One-way ANOVA Research Articles

Prevalence and associated factors of mental health distress among hospitalized patients in general hospitals: a multi-center cross-sectional study in Iran.

Understanding the prevalence of mental distress in hospitalized patients and identifying associated factors can help reduce the burden of mental disorders on their medical management and improve their quality of life. This study aimed to examine the prevalence of mental distress among hospitalized patients in general hospitals and assess its associated factors. In this cross-sectional study, we evaluated the mental health status of inpatients in seven cities in Iran, using the General Health Questionnaire-12 (GHQ-12), with a total GHQ-12 score ≥ 4 or higher categorized as "mentally distressed." Statistical analyses were conducted using independent t-tests, one-way analysis of variance, and cross-tabulations. A total of 524 patients (347 females) were assessed, with 208 (38.7%) being classified as mentally distressed. The prevalence of mental distress was significantly higher among males (52.0%) compared to females (34.0%) (p = 0.002). There were no significant differences in GHQ-12 scores among different age groups (p > 0.05). Significant differences were observed in mental health status based on job status, with retired (64.7%) and laborer (22.8%) patients showing the highest and lowest rates of mental distress, respectively (p < 0.001). Additionally, mental distress prevalence varied significantly across hospital wards, with internal medicine (47.6%) and obstetrics and gynecology (28.3%) having the highest and lowest prevalence, respectively (p = 0.004). A considerable proportion of patients hospitalized for medical reasons also experience mental distress. Various demographic factors are associated with their mental health status. This highlights the need for integrated mental health assessments alongside medical treatment to alleviate the burden of mental disorders.

Does amide proton transfer-weighted MRI have diagnostic and differential value in ovarian cystic and predominantly cystic lesion?

This study aims to evaluate the diagnostic value of amide proton transfer-weighted (APTw) imaging in distinguishing cystic or predominantly cystic ovarian lesions. 49 patients underwent APTw imaging at 3T-MR before surgery, with 20 volunteers serving as the control group. Participants were divided into the following groups: solid components of normal ovaries (Group A, n = 29), solid components of malignant lesions (Group B, n = 7), cystic fluid of follicles (Group C, n = 31), cystic fluid of benign lesions (Group D, n = 46), functional cysts (Group d1, n = 8), endometriomas (Group d2, n = 28), cystadenomas (Group d3, n = 10), and cystic fluid of malignant lesions (Group E, n = 12). Independent t-tests or Mann-Whitney U tests and one-way ANOVA were used to compare group differences. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy in distinguishing between different lesions. For solid components, significant differences in MTRasym values were observed between Groups A and B (P < 0.001). For cystic components, significant differences were found between Groups C and D, C and E, d1 and d2, d2 and d3, d1 and d3, C and d2, C and d3, E and d1, and E and d2 (all P < 0.01). ROC analysis of these results showed high AUC values (ranging from 0.813 to 1.0), all P < 0.05. APTw can reveal differences in MTRasym values between normal and diseased ovarian tissues, demonstrating high clinical value in differentiating functional cysts, endometriomas, and cystadenomas, as well as distinguishing benign lesions (functional cysts or endometriomas) from malignant tumors.

Towards sustainable development at full-service restaurants in west Malaysia

The food and beverage sector played a big part in contributing to the economic growth in Malaysia hence there was a major increase in the numbers of restaurants opening up for businesses. This study therefore examines factors with the aims of ensuring a sustainable development in full-service restaurants in West Malaysia. The results of this study have made a substantial contribution to restaurant owner’s’ comprehension of the fundamental components that underlie customer satisfaction and loyalty. By examining the moderating effect of the customer’s gender in full-service restaurants in West Malaysia, the objective of this study was to ascertain the relationships between the three variables (quality of the food served at the restaurant, service quality, and environment), as well as the degree to which each attribute was able to relate to diner satisfaction. The underpinning theory for this study was the Theory of Planned Behavior (TPB). Quantitative methods according to descriptive research and convenience sample strategy were utilized in this cross-sectional study. Questionnaires were distributed to 264 respondents through various online platforms such as WhatsApp, Telegram, Facebook, and email. Data collection was evaluated using the Statistical Program for Social Sciences (SPSS) version 27. In order to examine the connection between the three factors and diner’s satisfaction, various tests such as the multiple regression analysis, One-way ANOVA and Beta Coefficient test were carried out. The findings gave current restaurant owners and potential restaurant owners an overview of the different attributes influencing diner’s satisfaction at full-service restaurants in West Malaysia and also the extent of the moderating effect of diner’s gender had on each attribute. The outcome of this paper is expected to provide a sustainable growth in this industry.

