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.

Constrained Geometric Attitude Control on SO(3)

Shankar Kulumani,이태영 제어·로봇·시스템학회 2017 International Journal of Control, Automation, and Vol.15 No.6

This paper presents a new geometric adaptive control system with state inequality constraints for theattitude dynamics of a rigid body. The control system is designed such that the desired attitude is asymptoticallystabilized, while the controlled attitude trajectory avoids undesired regions defined by an inequality constraint. Inaddition, we develop an adaptive update law that enables attitude stabilization in the presence of unknown disturbances. The attitude dynamics and the proposed control systems are developed on the special orthogonal group suchthat singularities and ambiguities of other attitude parameterizations, such as Euler angles and quaternions are completelyavoided. The effectiveness of the proposed control system is demonstrated through numerical simulationsand experimental results.

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.

Equations for Cervical Lordosis and T1 Slope in Young Adults Without Any Neck Symptoms: An Analysis of 171 Radiographs

Shankar Acharya,Varun Khanna,Manoj Kumar 대한척추외과학회 2022 대한척추외과학회지 Vol.29 No.4

Study Design: Cross-sectional, record-based. Objectives: To analyze the cervical sagittal (CS) and thoracic inlet (TI) parameters in asymptomatic adults and form predictive equations for cervical lordosis (CL) and T1 slope (T1S). Summary of Literature Review: Normative values of CS parameters, including physiological CL, and their relationship with TI parameters among healthy Indian adults have been scarcely documented in the literature. Methodology: We analyzed cervical radiographs of 171 healthy adult volunteers and estimated normative values of CS and TI parameters. The thoracic inlet angle (TIA), neck tilt (NT) and T1S were the TI parameters, while the cervical parameters included C2- C7 CL (Cobb’s method), the cervical sagittal vertical axis (cSVA), and C7 slope (C7S). T1S-CL was also calculated. The correlations were estimated and predictive equations were established using simple linear and stepwise multiple regression. The paired-sample t-test was used to evaluate the statistical significance of differences between the estimated and measured values. Results: The mean age of participants was 30±7.76 years. The mean TIA, T1S, NT, CL, cSVA, C7S, and T1S-CL were 79.6°±9.08°, 29.5°±8.6°, 49.3°±8.7°, 21.4°±16.5°,18.8±12.4 mm, 25.7°±7.9°, 8.7°±13.8° respectively. We established the following predictive equations: CL= 0.66 T1S+0.57 TIA - 0.68 SVA - 30.9 (r=0.72; R2 =0.53; p<0.01); CL=0.68 TIA - 30.4 (r=0.41, R2 =0.34; p=0.04) and T1S= 4.45+ 0.72 C7S (r=0.77; R2 =0.62; p<0.01). There was no statistically significant difference between the predicted and the measured values of CL (t=0.09, p=0.973) or T1S (t=0.14; p=0.84). Conclusions: This analysis of sagittal parameters in an asymptomatic adult population provides valuable reference points for the management of various cervical alignment disorders.

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.

Change in Trend in Various Clinico-Pathological Factors and Treatment Profile of Breast Cancer Patients: a Tertiary Cancer Centre Experience

Shankar, Abhishek,Roy, Shubham,Rath, GK,Kamal, Vineet Kumar,Bhandari, Menal,Kulshrestha, Rashi,Prasad, Neelam,Sachdev, Jaineet,Jeyaraj, Pamela Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

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. Since there has been change in clinico-pathological factors and treatment profiles for breast cancer patients over the years, the present study to evaluate the change trends in India. 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. Change in various clinico-pathological factors and treatments of breast cancer cases was recorded and analysed. Results: Mean age at presentation was found to be earlier in 2005-2006 compared with 1997-98 (p value: 0.046). More premenopausal women were diagnosed with breast cancer in 2005-2006 when this was compared with initial years of assessment (p value ${\leq}0.001$). When change in the receptor status was evaluated, we observed that there was a decrease in cases of ER and PR receptor positivity which was significant (p value: 0.007). Over the period of time, more f patients were not offered surgery initially in view of advanced disease when the two time periods were compared (p value: ${\leq}0.001$). There was a significant increase in patients who were initially offered neo-adjuvant chemotherapy in view of advanced disease at presentation (p value: ${\leq}0.001$). There was increasing number of patients who received palliative treatment for symptoms in 2005-2006 when compared to patients treated in 1997-98((p value: ${\leq}0.001$). Conclusions: Changes in mean age at presentation, premenopausal status, and stage at presentation have occurred over the years. More aggressive patterns of disease have become more common with early age at presentation and aggressive biological behaviour with receptor negative tumours.

