bluuebunny/crossref_metadata_2025 huggingface dataset:
Polygenic risk score model for renal cell carcinoma in the Korean population and relationship with lifestyle-associated factors
Authors: Hong Joo Young , Han Jang Hee , Jeong Seung Hwan , Kwak Cheol , Kim Hyeon Hoe , Jeong Chang Wook
Published: January 2024

Background

The polygenic risk score (PRS) is used to predict the risk of developing common complex diseases or cancers using genetic markers. Although PRS is used in clinical practice to predict breast cancer risk, it is more accurate for Europeans than for non-Europeans because of the sample size of training genome-wide association studies (GWAS). To address this disparity, we constructed a PRS model for predicting the risk of renal cell carcinoma (RCC) in the Korean population.

Results

Using GWAS analysis, we identified 43 Korean-specific variants and calculated the PRS. Subsequent to plotting receiver operating characteristic (ROC) curves, we selected the 31 best-performing variants to construct an optimal PRS model. The resultant PRS model with 31 variants demonstrated a prediction rate of 77.4%. The pathway analysis indicated that the identified non-coding variants are involved in regulating the expression of genes related to cancer initiation and progression. Notably, favorable lifestyle habits, such as avoiding tobacco and alcohol, mitigated the risk of RCC across PRS strata expressing genetic risk.

Conclusion

A Korean-specific PRS model was established to predict the risk of RCC in the underrepresented Korean population. Our findings suggest that lifestyle-associated factors influencing RCC risk are associated with acquired risk factors indirectly through epigenetic modification, even among individuals in the higher PRS category.
Unique composition of ocular surface microbiome in the old patients with dry eye and diabetes mellitus in a community from Shanghai, China
Authors: Chen Zhangling , Lin Senlin , Xu Yi , Lu Lina , Zou Haidong
Published: January 2024

Background

This study investigates the variations in microbiome abundance and diversity on the ocular surfaces of diabetic patients suffering from dry eye within a community setting. The goal is to offer theoretical insights for the community-level prevention and treatment of dry eye in diabetic cohorts.

Methods

Dry eye screening was performed in the Shanghai Cohort Study of Diabetic Eye Disease (SCODE) from July 15, 2021, to August 15, 2021, in the Xingjing community; this study included both a population with diabetes and a normal population. The population with diabetes included a dry eye group (DM-DE, n = 40) and a non-dry eye group (DM-NoDE, n = 39). The normal population included a dry eye group (NoDM-DE, n = 40) and a control group (control, n = 39). High-throughput sequencing of the 16 S rRNA V3-V4 region was performed on conjunctival swab from both eyes of each subject, and the composition of microbiome on the ocular surface of each group was analyzed.

Results

Significant statistical differences were observed in both α and β diversity of the ocular surface microbiome among the diabetic dry eye, diabetic non-dry eye, non-diabetic dry eye, and normal control groups (P < 0.05).

Conclusions

The study revealed distinct microecological compositions on the ocular surfaces between the diabetic dry eye group and other studied groups. Firmicutes and Anoxybacillus were unique bacterial phyla and genera in the dry eye with DM group, while Actinobacteria and Corynebacterium were unique bacterial phyla and genera in the normal control group.
Photosynthetic mechanisms underlying NaCl-induced salinity tolerance in rice (Oryza sativa)
Authors: Zuo Guanqiang , Huo Jingxin , Yang Xiaohui , Mei Wanqi , Zhang Rui , Khan Aaqil , Feng Naijie , Zheng Dianfeng
Published: January 2024

Background

Salinity stress is an environmental constraint that normally develops concurrently under field conditions, resulting in drastic limitation of rice plant growth and grain productivity. The objective of this study was to explore the alleviating effects of NaCl pre-treatment on rice seedlings as well as the salt tolerance mechanisms by evaluating morph-physiological traits.

Results

Variety Huanghuazhan, either soaked in distilled water or 25 mg/L Prohexadione calcium (Pro-Ca), were first hardened with varying concentrations of NaCl solutions (0 and 50 mM NaCl), and then subjected to varying degrees of salt stress (0 and 100 mM NaCl), indicated by S0, S1, S2 and S3, respectively. Growth analysis suggested that NaCl-pretreatment improved the root/shoot ratio in water-soaked rice plant at DAP 0. Data related to the reaction center density, photosynthetic electron transport efficiency, trapping efficiency were compared before (CK) using performance Index (PIabs). Compared to S2 (Pro-Ca-S2) treatment, PIabs did not show any difference with plants pre-treated with NaCl (S3 or Pro-Ca-S3). Rather than PIabs, significant difference was found in photosynthetic electron transport efficiency (ΨEo). The ΨEo value in Pro-S2 was significantly lowered as compared to Pro-S3 treatment at DAP 7, and the decrease rate was about 6.5%. Correlation analysis indicated leaf PIabs was weak correlated with plant biomass while the quantum yield for reduction of the PSI end electron acceptors, trapped energy flux per reaction center and PSII antenna size displayed strong positive correlation with biomass. Additional analysis revealed that 100 mM NaCl significantly reduced leaf linear electron flux under low-light conditions, regardless of whether seedlings had been pre-treated with 50 mM NaCl or not.