Influence of etiology on the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve anastomosis in the treatment of unilateral vocal ford paralysis

Objective: To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy. Methods: From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance. Results: At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups (P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer (P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery (P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant (P<0.05). Conclusion: Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

Intramuscular fatty infiltration and its correlation with muscle composition and function in hip osteoarthritis

BackgroundHip osteoarthritis patients display higher levels of fatty infiltration (FI) in the gluteus minimus (GM) compared to other hip muscles. We investigated specific histological factors such as fiber type composition and collagen deposition, and functional outcomes like muscle strength and activation associated with FI in these patients.MethodsIn twelve men (67 ± 6 y) undergoing total hip replacement (THR), hip and knee muscle strength and activation (electromyography, EMG) were assessed bilaterally. Magnetic resonance imaging (MRI) was used to compare the relative FI area and muscle cross sectional area (CSA) of the GM, rectus femoris (RF), tensor fascia latae (TFL) and vastus lateralis (VL). Adipocyte content, fiber type composition, grouping, fiber size, centrally nucleated fiber frequency, collagen deposition, satellite cell density and capillarization were assessed in intraoperative biopsies of the four muscles. Differences between GM and other muscles were assessed with repeated-measures one-way ANOVA followed by Dunnett’s post-hoc test. Pearson coefficients were calculated for the correlations between FI measurements and the other histological and functional parameters.ResultsStrength was lower in the affected limb. Knee extensor weakness was accompanied by lower VL muscle activation. Muscle CSA and FI did not differ between sides. In the affected limb, GM displayed larger relative FI area (MRI) compared to RF and VL. Biopsy adipocyte content was higher in GM than RF and TFL. Compared to the other hip muscles, GM displayed higher type 1 fiber content while its type 2X fiber content was lower. Fiber grouping levels were higher in GM than the other muscles. Collagen content was higher in GM than TFL and VL. FI in GM was associated with type 1 (r = 0.43) and type 2X (r = -0.34) fiber content, fiber grouping (r = 0.39), and collagen deposition (r = 0.37). FI in VL was negatively associated with maximal knee extension strength (r = -0.65).ConclusionsIn patients undergoing THR, the higher FI levels of GM compared to other hip muscles were associated with fiber type composition and grouping, and with higher collagen deposition. Experimental studies exploring these associations could potentially uncover new targets for the treatment of intramuscular FI and related impairments in muscle function.Trial registrationKEK number: 2016–01852, date of registration: 12-4-2017.

Time-efficient strategies in human iPS cell-derived pancreatic progenitor differentiation and cryopreservation: advancing towards practical applications

BackgroundDifferentiation of patient-specific induced pluripotent stem cells (iPS) helps researchers to study the individual sensibility to drugs. However, differentiation protocols are time-consuming, and not all tissues have been studied. Few works are available regarding pancreatic exocrine differentiation of iPS cells, and little is known on culturing and cryopreserving these cells.MethodsWe differentiated the iPS cells of two pediatric Crohn’s disease patients into pancreatic progenitors and exocrine cells, adapting and shortening a protocol for differentiating embryonic stem cells. We analyzed the expression of key genes and proteins of the differentiation process by qPCR and immunofluorescence, respectively. We explored the possibility of keeping differentiated cells in culture and freezing and thawing them to shorten the time needed for the differentiation. We analyzed the cell cycle of undifferentiated and differentiated cells by flow cytometry.ResultsThe analysis of mRNA levels of key pancreatic differentiation genes PDX1 and pancreatic amylase indicate that iPS cells were successfully differentiated into pancreatic exocrine cells with expression of PDX1 (one way ANOVA p < 0.0001), and the two isoforms of amylase (one way ANOVA p < 0.05) significantly higher in exocrine cells in comparison to iPS cells. Differentiation efficiency was also confirmed by immunofluorescence analysis of PDX1 and amylase. We confirmed the possibility of shortening the time necessary for obtaining pancreatic cells without losing differentiation efficiency. Pancreatic progenitors and exocrine cells were maintained in culture and cryopreserved. Interestingly, the stemness marker OCT4 resulted significantly lower after subculturing (OCT4 p < 0.001; one-way ANOVA) and after freezing and thawing procedures (p < 0.05, one-way ANOVA) suggesting a reduction of undifferentiated stem cells leading to a purer population of pancreatic progenitor cells. Also, the stemness marker NANOG resulted lower after passaging, corroborating this result.ConclusionsIn this work, we optimized the generation of patient-specific pancreatic differentiated cells and laid the foundation for creating a bank of patient-specific pancreatic lines exploitable for tailored pharmacological assays.Trial registrationThe study was approved by the Ethical Committee of the Institute of Maternal and Child Health IRCCS Burlo Garofolo, with approval number 1556 (internal ID RC 44/22).

