Based on QR code technology in training of individual identification provide hands-on forensic DNA genotyping introduction to medical students

doi:10.21203/rs.3.rs-1564828/v1

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Based on QR code technology in training of individual identification provide hands-on forensic DNA genotyping introduction to medical students

https://doi.org/10.21203/rs.3.rs-1564828/v1

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Background: Forensic biology is a subject that lay stress on practical teaching and laboratory skill training in the field of forensic science. Visualization of DNA profiles is considered to be the major section of individual identification and easily handled by well trained examiner. So developing a novel training project about obtaining individual DNA profiles will improve the quality of teaching about medical students or trainees. It also can explore the application value of DNA profiles based on QR codes in practical teaching and operation training of individual identification.

Methods: The novel training project was developed on the basis of experimental course of Forensic Biology. Blood samples and buccal swabs with oral epithelial cells used in the forensic DNA laboratory were obtained from the participants of medical students in Fujian Medical University. DNA was isolated and several STR loci were detected. Illustrative genetic reports were compiled and provided to the students. Both the individual identity information and DNA profile of each individual were transformed to a particular QR code for data storage. The electronic individual information generated by the QR code was scanned by a mobile phone for consulting and retrieval.

Comparing to the traditional experimental course, the participation rate and passing rate of students enrolled in the training project were calculated and Chi-square test was carried out by SPSS 23.0 software to evaluate the teaching effectiveness. Differences were declared statistically significant if p<0.05.

A survey was conducted to investigate the likelihood of utilization of Gene Identity Cards with QR codes after the project was accomplished.

Results: There were 54 in 91 medical students took participate in training project and 31 in 78 students took participate in the traditional experimental course previously. The participation rate of training project had 24 percent higher than the rate of traditional experimental course. The participants enrolled in training project had shown better performance about handling forensic biological basic skills. The passing rate of Forensic Biology course with training project had increased approximately 17 percent than the traditional one. The participation rate and passing rate of two groups of students had significant difference( χ=6.452 ,P=0.008 and χ=11.043,P=0.001).

In the training project, all participants had made 54 pieces of Gene Identity Cards with QR codes by their own hands. Furthermore, some students originated from Africa had found two particular alleles which were not discovered in Asians previously. The survey showed that the mean of Gene Identity Cards with QR codes was accepted by most participants, the expected likelihood of utilization was up to 78 percent.

Conclusion: According to the results, we have established the novel training project which can promote the learning activities of medical students, especially in experimental course of forensic biology. The enrolled students showed a great interesting in using Gene Identity Cards with QR codes to storage individual information, not only the general information but also DNA profiles. They also had recognized the population genetic differences between different races based on the training project. Hence, the training project can be useful for training workshops and forensic science and medical genetics college courses. It also has great value to establish and support the foundation of Medical Big Data Research.

QR code

Hands-on

Individual identification

Education

Training

Forensic biology is a subject in studying the biological materials related to human body in the medico-legal cases for the purpose of providing scientific evidence. It involves many disciplines, such as medicine, laboratory, genetics, chemistry and biochemistry,etc[1] .At present,individual identification by using DNA profiles is the main task of forensic biology deal with human identity problem.

Among all medical universities in China,only a few can offer the courses of forensic biology to medical students,furthermore,the fewer experimental courses about forensic biological technique can be carried out because of the limitations of laboratory space and instruments.The traditional teaching mode of forensic biology is mainly lectured by teachers,hence,the medical students are lack of learning interest and motivation[2].Because the mastery of forensic biological technique must be based on a large number of practical training,so it is essentially important to carry out experimental course about forensic biological technique in medical universities.

According to the early interview survey on medical students of Fujian Medical University,they had a strong willing to gain hands-on experience of forensic biological technique.For the purpose of cultivating more well-trained students,we set up the training project of a visualization of DNA profiles and used QR codes as the information storage medium.The training project was designed to be the upgrade of traditional experimental course of Forensic Biology.