Conclusions

NaCl-induced salt tolerance was related to the robust photosynthetic machinery.
Regional anesthesia might reduce recurrence and metastasis rates in adult patients with cancers after surgery: a meta-analysis
Authors: Xie Shuang , Li Liang , Meng Fanqing , Wang Huanliang
Published: January 2024

Background

The influence of anesthesia techniques on cancer recurrence and metastasis following oncological surgery is a topic of growing interest. This meta-analysis investigates the potential effects of regional anesthesia (RA), either independently or combined with general anesthesia (GA), on these outcomes.

Methods

We performed an extensive search across PubMed, Embase, and the Cochrane Library databases. The primary outcome was cancer recurrence, while the secondary outcomes were local recurrence and distant metastasis. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by utilizing random-effects models. The Newcastle-Ottawa Scale (NOS) was used for quality assessment of observational studies, the Cochrane Risk of Bias Tool for Randomized Trials (Rob 2.0) was used for randomized controlled trials, and all the outcomes were assessed by using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE).

Results

This study included 32 studies comprising 24,724 cancer patients. RA, either alone or in combination with GA, was significantly associated with reduced cancer recurrence compared to GA alone (OR = 0.82; 95% CI = 0.72 to 0.94; p < 0.01). This association remained significant for prostate cancer patients in subgroup analyses (OR = 0.71; 95% CI = 0.51 to 0.98; p = 0.04) and in the context of epidural anesthesia combined with GA. However, there were no significant associations noted for local recurrence or distant metastasis.

Conclusions

This meta-analysis provides evidence that RA, used alone or adjunctively with GA, is associated with a lower risk of cancer recurrence, particularly in patients with prostate cancer. However, no significant effects were observed on local recurrence or distant metastasis. Further prospective studies should be conducted to clarify this important issue.
Determinants of poor glycaemic control and proteinuria in patients with type 2 diabetes: a retrospective analysis of general practice records in Ireland
Authors: Sullivan Maria , O’Connor Raymond , Hannigan Ailish
Published: January 2024

Background

Analysis of general practice records can address the information gap on the epidemiology of type 2 diabetes (T2DM) in Ireland, informing practice and the development of interventions in primary care. The aim of this study was to identify patients with poor glycaemic control, risk factors for complications and evidence of end organ damage in a large multi-practice study and to profile their characteristics.

Methods

Patients with T2DM were identified using disease coding in Health One practice management software in 41 general practices. Patients’ demographics and clinical data were extracted. Rates of poor glycaemic control (glycated haemoglobin > 58 mmol/mol) and albumin creatinine ratio > 3 mg/mmol were calculated. A multilevel logistic regression analysis using both patient and practice variables was conducted.

Results

Data was collected from 3188 patients of whom 29% (95% CI 28 to 31%) had poor glycaemic control, which was associated with younger age, higher BMI and higher total cholesterol. Only 42% of patients (n = 1332) had albumin creatinine ratio measured with 42% (95% CI 40 to 45%) of these having values > 3 mg/mmol. Older age groups, men, those with hypertension, eGFR < 60 ml/min/1.73m2 and poor glycaemic control were most associated with higher values of albumin creatinine ratio.

Conclusions

Analysing this large multi-practice dataset gives important information on the prevalence and characteristics of diabetic patients who are most at risk of poor outcomes. It highlights that recording of some data could be improved.
Loneliness among older Chinese individuals: the status quo and relationships with activity-related factors
Authors: Wang Jiazhou , Zhou Yueyue , Zhang Qiuxia , Li Jing , Zhai Dehua , Li Jia , Han Buxin , Liu Zhengkui
Published: January 2024

Background

With the rapid population aging, healthy aging has become a concern for society as a whole. In this study, loneliness and its relationships with activity-related individual factors were examined among older Chinese individuals from the perspective of mental health and daily leisure activities.

Methods

The data were from the fourth investigation of the Sample Survey of the Aged Population in Urban and Rural China, which had a total of 220,506 participants. Activity ability was assessed by the Barthel Activity of Daily Living Index, a self-designed activity type questionnaire was used to evaluate activity participation, and loneliness was measured with a single-item question.

Results

The prevalence of varying degrees of loneliness among Chinese older individuals was 36.6%. The prevalence of loneliness among the older individuals differed significantly by age gender, age, physical health status, annual household income, education level, marital status, living status, ethnic minority status, religious faith and territory of residence. There were differences in activity participation among older Chinese adults in terms of all the demographic factors mentioned above, while there were no significant differences in living status or religious faith, and significant differences in several other demographic factors in terms of activity ability. Self-care ability, as a form of activity ability, and activity participation significantly predicted loneliness among the older participants.

Conclusion

The topic of loneliness among Chinese older individuals is complex and requires greater attention. The buffering effect of activity-related factors on loneliness suggests that old people should improve their activity ability and participate more in daily activities.
The prognostic importance of the pan-immune-inflammation value in patients with septic shock
Authors: Turan Yasemin Bozkurt
Published: January 2024

Introduction

The purpose of this study was to determine whether the pan-immune-inflammation value (PIV), a novel biomarker combining neutrophil platelet, monocyte, and lymphocyte counts, some of the most widespread indicators of systemic inflammation, can predict mortality and prognosis in patients admitted to the intensive care unit (ICU) with septic shock.

Method

This prospective study was performed with 82 patients aged 18 or over admitted to a tertiary ICU with diagnoses of septic shock. Patients with hematological disease and neutropenia were excluded. PIV was calculated with the formula [neutrophil count (103/μL) × platelet count (103/μL) × monocyte count (103/μL)]/lymphocyte count (103/μL).

