Score Analysis Research Articles

Phenolic compounds' stability in reduced-calorie plum spread fortified with freeze-dried plum pomace: Effects of processing techniques and pasteurization

Fortified reduced-calorie plum spreads (∼40°Brix), containing 10 % (w/w) freeze-dried plum pomace (FD-PP), were analyzed for phenolic compounds (spectrophotometrically and chromatographically determined) and antioxidant activity to evaluate the effects of processing and pasteurization during the transition from laboratory (LS-S) to industrial scale (IS-S) spread manufacturing. Additionaly, a control sample at an industrial scale (IS-CS) was prepared to estimate FD-PP's functional contribution. The physicochemical properties of spreads and plum materials used (FD-PP and plum purée, PP), were also investigated. IS-S exhibited increased levels of total phenols, total flavonoids, total anthocyanins, catechin, chlorogenic acid, caffeic acid, rutin, quercetin, cyanidin 3-O-glucoside, and cyanidin 3-O-rutinoside, alongside higher antioxidant activity compared to IS-CS. LS-S retained more phenolics than IS-S, possibly due to the pasteurization step (85 °C, 1 h) introduced in IS-S processing. Although characterised by reduced phenolic and anthocyanins content upon pasteurization, appealing colour of the IS-S spread was retained. Significant correlations (p<0.05) were observed across most individual phenolic compounds and antioxidant activity. Standard score (SS) analysis showed that phenolic retention and antioxidant activity were highest in LS-S (SS=0.754), followed by IS-S (SS=0.490) and IS-CS (SS=0.163). Pasteurization and the use of FD-PP contributed to the microbiologically stable spread after 21 days of storage.

Safety and efficacy of bridging intravenous thrombolysis plus mechanical thrombectomy versus direct mechanical thrombectomy in different age groups of acute ischemic stroke patients.

To evaluate the safety and efficacy of bridging intravenous thrombolysis plus mechanical thrombectomy (MT) versus direct MT in different age groups of patients with acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO) of the anterior circulation. Consecutive patients from the prospective endovascular stroke registry of the Comprehensive Stroke Center, University of Rome Tor Vergata, Italy, between January 2015 and June 2021 were retrospectively analyzed. Patients were divided into age groups (≤ 80 years old and > 80 years old); for each age group, they were further divided in the bridging therapy group and the direct MT group. We performed a propensity score analysis according to baseline characteristics. Safety outcomes were any intracerebral hemorrhage (ICH), symptomatic ICH (sICH) and 3-month mortality. Efficacy outcomes were successful recanalization (modified Thrombolysis in Cerebral Infarction, mTICI, score ≥ 2b) and 3-month functional independence (modified Rankin Scale, mRS, ≤ 2). We included 761 AIS patients with anterior circulation LVO (mean age 73.5 ± 12.8 years; 44.8% males; mean baseline NIHSS 16 ± 5). After propensity score, there were 365 patients ≤ 80 years old (52% bridging therapy) and 187 patients > 80 years old (57% bridging therapy). In both age groups of patients, we found no statistically significant differences in the rates of any ICH, sICH, successful recanalization and 3-month mortality and functional independence between bridging therapy and direct MT groups. In our population, safety and efficacy outcomes of bridging therapy versus direct MT did not differ in both AIS patients ≤ 80 and > 80 years old.

From Counting Dollars to Counting Sheep: Exploring Simultaneous Change in Economic Well-Being and Sleep among African American Adolescents.

In the U.S.A., Black/African American adolescents disproportionately experience short and poor-quality sleep, and there is little understanding of why some experience decrements or improvements in sleep over time. Toward conducting culturally specific research and identifying processes that uniquely explain variability within a racial/ethnic group, we utilized a within-group design to examine socioeconomic status (SES) as a predictor of Black adolescents' sleep. Few studies have examined change-on-change processes in sleep over time. Contributing to the literature in novel ways, we assessed the predictive effect of change in SES over one year on changes in four actigraphy-derived sleep parameters over the same time period. Participants were 218 Black adolescents (Time 1: Mage = 17.09 years; 54.6% female) and their mothers from socioeconomically diverse backgrounds. Adolescents participated in two-waves of data collection spaced approximately one year apart. At each wave, we assessed economic well-being (used to index SES) and sleep using 7 nights of actigraphy from which we derived measures of sleep duration (minutes) and quality (efficiency, long-wake episodes, activity). Latent difference score analyses revealed that adolescents experiencing increases in SES over one year exhibited decreases in both long-wake episodes and sleep activity over one year. Findings suggest that individual differences in change in SES explain individual differences in change in adolescents' sleep quality. Notably, findings highlight the utility of within-group designs for identifying culturally specific processes that predict improvements in sleep quality in a sample at disproportionate risk for sleep and health disparities.