The QR codes are information carriers and are currently widely used by scanning with a mobile phone. They have the advantages of a high recognition rate, a large amount of stored information, low cost and simple operation[3].Because of these advantages of QR codes,they also were considered as a treatment for COVID-19 information overload during the epidemic[4].

Our purpose is that the novel training project will present a visualization of DNA profiles used in individual identification to medical students so that they can handle the operation skills of individual identification based on DNA profiles very well.We also expect that medical students will promote their learning interest and take full participant in hands-on experimental courses,eventually, improving the passing rates.

The total of 91 medical students in Fujian Medical University came from 2020 and 2021 grades chose to join Forensic Biology course in 2021 and 54 of them were willing to take participant in the training project. 78 medical students came from 2018 and 2019 grades chose to join Forensic Biology course in 2020 and 31 of them were willing to take participant in the traditional experimental course.

The project is composed of two parts of practical application,one is making individual DNA profiles and the other is the generating QR codes.As the storage medium, QR codes are used to store the common individual information and DNA profiles.

Making individual DNA profiles includes five steps (biological material collection, DNA extraction,amplification,capillary electrophoresis and DNA profiles analysis).The QR codes contain not only the common individual information,such as name,gender,ancestry,identity number,etc,but also DNA profiles.The whole procedure of practical operation will be conduct by medical students themselves and instructed by monitors.Figure 1 illustrates the overall process used for the hands-on individual identification training using DNA profiles and individual information.

Described below are details of how a practical introduction to individual identification was integrated into the forensic DNA laboratory along with details of the processes for generating QR codes that contain both individual DNA profiles and common individual information.

In addition to analyzing the relevance of genetic findings to population specificity, four overseas students from African who expressed an interest in participating in project,were also engaged to perform the whole biological procedures by themselves and make a Gene Identity Card with QR codes under the guidance of faculty,respectively.

After the project was accomplished, the participation rate of medical students enrolled in the training project was calculated compared to the traditional course.The scores and the passing rates of the final examination about forensic biology were compared between the participants and the traditional course.

Sample collection

In the project,we allowed the participants to collect two types of biological samples by their willingness.Before collecting biological samples on-site, 75% alcohol was sprayed on-site for disinfection, and the specimens were subjected to ultraviolet radiation for 30 minutes.

First of all,the participants completely filled out the individual information registration forms including their Name,Gender,Nationality and the Signatures.The left thumbprints and right thumbprints of participants were also recorded as individual-specific markers.

Bodily fluids(blood) and buccal (cheek) samples were collected with sterile cotton swabs by participants from themselves as experimental materials for the training experiment.

The procedures of sample collection were followed by the manufacturer instructions. The biological samples were transported to FTA® Micro Card for storage purposes with the Subject’s name, initials of person collecting sample, and date of collection labeled on the surface of FTA® Micro Card.Allow the FTA® Micro Card to dry completely (30-60 minutes) at room temperature.

DNA extraction of samples

This process involved the isolation of the DNA from the cell nucleus operated by hand.In the process of DNA extraction, no matter the blood or buccal sample, was transferred to an Eppendorf (EP) tube and sample pre-processing was performed using the TE(Tris-EDTA)solution.Each sample was centrifuged at the maximum speed for 2 minutes at room temperature. After that,the supernatant of lytic product was discarded and 300 microliters of 5% Chelex-100 solution was added to the sediment.The mixture was incubated at 56℃for 30 minutes and held at 100℃ for 8 minutes to release DNA double stranded.

DNA amplification and detection

In training project,we adopted a commercial STR kit to obtain individual DNA profiles,which included 20 STR loci and Amelogenin.DNA amplification was carried out using a 25 ml reaction volume with an PowerPlex 21 kit (Promega, Madison, WI, USA). The amplification reactions generally contained 0.5-1ng DNA in 25 ml and used 28-30 cycles as described in the PowerPlex 21 System technical manual.

