Effects of targeted remediation in anatomy for first year medical students

Nachiket Shankar,Nachiket Shankar,Yogitha Ravindranath,Roopa Ravindranath,Henal Shah 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.1

The aim of this study was to assess the effectiveness of a questionnaire to guide targeted remediation among undergraduate medical students in anatomy. Seventy-five students from a medical college in South India who failed in the first internal theory examination were administered a validated 35-item questionnaire. The total and domain specific questionnaire scores were calculated. Specific weekly interventions for each student based on the questionnaire scores were conducted by appointed academic mentors for three months prior to the second internal examination. The dependent variable was performance in the second internal examination. The students were re-administered the questionnaire after the second internal examination. The independent variables were the marks obtained in the first internal examination, domain specific and total questionnaire scores, sex, and regularity of the student in attending the remedial sessions. Inferential statistical tests used were the chi-square test, independent sample t test, paired t test, multiple regression and binomial logistic regression. Of the 75 students who underwent remediation, 54 (72%) passed in the second internal examination. The scores in the second internal examination among these students was found to be significantly higher as compared to the first internal examination. The total, subject related and study skills questionnaire score were significantly lower after remediation. Students who were irregular had a significantly lower pass rate. The multivariate analysis showed that only the first internal marks added significantly to the prediction about second internal performance. This study provides evidence to show that struggling students perceive a benefit from targeted remediation.

Contralateral Breast Cancer: a Clinico-pathological Study of Second Primaries in Opposite Breasts after Treatment of Breast Malignancy

Shankar, Abhishek,Roy, Shubham,Malik, Abhidha,Kamal, Vineet Kumar,Bhandari, Ruchir,Kishor, Kunal,Mahajan, M.K.,Sachdev, Jaineet,Jeyaraj, Pamela,Rath, G.K. Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Breast cancer is by far the most frequent cancer of women (23 % of all cancers), ranking second overall when both sexes are considered together. Contralateral breast cancer (CBC) is becoming an important public health issue because of the increased incidence of primary breast cancer and improved survival. The present communication concerns a study to evaluate the role of various clinico-pathological factors on the occurrence of contralateral breast cancer. Materials and Methods: A detailed analysis was carried out with respect to age, menopausal status, family history, disease stage, surgery performed, histopathology, hormone receptor status, and use of chemotherapy or hormonal therapy. The diagnosis of CBC was confirmed on histopathology report. Relative risk with 95%CI was calculated for different risk factors of contralateral breast cancer development. Results: CBC was found in 24 (4.5%) out of 532 patients. Mean age of presentation was 43.2 years. Family history of breast cancer was found in 37.5% of the patients. There was statistically significant higher rate (83.3%) of CBC in patients in age group of 20-40 years with RR=11.3 (95% CI: 1.4, 89.4, p=0.006) seen in 20-30 years and RR=10.8 (95% CI:1.5-79.6, p=0.002) in 30-40 years as compared to older age of 60-70 years. Risk of development was higher in premenopausal women (RR=8.6, 95% CI: 3.5-21.3, $p{\leq}0.001$). Women with family history of breast cancer had highest rate (20.9%) of CBC (RR=5.4, 95% CI: 2.5-11.6, $p{\leq}0.001$). Use of hormonal therapy in hormone receptor positive patients was protective factor in occurrence of CBC but not significant (RR=0.7, 95% CI: 0.3-1.5, p=0.333). Conclusions: Younger age, premenopausal status, and presence of family history were found to be significant risk factors for the development of CBC. Use of hormonal therapy in hormone receptor positive patients might be protective against occurrence of CBC but did not reach significance.

Preparation of antimicrobial hybrid nano-materials using regenerated cellulose and metallic nanoparticles

Shankar, Shiv,Oun, Ahmed A.,Rhim, Jong-Whan Elsevier 2018 INTERNATIONAL JOURNAL OF BIOLOGICAL MACROMOLECULES Vol.107 No.1

<P><B>Abstract</B></P> <P>In this study, antimicrobial hybrid nano-materials were prepared by one-pot syntheses of silver (Ag), copper oxide (CuO), or zinc oxide (ZnO) nanoparticles (NPs) during regeneration of cellulose from cotton linter (CL) and microcrystalline cellulose (MCC). SEM micrographs indicated that the metallic nanoparticles were attached to the surface of the regenerated cellulose. EDX and ICP results showed that more AgNPs were adsorbed on the cellulose than CuONPs or ZnONPs. FTIR results revealed that the metallic nanoparticles were attached to the cellulose through the interaction with the hydroxyl group of cellulose. XRD results showed the characteristic diffraction peaks of individual metallic nanoparticles. The thermal stability of the R-CL and R-MCC increased in the hybrids with AgNPs and ZnONPs. The R-cellulose/metallic NPs hybrids showed strong antibacterial activity against <I>E. coli</I> and <I>L. monocytogenes</I>. Thus, the hybrid nano-materials can be used as nanofillers for the preparation of antibacterial packaging films.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Hybrid nano-materials of regenerated cellulose and metallic nanoparticles were prepared. </LI> <LI> Hybrid nano-materials were characterized by SEM, EDX, ICP, TGA, FTIR, and XRD. </LI> <LI> Hybrid nano-materials exhibited strong antibacterial activity. </LI> <LI> Developed hybrid nanocomposites can be used as a multifunctional nanofillers. </LI> </UL> </P>