Results

Median age, presence of hypertension, Acute Physiology and Chronic Health Evaluation II (APACHE II) levels, and neutrophil, monocyte, and platelet counts were lower in the low-PIV group than in the high-PIV group (p < 0.05). The highest area under ROC curve (AUC) was determined for Sequential Organ Failure Assessment (SOFA) (0.94 (0.89 – 0.99)), followed by Glasgow Coma Scale (GCS) (0.81 (0.70 – 0.91)), APACHE II (0.80 (0.69 – 0.91)) and lactate (0.77 (0.67 – 0.88)). Median survival was longer in the low-PIV group than in the high-PIV group (28 (15.25 – 40.76) vs 16 (9.46 – 22.55) days, respectively, p < 0.05). The univariate Cox proportional hazards (CPH) model showed that high PIV (HR = 2.13 (1.03—4.38)), low GCS (HR = 3.31 (1.34 – 8.15)), high SOFA (HR = 9.41 (2.86 – 30.95)), high APACHE II (HR = 3.08 (1.47 – 6.45)), high lactate (HR = 6.56 (2.73 – 15.75)), and high procalcitonin (PCT) (HR = 2.73 (1.11 – 6.69)) values were associated with a decreased survival time among ICU patients (p < 0.05). The multivariate CPH model showed the age-adjusted risk estimates for these six laboratory parameters. High lactate (HR = 7.97 (2.19 – 29.08)) and high SOFA scores (HR = 4.85 (1.22 – 19.32)) were significantly associated with shorter survival in ICU patients (p < 0.05).

Conclusion

The findings of this research suggest that PIV could predict the longer survival in patients with septic shock. Despite PIV score’s capability to show inflammation, it is not significantly associated with mortality in the multivariate analysis.
Effect of mixed Mycobacterium tuberculosis infection on rapid molecular diagnostics among patients starting MDR-TB treatment in Uganda
Authors: Komakech Kevin , Nakiyingi Lydia , Fred Ashab , Achan Beatrice , Joloba Moses , Kirenga Bruce J. , Ssengooba Willy
Published: January 2024

Background

Mixed M. tuberculosis (MTB) infection occurs when one is infected with more than one clonally distinct MTB strain. This form of infection can assist MTB strains to acquire additional mutations, facilitate the spread of drug-resistant strains, and boost the rate of treatment failure. Hence, the presence of mixed MTB infection could affect the performance of some rapid molecular diagnostic tests such as Line Probe Assay (LPA) and GeneXpert MTB/RIF (Xpert) assays.

Methods

This was a cross-sectional study that used sputum specimens collected from participants screened for STREAM 2 clinical trial between October 2017 and October 2019. Samples from 62 MTB smear-positive patients and rifampicin-resistant patients from peripheral health facilities were processed for Xpert and LPA as screening tests for eligibility in the trial. From November 2020, processed stored sputum samples were retrieved and genotyped to determine the presence of mixed-MTB strain infection using a standard 24-locus Mycobacterial Interspersed Repetitive Unit–Variable Number Tandem-Repeat (MIRU-VNTR). Samples with at least 20/24 MIRU-VNTR loci amplified were considered for analysis. Agar proportional Drug Susceptibility Test (DST) was performed on culture isolates of samples that had discordant results between LPA and Xpert. The impact of the presence of mixed-MTB strain on Xpert and LPA test interpretation was analyzed.

Results

A total of 53/62 (85%) samples had analyzable results from MIRU-VNTR. The overall prevalence of mixed-MTB infection was 5/53 (9.4%). The prevalence was highest among male’s 3/31 (9.7%) and among middle-aged adults, 4/30 (33.3%). Lineage 4 of MTB contributed 3/5 (60.0%) of the mixed-MTB infection prevalence. Having mixed MTB strain infection increased the odds of false susceptible Xpert test results (OR 7.556, 95% CI 0.88–64.44) but not for LPA. Being HIV-positive (P = 0.04) independently predicted the presence of mixed MTB infection.

Conclusions

The presence of mixed-MTB strain infection may affect the performance of the GeneXpert test but not for LPA. For patients with high pre-test probability of rifampicin resistance, an alternative rapid method such as LPA should be considered.
Study protocol for the family empowerment program: a randomized waitlist-controlled trial to evaluate the effectiveness of online Community Reinforcement and Family Training (CRAFT) on the wellbeing of family members with a relative experiencing substance dependence and mental illness
Authors: Allan Julaine , Snowdon Nicole , Thapa Subash , Ahmed Kedir Y.
Published: January 2024

Background

Systematic reviews consistently show that family-focused interventions are effective at improving substance treatment engagement and outcomes across the lifespan. Yet, Australian substance use treatment services rarely incorporate family members and concerned significant others. Testing of family focussed interventions in the Australian context is required.

Methods

The trial is a randomized wait-list control trial assessing the effectiveness, feasibility and acceptability of online CRAFT with a parallel group. Participants will be randomised to receive either online CRAFT or to a wait-list control group who are provided with CRAFT related reading material during the waiting period. Outcomes will be assessed at baseline and then at 6- and 15-weeks post baseline. The primary outcome will be improved wellbeing of participating family members. The trial reporting will comply with SPIRIT guidelines.

