Medical Sciences University Research Articles

Needs assessment of military medicine education curriculum in medical students and upcoming challenges

ABSTRACT Introduction: The curriculum of military medicine for medical students of universities of military medical sciences is a priority and a practical goal. Paying attention to the educational needs of students creates vitality and motivation among students for better learning and improving the learning environment. Frequent monitoring and updating of the content of military courses and modern teaching improve the quality and quantity of the military medicine curriculum. Materials and Methods: This applied, inductive, and exploratory descriptive was conducted in a single cross-sectional and qualitative method. The data were collected using the brainstorming method and individual and collective Delphi techniques. The population included the medical students of Baqiyatallah University of Medical Sciences in Tehran, Iran, who completed the course in military medicine. The data were collected by purposive sampling and classified until the saturation limit was reached. EXCEL 2019 and MAXQDA2020 software were used for data analysis. Findings: This research was carried out in collaboration with the military medicine department of the university to identify the needs of students in the military medicine curriculum. First, the findings were collected in 22 axes. In the next step, the needs were prioritized in the four main components of the combat medicine curriculum (1 goal, 2 content, 3 teaching strategy, 4 evaluation), and the results were extracted. Conclusion: Identifying the needs of students; improving the current military medicine curriculum; paying attention to individual differences, interests, and talents of students; and enhancing the motivation and level of satisfaction of students are the study results.

Effect of simulating training of the fundamentals of laparoscopic surgery on the attitude of operating room nurses students: an intervention study

Abstract Objective Clinical education plays a key role in preparing students for patient care. Laparoscopy is one of the most important minimally invasive surgeries (MISs) wherein surgical technologists are responsible for camera navigation and assistant surgeons are responsible for peg transfer. Therefore, it is necessary to improve the attitude of the operating room students toward these skills during their study period. The present study was conducted to determine the effect of simulating training in the fundamentals of laparoscopic surgery (FLS) on the attitude of the operating room students. Methods This interventional study was conducted on 28 operating room students of Iran University of Medical Sciences in 2019. The census sampling method was used. The data-collection tool included the “Intrinsic motivation inventory (IMI) questionnaire.” The educational intervention was carried out in theoretical (booklet design) and practical (simulation) sections. Data analysis was carried out using descriptive and inferential analyses including the paired t-test, Mann–Whitney U test, and independent t-test. The collected data were analyzed using R and SPSS software. P-value <0.05 was considered as the significant level. Results The mean ± SD of the participants’ age was 22.93 ± 2.14 years, and the majority of them were women (67.9%). There was a significant difference in the mean scores of students’ attitudes toward the FLS before and after the educational intervention (P < 0.001) in all dimensions (interest, perceived competence, perceived choice, and tension). There was also a significant correlation between gender and interest dimension (P = 0.005). Conclusions The results of the present study showed that simulating the training FLS curriculum positively affects students’ attitudes. Therefore, the researchers suggest that for creating a positive attitude, increasing students’ interest in laparoscopic surgery, and ensuring a more effective presence in the operating room, this training should be considered in the operating room curriculum.

Expression of Concern

A. Ghaderi, H.R. Banafshe, N. Mirhosseini, M, Motmaen, F. Mehrzad, F. Bahmani, E. Aghadavod, M.A. Mansournia, R.J. Reiter, M‐A. Karimi, and Z. Asemi, “The Effects of Melatonin Supplementation on Mental Health, Metabolic and Genetic Profiles in Patients Under Methadone Maintenance Treatment,” Addiction Biology 24, no. 4 (2019): 754‐764, https://doi.org/10.1111/adb.12650.This Expression of Concern is for the above article, published online on 27 June 2018 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor‐in‐Chief, Rainer Spanagel, Society for the Study of Addiction, and John Wiley & Sons Ltd. The Expression of Concern has been agreed due to concerns raised regarding the integrity of the research and discrepancies in reporting. An investigation has been conducted by the National Committee for Ethics in Biomedical Research Iran, in coordination with Kashan University of Medical Sciences (KAUMS). However, without the verification of clinical records there remain sufficient doubts about the feasibility and integrity of the research undertaken. As a result, the journal has decided to issue an Expression of Concern to alert readers.