Structural and Thermal Analyses of 3U CubeSat’s Deployable Solar Panel Module

Shankar Bhattarai(바타라이 샹카),Su-Hyeon Kim(김수현),Ji-Seong Go(고지성),Hyun-Ung Oh(오현웅) 항공우주시스템공학회 2019 항공우주시스템공학회 학술대회 발표집 Vol.2019 No.5

Effects of Concentration of ZnO Nanoparticles on Mechanical, Optical, Thermal, and Antimicrobial Properties of Gelatin/ZnO Nanocomposite Films

Shankar, Shiv,Teng, Xinnan,Rhim, Jong-Whan Korea Society of Packaging Science and Technology 2014 한국포장학회지 Vol.20 No.2

This study illustrates the synthesis of gelatin based zinc oxide nanoparticle (ZnONPs) incorporated nanocomposite films using different concentrations of ZnONPs. The ZnONPs were oval in shape and the size ranged from 100- 200 nm. The nanocomposite films were characterized by UV-visible, FE-SEM, FT-IR, and XRD. The concentrations of ZnONPs greatly influenced the properties of nanocomposite films. The absorption peaks around 360 nm increased with the increasing concentrations of ZnONPs. The surface color of film did not change while transmittance at 280 nm was greatly reduced with increase in the concentration of ZnONPs. FTIR spectra showed the interaction of ZnONPs with gelatin. XRD data demonstrated the crystalline nature of ZnONPs. The thermostability, char content, water contact angle, water vapor permeability, moisture content, and elongation at break of nanocomposite films increased, whereas, tensile strength and modulus decreased with increase in the concentrations of ZnONPs. The gelatin/ZnONPs nanocomposite films showed profound antibacterial activity against both Gram-positive and Gram-negative food-borne pathogenic bacteria. The gelatin/$ZnONP^{1.5}$ nanocomposite film showed the best UV barrier and antimicrobial properties among the tested-films, which indicated a high potential for use as an active food packaging films with environmentally-friendly nature.

Analysis of pile-up/sink-in during spherical indentation for various strain hardening levels

Shankar, S.,Loganathan, P.,Mertens, A. Johnney Techno-Press 2015 Structural Engineering and Mechanics, An Int'l Jou Vol.53 No.3

The measurement from the indentation process depends on the amount of pile-up or sink-in around the contact impressions. In this paper, finite element concept is utilized to study the pile-up and sink-in behaviour for the wide range of materials with different young's modulus, yield stresses, strain-hardening exponents and coefficient of friction values. The exact indentation model is created by using the two dimensional axisymmetrical model for simulating the spherical indentation process on the lines of Taljat and Pharr (2004) work. The result shows that during spherical indentation process the amount of pile-up is greatly influenced by the strain hardening exponents in addition to other material properties and depth of penetration. The numerical results from the finite element analysis are also validated using the exact multilinear material properties obtained from the tensile testing for the materials like mild steel, brass and aluminium.

Faculty perceptions regarding an individually tailored, flexible length, outcomes-based curriculum for undergraduate medical students

Shankar Pathiyil Ravi,Azhar Tayyaba,Nadarajah Vishna Devi,Er Hui Meng,Arooj Mahwish,Wilson Ian G. 한국의학교육학회 2023 Korean journal of medical education Vol.35 No.3

Purpose: The perception of faculty members about an individually tailored, flexible-length, outcomes-based curriculum for undergraduate medical students was studied. Their opinion about the advantages, disadvantages, and challenges was also noted. This study was done to help educational institutions identify academic and social support and resources required to ensure that graduate competencies are not compromised by a flexible education pathway.Methods: The study was done at the International Medical University, Malaysia, and the University of Lahore, Pakistan. Semi-structured interviews were conducted from 1st August 2021 to 17th March 2022. Demographic information was noted. Themes were identified, and a summary of the information under each theme was created.Results: A total of 24 (14 from Malaysia and 10 from Pakistan) faculty participated. Most agreed that undergraduate medical students can progress (at a differential rate) if they attain the required competencies. Among the major advantages mentioned were that students may graduate faster, learn at a pace comfortable to them, and develop an individualized learning pathway. Several logistical challenges must be overcome. Providing assessments on demand will be difficult. Significant regulatory hurdles were anticipated. Artificial intelligence (AI) can play an important role in creating an individualized learning pathway and supporting time-independent progression. The course may be (slightly) cheaper than a traditional one.Conclusion: This study provides a foundation to further develop and strengthen flexible-length competency-based medical education modules. Further studies are required among educators at other medical schools and in other countries. Online learning and AI will play an important role.