Individual DNA profiles were generated using an PowerPlex 21 kit per manufacturer instructions (www.thermofisher.com).DNA fragments in the amplification products were separated and detected on a 3130 Genetic Analyzer per manufacturer instructions and analyzed using GeneMapper ID v3.2 Software.

Generating QR codes and scanning

According to the design of hands-on experimental course, we allowed the participants to record the individual information such as the Name,Gender and Nationality by themselves.Furthermore,we showed the whole procedures of forensic DNA genotyping and led the participants to obtain the individual DNA profiles by their own hands.We also instructed them to convert individual information and DNA profiles into a QR code by using particular QR code registers,when the hands-on experimental course was accomplished. The QR codes could be easily scanned by a smartphone and the hidden information could be directly obtained by this mean.

Efficacy evaluation

In this study,we focused on whether the novel training project is better than traditional experimental course of Forensic Biology.The participation rate and passing rate of medical students enrolled in training project were calculated and Chi-square test was carried out by SPSS 23.0 software to evaluate the teaching effectiveness.Enumeration data were analyzed with the Chi-square test. Differences were declared statistically significant if p<0.05.

DNA profiles of the participants were analyzed to find some meaningful findings which were useful to reveal population difference issue.A survey was conducted to investigate the likelihood of utilization of Gene Identity Cards with QR codes after the project was accomplished.The survey was carried out in the participants of training project.

Hazards and Safety Precautions

Any hazards and safety precautions are typically handled by the safety regulations of Fujian Provincial Hospital and Fujian Medical University. Material safety data sheets (MSDS) are available for chemical safety and exposure information from chemical suppliers. Proper laboratory safety guidelines of Fujian Provincial Hospital Forensic DNA laboratory should reduce or eliminate any safety issues for handling chemicals, handling glass slides, operating laboratory equipment and for waste disposal.

As the supplementary of experimental course of Forensic Biology in Fujian Medical University,training project was offered in 2021 and 54 medical students took participate in it. The 54 students belonged to 91 students of 2020−2021Grades who joined Forensic Biology course. As the control group, 78 medical students of 2018–2019 Grades joined Forensic Biology course in 2020,and 31 of them took participate in traditional experimental course.The numbers and participation rates of two groups of medical students are shown in Table 1.There was significant difference in the items of participant rates of two groups( χ= 6.452 and P = 0.008).

Table 1 Differences in participation of two groups of medical students

	Number of students Traditional course Novel training project		P value
Participate	31	54	c=6.452 P=0.008
Not participate	47	37	c=6.452 P=0.008
Participation Rate	35%(31/78)	59%(54/91)

The participants had shown better performance on the experiment course about forensic biological basic skills. The teaching effectiveness was evaluated by analyzing the passing rates of two groups.Based on the scores of final examination of Forensic Biology,the students joined Forensic Biology course with a novel training project had 94.5% of passing rate. On the contrary,the students of control group with traditional experimental course had 76.9% of passing rate. There was significant difference in the items of passing rates of two groups( χ= 11.043 and P = 0.001).

Table 2 Differences in teaching effectiveness of two groups of medical students

	Number of students Traditional course Novel training project		P value
Failed	18	5	c=11.043 P=0.001
Passed	60	86	c=11.043 P=0.001
Passing Rate	76.9%(60/78)	94.5%(86/91)

All the participants had made 54 pieces of Gene Identity Cards with QR codes by their own hands.Furthermore,some students originated from Africa had found two particular alleles which were not discovered in Asians previously. Figure 2 shows an unusual DNA profile including 20 STR loci belong to a Nigerian student,two particular alleles such as allele 2.2 in Penta D and allele 45.2 in FGA were discovered in the DNA profile.