Assessment of the Need for Designing an Interactive Educational Tool on Exophytic Lesions of the Oral Mucosa.

Introduction This study sought to evaluate the necessity of creating an interactive educational resource for instructing dental students on oral exophytic lesions. It also aimed to determine the validity and reliability of a questionnaire designed to assess the quality of educational software tailored to these lesions. Materials and methods This descriptive cross-sectional study involved 102 dental students from Mashhad University of Medical Sciences, Iran, who had completed the theoretical course on oral exophytic lesions. A paper questionnaire, including 23 items, assessed their clinical knowledge, the efficacy and limitations of existing educational resources, and the need for interactive electronic courseware (e-courseware). The questionnaire's validity and reliability were evaluated through expert feedback and statistical measures (intraclass correlation coefficient (ICC) and Cronbach's alpha). Results Students' answers to the seven items about evaluating their clinical diagnosis knowledge of oral exophytic lesions were between four and five items correct on average. This finding indicated that students' overall skill in diagnosing exophytic lesions was poor to moderate.The study highlighted a moderate level of self-assessed clinical ability in diagnosing oral exophytic lesions among students (62.7%), with a preference for textbooks and color atlases as primary information sources. The disadvantages of existing electronic resources were noted, alongside a strong student consensus (88.23%) on the need for interactive e-courseware featuring comprehensive, visually engaging content for differential diagnosis education. The reliability and validity analyses of the questionnaire underscored its appropriateness for assessing educational needs. In this regard, ICC for the usability of scientific context, training ability, and interaction was 0.92, 0.73, and 0.82, respectively. Also, Cronbach's alpha score was at 0.90. Conclusion The research underscores a significant gap in dental students' knowledge and diagnostic skills regarding oral exophytic lesions. It emphasizes the critical need for an innovative, interactive educational tool that aligns with contemporary students' digital learning preferences. The envisioned e-courseware would facilitate self-learning and address current resources' limitations, potentially transforming dental education by enhancing clinical diagnostic skills through accessible, effective, and engaging digital content.

Assessment of the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients: A retrospective study.

Antibiotic resistance has become quite a challenge in the treatment of bacterial infections in the world. Therefore, the present study was conducted with the aim of investigating the pattern of antibiotic resistance among microorganisms isolated from the culture medium prepared from hospitalized patients. The type of study was cross-sectional descriptive. The antibiotic resistance pattern of positive samples collected from patients who got hospitalized in Shahid Faghihi hospital of Shiraz University of Medical Sciences between 2020 and 2021 using the disc diffusion method according to CLSI standards was measured. Then the data were entered into SPSS version 22 software and analyzed with appropriate statistical tests. Of all positive samples, 69.7% were Gram-negative and the rest were Gram-positive. The most frequent Gram-negative bacteria were Acinetobacter baumannii (31.4%), Escherichia coli (25.3), and Klebsiella pneumonia (21.2%), and the most frequent Gram-positive bacteria were Staphylococcus aureus (79%), Coagulase-negative staphylococci (15.4%), and Enterococcus (3.6%). The resistance rate of Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeroginosa against ciprofloxacin was 91.4%, 74.3%, and 52.3%; the resistance rate against gentamicin was 90.5%, 54.3%, and 43.9%; the resistance rate against Piperacillin-Tazobactam was 85.6%, 65%, and 43.1%; the resistance rate against imipenem was 97.1%, 57.9%, and 65.4%; and the resistance rate against colostin was 1.9%, 0%, and 3.4%, respectively. The resistance rate of Staphylococcus aureus against cefoxotin and vancomycin was 42.7% and 2.8%, respectively. Finally, we concluded from this study that microorganisms isolated from patients have developed resistance to many commonly used antibiotics.

Severity of Pain Catastrophizing and Its Associations With Cognitive Flexibility and Self-Efficacy in Patients With Rheumatoid Arthritis.