Myeloid-derived growth factor promotes M2 macrophage polarization and attenuates Sjögren's syndrome via suppression of the CX3CL1/CX3CR1 axis.

Primary Sjögren syndrome (pSS) is a systemic autoimmune disease that is characterized by the infiltration of immune cells into the salivary glands. The re-establishment of salivary glands (SGs) function in pSS remains a clinical challenge. Myeloid-derived growth factor (MYDGF) has anti-inflammatory, immunomodulatory, and tissue-functional restorative abilities. However, its potential to restore SGs function during pSS has not yet been investigated. Nonobese diabetic (NOD)/LtJ mice (pSS model) were intravenously administered with adeno-associated viruses carrying MYDGF at 11 weeks of age. Salivary flow rates were determined before and after treatment. Mice were killed 5 weeks after MYDGF treatment, and submandibular glands were collected for analyses of histological disease scores, inflammatory cell infiltration, PCR determination of genes, and Western blotting of functional proteins. Furthermore, mRNA sequencing and bioinformatics were used to predict the mechanism underlying the therapeutic effect of MYDGF. Treatment of NOD/LtJ mice with MYDGF alleviated pSS, as indicated by increased salivary flow rate, reduced lymphocyte infiltration, attenuated glandular inflammation, and enhanced AQP5 and NKCC1 expression. The gene expression levels of cytokines and chemokines, including Ccl12, Ccl3, Il1r1, Ccr2, Cx3cr1, Il7, Mmp2, Mmp14, Il1b, and Il7, significantly decreased after treatment with MYDGF, as determined by RNA sequencing. Meanwhile, MYDGF inhibits infiltration of macrophages (Mϕ) in SGs, induces polarization of M2ϕ, and suppresses C-X3C motif ligand 1 (CX3CL1)/C-X3C motif receptor 1 (CX3CR1) axis. Our findings showed that MYDGF could revitalize the SGs function of pSS, inhibit infiltration of Mϕ, and promote M2ϕ polarization via suppression of the CX3CL1/CX3CR1 axis, which has implications for potential therapy for pSS.

Validity and Reliability Testing of the Turkish Version of the Self-Acceptance Scale for Pregnant Women

Objective: This study was conducted to adapt the Self-Acceptance Scale for Pregnant Women (SAS-PW), which was developed in Brazil, to Turkish and test the psychometric properties of its Turkish version. Method: This methodological study was carried out with 576 pregnant women who presented to the pregnancy outpatient clinics of a Research and Training Hospital in northern Turkey between December 2021 and April 2022. The validity of the Turkish version of SAS-PW was tested by conducting linguistic, content, and construct validity analyses, while its reliability was tested by conducting internal consistency and test-retest analyses. Results: According to the results of the exploratory factor analysis, the factor load values of the items and the rates of the total variance in scale scores explained by the factors were sufficient. The confirmatory factor analysis results demonstrated that the goodness-of-fit indices of the scale were within suitable ranges. The 2-factor and 10-item construct of the original SAS-PW was confirmed based on the factor analyses. The item-total score correlations of the scale were found sufficient, and the total Cronbach’s alpha coefficient of SAS-PW was determined to be 0.933. The test-retest analysis of the scale scores revealed a strong correlation between the scores of the two implementations. Conclusions: The Turkish version of SAS-PW is a valid and reliable measurement instrument to evaluate the self-acceptance levels of pregnant women in Turkish society.