Discussion

This study will focus on people living in rural areas. Substance treatment programs are limited in rural Australia. The provision of the Family Empowerment Program (CRAFT) online should make family focused substance treatment support accessible and attainable for the first time in rural areas. The outcomes of this trial could have meaningful implications for the future funding and support of family focused substance treatment services that are inclusive of people with mental health conditions.

Trial registration

ANZCTR, ACTRN12623000796684p, Registered 26 July 2023. Prospectively registered with protocol version 3.
Immunisation coverage and factors associated with incomplete immunisation in children under two during the COVID-19 pandemic in Sierra Leone
Authors: Wassenaar Myrte , Fombah Augustin E. , Chen Haily , Owusu-Kyei Kwabena , Williams Julian , Sunders Joe-Henry C. , Llach Mireia , Quinto Llorenç , Sesay Tom , Samai Mohamed , Menéndez Clara , González Raquel
Published: January 2024

Background

Routine childhood immunisation is one of the most important life-saving public health interventions. However, many children still have inadequate access to these vaccines and millions remain (partially) unvaccinated globally. As the COVID-19 pandemic disrupted health systems worldwide, its effects on immunisation have become apparent. This study aimed to estimate routine immunisation coverage among children under two in Sierra Leone and to identify factors associated with incomplete immunisation during the COVID-19 pandemic.

Methods

A cross-sectional household survey was conducted in three districts in Sierra Leone: Bombali, Tonkolili and Port Loko. A three-stage cluster sampling method was followed to enrol children aged 10–23 months. Information regarding immunisation status was based on vaccination cards or caretaker’s recall. Using WHO’s definition, a fully immunised child received one BCG dose, three oral polio vaccine doses, three pentavalent vaccine doses and one measles-containing vaccine dose. Following the national schedule, full immunisation status can be achieved at 9 months of age. Data were weighted to reflect the survey’s sampling design. Associations between incomplete immunisation and sociodemographic characteristics were assessed through multivariable logistic regression.

Results

A total of 720 children were enrolled between November and December 2021. Full vaccination coverage was estimated at 65.8% (95% CI 60.3%-71.0%). Coverage estimates were highest for vaccines administered at birth and decreased with doses administered subsequently. Adjusting for age, the lowest estimated coverage was 40.7% (95% CI 34.5%-47.2%) for the second dose of the measles-containing vaccine. Factors found to be associated with incomplete immunisation status were: living in Port Loko district (aOR = 3.47, 95% CI = 2.00-6.06; p-value < 0.001), the interviewed caretaker being Muslim (aOR = 1.94, 95% CI = 1.25–3.02; p-value = 0.015) and the interviewed caretaker being male (aOR = 1.93, 95% CI = 1.03–3.59, p-value = 0.039).

Conclusion

Though full immunisation coverage at district level improved compared with pre-pandemic district estimates from 2019, around one in three surveyed children had missed at least one basic routine vaccination and over half of eligible children had not received the recommended two doses of a measles-containing vaccine. These findings highlight the need to strengthen health systems to improve vaccination uptake in Sierra Leone, and to further explore barriers that may jeopardise equitable access to these life-saving interventions.
Predicting mortality risk in hospitalized COVID-19 patients: an early model utilizing clinical symptoms
Authors: Hai Cong Nguyen , Duc Thanh Bui , Minh The Nguyen , Quang Lich Ngo , Tung Son Luong Cao , Duc Loi Trinh , Duong-Quy Sy
Published: January 2024

Background

Despite global efforts to control the COVID-19 pandemic, the emergence of new viral strains continues to pose a significant threat. Accurate patient stratification, optimized resource allocation, and appropriate treatment are crucial in managing COVID-19 cases. To address this, a simple and accurate prognostic tool capable of rapidly identifying individuals at high risk of mortality is urgently needed. Early prognosis facilitates predicting treatment outcomes and enables effective patient management. The aim of this study was to develop an early predictive model for assessing mortality risk in hospitalized COVID-19 patients, utilizing baseline clinical factors.

Methods

We conducted a descriptive cross-sectional study involving a cohort of 375 COVID-19 patients admitted and treated at the COVID-19 Patient Treatment Center in Military Hospital 175 from October 2021 to December 2022.

Results

Among the 375 patients, 246 and 129 patients were categorized into the survival and mortality groups, respectively. Our findings revealed six clinical factors that demonstrated independent predictive value for mortality in COVID-19 patients. These factors included age greater than 50 years, presence of multiple underlying diseases, dyspnea, acute confusion, saturation of peripheral oxygen below 94%, and oxygen demand exceeding 5 L per minute. We integrated these factors to develop the Military Hospital 175 scale (MH175), a prognostic scale demonstrating significant discriminatory ability with an area under the curve (AUC) of 0.87. The optimal cutoff value for predicting mortality risk using the MH175 score was determined to be ≥ 3 points, resulting in a sensitivity of 96.1%, specificity of 63.4%, positive predictive value of 58%, and negative predictive value of 96.9%.

Conclusions

The MH175 scale demonstrated a robust predictive capacity for assessing mortality risk in patients with COVID-19. Implementation of the MH175 scale in clinical settings can aid in patient stratification and facilitate the application of appropriate treatment strategies, ultimately reducing the risk of death. Therefore, the utilization of the MH175 scale holds significant potential to improve clinical outcomes in COVID-19 patients.