Pain catastrophizing in patients with rheumatoid arthritis exacerbates negative pain-related outcomes, such as anxiety, depression, and pain intensity. Therefore, it is essential to investigate the severity of pain catastrophizing and the factors contributing to it among these patients. The present study aimed to assess the severity of pain catastrophizing and its association with cognitive flexibility and self-efficacy in a sample of Iranian patients with rheumatoid arthritis. A descriptive correlational study was conducted on 220 rheumatoid patients referred to a rheumatology clinic affiliated with Birjand University of Medical Sciences, Birjand, Iran. The instruments used to collect data included a demographic form, the Pain Catastrophizing Scale, the Cognitive Flexibility Inventory, and the Arthritis Self-Efficacy Scale. The data were analysed using SPSS version 24. The mean age of the participants was 53.25±12.41years, and the mean duration of their disease was 6.63±3.39years. The majority of participants, specifically 61.8%, reported high levels of pain catastrophizing. An inverse and significant correlation was found between pain catastrophizing and cognitive flexibility (p<0.001). Likewise, pain catastrophizing exhibited an inverse and significant correlation with self-efficacy and all its dimensions (p<0.001). The results of the multiple linear regression analysis indicate that the final significant predictors of pain catastrophizing were cognitive flexibility (β=-0.34, p<0.001) and self-efficacy (β=-0.53, p<0.001). These predictors were found to significantly explain 51% of the variance in catastrophizing. Through psychosocial interventions aimed at enhancing pain self-efficacy and cognitive flexibility, healthcare providers can hope to reduce pain catastrophizing and its adverse effects in patients with rheumatoid arthritis.

Diagnostic Accuracy of Polymerase Chain Reaction Against Giemsa Staining on Tissue Biopsy for Cutaneous Leishmaniasis.

To evaluate the diagnostic accuracy of a commercial real-time polymerase chain reaction (PCR) kit targeting 18S rRNA against Giemsa-stained tissue slides in patients clinically suspected of cutaneous leishmaniasis (CL). Cross-sectional analytical study. Place and Duration of the Study: Department of Microbiology, Armed Forces Institute of Pathology / National University of Medical Sciences, Rawalpindi, Pakistan, from July to December 2022. Samples of skin tissue in 98 patients suspected of CL were evaluated. These samples were subjected to Giemsa-staining for microscopy and real-time PCR. Sensitivity, specificity, and accuracy of the PCR were calculated keeping Giemsa-stained tissue slide microscopy as gold standard. Out of the 98 tissue samples, 37 were found positive for leishmaniasis on PCR while 13 were found Leishmania positive on microscopy of Giemsa-stained slides. The sensitivity, specificity, and accuracy of the PCR for the detection of Leishmania species were 100%, 71.8%, and 91.8%, respectively with 100% negative predictive value. This study demonstrates that the commercial PCR is a reliable diagnostic test for the diagnosis of CL. The ease, rapidity, and reliability of the PCR make it a dependable tool in diagnostic repertoire of CL. Giemsa stain, Leishmania spp., Polymerase chain reaction, Viasure.

RAS, BRAF, and MMR system mutations in metastatic colorectal cancers: an observational study

Introduction: Colorectal cancers (CRCs) are the second cause of malignancy-related deaths and over half of CRCs become metastatic. Genetics plays a critical role in understanding metastatic colorectal cancers (MCRCs), as various genetic mutations influence progression and treatment responses. While there exists plenty of research on genetic mutations in CRCs, few studies have focused on mutations in MCRC patients. The present study aims to provide an overview of the prevalence of KRAS, NRAS, BRAF, and MMR mutations in Iranian MCRC patients. Methods: The present study is a descriptive cross-sectional study on patients with MCRCs referred to a tertiary medical center in Iran from March 2015 to March 2022. Ethics approval was obtained from the ethics committee of the University of Medical Sciences. The patient’s MCRC was confirmed by pathology and Genotyping Assessments of tissue for KRAS, NRAS, BRAF, and MMR mutations. Results: A total of 136 MCRC patients were included in this study; 44 patients (40.7%) had KRAS mutations in their lesions. KRAS mutation status was not significantly related to age or gender (P &gt; 0.05). Only one NRAS mutation was found in one patient. There were no cases of BRAF mutation identified. Among 48 patients assessed for MMRs deficiency, 8 cases (16.7%) were positive, 7 cases (14.6%) were MSI-H, and 1 case (2.1%) was MSI-L. Conclusion: Although no significant relation was found between the KRAS mutation pattern and gender, age, or tumor primary location, the MSI-H mutation-positive tumors were significantly more prevalent in younger patients.