After training project was accomplished,a survey was carried out to evaluate the likelihood of utilization of Gene Identity Card with QR codes.The survey was distributed to 54 participants including men (n = 32) and women (n = 22).The result showed that the mean of Gene Identity Cards with QR codes was accepted by most participants, the expected likelihood of utilization was up to 78 percent.There were 42 participants showed their willingness to use Gene Identity Cards with QR codes,but 7 participants thought that there was no change in the experiment course no matter the information storage mode,the other 5 participants expressed their concern about human rights and privacy policy.

In training project,the participants made 54 pieces of Gene Identity Cards by themself. Gene Identity Cards are produced by card printers.The common individual information including head portrait of participants, QR codes,etc,are shown on the front side.The details of Forensic DNA laboratory are shown on the reverse side. Figure 4 shows a sample picture of Gene Identity Cards.

In current situation,few universities in China can offer a overall Forensic Medicine course,especially Forensic Biology,an important branch of Forensic Medicine which depends on advanced instruments and the basis of molecular genetics.

The Forensic Biology lesson set up in Fujian Medical University was composed of two parts such as traditional theory course and hands-on experimental course.

The traditional theory course is so uninteresting that the students were difficult to master the essence of the course.The traditional experimental course can not provide a nice hands-on experience and the enthusiasm of students will be exhausted because of lacking a lively way of product display. Hence,we put forward the idea about the visualization of DNA profiles and quick data-access.We also supply a data dump tool to transform the common manifestation of individual information in order to enhance the students’ interest.

To achieve this,we set up a novel training project based on the hands-on experimental course.The content of training project included six steps (such as biological material collection,DNA extraction, amplification, capillary electrophoresis,DNA profiles analysis and QR code generating) is taught by theoretical explanation and practice content at the same time.

As the promotion of teaching models,applying several advanced techniques into teaching practice will enhance the effective of teaching skills[5].

Theoretical teaching will be more easier to understand,and practical teaching will become more vivid.

Ramu [6] provided hands-on precision medicine introduction to medical students by combing the analysis of whole exome sequencing data with the students’ anatomical findings.Haseena Rajeevan[7] present an open access web application(FROG-kb) and proved that FROG-kb was a useful tool facilitating forensic practice in teaching and research.Praveen Maurye[8]developed a compact and impeccable mobile electrophoresis kit suitable for any vertically oriented PAGE technique and verified through a practical exercises executed by high school students.

In a rapidly evolving business and technological environment,students will face more workforce challenges and integrating skills will be the essential ability.Integrating multiple disciplines were involved in more and more experimental courses and practical training.

In this study,we present a novel training project combing molecular biological technique with data dump technique for the improvement of teaching models.

QR codes are information carriers and are currently widely used. They have the advantages of a high recognition rate, a large amount of stored information, low cost and, simple operation. The information can be obtained by directly scanning the code with a mobile phone.QR codes can be easily created that link to websites, show a geographical location, access a document or specific application.

Recently,QR codes have generated interest for their use in education,presenting an opportunity to excite and engage students[9].According to a study done by Bellot[10], 83% of participants agreed to the benefits of QR code in healthcare education and were likely to use QR code technology in the future.Luhong Li[11]applied the standardized clinical skills instruction video based on QR code management to arouse the interest of interns in learning, as a novel clinical teaching model to improves clinical teaching effectiveness. Based on the same skill,Elwin [12] assessed the feasibility of using QR code for registration and evaluated the training effect about increasing the learners' perception. Lifang Ma[3]considered that QR code manuals were very effective in operating theater equipment management and training.Brodie[13]integrated virtual delivery of courses and QR codes in Healthcare education to access learning material, register attendance, and gather evaluations.

Ramalingam[14]had good good experience of using QR codes to improve the evaluation response rates, documentation, and timeliness in resident rotation evaluations.

The participant rate was the important parameter indicated the intentions of students joined the novel training project or the traditional experimental course.The participant rate of novel training project was 24 percent higher than the traditional one.There were significant differences in participant rates of two groups (P < 0.05).