Trial registration

An independent ethics committee approved the study (Research Ethics Committee of Military Hospital 175 (No. 3598GCN-HDDD; date: October 8, 2021), which was performed in accordance with the Declaration of Helsinki, Guidelines for Good Clinical Practice.
Association between spinal manipulative therapy and lumbar spine reoperation after discectomy: a retrospective cohort study
Authors: Trager Robert J. , Gliedt Jordan A. , Labak Collin M. , Daniels Clinton J. , Dusek Jeffery A.
Published: January 2024

Background

Patients who undergo lumbar discectomy may experience ongoing lumbosacral radiculopathy (LSR) and seek spinal manipulative therapy (SMT) to manage these symptoms. We hypothesized that adults receiving SMT for LSR at least one year following lumbar discectomy would be less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT, over two years’ follow-up.

Methods

We searched a United States network of health records (TriNetX, Inc.) for adults aged ≥ 18 years with LSR and lumbar discectomy ≥ 1 year previous, without lumbar fusion or instrumentation, from 2003 to 2023. We divided patients into two cohorts: (1) chiropractic SMT, and (2) usual care without chiropractic SMT. We used propensity matching to adjust for confounding variables associated with lumbar spine reoperation (e.g., age, body mass index, nicotine dependence), calculated risk ratios (RR), with 95% confidence intervals (CIs), and explored cumulative incidence of reoperation and the number of SMT follow-up visits.

Results

Following propensity matching there were 378 patients per cohort (mean age 61 years). Lumbar spine reoperation was less frequent in the SMT cohort compared to the usual care cohort (SMT: 7%; usual care: 13%), yielding an RR (95% CIs) of 0.55 (0.35–0.85; P = 0.0062). In the SMT cohort, 72% of patients had ≥ 1 follow-up SMT visit (median = 6).

Conclusions

This study found that adults experiencing LSR at least one year after lumbar discectomy who received SMT were less likely to undergo lumbar spine reoperation compared to matched controls not receiving SMT. While these findings hold promise for clinical implications, they should be corroborated by a prospective study including measures of pain, disability, and safety to confirm their relevance. We cannot exclude the possibility that our results stem from a generalized effect of engaging with a non-surgical clinician, a factor that may extend to related contexts such as physical therapy or acupuncture.

Registration

Open Science Framework (https://osf.io/vgrwz).
A comparative evaluation of physical properties of CAD/CAM complete denture resins- an in vitro study
Authors: Arora Ojasvini , Ahmed Nabeel , Siurkel Yuliia , Ronsivalle Vincenzo , Cicciù Marco , Minervini Giuseppe
Published: January 2024

Background

In dentistry, there is a growing preference for computer-aided design and computer-aided manufacturing (CAD/CAM) systems over traditional laboratory procedures. However, there is not much literature comparing various CAD/CAM materials. Thus, this study aimed to assess and compare the color stability and hardness of gingival and tooth colored milled and 3D-printed acrylic resins.

Materials and methods

Four types of CAD/CAM materials were prepared: 3D-printed pink shade (PP), milled polymenthymethacrylate (PMMA) pink shade (MP), 3D-printed tooth shade (PT) and milled PMMA tooth shade (MT) (n = 6). For hardness, disc shaped samples of 15 mm × 2 mm and for color stability, bar shaped samples of 65mmx10mmx2.5 mm were prepared and polished. Vickers hardness test was performed in a microhardness tester. Color stability test was done by immersing in coffee solution and coca cola for 7 days. Day 0 and day 7 measurements were recorded using a digital spectrophotometer and the change in color was calculated. For statistical analysis, one-way ANOVA and Tukey’s post hoc tests were done.

Results

For color stability, milled PMMA was superior to 3D-printed resin samples. Milled pink and tooth shade samples had similar color stability, whereas 3D-printed tooth shade samples were more color stable as compared to pink shade 3D-printed samples. For hardness, milled tooth shade PMMA was the most superior one, followed by 3D-printed tooth shade, whereas pink shade milled PMMA and 3D-printed resin samples had similar hardness values and were inferior to the tooth shade CAD/CAM materials.

Conclusion

Color stability of milled PMMA is superior to that of 3D-printed resins. Hardness of tooth shade milled and 3D-printed resins is more than that of pink shade milled and 3D-printed resins.
The use of instructional videos to compensate for flexible physiology learning during the pandemic of COVID 19
Authors: Lasheen Noha N. , Fawzy Maram M. , Ibrahim Mostafa B.
Published: January 2024

Background

This study aimed at using instructional videos in physiology created by students to improve the process of learning Physiology especially during the COVID-19 Pandemic which enforced the lectures to be online. Additionally, it allowed students to visualize and understand clinical scenarios and the physiological reasons behind them while assessing how much they stand to gain from the experience.

Methods

This study is a project to implement FAIMER, ASU MENA-FRI Institute, Cairo, Egypt. In a foundation course for first-year medical students, the instructor utilized a variety of instructional methods including lecture, small group discussion, individual assignments, and reflection. Students were randomly allocated into 18 groups, then a topic in their physiology curriculum was chosen and they formulated a related case scenario, thereafter a video was made by themselves. This intervention was rewarded by activity mark in their course. Post-project questionnaire was used, and an external reviewer evaluated the videos presented by students. This study obtained IRB approval from the Faculty of Medicine, Ain Shams Medical Ethics committee.