Bibliometric Mapping of the Scientific Production of Lasers in Endodontics: Collaborative Networks, Impact, and Trends

Abstract Aim: The objective of this study is to perform a bibliometric mapping of the scientific production of lasers in endodontics using collaborative networks, impact, and trends. Materials and Methods: This retrospective and descriptive study used a bibliometric design to analyze laser use in endodontics in Scopus from 2018 to 2024. In total, 877 documents were identified using key terms and MeSH. Bibliometric indicators were used to explore scientific activity and impact, and VOSviewer was used for data analysis. Results: It was found that the year with the highest number of publications was 2023, with 166, and the quartiles with the highest productivity were Q1 (40.3%) and Q2 (31.1%). Among the top 5 countries with the highest publications production, Brazil led the group with 125, followed by India (111). Among the institutions with the highest production, the Universidade de São Paulo tops the list with 51 research papers, closely followed by the Tehran University of Medical Sciences with 32 and the Universidade Estadual Paulista Júlio de Mesquita Filho with 30. Among the most outstanding authors, we have Chiniforush Nasim, who has 20 papers; however, Duarte Marco has an h-index of 48, and Sivieri-Araújo Gustavo has the highest number of citations. Conclusion: This bibliometric mapping reaffirmed the vision and trends of lasers in endodontics, with 2023 being the most relevant in terms of scientific production and, among the countries with the highest number of publications, Brazil stood out.

Investigation the level of Moral Skills Among Dental Students in Tehran Islamic Azad University of Medical Sciences In 2023

Investigation the level of Moral Skills Among Dental Students in Tehran Islamic Azad University of Medical Sciences In 2023

P.384: The effect of different factors on the increase transplantation of organ donation from brain dead donors in Mashhad University of Medical Sciences between 2015 and 2023.

P.384: The effect of different factors on the increase transplantation of organ donation from brain dead donors in Mashhad University of Medical Sciences between 2015 and 2023.

The prevalence of hepatitis C virus genotypes and factors associated with cirrhosis, fatty liver, and viral load: A registry-based cross-sectional cohort study in Western Iran during 1999-2023.

Hepatitis C virus (HCV) is an important infectious disease that imposes a significant burden on healthcare systems. Determining the prevalence of HCV genotypes in a area is essential for the successful implementation of HCV elimination programs and allocation of financial resources to direct-acting antiviral direct-acting antivirals (DAA) treatments against prevalent HCV genotypes. Accordingly, we conducted a registry-based cross-sectional cohort study to investigate the prevalence of HCV genotypes and factors associated with cirrhosis, fatty liver, and viral load in Kermanshah Province, Western Iran. Patients presenting to the Hepatitis Clinic of the Research Center for Infectious Diseases affiliated with Kermanshah University of Medical Sciences between 1999 and 2023 were enrolled in this study. Serum samples were collected to assess HCV genotypes and viral load. Additionally, demographic data and the status of cirrhosis and fatty liver were extracted from the registry system records throughout the study period. Records of 828 patients with an average age of 40.38 ± 11.72 years (range: 11-80 years) were included in the study that 721 individuals were male, and 107 were female. The prevalence of fatty liver and cirrhosis was 30.3% and 12.9%, respectively. Four genotypes (1, 2, 3, and 4) and four subtypes (1a, 1b, 3a, and 3b) were identified, with subtype 3a (55.7%) being the most prevalent, followed by subtype 1a (34.3%). None of the variables including age, gender, viral load level, and genotypes 1 and 3 were associated with fatty liver or cirrhosis. However, age, gender, and genotype were correlated with the viral load (p ≤ 0.05). The most common HCV subtypes in Kermanshah were 3a and 1a. Genotypes 2 and 4 were identified in one case each. Further studies on identifying HCV subtypes in different regions of the country are recommended to manage HCV infection and predict the prognosis.