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.

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 and properties of carbohydrate-based composite films incorporated with CuO nanoparticles

Shankar, Shiv,Wang, Long-Feng,Rhim, Jong-Whan Applied Science Publishers 2017 Carbohydrate Polymers Vol.169 No.-

<P><B>Abstract</B></P> <P>The present study aimed to develop the carbohydrate biopolymer based antimicrobial films for food packaging application. The nanocomposite films of various biopolymers and copper oxide nanoparticles (CuONPs) were prepared by solvent casting method. The nanocomposite films were characterized using SEM, FTIR, XRD, and UV–vis spectroscopy. The thermal stability, UV barrier, water vapor permeability, and antibacterial activity of the composite films were also evaluated. The surface morphology of the films was dependent on the types of polymers used. The XRD revealed the crystallinity of CuONPs in the composite films. The addition of CuONPs increased the thickness, tensile strength, UV barrier property, relative humidity, and water vapor barrier property. The CuONPs incorporated composite films exhibited strong antibacterial activity against <I>Escherichia coli</I> and <I>Listeria monocytogenes</I>. The developed composite films could be used as a UV-light barrier antibacterial films for active food packaging.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Nanocomposite films of biopolymers and CuO nanoparticles were prepared. </LI> <LI> Mechanical, UV barrier, and water vapor barrier properties increased. </LI> <LI> Different biopolymer interacted with CuO nanoparticles differently. </LI> <LI> CuO nanoparticles incorporated films exhibited strong antibacterial activity. </LI> </UL> </P>

Antimicrobial wrapping paper coated with a ternary blend of carbohydrates (alginate, carboxymethyl cellulose, carrageenan) and grapefruit seed extract

Shankar, Shiv,Rhim, Jong-Whan Elsevier 2018 Carbohydrate Polymers Vol.196 No.-

<P><B>Abstract</B></P> <P>A functional biopolymer-coated paper was prepared by coating a ternary blend of the alginate, carboxymethyl cellulose, and carrageenan with grapefruit seed extract (GSE) for the substitute use of synthetic polymer-coated paper. The microstructure of the surface and cross-section of the coated paper analyzed by field emission scanning electron microscope (FE-SEM) indicated that the biopolymer was compatible with the base paper and filled the pores of the porous fiber to make a smooth-surfaced coating paper. The properties of the biopolymer-coated paper, such as water and oil resistance, water vapor barrier, surface hydrophobicity, and mechanical properties, increased significantly compared with not only the base paper but also commercially used PE-coated paper. The blended biopolymer coating material exhibited strong antibacterial activity against food-borne pathogenic bacteria, <I>Listeria monocytogenes</I> and <I>Escherichia coli</I>, which were destroyed completely within 3 and 9 h, respectively. The packaging test for a minced fish cake packed with the biopolymer-coated paper showed the complete destruction of surface inoculated bacteria in 6–9 days. The biopolymer-coated paper showed a high potential for disposable food packaging applications to increase the shelf-life of packaged food.</P> <P><B>Highlights</B></P> <P> <UL> <LI> A ternary blend of the alginate, carboxymethyl cellulose, and carrageenan with grapefruit seed extract (GSE) was used for coating of paper. </LI> <LI> Water and oil resistance properties of paper increased after coating. </LI> <LI> Water vapor barrier, surface hydrophobicity, and mechanical properties, increased significantly after coating. </LI> <LI> Blended biopolymer coating material exhibited strong antibacterial activity. </LI> <LI> The biopolymer-coated paper showed a high potential for disposable food packaging applications. </LI> </UL> </P>