Results

the project helped students to improve their skills in problem-solving, teamwork, active learning, communication, planning, and time management. In addition, it also increased their confidence in their abilities to learn, face unexpected challenges, and achieve goals, while considering new life opportunities, those which became an option when the students searched by themselves and learned more about the different angles of medicine.

Conclusion

Compared to the traditional lecture format that focuses on memorizing definitions and theoretical structures, instructional videos can be regarded as an innovative teaching tool and a unique medical education method that allowed students to participate more in the learning process even if their lectures were online. This article proposes an active learning method in undergraduate medical education which compensate for limited face-to-face attended during the pandemic.
Mapping the learning styles of medical students in Brazil
Authors: Cardozo Marcel Fernando Inácio , de Jesus Gilmar Cardozo , de Sousa Maria Helena , Iatecola Amilton , Melgaço Maia Fernanda Latorre , de Carvalho Gisele Massarani Alexandre , Silva Vinícius Rodrigues , Buchaim Daniela Vieira , Moura Cardozo Adriane Gonçalves , Correia Ronny Rodrigues , Buchaim Rogerio Leone , da Cunha Marcelo Rodrigues
Published: January 2024

Background

Medical education has evolved based on the application of pedagogical actions that place the student as the protagonist of the learning process through the use of active teaching methodologies. Within this context, higher education teachers should use strategies that focus on the student and his/her context and avoid traditional teaching methods. Specifically in medical schools, there is an even greater challenge since the teaching methods of medical curricula differ from those used in previous schooling. Consequently, students acquire their own style of processing information that is often incompatible with the profile of medical schools. This may be one of the factors responsible for the lack of motivation among undergraduates.

Objective

The aim of this study was to characterize the learning styles of students enrolled in a Brazilian medical school using the Felder-Soloman Index of Learning Styles (ILS).

Methods

This was a cross-sectional, descriptive, quantitative study that included students from the 1st to the 6th year of a Brazilian medical school. The students participating in this study voluntarily answered 44 questions about learning styles of the Felder-Silverman instrument validated in Brazil. The instrument was divided so that each domain consisted of 11 questions with two response options in which only one could be selected. For each domain, a score (1 point) was assigned to the selected option (a, b) of the question and the learning style category was determined as the difference between these values. For data collection and tabulation, we used the Learning Syle Platform (EdA Platform) developed based on Felder’s studies since this system processes information about the dimension analyzed, the preferred style, and the most striking characteristics of each style.

Results

The results showed that sensing was the preferred learning style of the students, followed by the sequential and visual styles. It was not possible to determine whether gender or age influences the choice of learning methods because of the homogeneity of the results.

Conclusions

The present data will enable teachers of the institution involved in this study to plan pedagogical actions that improve the students’ self-awareness, as well as their teaching-learning skills, by choosing the most adequate active methodologies for the medical education programs considering the individuality of each student and class.
Risks of digestive diseases in long COVID: evidence from a population-based cohort study
Authors: Ma Yuying , Zhang Lijun , Wei Rui , Dai Weiyu , Zeng Ruijie , Luo Dongling , Jiang Rui , Zhuo Zewei , Yang Qi , Li Jingwei , Leung Felix W , Duan Chongyang , Sha Weihong , Chen Hao
Published: January 2024

Background

In the post-pandemic era, a wide range of COVID-19 sequelae is of growing health concern. However, the risks of digestive diseases in long COVID have not been comprehensively understood. To investigate the long-term risk of digestive diseases among COVID patients.

Methods

In this large-scale retrospective cohort study with up to 2.6 years follow-up (median follow-up: 0.7 years), the COVID-19 group (n = 112,311), the contemporary comparison group (n = 359,671) and the historical comparison group (n = 370,979) predated the COVID-19 outbreak were built using UK Biobank database. Each digestive outcome was defined as the diagnosis 30 days or more after the onset of COVID-19 infection or the index date. Hazard ratios (HRs) and corresponding 95% confidence intervals (CI) were computed utilizing the Cox regression models after inverse probability weighting.

Results

Compared with the contemporary comparison group, patients with previous COVID-19 infection had higher risks of digestive diseases, including gastrointestinal (GI) dysfunction (HR 1.38 (95% CI 1.26 to 1.51)); peptic ulcer disease (HR 1.23 (1.00 to 1.52)); gastroesophageal reflux disease (GERD) (HR 1.41 (1.30 to 1.53)); gallbladder disease (HR 1.21 (1.06 to 1.38)); severe liver disease (HR 1.35 (1.03 to 1.76)); non-alcoholic liver disease (HR 1.27 (1.09 to 1.47)); and pancreatic disease (HR 1.36 (1.11 to 1.66)). The risks of GERD were increased stepwise with the severity of the acute phase of COVID-19 infection. Even after 1-year follow-up, GERD (HR 1.64 (1.30 to 2.07)) and GI dysfunction (HR 1.35 (1.04 to 1.75)) continued to pose risks to COVID-19 patients. Compared to those with one SARS-CoV-2 infection, reinfected patients were at a higher risk of pancreatic diseases (HR 2.57 (1.23 to 5.38)). The results were consistent when the historical cohort was used as the comparison group.

