Background: Medical institutes in India and globally were widely affected by the COVID-19 pandemic, and there was an almost immediate need to adapt modules for delivery on e-learning platforms. This study was undertaken to gauge the future and usefulness of e-learning in medical education by analyzing the perception, attitude, and readiness of healthcare learners during the ongoing pandemic.Methodology: A quantitative survey was conducted among the healthcare community, during lockdown i.e., over a period of five weeks from 8th May to June 13, 2020. A survey questionnaire was developed to understand the demographic details, knowledge, infrastructure access, and attitude of the healthcare professionals. It was circulated through snow-balling technique with one hundred healthcare and allied professionals (linked with Project ILBS-ECHO) as the initial seeds. Each person was asked to then circulate the survey to 20 or more of their contacts and so on for the proposed duration of the study. Identifying information was anonymized before and ethical approval was obtained prior to initiating the survey.Results: A total of 3,004 healthcare professionals voluntarily participated in the survey. The respondents were mostly young adults, with 61% of participants being <30 years of age. About 65.41% used e-learning platforms for obtaining knowledge and skills during the pandemic, despite 71.1% of the respondent reporting cyber security concerns. Significant advantages of e-learning mentioned by participants was reduction in travel time and assistance in maintaining social distancing (68.21%) without compromising learning.Conclusion: With learners consistently jumping on to the bandwagon, the trend can be anticipated to continue post pandemic. For this reason, the study tried to highlight the awareness, perceptions, and potential challenges faced by Indian healthcare and allied professionals regarding e-learning as a method of education.

Ligand-activated glucocorticoid receptor (GR) elicits variable glucocorticoid-modulated transcriptomes in different cell types. However, some genes, including Krüppel-like factor 9 (KLF9), a putative transcriptional repressor, demonstrate conserved responses. We show that glucocorticoids induce KLF9 expression in the human airways in vivo and in differentiated human bronchial epithelial (HBE) cells grown at air-liquid interface (ALI). In A549 and BEAS-2B pulmonary epithelial cells, glucocorticoids induce KLF9 expression with similar kinetics to primary HBE cells in submersion culture. A549 and BEAS-2B ChIP-seq data reveal four common glucocorticoid-induced GR binding sites (GBSs). Two GBSs mapped to the 5ʹ-proximal region relative to KLF9 transcription start site (TSS) and two occurred at distal sites. These were all confirmed in primary HBE cells. Global run-on (GRO)-sequencing indicated robust enhancer RNA (eRNA) production from three of these GBSs in BEAS-2B cells. This was confirmed in A549 cells, plus submersion and ALI culture of HBE cells. Cloning each GBS into luciferase reporters revealed glucocorticoid-induced activity requiring a glucocorticoid response element (GRE) within each distal GBS. While the proximal GBSs drove modest reporter induction by glucocorticoids, this region exhibited basal eRNA production, RNA polymerase II enrichment and looping to the TSS, plausibly underlying constitutive KLF9 expression. Post-glucocorticoid treatment, interactions between distal and proximal GBSs, and the TSS correlated with KLF9 induction. CBP/P300 silencing reduced proximal GBS activity, but negligibly effected KLF9 expression. Overall, a model for glucocorticoid-mediated regulation of KLF9 involving multiple GBSs is depicted. This work unequivocally demonstrates that mechanistic insights gained from cell-lines can translate to physiologically relevant systems.

There are very few reports that describe the mutational landscape of cervical cancer, one of the leading cancers in Indian women. The aim of the present study was to investigate the somatic mutations that occur in cervical cancer. Whole exome sequencing of 10 treatment naïve tumour biopsies with matched blood samples, from a cohort of Indian patients with locally advanced disease, was performed. The data revealed missense mutations across 1282 genes, out of 1831 genes harbouring somatic mutations. These missense mutations (nonsynonymous + stop-gained) when compared with pre-existing mutations in the COSMIC database showed that 272 mutations in 250 genes were already reported although from cancers other than cervical cancer. More than 1000 novel somatic variations were obtained in matched tumour samples. Pathways / genes that are frequently mutated in various other cancers were found to be mutated in cervical cancers. A significant enrichment of somatic mutations in the MAPK pathway was observed, some of which could be potentially targetable. This is the first report of whole exome sequencing of well annotated cervical cancer samples from Indian women and helps identify trends in mutation profiles that are found in an Indian cohort of cervical cancer.

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