The growing creative challenge for advertising engagement: An analysis of Super Bowl Ad Meter likeability scores from 2013 to 2024

ABSTRACT In the world of advertising, creativity is king. For at least fifty years, the Super Bowl has reigned as the industry’s annual showcase of creative commercials. This study explores consumer perceptions of television advertising creativity as reflected in the popular Super Bowl Ad Meter likeability scores. Specifically, are there any trends or patterns evident in likeability scores that shed light on emerging audience attitudes toward creativity? Analysis of likeability scores from 2013–2024 indicates that average ratings remain relatively constant. However, an intriguing trend appears with consistently decreasing variance among likeability scores year-on-year. This indicates growing homogeneity in advertising as the distinction between standout creativity and conformity grows more challenging to distinguish. Thus, a critical question for brands is: How can advertisers cut through and engage audiences? Recent Super Bowl favorites indicate potential formulas for success – humor, heartwarming narratives, and celebrity identities. As the advertising landscape evolves, future research should explore emerging opportunities to engage audiences and distinguish brands from a sea of sameness.

Geographic Socioeconomic Influences on Disease Activity in Rheumatoid Arthritis in an Academic and Safety Net Hospital System.

The objective of this study was to analyze the impact of the Area Deprivation Index (ADI) on disease activity and cardiovascular comorbidity in rheumatoid arthritis (RA). A retrospective analysis of adult patients with RA was conducted to highlight differences in academic and safety net hospital clinics. Demographics, RA medication history, patient portal engagement, primary care presence, emergency or inpatient visits, RA disease activity and functional scores, Charlson Comorbidity Index (CCI), and cardiovascular disease (CVD) presence were captured. The ADI rank was assigned using nine-digit zip codes. Patients were stratified by the upper versus lower ADI decile group and matched by age, sex, race, ethnicity, insurance, and CCI using propensity score analysis. Patients with RA from the academic practice (n = 542) and the safety net hospital (n = 496) were assessed. In the academic cohort, those with high ADI scores (>8, more deprivation) had higher RA disease activity scores (Routine Assessment of Patient Index Data 3 mean ± SD: high 13.83 ± 6.94 vs low 11.17 ± 7.37, P < 0.0001; Clinical Disease Activity Index mean ± SD: high 11.97 ± 11.74 vs low 9.40 ± 7.97, P < 0.05), more functional impairment (Multidimensional Health Assessment Questionnaire mean ± SD: high 2.99 ± 2.29 vs low 2.34 ± 2.23, P < 0.01), lower MyChart use (P < 0.001), and different smoking history (P < 0.01) compared to those with low ADI scores (<3, less deprivation). In the safety net cohort, there was a statistically significant difference only in smoking status (P < 0.05). CVD was not significantly different in either cohort. The absence of differences in RA disease activity and functional impairment in patients suggests that the ADI may not be as effective at predicting RA disease activity specifically in a safety net health care context. Identifying the discrepancies between the two systems may elucidate areas of improvement for patient care.

Establishment and Verification of a Novel Gene Signature Connecting Hypoxia and Lactylation for Predicting Prognosis and Immunotherapy of Pancreatic Ductal Adenocarcinoma Patients by Integrating Multi-Machine Learning and Single-Cell Analysis.

Pancreatic ductal adenocarcinoma (PDAC) has earned a notorious reputation as one of the most formidable and deadliest malignant tumors. Within the tumor microenvironment, cancer cells have acquired the capability to maintain incessant expansion and increased proliferation in response to hypoxia via metabolic reconfiguration, leading to elevated levels of lactate within the tumor surroundings. However, there have been limited studies specifically investigating the association between hypoxia and lactic acid metabolism-related lactylation in PDAC. In this study, multiple machine learning approaches, including LASSO regression analysis, XGBoost, and Random Forest, were employed to identify hub genes and construct a prognostic risk signature. The implementation of the CERES score and single-cell analysis was used to discern a prospective therapeutic target for the management of PDAC. CCK8 assay, colony formation assays, transwell, and wound-healing assays were used to explore both the proliferation and migration of PDAC cells affected by CENPA. In conclusion, we discovered two distinct subtypes characterized by their unique hypoxia and lactylation profiles and developed a risk score to evaluate prognosis, as well as response to immunotherapy and chemotherapy, in PDAC patients. Furthermore, we indicated that CENPA may serve as a promising therapeutic target for PDAC.