Conclusions

Our study provides insights into the association between COVID-19 and the long-term risk of digestive system disorders. COVID-19 patients are at a higher risk of developing digestive diseases. The risks exhibited a stepwise escalation with the severity of COVID-19, were noted in cases of reinfection, and persisted even after 1-year follow-up. This highlights the need to understand the varying risks of digestive outcomes in COVID-19 patients over time, particularly those who experienced reinfection, and develop appropriate follow-up strategies.
Exploring Mycoplasma ovipneumoniae NXNK2203 infection in sheep: insights from histopathology and whole genome sequencing
Authors: Wang Jiandong , Liu Hongyan , Raheem Abdul , Ma Qing , Liang Xiaojun , Guo Yanan , Lu Doukun
Published: January 2024

Background

Mycoplasma ovipneumoniae (M. ovipneumoniae) is a significant pathogen causing respiratory infections in goats and sheep. This study focuses on investigating vulnerability of Hu sheep to M. ovipneumoniae infection in the context of late spring’s cold weather conditions through detailed autopsy of a severely affected Hu sheep and whole genome sequencing of M. ovipneumoniae.

Results

The autopsy findings of the deceased sheep revealed severe pulmonary damage with concentrated tracheal and lung lesions. Histopathological analysis showed tissue degeneration, mucus accumulation, alveolar septum thickening, and cellular necrosis. Immunohistochemistry analysis indicated that M. ovipneumoniae was more in the bronchi compared to the trachea. Genome analysis of M. ovipneumoniae identified a 1,014,835 bp with 686 coding sequences, 3 rRNAs, 30 tRNAs, 6 CRISPRs, 11 genomic islands, 4 prophages, 73 virulence factors, and 20 secreted proteins.

Conclusion

This study investigates the vulnerability of Hu sheep to M. ovipneumoniae infection during late spring’s cold weather conditions. Autopsy findings showed severe pulmonary injury in affected sheep, and whole genome sequencing identified genetic elements associated with pathogenicity and virulence factors of M. ovipneumoniae.
Potassium levels and the risk of all-cause and cardiovascular mortality among patients with cardiovascular diseases: a meta-analysis of cohort studies
Authors: Fan Yahui , Wu Min , Li Xiaohui , Zhao Jinping , Shi Jia , Ding Lu , Jiang Hong , Li Zhaofang , Zhang Wei , Ma Tianyou , Wang Duolao , Ma Le
Published: January 2024

Background

Abnormal blood potassium levels are associated with an increased risk of cardiometabolic diseases and mortality in the general population; however, evidence regarding the association between dyskalemia and mortality among patients with cardiovascular disease (CVD) remains inconclusive. This study aimed to evaluate the association of potassium levels with all-cause and cardiovascular mortality among patients with CVD.

Methods

PubMed, Embase, Web of Science, and Cochrane Library databases were searched up to August 2023 to identify relevant cohort studies among patients with CVD, such as myocardial infarction, stroke, and heart failure. Abnormal potassium levels were considered as hypokalemia or hyperkalemia. The primary outcomes were all-cause mortality based on follow-up length (including in-hospital, short-term and long-term mortality) and cardiovascular mortality. The methodological quality of included studies was assessed by using the Newcastle-Ottawa Scale. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Restricted cubic splines were applied to explore the dose-response relationship.

Results

Thirty-one cohort studies involving 227,645 participants with an average age of 68.3 years were included in the meta-analysis, all of which achieved moderate to high quality. Hyperkalemia was significantly associated with an approximately 3.0-fold increased risk of all-cause in-hospital mortality (RR:2.78,95CI%:1.92,4.03), 1.8-fold of all-cause short-term mortality (RR:1.80, 95CI%:1.44,2.27), 1.3-fold of all-cause long-term mortality (RR:1.33, 95CI%:1.19,1.48) and 1.2-fold of cardiovascular mortality (RR:1.19, 95CI%:1.04,1.36). Similar positive associations were also observed between hypokalemia and risk of all-cause mortality and cardiovascular mortality. The RRs of all-cause in-hospital, short-term, long-term mortality and cardiovascular mortality with hyperkalemia were attenuated to 2.21 (95CI%:1.60,3.06), 1.46(95CI%:1.25,1.71), 1.23 (95CI%:1.09,1.39) and 1.13 (95CI%:1.00,1.27) when treating hypokalemia together with normokalemia as the reference group. A U-shaped association was observed between potassium levels and mortality, with the lowest risk at around 4.2 mmol/L.

Conclusions

Both hypokalemia and hyperkalemia were positively associated with the risk of mortality in patients with CVD. Our results support the importance of potassium homeostasis for improving the CVD management.

Registration

PROSPERO, CRD42022324337.
Stratifying esophago-gastric cancer treatment using a patient-derived organoid-based threshold
Authors: Schmäche Tim , Fohgrub Juliane , Klimova Anna , Laaber Karin , Drukewitz Stephan , Merboth Felix , Hennig Alexander , Seidlitz Therese , Herbst Friederike , Baenke Franziska , Ada Anne-Marlen , Groß Thomas , Wenzel Carina , Ball Claudia R. , Praetorius Christian , Schmidt Thomas , Ringelband-Schilling Barbara , Koschny Ronald , Stenzinger Albrecht , Roeder Ingo , Jaeger Dirk , Zeissig Sebastian , Welsch Thilo , Aust Daniela , Glimm Hanno , Folprecht Gunnar , Weitz Jürgen , Haag Georg M. , Stange Daniel E.
Published: January 2024

Background and aims

This study sought to determine the value of patient-derived organoids (PDOs) from esophago-gastric adenocarcinoma (EGC) for response prediction to neoadjuvant chemotherapy (neoCTx).

