species production, and decreased mitochondrial membrane potential and depolarization threshold. Furthermore, we demonstrate that the distance-dependent mitochondrial membrane potential gradient exists in vivo in mice. We demonstrate that impaired distal mitochondria have a lower threshold for focal/nonlethal neuritic caspase-3 activation in normal neurons that is exacerbated in aging, stress, and neurodegenerative conditions, thus delineating a fundamental mechanistic underpinning for synaptic vulnerability.