Evaluation of functional magnetic resonance APT and DKI imaging for breast cancer

ObjectiveThis study aimed to compare the performance of amide proton transfer–weighted imaging (APTWI) and diffusion kurtosis imaging (DKI) in differentiating benign from malignant breast lesions, evaluate molecular subtypes of breast cancer, and determine the diagnostic efficacy of the quantitative magnetic resonance imaging (qMRI) parameters in differentiating benign from malignant breast diseases.MethodsThe study included 168 women who underwent breast APTWI and DKI at Yunnan Cancer Hospital between December 2022 and July 2023. The APT signal intensity (SI), apparent kurtosis coefficient (Kapp), non-Gaussian diffusion coefficient (Dapp), and apparent diffusion coefficient (ADC) values were measured before surgery. The differences in the aforementioned qMRI parameters in molecular subtypes of breast cancer were analyzed using one-way analysis of variance. The efficacy of each quantitative parameter in differentiating benign from malignant breast diseases was evaluated using the receiver-operating characteristic curve.ResultsSignificant differences in qMRI parameters were noted between benign and malignant breast lesions. The Kapp (P < .0001) and APT (P < .05) values were higher for malignant tumors than for benign lesions. Conversely, the ADC (P < .0001) and Dapp (P < .0001) values were lower for malignant tumors than for benign lesions. The diagnostic performance was assessed using the area under the curve (AUC) for various parameter combinations. The AUC of Kapp was 0.871, Dapp was 0.872, APT SI was 0.643, DKI + APT was 0.893, DKI + ADC was 0.936, APT + ADC was 0.925, and DKI + APT + ADC was 0.933. Additionally, ADC values (P = .01) demonstrated superior diagnostic performance compared to Kapp (P = .03), Dapp (P = .03), and APT values (P = .06) in distinguishing between different molecular subtypes of breast cancer.ConclusionsAPTWI distinguished benign from malignant breast disease and enhanced the utility of diffusion-weighted MRI. However, it was not superior to DKI and DWI in identifying the molecular subtypes of breast cancer.

Vitamin A and D3 combinations reduce breast cancer tumor load in a postmenopausal MCF-7 xenograft mouse model in a dose- and time- dependent manner

Introduction: Earlier, we documented that a combination of vitamins A and D3 synergistically inhibited the growth of MCF-7, T48:A18 and SKBR3 breast cancer cells with the best activity seen in the ER+ cell line MCF-7. Transcriptomic analysis of treated MCF-7 cells also showed that the combination significantly upregulated the apoptosis and unfolded protein response canonical pathways, and reduced estrogen signaling. Objective: This study aimed to explore the impact of increasing vitamin A and D3 dose combinations over time in a postmenopausal model of breast cancer using ovariectomized athymic female mice bearing MCF-7 xenografts and further analyze mechanisms of action in MCF-7 cells using RNA-seq analysis. Methods: MCF-7 breast cancer cells were grown in culture for the xenograft experiments. Athymic female mice were injected with MCF-7 cells (1 x 10^6 in 100 µl of 50% Matrigel mixed with sterile PBS) via subcutaneous injection. Once the tumors reached an average volume of 100 mm³, the mice were randomly divided into four groups and treated with different vitamin A and D3 combinations. Tumor sizes and mouse body weights were monitored on a biweekly basis. After the treatment period, the mice were euthanized, and the tumors were surgically removed and measured. RNA-seq data from the treated MCF-7 cells were then further evaluated using IPA. Results: As compared with controls, treatment with vitamin A (25,000 IU) and vitamin D (10,000 IU) led to a significant reduction in tumor volume &gt;70%, (p &lt; 0.05-0.01) in OVX athymic mice with MCF-7 xenografts as determined by a two-tailed Student T test. Over the treatment period, the tumor volume in mice treated with vitamin A (10,000 IU) and vitamin D (5,000 IU) or vitamin A (25,000 IU) and vitamin D (5,000 IU) also trended downward and was statistically significant using one-way analysis of variance (ANOVA) followed by Dunnett’s multiple comparison test (p&lt;0.05 and p&lt;0.0001, respectively) but was not significant using a two-tailed Student T test. In cultured MCF-7 cells, Ingenuity Pathway Analysis of mRNA-seq data showed that the vitamin A and D combination significantly altered the expression of 101 genes out of 864 in the molecular mechanisms in cancer canonical pathway, downregulating gene expression in the integrin/P13K/Akt/mTOR pathway. Conclusions: The findings showed that the combination of vitamins A and D3 effectively reduced tumor burden in a postmenopausal MCF-7 xenograft mouse model, with effects that were both dose-dependent and time-dependent. The combination also significantly altered the expression of genes in the molecular mechanisms of cancer canonical pathway in cultured MCF-7 cells. These preclinical data support the use of vitamins A and D3 in the management of estrogen-dependent breast cancers, with the caveat that higher doses and longer treatment periods may be needed to observe anti-tumor effects. Keywords: Apoptosis, autophagy, breast cancer, cell cycle, integrin, postmenopausal, P13K, tumor load, xenograft