Methods

Endoscopic biopsies of patients with locally advanced EGC (n = 120) were taken into culture and PDOs expanded. PDOs' response towards the single substances of the FLOT regimen and the combination treatment were correlated to patients' pathological response using tumor regression grading. A classifier based on FLOT response of PDOs was established in an exploratory cohort (n = 13) and subsequently confirmed in an independent validation cohort (n = 13).

Results

EGC PDOs reflected patients' diverse responses to single chemotherapeutics and the combination regimen FLOT. In the exploratory cohort, PDOs response to single 5-FU and FLOT combination treatment correlated with the patients' pathological response (5-FU: Kendall's τ = 0.411, P = 0.001; FLOT: Kendall's τ = 0.694, P = 2.541e-08). For FLOT testing, a high diagnostic precision in receiver operating characteristic (ROC) analysis was reached with an AUCROC of 0.994 (CI 0.980 to 1.000). The discriminative ability of PDO-based FLOT testing allowed the definition of a threshold, which classified in an independent validation cohort FLOT responders from non-responders with high sensitivity (90%), specificity (100%) and accuracy (92%).

Conclusion

In vitro drug testing of EGC PDOs has a high predictive accuracy in classifying patients' histological response to neoadjuvant FLOT treatment. Taking into account the high rate of successful PDO expansion from biopsies, the definition of a threshold that allows treatment stratification paves the way for an interventional trial exploring PDO-guided treatment of EGC patients.
Aberrant R-loop–mediated immune evasion, cellular communication, and metabolic reprogramming affect cancer progression: a single-cell analysis
Authors: Zhang Shichao , Liu Yang , Sun Yichi , Liu Qin , Gu Yan , Huang Ya , Zeng Zhu , Tang Fuzhou , Ouyang Yan
Published: January 2024

Dysregulation of R-loop homeostasis is closely related to various human diseases, including cancer. However, the causality of aberrant R-loops in tumor progression remains unclear. In this study, using single-cell RNA-sequencing datasets from lung adenocarcinoma (LUAD), we constructed an R-loop scoring model to characterize the R-loop state according to the identified R-loop regulators related to EGFR mutations, tissue origins, and TNM stage. We then evaluated the relationships of the R-loop score with the tumor microenvironment (TME) and treatment response. Furthermore, the potential roles of FANCI-mediated R-loops in LUAD were explored using a series of in vitro experiments. Results showed that malignant cells with low R-loop scores displayed glycolysis and epithelial–mesenchymal transition pathway activation and immune escape promotion, thereby hampering the antitumor therapeutic effects. Cell communication analysis suggested that low R-loop scores contributed to T cell exhaustion. We subsequently validated the prognostic value of R-loop scores by using bulk transcriptome datasets across 33 tumor types. The R-loop scoring model well predicted patients’ therapeutic response to targeted therapy, chemotherapy, or immunotherapy in 32 independent cohorts. Remarkably, changes in R-loop distribution mediated by FANCI deficiency blocked the activity of Ras signaling pathway, suppressing tumor-cell proliferation and dissemination. In conclusion, this study reveals the underlying molecular mechanism of metabolic reprogramming and T cell exhaustion under R-loop score patterns, and the changes in R-loops mediated by R-loop regulators resulting in tumor progression. Therefore, incorporating anticancer methods based on R-loop or R-loop regulators into the treatment schemes of precision medicine may be beneficial.
Evaluation of atherosclerosis as a risk factor in COPD patients by measuring the carotid intima-media thickness
Authors: Firincioglulari Ali , Erturk Hakan , Firincioglulari Mujgan , Biber Cigdem
Published: January 2024

Background

This study aimed to evaluate atherosclerosis as comorbidity by measuring the carotid (bulb and common carotid artery) Carotid intima-media thickness in COPD-diagnosed patients and to evaluate the relationship of atherosclerosis with the prevalence of COPD, hypoxemia and hypercapnia.

Methods

This study was conducted out between January 2019-December 2019 consisting of a total of 140 participants (70 COPD-diagnosed patients-70 healthy individuals). The COPD-diagnosed patients have been planned according to the selection and diagnosis criteria as per the GOLD 2019 guide. It is planned to evaluate as per prospective matching case-control study of the carotid thickness, radial gas analysis, spirometric and demographic characteristics of COPD diagnosed patients and healthy individuals.

Results

The average Carotid intima-media thickness in COPD patients was 0.8746±0.161 (p<0.05), and the thickness of the carotid bulb was 1.04±0.150 (p<0.05). In the control group, the average CCA intima-media thickness was 0.6650±0.139 (p<0.05), and the thickness of the carotid bulb was 0.8250±0.15(p<0.05) For the carotid thickness that has increased in COPD diagnosed patients a significant relationship is determined between hypoxemia (p<0.05) and hypercapnia(p<0.05). A significant relationship determined between CIMT and severity of COPD (p<0.05) The CIMT was high in COPD patients with hypoxemia and hypercapnia(p<0.05).

Conclusion

Significant difference was determined between the severity (grades) of COPD (mild, moderate, severe, very severe) in carotid thickness. Also, CIMT was found to be high in patients who is in the early phases of the prevalence of COPD. In COPD-diagnosed patients, it was determined that severity of COPD, hypoxemia, hypercapnia and age were determining factors of atherosclerosis.

Graphical Abstract