Biomedical subjects

Joseph O Lopreiato

Publications and source records attributed to Joseph O Lopreiato.

3 recordsLinked to original sources

PubMed2006

Cooperative sequence modules determine replication initiation sites at the human beta-globin locus.

The human beta globin locus contains two adjacent replicators, each capable of initiating DNA replication when transferred from its native locus to ectopic sites. Here, we report a detailed analysis of the sequence requirements for replication initiation from these replicators. In both replicators, initiation required a combination of an asymmetric purine:pyrimidine sequence and several AT-rich stretches. Modules from the two replicators could combine to initiate replication. AT-rich sequences were essential for replicator activity: a low frequency of initiation was observed in DNA fragments that included a short stretch of AT-rich sequences, whereas inclusion of additional AT-rich stretches increased initiation efficiency. By contrast, replication initiated at a low level without the asymmetric purine:pyrimidine modules but they were required in synergy to achieve efficient initiation. These data support a combinatorial model for replicator activity and suggest that the initiation of DNA replication requires interaction between at least two distinct sequence modules.

Base Sequence↗

PubMed2006

Combining high-fidelity human patient simulators with a standardized family member: a novel approach to teaching breaking bad news.

Our novel approach to teaching Breaking Bad News (BBN) involves having students actively participate in an unsuccessful resuscitation (mannequin) followed immediately by BBN to a standardized patient wife (SPW) portrayed by an actress. Thirty-nine 3(rd) year medical students completed a questionnaire and then were divided as follows: Group 1 (n=21) received little to no training prior to speaking with the SPW. Group 2 (n =18) received a lecture and practiced for 1 hour in small groups prior to the resuscitation and BBN. Both groups self assessed ability to BBN (p<.0002 & p<.00001), and ability to have a plan (p<.0004 & p <.0003) improved significantly over base line with greater improvement in group 2. Group 2 (pre-trained) students were rated superior by SPW's in several key areas. This novel approach to teaching BBN to 3(rd) year medical students was well received by the students and resulted in marked improvement of self assessed skills over baseline.

Education, Medical↗

PubMedDate not supplied

Assessment of pediatric residents' otoscopic interpretive skills by videotaped examinations.

BACKGROUND: Accurate diagnosis of otitis media is essential to facilitate appropriate management. Few residency programs assess formally their residents' competency in diagnosing middle ear disease. OBJECTIVE: To evaluate the performance of pediatric residents' otoscopic interpretive skills by level of training, with a videotaped otoendoscopic examination (VOE). METHODS: A VOE was used to assess and compare the performance of a cross-sectional sample of 141 residents with one another by level of training as well as with novice and expert groups. Total score, sensitivity, specificity, and kappa coefficients were calculated for each subject by comparing the subject's answers on the 50-ear test with the VOE's expert panel-derived answers, and averages were determined for each training level. RESULTS: Each pediatric resident training group had moderate agreement (mean kappa coefficient range: .45-.56) with the VOE answers, compared with the novice group (mean kappa: .31, fair) and expert group (mean kappa: .80, substantial). Twenty-eight residents (20%) had fair or less agreement (kappa<.41) with the VOE answers. The mean total scores of all pediatric resident training levels were significantly (P<.05) lower than the expert group and significantly (P<.05) higher than the novice group (with exception of the early postgraduate year-1 group). Subjects with more training had higher kappa levels (r=.33,<.001, Spearman) when results were compared among novice, residents, and experts. CONCLUSIONS: We found the VOE to be a feasible and reliable instrument to accurately distinguish novice, resident, and expert level skills in the determination of middle ear effusion status.

Child↗