Association between chronotype, social jetlag, sleep quality, and academic burnout among nursing students: A cross-sectional study

ABSTRACT Academic burnout in nursing students is a serious problem worldwide that results in emotional exhaustion, cynicism and low professional efficacy. The aim of the current study was to examine the association between sleep quality and circadian rhythm indicators and academic burnout among Iranian nursing students. This cross-sectional study was conducted on 325 undergraduate nursing students studying at Qazvin University of Medical Sciences between November and February 2023. Data collection was carried out using self-report questionnaires including demographic characteristics, The Pittsburgh Sleep Quality Index (PSQI), reduced-Morningness-Eveningness Questionnaire (r-MEQ), and the Maslach Burnout Inventory-Student Survey (MBI-SS). Social jetlag (SJL) was defined as the absolute value of the difference between the midpoint of sleep on free days (MSF) and the midpoint of sleep on workdays (MSW). Data were analyzed using univariate and multivariate linear regression models. About 31.4% of participants had evening chronotype and almost half of them suffered from poor sleep quality. About 47.7% of the participants had SJL ≥ 2 h. In the multivariate linear regression model, students with evening chronotype compared to morning chronotype experienced more academic burnout in emotional exhaustion, cynicism and professional efficacy. PSQI score was only correlated with emotional exhaustion and cynicism subscales. Increased SJL was a predictor on all three subscales of academic burnout. The findings suggested that evening chronotype, poor sleep quality, and high SJL were associated with increased likelihood of academic burnout in nursing students. Assessment of circadian preference and sleep quality is beneficial for timely identification and prevention of academic burnout in nursing students.

Impact of yoga-based interventions on cognitive and autonomic functions in major depressive disorder population.

Cognitive and autonomic dysfunction is increasingly being recognized as an important clinical dimension in major depressive disorder. The aim of this study is to evaluate the effect of a combined approach of yoga and diet intervention on cognitive and autonomic functions in individuals with major depressive disorders. This experimental observational study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, on the major depressive disorder population of either sex cognitive function (mini-mental score, Montreal cognitive protocol A and B, P300 latency and amplitude) and autonomic function parameters (frequency and time domain) were recorded at baseline and after three months of a combined approach of yoga and diet intervention. This study compared cognitive and autonomic function parameters at baseline and after three months of yoga and diet intervention in a major depressive disorder population. Analysis revealed a significant decrease in body mass index (<0.05), systolic blood pressure (<0.001), Hamilton rating scale for depression (<0.001), P300 latency (<0.001), standard deviation of NN interval (SDNN) (<0.001), and mean heart rate (<0.001), whereas there was a significant increase in mini-mental score (<0.001), Montreal cognitive protocol A and B (<0.001), high frequency (HF) (<0.001), root mean square standard deviation (RMSSD) (<0.001), and PNN50 (<0.001) after a combined approach of yoga and diet in the study group as compared to control group participants. Yoga and diet combined may be an effective adjunct therapy for improving brain health and mental performance, lowering the risk of depression by affecting the neurotransmitter system and raising vagal tone which contributes to learning and memory.

The Prevalence of Cancer Predisposition Syndromes (CPSs) in Children with a Neoplasm: A Cohort Study in a Central and Eastern European Population.

The etiology of pediatric cancers is often unclear; however, advancements in genetics have identified significant roles for genetic disorders in their development. Over time, the number of cancer predisposition syndromes (CPSs) and awareness of them have increased, providing the possibility of cancer prevention and early detection. In this study, we present data concerning the number and type of oncological cases and their correlation with CPS occurrence in a cohort of Central and Eastern European pediatric patients. The data were collected between 2000 and 2019 at the Karol Jonscher Clinical Hospital of Poznan University of Medical Sciences, resulting in a cohort of 2190 cases in total, of which 193 children (8.81%) were confirmed to have a CPS. CPSs occurred most frequently in infancy (22.90% of all children suffering from any diagnosed cancer during the first year of life; p < 0.0001), accounting for more than one-quarter of all CPS cases in our cohort. CPSs were least likely to be observed in patients aged 14 and 15 years (2.17% and 2.44% of children diagnosed with any of the listed cancers at the exact age, respectively; p < 0.05). Among CPSs, the most common were neurofibromatosis type I (NF1), Li-Fraumeni syndrome (LFS), and Down syndrome (DS). To conclude, it is important to emphasize the need for personalized treatment for each patient affected by both CPSs and subsequent cancer in order to reduce the toxicity of therapy and improve quality of life by reducing the risk of side effects.