Automated analysis of flow cytometry data with minimal training files: Research evaluation of an elastic image registration algorithm for TBNK, stem cell enumeration, and lymphoid screening tube assays.

Automated analysis of flow cytometry data can improve objectivity and reduce analysis time but has generally required work by software and algorithm experts. Here, we investigated the performance of BD ElastiGate™ Software (hereafter ElastiGate), which allows users to automate gating by selecting gated training files, then uses elastic image registration to gate new files. Three assays of increasing complexity were examined: TBNK, stem cell enumeration (SCE), and lymphoid screening tube (LST). For TBNK analysis, 60 peripheral blood (PB) samples from normal, HIV+, and controls were tested with ground truth analysis by an existing automated method. For SCE, 128 samples including bone marrow (BM), cord blood (CB), and apheresis were tested with analysis by multiple manual analysts. For LST, 80 PB and 28 BM samples were tested with manual analysis. For ElastiGate, a minimal number of training files was selected. Results were compared by Bland-Altman or F1 score analysis. For TBNK, ElastiGate using three training files (1 control, 1 normal, 1 HIV+) showed mean %bias across all reported populations between -1.48% and 7.13% (average 2.08%). For SCE, ElastiGate using three BM and two CB training files showed median F1 scores >0.93 in comparison to >0.94 and >0.92 for two other manual analysts. For LST, ElastiGate using four training files for each of PB and BM showed median F1 scores >0.945 for 13 of 14 PB populations and 10 of 14 BM populations, with generally similar or better performance for normal samples compared to abnormal; populations with lower scores were often associated with lower agreement between manual analysts. Based on analysis of three assays with four sample types of increasing complexity, ElastiGate with minimal training files may perform as an automated gating assistant. The results reported here are for research use only, not for use in diagnostic or therapeutic procedures.

Canadian adult reference data for body composition, trabecular bone score and advanced hip analysis using DXA

DXA-derived reference data for visceral adipose tissue (VAT) and advanced hip analysis (AHA) parameters spanning the entire adult lifespan are limited. The purpose of this study was to develop age-, site- and sex-specific reference data for dual X-ray absorptiometry (DXA) -derived body composition, trabecular bone score (TBS) and advanced hip analysis (AHA) parameters across the adult lifespan. Adults (N = 908; female: 561 and male: 347) from Calgary and the surrounding area over the age of 20 years participated in this study. Participants received DXA scans of their hip (total hip [TH] and femoral neck [FN]), lumbar spine [LS], forearm [33 % site] and total body (iDXA, GE Lunar, GE Healthcare). Areal bone mineral density (aBMD, g/cm2) was captured at all sites, and body composition variables, including lean mass, fat mass and percent fat, were analyzed from the total body scan. VAT mass was assessed from total body DXA scans. Advanced hip analysis (AHA) was performed on hip scans and trabecular bone score (TBS) on the LS scans to assess bone quality. Site- and sex-specific centile curves and tables were generated using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) method. Clinicians and researchers can use these Canadian reference data as a tool to assess body composition, TBS and AHA parameters across the adult lifespan.

A Country-Specific Analysis of CCN Pre-College IFP Business Chinese Scores

With the increasing international status of China, there are more and more Chinese language learners. China actively supports this trend and has implemented a series of policies to encourage foreigners to study in China. There are also many institutions that directly connect with Chinese universities to help more people study Chinese in China. This paper mainly studies the CCN pre-college education alliance’s business Chinese C pathway as the research object, and Chinese scores as the research theme, to analyze the country-specific Chinese scores of business students and analyze the results and propose improvement measures.

Virtual reality for the management of pain and anxiety during outpatient manual vacuum aspiration for miscarriage or incomplete abortion: a mixed methods trial.