Preparation of sulfur nanoparticles and their antibacterial activity and cytotoxic effect

Shankar, Shiv,Pangeni, Rudra,Park, Jin Woo,Rhim, Jong-Whan Elsevier 2018 Materials Science and Engineering C Vol.92 No.-

<P><B>Abstract</B></P> <P>Sulfur nanoparticles (SNPs) were prepared using sodium thiosulfate and hydrochloric acid, and the UV–visible spectrum showed the formation of nanoparticulate sulfur. The SNPs were characterized by UV–visible spectrophotometer, transmission electron microscope (TEM), energy dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The antibacterial activity and the cytotoxic effects of the SNPs on the human lung carcinoma (A549), mouse colon carcinoma (CT26), Caco-2, and human fibroblast (CCD-986sk) cells were tested. In addition, the inhibitory effect of the SNPs on the cancer cell migration was evaluated. The SNPs capped with chitosan (SNP2) exhibited strong antibacterial activity against <I>Escherichia coli</I> and <I>Staphylococcus aureus.</I> SNP2 also effectively inhibited the proliferation and migration of cancer cells with minimal toxic effect on normal cells. SNP2 therefore has potential for medical applications, including those used as antibacterial and chemotherapeutic agents.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Sulfur nanoparticles (SNPs) were prepared by sodium thiosulphate and hydrochloric acid. </LI> <LI> Chitosan and ultrasonication reduced the size of SNPs. </LI> <LI> SNPs capped with chitosan (SNP2) showed strong antibacterial activity. </LI> <LI> SNP2 exhibited strong cytotoxic activity and inhibitory effect on the cancer cell migration. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Aromatase Inhibition and Capecitabine Combination as 1^st or 2^nd Line Treatment for Metastatic Breast Cancer - a Retrospective Analysis

Shankar, Abhishek,Roy, Shubham,Rath, Goura Kishor,Julka, Pramod Kumar,Kamal, Vineet Kumar,Malik, Abhidha,Patil, Jaineet,Jeyaraj, Pamela Alice,Mahajan, Manmohan K Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

Background: Preclinical studies have shown that the combination of an aromatase inhibitor (AI) and capecitabine in estrogen receptor (ER)- positive cell lines enhance antitumor efficacy. This retrospective analysis of a group of patients with metastatic breast cancer (MBC) evaluated the efficacy and safety of combined AI with capecitabine. Materials and Methods: Patients with hormone receptor-positive metastatic breast cancer treated between 1st January 2005 and 31st December 2010 with a combination of capecitabine and AI were evaluated and outcomes were compared with those of women treated with capecitabine in conventional dose or AI as a monotherapy. Results: Of 72 patients evaluated, 31 received the combination treatment, 22 AI and 19 capecitabine. The combination was used in 20 patients as first-line and 11 as second-line treatment. Mean age was 46.2 years with a range of 28-72 years. At the time of progression, 97% had a performance status of <2 and 55% had visceral disease. No significant difference was observed between the three groups according to clinical and pathological features. Mean follow up was 38 months with a range of 16-66 months. The median PFS of first-line treatment was significantly better for the combination (PFS 21 months vs 8.0 months for capecitabine and 15.0 months for AI). For second-line treatment, the PFS was longer in the combination compared with capecitabine and Al groups (18 months vs. 5.0 months vs. 11.0 months, respectively). Median 2 year and 5 year survival did not show any significant differences among combination and monotherapy groups. The most common adverse events for the combination group were grade 1 and 2 hand-for syndrome (69%), grade 1 fatigue (64%) and grade 1 diarrhoea (29%). Three grade 3 hand-foot syndrome events were reported. Conclusions: Combination treatment with capecitabine and AI used as a first line or second line treatment was safe with much lowered toxicity. Prospective randomized clinical trials should evaluate the use of combination therapy in advanced breast cancer to confirm these findings.

Design and analysis of energy-harvesting shock absorber with electromagnetic and fluid damping

Shankar Singh,Nitin Vijay Satpute 대한기계학회 2015 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.29 No.4

The design and numerical simulation of a linear generator for use in an automobile shock absorber are presented in this paper. Theconceived linear generator employs high-performance rare earth permanent magnets with compact size to ensure efficient energy recovery. Finite element analysis and Matlab simulation are utilized to derive the generator configurations for the satisfactory utilization ofmagnets and optimized functioning. Experimentation was performed on a linear generator prototype and electromagnetic shock absorberto validate the numerical analysis. The numerical model is then utilized in the design of a full-scale energy-harvesting shock absorberwith fluid damping and a linear generator. A novel feature of the presented work is the use of fluid amplification to simultaneouslyachieve energy dissipation and velocity amplification. Fluid amplification does not affect the dynamics of the system and increases thecoil velocity by approximately eight times. Smooth variation in damping force, improved fail-safe characteristics, and absence of transmissionelements, such as mechanical gears, are additional advantages of the system. Matlab Simscape evaluation is employed to analyzecomfort, safety, and energy-harvesting characteristics, which are then compared with that of the conventional fluid shock absorber. Simulationwith actual road excitation data indicates that the presented system harvests 15 W of the average power from each wheel. Lastly,the layout for integrating the presented shock absorber in McPherson suspension is discussed.