A New Remote Monitoring System: Evaluation of the Efficiency and Accuracy of the Smart Emergency Medical System-Health Internet of Things Device.

The remote medical monitoring system can facilitate monitoring patients with cardiac arrhythmia, and consequently, reduce mortality and complications in individuals requiring emergency interventions. Hence, it is necessary to evaluate new telemedicine devices and compare them with standard devices. Therefore, this study aimed to evaluate and compare the new remote monitoring system, Smart Emergency Medical System-Health Internet of Things (SEMS-HIOT) developed by the Health Technology Development Centre of Babol University of Medical Sciences on patients with different cardiac arrhythmias and compare it with the standard device. In this case-control study, 60 patients were divided into the six most common arrhythmia groups (n=10 per each group and equal gender) as atrial fibrillation, ventricular tachycardia, paroxysmal supraventricular tachycardia, premature ventricular contractions, atrial tachycardia, and premature atrial contractions. Also, 20 healthy individuals (including 10 men and 10 women) without any arrhythmia (normal rhythm) were considered as the control group. Three similar SEMS-HIOT devices were used as test devices and a standard cardiac monitoring device as the control device. The clinical parameters, including heart rate, pulse rate, oxygen saturation, body temperature, and cardiac electrical activity via electrocardiogram (ECG) lead-II were recorded. Findings showed that the performance of the SEMS-HIOT test device was similar and in the same range for all indices in each group and there were no significant differences compared to the performance of the control device (P0.05). Also, the ECG records measured with SEMS-HIOT and standard device indicate no significant differences (P0.05). Our study showed that the cardiac indices as well as ECG findings, which were measured with SEMS-HIOT and common standard devices confirmed the accuracy and reliability of the new telematics device for monitoring patients with cardiac diseases.

Exploring Ethical Theories Among Medical Residents in Clinical Situations: A Cross-Sectional Study

Human beings are faced with numerous behavioral options in different situations, but they can only choose a limited number of them. Ethical beliefs, values, and principles guide individuals in decision-makings. This study focuses on medical residents' perspectives towards four ethical principles (Deontology, Utilitarianism, Virtue, and Principlism) in various clinical situations. This descriptive-analytical study was performed cross-sectional basis among a population of medical residents of Shiraz University of Medical Sciences. Data were gathered by multi-stage cluster sampling method using a researcher-made questionnaire including demographic information and five different clinical scenarios. The data were analyzed using the Chi-square test and descriptive and inferential statistics in SPSS22. The results of this study showed that there was no significant relationship between gender, specialty, year of study, and the four ethical principles mentioned in the participants. However, a significant correlation was observed between the types of scenarios and their alignment with a particular type of decision or ethical theory. The ethical philosophy of medical residents has been evolving gradually over time, even before entering the residency period. Therefore, focusing on practical ethics training and the commitment of residents to implementing the principles and values of professional ethics can shape the ethical philosophy of residents towards professional ethics and humanity.