To evaluate the efficacy and acceptability of virtual reality (VR) as a distraction technique in the management of acute pain and anxiety during outpatient uterine aspiration using a manual vacuum aspirator (MVA). This mixed methods study included a prospective multi-centre randomised controlled trial and structured individual interviews. Of the 72 patients approached, 50 consenting, eligible participants were randomised to VR intervention (immersive video content 'The Forest of Serenity') or standard care during MVA for the management of miscarriage or incomplete abortion from July 2021-July 2022 across two university hospitals in London, UK. Expected and actual pain scores, and anxiety before and after the procedure were measured as numeric rating scores (0-10). Structured interviews were undertaken after the procedure in women randomised to VR. Statistical analysis of pain and anxiety scores were by intention-to-treat including all randomised participants, using Stata-12 software. Qualitative analysis was achieved by thematic analysis of transcribed interviews. There was no significant difference in pain or anxiety scores reported by participants randomised to VR compared with standard care. Mean worst pain scores were 5.98 and 6.88 in the standard care and VR groups respectively (p-value 0.13), with corresponding anxiety scores at the end of the procedure 3.94 and 3.3 (p-value 0.57). Qualitative analysis from interviews was highly favourable from women randomised to VR with all participants reporting a positive experience. 90% (18/20) of participants reported that VR reduced their anxiety and 71% (15/21) stated that it helped to reduce or distract from their pain. While virtual reality did not decrease pain or anxiety scores during MVA, it is a feasible and acceptable option that may improve patient experience. Randomisation to VR during MVA did not reduce pain or anxiety scores. However, at structured interview most participants reported that VR reduced their anxiety and reduced or distracted them from their pain. VR is a feasible and acceptable option that may improve patient experience during MVA.

Genome-wide profiling of bZIP transcription factors in Camelina sativa: implications for development and stress response

BackgroundThe bZIP transcription factor family, characterized by a bZIP domain, plays vital roles in plant stress responses and development. While this family has been extensively studied in various plant species, its specific functions in Camelina sativa (False Flax) remain underexplored.Methods and resultsThis study identified 71 bZIP transcription factors in C. sativa, classified into nine distinct groups based on phylogenetic analysis. Subcellular localization predicted a nucleus-specific expression for these bZIPs. Analysis of GRAVY scores revealed a range from 0.469 to -1.256, indicating a spectrum from hydrophobic to hydrophilic properties. Motif analysis uncovered 10 distinct motifs, with one motif being universally present in all CsbZIPs. Conserved domain analysis highlighted several domains beyond the core bZIP domain. Protein-protein interaction predictions suggested a robust network involving CsbZIPs. Moreover, promoter analysis revealed over 60 types of cis-elements, including those responsive to stress. Expression studies through RNA-seq and Real-time RT-qPCR demonstrated high expression of CsbZIPs in roots, leaves, flowers, and stems. Specifically, CsbZIP01, CsbZIP02, CsbZIP44, and CsbZIP60 were consistently up-regulated under cold, salt, and drought stresses, whereas CsbZIP34 and CsbZIP35 were down-regulated.ConclusionThis study presents the first comprehensive genome-wide profiling of bZIP transcription factors in Camelina sativa, providing novel insights into their roles in plant development and stress response mechanisms. By identifying and characterizing the bZIP gene family in C. sativa, this research offers new opportunities for improving stress tolerance and crop resilience through targeted genetic approaches, addressing key challenges in agriculture under changing environmental conditions.

Integration of ubiquitination-related genes in predictive signatures for prognosis and immunotherapy response in sarcoma.