Digital Healthy Diet and Health Literacy as Determinants of Physical Activity Level in Adults: A Descriptive Correlational Study.

This study was conducted to determine the level of health literacy, digital healthy diet literacy, and physical activity of adult individuals to evaluate the relationship of physical activity with health literacy and digital healthy diet literacy and to examine the determinants of physical activity level. It is a descriptive and correlational study. The sample of the study consists of 404 individuals aged 18-65. Personal Information Form, International Physical Activity Questionnaire-Short Form, Health Literacy Scale-Short Form, and Digital Healthy Diet Literacy Scale were used to collect the study data. Number, percentage, mean and standard deviation, t test in independent groups, one-way analysis of variance, and multiple regression analysis were used in the analysis of the study data. Participants' gender (β = 0.572, p = 0.000), educational status (β = 0.630, p = 0.000), employment status (β = 0.573, p = 0.000), perceived economic situation (β = 0.774, p = 0.000), cohabitants (β = 0.609, p = 0.000), perceived health (β = 0.580, p = 0.000), smoking status (β = 0.639, p = 0.045), health literacy total score (β = 0.603, p = 0.000), and digital health literacy (β = 0.782, p = 0.000) were found to be predictors of physical activity level (p < 0.001). It was determined that these determinants explained 57.3% (adjusted R2 = 0.573) of the change in physical activity level. The mean scores of the participants' physical activity level were at a medium level. Increasing the participants' awareness of health literacy and digital healthy diet literacy may be effective in increasing the level of physical activity.

Performance and durability of additively and subtractively manufactured resin-based onlay restorations after thermomechanical aging.

To evaluate the effect of material type on dimensional stability, occlusal surface wear, fracture resistance, and failure behavior of resin-based onlay restorations. A mandibular right first molar typodont was prepared and digitized using an intraoral scanner to virtually design an onlay restoration with the minimum occlusal thickness of 1.5mm. Resin-based onlay restorations (n = 15 per group) were fabricated either additively from 2 different resins indicated either for definitive or interim use or subtractively with a composite resin. After cementing onlays to corresponding dies, each of them was digitized before and after thermomechanical aging (B-STL and A-STL), and then subjected to load-to-failure test to evaluate fracture resistance. The B-STL and A-STL of each onlay were also compared to assess the dimensional stability and occlusal surface wear. One-way analysis of variance and Tukey honestly significant difference tests were used to evaluate dimensional stability, occlusal surface wear, and fracture resistance. The chi-square test was used to evaluate the Weibull modulus and characteristic strength among the groups (α = 0.05). Material type affected investigated outcomes (p<0.001). The additively manufactured resin indicated for definitive use led to the highest external surface deviations and the additively manufactured resin indicated for interim use led to the highest mesiodistal width deviations (p≤0.033). The onlays fabricated from the additively manufactured resin indicated for definitive use had the highest occlusal surface wear, while those in composite resin had the lowest (p≤0.006). The composite resin onlays had the highest fracture resistance values and reliability (p≤0.035). Tested subtractively manufactured composite resin had the lowest occlusal surface wear with the highest fracture resistance and reliability. Additively manufactured resins had lower dimensional stability, while tested resin for additively manufactured definitive restorations had the highest occlusal surface wear.