Molecular Evaluation of Aminoglycoside Resistance and Biofilm Formation Potential in Escherichia coli Isolates Collected from Hospitalized Patients

Background: Resistance to antibiotics and the ability to develop biofilms, two main virulence determinants of Escherichia coli, play a crucial role in the persistence of infections. Objectives: The aim of this study was to evaluate aminoglycoside resistance and biofilm formation potential in E. coli isolates collected from hospitalized patients in the Southwest of Iran. Methods: A total of 70 E. coli clinical isolates from different specimens were collected from Ahvaz teaching hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. All the isolates were identified as E. coli using conventional microbiological tests. Susceptibility to antibiotics was determined using the Kirby–Bauer disk diffusion method. Biofilm formation was assessed using the microtiter plate method. Finally, PCR was conducted to detect virulence gene determinants, including fimbrial genes, aminoglycoside modifying enzymes (AMEs), and 16S rRNA methylase (RMTase) genes. Results: Among aminoglycoside antibiotics, E. coli isolates showed the highest and lowest resistance rates to tobramycin (TOB; 51.4%) and gentamicin (GEN; 24.2%), respectively. Simultaneous resistance to GEN, amikacin, and TOB was observed in 28.5% of the isolates, representing the most common antibiotic resistance pattern. The prevalence of strong biofilm producers was higher in the extensively drug-resistant (XDR) phenotype group compared to the multiple drug-resistant (MDR) group (76.1% vs. 23.8%). Among the 36 isolates resistant to at least one of the aminoglycoside antibiotics, 36.1% had AME-related genes, either alone or in various combinations. Most isolates harboring AME genes were also positive for the presence of biofilm-related genes, including ecpA and fimA. Conclusions: The most frequent AME-related genes were ant(2”)-Ia and aph(3’)-Ia, followed by aac(3’)-IIa. The findings of the present study provide probable evidence that GEN is an effective aminoglycoside against biofilm-producing and antibiotic-resistant E. coli isolates.

Investigating the usefulness of artificial intelligence-driven robots in developing empathy for English for medical purposes communication: The role-play of Asian and African students

Studies have shown that integrating Artificial Intelligence into robot-assisted language learning ushers in an immersive situation to establish empathy for communication competence and enjoyment. To investigate the usefulness of Artificial Intelligence-driven robots in learning English for Medical Purposes oral skills, this quasi-experimental study was conducted through an embedded mixed methods design in the 2024 academic year. One thousand and forty male (n = 398) and female (n = 642) students of different academic disciplines from the Isfahan University of Medical Sciences were included in the study and grouped under three categories. They were randomly assigned to control (n = 520) and experimental (n = 520) groups. In the qualitative phase, students’ communication enjoyment was debriefed through semi-structured interviews. Simultaneously, in the quantitative phase, once the participants watched simulcast lectures and joined in conversation with Artificial Intelligence-driven (non)-robots, their academic and professional oral skills were assessed. The collected data were the participants’ responses to the interviews and formative assessment of their progress and performance through Objective Structured Video Examinations and Mini-Clinical Evaluation Exercises. The interview results suggested that the participants had empathy in joining conversations with robots. The statistical analysis indicated that in performing role-play to teach oral skills to the Artificial Intelligence-driven robot, the participants achieved significantly greater communication competence than those who did role-play for virtual agents. Students of Medicine were great academic and professional achievers as they were significantly successful in establishing empathy and communication. The findings could open up further prospects for using Artificial Intelligence-driven robots in discipline-specific language learning contexts.

Identifying the Components of Organizational Culture in Hospital Environments: A Qualitative Study

Background: Weak organizational culture is one of the main factors of inefficiency in hospitals. Identifying the type of organizational culture of hospitals is an important step in increasing productivity. Therefore, this study was conducted with the aim of identifying the components of organizational culture. Methods: This qualitative study was conducted in Shahid Sadoughi Hospital in Yazd in 1400. The statistical population included the nurses of Shahid Sadoughi Hospital in Yazd. The sampling method used in this study was purposive and snowball sampling. To collect data, semi-structured interviews were used. The content analysis method was used to analyze the texts using MAXQDA version 10 software. Results: In this study, 13 experts were interviewed. The results of the data analysis showed that the 11 main components of organizational culture at Yazd University of Medical Sciences are rational, ideological, agreement and participation, hierarchical, constructive, passive, work and open culture, club, stronghold, flexible, Learner, and value orientation. Conclusion: The identified components of organizational culture can help healthcare managers and policymakers to improve service quality, job satisfaction, and organizational commitment of employees, improve organizational performance, and increase patient satisfaction.