Ubiquitination is one of the most prevalent and complex post-translational modifications of proteins in eukaryotes, playing a critical role in regulating various physiological and pathological processes. Targeting ubiquitination pathways, either through inhibition or activation, holds promise as a novel therapeutic approach for cancer treatment. However, the expression patterns, prognostic significance, and underlying mechanisms of ubiquitination-related genes (URGs) in sarcoma (SARC) remain unclear. We analyzed URG expression patterns and prognostic implications in TCGA-SARC using public databases, identifying DEGs related to ubiquitination among SARC molecular subtypes. Functional enrichment analysis elucidated their biological significance. Prognostic signatures were developed using LASSO-Cox regression, and a predictive nomogram was constructed. External validation was performed using GEO datasets and clinical tissue samples. The association between URG risk scores and various clinical parameters, immune response, drug sensitivity, and RNA modification regulators was investigated. Integration of data from multiple sources and RT-qPCR confirmed upregulated expression of prognostic URGs in SARC. Single-cell RNA sequencing data analyzed URG distribution across immune cell types. Prediction analysis identified potential target genes of microRNAs and long non-coding RNAs. We identified five valuable genes (CALR, CASP3, BCL10, PSMD7, PSMD10) and constructed a prognostic model, simultaneously identifying two URG-related subtypes in SARC. The UEGs between subtypes in SARC are mainly enriched in pathways such as Cell cycle, focal adhesion, and ECM-receptor interaction. Analysis of URG risk scores reveals that patients with a low-risk score have better prognoses compared to those with high-risk scores. There is a significant correlation between DRG riskscore and clinical features, immune therapy response, drug sensitivity, and genes related to pan-RNA epigenetic modifications. High-risk SARC patients were identified as potential beneficiaries of immune checkpoint inhibitor therapy. We established regulatory axes in SARC, including CALR/hsa-miR-29c-3p/LINC00943, CASP3/hsa-miR-143-3p/LINC00944, and MIR503HG. RT-qPCR data further confirmed the upregulation of prognostic URGs in SARC. Finally, we validated the prognostic model's excellent predictive performance in predicting outcomes for SARC patients. We discovered a significant correlation between aberrant expression of URGs and prognosis in SARC patients, identifying a prognostic model related to ubiquitination. This model provides a basis for individualized treatment and immunotherapy decisions for SARC patients.

Stereotactic body radiotherapy versus lenvatinib for hepatocellular carcinoma with portal vein tumor thrombosis: a propensity matching score analysis

Background and objectivesThe purpose of this study was to investigate the survival benefit of Stereotactic Body Radiotherapy (SBRT) versus lenvatinib as first-line therapy in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT).Materials and methods147 HCC patients with PVTT were included in this retrospective study, 70 were treated with SBRT and 77 of were treated with lenvatinib. Propensity score matching (PSM) analysis was employed to balance the differences in baseline characteristics between the two groups. Overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) were compared between the two groups. In addition, the safety of patients in both groups was also evaluated.ResultsAfter PSM, 38 patients were matched in each of the two groups. The median OS was 14.5 (95% CI: 10.1–18.9) and 11.1 (95% CI: 9.3–12.9) months in the SBRT and lenvatinib groups, respectively (P = 0.014). The median PFS was 6.8 (95% CI: 5.1–8.5) and 5.0 (95% CI: 3.0–7.0) months, respectively (P = 0.010). The 1-, 2-years OS rates in the two groups were 65.8% vs. 39.5% and 31.6% vs. 10.5%, respectively. The 6-, 12-months PFS rates in the two groups were 57.9% vs. 44.7% and 28.9% vs. 10.5%, respectively. In addition, the SBRT group had a better ORR than the lenvatinib group (52.6% vs. 23.7%, P = 0.009). Patients with good response to SBRT had better survival. Cox proportional hazard model showed that SBRT was an important prognostic factor for OS and PFS. The incidence of hypertension (34.2% vs. 0%) was higher in the LEN group, however, both treatment modalities were well tolerated in the two groups of patients.ConclusionIn HCC patients with PVTT, SBRT had a better survival benefit than Lenvatinib treatment as first-line therapy.

Estimation of Direct and Indirect Polygenic Effects and Gene-Environment Interactions using Polygenic Scores in Case-Parent Trio Studies.

Family-based studies provide a unique opportunity to characterize genetic risks of diseases in the presence of population structure, assortative mating, and indirect genetic effects. We propose a novel framework, PGS-TRI, for the analysis of polygenic scores (PGS) in case-parent trio studies for estimation of the risk of an index condition associated with direct effects of inherited PGS, indirect effects of parental PGS, and gene-environment interactions. Extensive simulation studies demonstrate the robustness of PGS-TRI in the presence of complex population structure and assortative mating compared to alternative methods. We apply PGS-TRI to multi-ancestry trio studies of autism spectrum disorders (N trio = 1,517) and orofacial clefts (N trio = 1,904) to establish the first transmission-based estimates of risk associated with pre-defined PGS for these conditions and other related traits. For both conditions, we further explored offspring risk associated with polygenic gene-environment interactions, and direct and indirect effects of genetically predicted levels of gene expression and metabolite traits.