The studying outcomes were evaluated by using a survey at the end-of-project and analyzing the passing rate of final examination.There were significant differences in passing rates of two groups (P < 0.05).

The survey indicated that the most students appreciated the form of identification tool( Gene Identity Cards with QR codes) and believed that it will bring great application value in the field of individual identification.

On the purpose of learning the racial difference of human genetic resource data in-depth,we invited some overseas students to join the training project.Two particular alleles such as allele 2.2 in Penta D and allele 45.2 in FGA were discovered in a DNA profile of a Nigerian student.These alleles were not revealed in Chinese on the account of previous study.According DNA Data of NIST STRBase

(https://strbase.nist.gov/NISTpop.htm),the frequency of allele 2.2 in Penta D was 0.0430 in the total of 1036 Americans,including 0.1140 in 342 Afro-Americans,0.0042 in 361 Caucasians,0.0170 in 236 Hispanic or Latino Americans and 0 in 97 Asian-Americans,respectively[15].The frequency of allele 45.2 in FGA was not supplied in DNA Data of NIST STRBase because of the limitation of study objects.

As part of the training project, we emphasized the protection of personal information security.On the purpose of changing expression mean of DNA profile,we chose the QR code to be a data storage device.The DNA profile of one person was hidden in the corresponding QR code and should avoid to be snooped by others.With regard to this privacy issue concerned by some students,we set up a upgrade approach that a database on a server will be established to store the data of individual features.The students can register the user name and set up a password on the database,so that they can scan QR codes to obtain a pathway to access the database, and they also can be authorized to browse their own individual information on the server.We had applied for a patent based on the upgrade approach and the patent had been granted in 2021 (Grant Number CN213910234U)by China National Intellectual Property Administration.

After the accomplishment of the novel training project, the teaching model of integrating multiple disciplines made the medical students(1)show their interesting to take participant in novel training project of Forensic Biology(2)have a deep understanding of the differences in human DNA phenotype by the visualization of DNA profiles(3)acquire proficiency in making DNA profiles and generating QR codes.So the novel training project had greatly improved the teaching effective of hands-on experimental course and was more suitable for the lesson teaching.

STR

Short tandem repeat

Quick response

Tris-EDTA

MSDS

Material safety data sheets

NIST

National Institute of Standards and Technology

Acknowledgements

We would like to thank the medical students from Fujian Medical University who participated in the training project.

Ethics approval and consent to participate

This training project was approved by the medical ethical committee of Fujian Provincial Hospital (K2020-09-026 ). All participants gave informed consent. All methods were carried out in accordance with the relevant guidelines and regulations.

Consent for publication

Not applicable.

Availability of data and materials

The datasets used in the training project are not publicly available due to the limitations of ethical approval and the confidentiality of participants’ information, but are available on reasonable request from corresponding author [email protected]

Competing interests

The authors declare that they have no competing interests.

Funding

This training project was funded by the Research project on education and Teaching Reform in Education Department of Fujian Province(FBJG20190034) and the Project of Cultivating Young Talent in Fujian Provincial Health Commission (2020GGA004).

The funding body was not involved in the design of the project and the collection, analysis, and interpretation of data and in writing the manuscript.

Authors' contributions

L LIU and L LAI conceived the training project. L LIU and YC W performed experimental course in Forensic DNA Laboratory. L LAI, YC W and SL L instructed the participants to extract DNA,conduct PCR amplification and DNA profiles analysis.L LIU performed efficacy evaluation and survey.JC Z and XC Z provided study materials for supporting this project.L LIU and L LAI wrote the manuscript.All authors have read and approved the final manuscript.

Authors' details

¹Provincial Clinical Collage of Fujian Medical University,No.134 East Road,Fujian,Fuzhou 350001, China.

²Central laboratory of Fujian Provincial Hospital,No.134 East Road,Fujian,Fuzhou 350001, China.

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No competing interests reported.

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Based on QR code technology in training of individual identification provide hands-on forensic DNA genotyping introduction to medical students

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