Enhancing academic performance: a shadow curriculum approach for medical and dental student preparation in basic sciences and pre-internship comprehensive exams

BackgroundThe shadow curriculum is an emerging concept in curriculum studies that has not yet garnered significant attention in medical education. It includes programs and activities outside formal education to improve students’ academic performance in the formal educational system.ObjectiveIn this study, we designed and developed an online course based on the shadow curriculum and evaluated its effect on students’ learning and academic performance.MethodsThis study represents a form of developmental research, with the study population comprising medical and dental students from universities of medical sciences in Iran. The course was conducted at the Smart University of Medical Sciences, following the ADDIE instructional design approach in three phases. The initial two phases involved designing and implementing the program according to the students’ needs and requirements. In the third phase, we evaluated the program using the Kirkpatrick model. In the first level evaluation, the reaction of 70 students in the course was investigated. To assess the impact of the course, pre and post-tests were administered to 30 students. Finally, the effect of the course on students’ success in the comprehensive exams for basic medical sciences, dentistry, and pre-internship was analyzed by examining the passing and failing statuses of 83 and 57 students who participated in the September 2023 and February 2024 exams.ResultsThe results indicated that the students responded positively to the program. The analysis of pre-test and post-test scores showed a significant improvement in the students’ academic performance across all the subjects presented in the course, including basic medical sciences, dentistry, and pre-internship (p < 0.01, p < 0.05). Overall, the descriptive analysis of the program’s influence on the students’ success in comprehensive exams in basic medical sciences, dentistry, and pre-internship showed that 70 out of 83 participating students passed the September 2023 comprehensive exams. Additionally, 51 out of 57 participants completed the comprehensive exams in February 2024.ConclusionsIn an era where the shadow curriculum is reshaping learning and the educational landscape, the findings presented in this study indicate that this type of curriculum should be given special attention in the theoretical, research, and practical dimensions of the field of medical education.

Multi-category sorting of plastic waste using Swin Transformer: A vision-based approach

Sorting out plastic waste (PW) from municipal solid waste (MSW) by material type is crucial for reutilization and pollution reduction. However, current automatic separation methods are costly and inefficient, necessitating an advanced sorting process to ensure high feedstock purity. This study introduces a Swin Transformer-based model for effectively detecting PW in real-world MSW streams, leveraging both morphological and material properties. And, a dataset comprising 3560 optical images and infrared spectra data was created to support this task. This vision-based system can localize and classify PW into five categories: polypropylene (PP), polyethylene (PE), polyethylene terephthalate (PET), polyvinyl chloride (PVC), and polystyrene (PS). Performance evaluations reveal an accuracy rate of 99.75% and a mean Average Precision (mAP50) exceeding 91%. Compared to popular convolutional neural network (CNN)-based models, this well-trained Swin Transformer-based model offers enhanced convenience and performance in five-category PW detection task, maintaining a mAP50 over 80% in the real-life deployment. The model's effectiveness is further supported by visualization of detection results on MSW streams and principal component analysis of classification scores. These results demonstrate the system's significant effectiveness in both lab-scale and real-life conditions, aligning with global regulations and strategies that promote innovative technologies for plastic recycling, thereby contributing to the development of a sustainable circular economy.

PERCUTANEOUS RELEASE OF THE MEDIAL COLLATERAL LIGAMENT DURING KNEE ARTHROSCOPY

The complete visualisation of the internal joint space is crucial for effective knee arthroscopy. However, limited access to certain areas can lead to complications, including cartilage damage. Percutaneous partial release of the medial collateral ligament has been shown to effectively widen the medial compartment of the joint. Objective. This study aimed to determine the effect of percutaneous release of the medial collateral ligament on the postoperative period and restoration of knee joint function. Methods. The patients were divided into two groups: the study group (n = 32) and the comparison group (n = 36). T he study group underwent partial resection of the medial meniscus in combination with percutaneous partial release of the medial collateral ligament, while the comparison group underwent only partial removal of the medial meniscus without widening the medial joint gap. The assessment included pain, functional recovery according to the Tegner Lisholm scale, and the possibility of developing medial instability. Results. The analysis of VAS scores showed a significant reduction in pain in both groups over time. However, there was no significant difference in pain intensity between the two groups during the study. According to the Tegner Lysholm scale, there was a statistically significant improvement in the functional status of patients 6 months after surgery compared to preoperative values in both the study group (p = 0.0034) and the control group (p = 0.0071). However, there was no statistically significant difference between the groups on t he s ame s cale ( p = 0 .871). The study g roup s howed a s light increase in valgus deviation of the tibia (no more than 5o) in 14 (43.75%) patients during the valgus stress test performed on days 7–10 postoperatively. However, after 6 weeks, none of the patients reported any subjective instability or weakness of the knee joint. Therefore, it can be concluded that the procedure was successful. Conclusion. Percutaneous release of the medial collateral ligament to widen the medial aspect during knee arthroscopy has no effect on the postoperative period or the results of partial removal of the medial meniscus.

Correlation and predictive value analysis of iliac artery calcification score and restenosis of lower extremity arteries after drug-coated balloon combined with stent implantation in patients with lower extremity atherosclerotic occlusive disease

Objective: To analyze the correlation between iliac artery calcification score and restenosis of lower extremity arteries in patients with lower extremity atherosclerotic occlusive disease (LEASO) who underwent drug-coated balloon (DCB) combined with stenting, and to assess the predictive value. Methods: A total of 105 patients with LEASO at Nanjing Drum Tower Hospital, Nanjing University Medicine School, from January 2018 to June 2023 were retrospectively included, and the patients were divided into 2 groups according to whether restenosis of the original lower limb arteries had occurred during follow-up after DCB combined stent implantation: the restenosis group (n=64) and the patency group (n=41). The clinical information of the study subjects was collected through the electronic case system, and all patients underwent CTA examination of both lower limb arteries before the operation, and the calcification scores of common iliac arteries and external iliac arteries of patients' bilateral and stenotic sides were calculated according to the results of the CTA examination. The follow-up time [M (Q1, Q3)] was 9.15 (5.67, 15.60) months in the patency group and 9.20 (6.85, 19.65) months in the restenosis group. Univariate and multivariate logistic regression models were used to analyze the factors associated with restenosis after DCB combined with stent implantation in LEASO patients. The predictive value of iliac artery calcification score for postoperative restenosis was assessed using the receiver operating characteristic (ROC) curves. Results: There were 44 males and 20 females in the restenosis group, aged (73±9) years; 31 males and 10 females in the patency group, aged (73±10) years. Compared with the patency group, the restenosis group had higher neutrophil counts, platelet counts, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLR), platelet-to-lymphocyte ratios (PLR), C-reactive protein, fibrinogen, stent lengths, stent numbers, common iliac artery calcification scores (bilateral and stenotic side), and external iliac artery calcification scores (bilateral and stenotic side) (all P<0.05). Multifactorial logistic regression analysis showed that higher external iliac artery calcification score on the stenotic side (OR=1.480, 95%CI: 1.130-1.939, P=0.004) was an associated factor for restenosis of the lower extremity arteries after DCB combined with stenting.ROC curve analysis showed that the cut-off value of the external iliac artery calcification score on the stenotic side was 5.5 score, the area under the curve (AUC) for predicting restenosis of lower extremity arteries after DCB combined stent implantation in LEASO patients was 0.818 (95%CI: 0.731-0.904, P<0.001), with a sensitivity of 85.4% and a specificity of 68.8%. Conclusions: An elevated calcification score of the external iliac artery on the stenotic side is a correlate of restenosis of the lower extremity arteries after DCB combined stenting in patients with LEASO. With a cut-off value of 5.5 points, its sensitivity for predicting restenosis of the lower extremity arteries after DCB combined stenting is 85.4%, and its specificity is 68.8%.