The relationship between delivery fear and childbirth experience with the level of adherence to the WHO recommendations for a positive childbirth experience in Iranian women: a cross-sectional study

BackgroundChildbirth experience is a unique event that involves psychological and physiological aspects influenced by social, environmental, organizational, and political factors. In 2018, the World Health Organization (WHO) introduced 56 recommendations for ensuring a positive childbirth experience at different stages of labor and delivery. Owing to the importance of implementing these guidelines, we have chosen to assess adherence to the WHO recommendations and their association with the fear and experience of childbirth.MethodsThis cross-sectional study was conducted on women hospitalized in the labor departments of the Al-Zahra and Taleghani Educational centers in Tabriz, Iran from 2023 to 2024. Sampling was performed via a convenience method, and data were collected via sociodemographic characteristics questionnaire, childbirth experience questionnaire.2 (CEQ.2), delivery fear scale (DFS), and the WHO recommendation checklist. The data were analyzed via Pearson correlation, independent t tests, one-way analysis of variance, and a general linear model (GLM).ResultsThe average adherence score to the WHO recommendations among the women studied was 36.4 (SD 9.3), out of a range of 0–56. There was a significant negative correlation between adherence to the recommendations and delivery fear (r = − 0.249; p < 0.001) and a significant positive correlation with childbirth experience (r = 0.414; p < 0.001). The GLM results, after adjusting for sociodemographic variables, revealed a significant increase in positive childbirth experience with increasing adherence score (B = 0.01; 95% CI 0.005 to 0.02, p = 0.001) and a nonsignificant association between delivery fear and adherence score (B = − 0.1; 95% CI − 0.4 to 0.04, p = 0.114).ConclusionThis study highlights the need to improve the implementation of WHO recommendations in educational and therapeutic centers and to consider various factors that affect the experience and fear of childbirth. Policymakers and medical center managers should place greater emphasis on training, monitor the complete implementation of the recommendations, and provide psychological and social support to pregnant women. This approach can help improve the childbirth experience, reduce delivery fear, and increase the preference for natural childbirth.

Comparison of the effects of group and individual reflection methods on self-regulated learning strategies and learning motivation among emergency medical technicians: a quasi-experimental study

BackgroundReflection is an essential educational practice often characterized as a self-regulated learning activity. Self-regulated learning has been shown to positively influence learning motivation and metacognition. This study aimed to compare the effect of group and individual reflection methods on self-regulation learning strategies and motivational components among emergency medical technicians.MethodsThis quasi-experimental study was conducted on 54 emergency medical technicians in South Khorasan province in 2023. Thirty pre-hospital emergency centers affiliated to Birjand University of Medical Sciences were randomly assigned to three blocks (A, B, and C). Participants were then selected through convenience sampling based on predetermined inclusion and exclusion criteria. Eighteen participants working in pre-hospital emergency centers were selected from each block. The three blocks (A, B, and C) were randomly assigned into three arms: individual reflection, group reflection, and control. The individual reflection group members were asked to record their feelings and experiences using the Gibbs model in provided notebooks during four weeks (at the end of each week). The group reflection members, after forming groups and selecting leaders, engaged in the group reflection sessions in a designated room, following the Gibbs model for four weeks. The self-regulated learning strategies and learning motivation components of all participants were measured using standardized questionnaires before and after the intervention. Data were analyzed using paired t-test, one-way analysis of variance, Tukey’s post hoc test, and Fisher’s exact test.ResultsThe mean score of self-regulation learning strategies and learning motivation significantly increased in the group reflection arm after the intervention (p < 0.05). While the mean scores of motivational component and its individual components increased significantly in the individual reflection group after the intervention (p < 0.05), no significant difference was observed in the mean scores of self-regulation learning strategies and their components before and after the intervention (p > 0.05).ConclusionThe results of this research highlight the superiority of group reflection method over individual reflection in promoting self-regulated learning. While both methods were effective in enhancing learning motivation, group reflection proved to be more beneficial. Therefore, it is recommended that Emergency Medical Services managers provide training programs that incorporate group reflection to enable technicians to benefit from its advantages in terms of self-regulated learning strategies and learning motivation.

Associations of TyG index with coronary heart disease risk and coronary artery sclerosis severity in OSA

BackgroundInsulin resistance (IR) is involved in the pathogenesis and progression of obstructive sleep apnea (OSA) and coronary heart disease (CHD). The triglyceride glucose(TyG) index, an alternative indicator of IR with high reliability, is linked to CHD development and severity. However, the association of TyG index with CHD in OSA cases remains undefined. This study explores the association of TyG index with CHD risk and coronary artery sclerosis severity in the OSA population.MethodsOSA cases with suspected CHD, enrolled at the Department of Hypertension, The First Affiliated Hospital of Xinjiang Medical University between February 2020 and June 2024, were assigned to the OSA and OSA + CHD groups, followed by TyG index assessment. The t-test, Mann-Whitney U-test and one-way analysis of variance were utilized to compare continuous data, while comparisons of categorical data utilized the chi-square test or Fisher’s exact test. Logistic regression analysis was conducted to determine factors independently predicting OSA with CHD and Gensini scores. Restrictive cubic spline (RCS) was used to assess potential non-linear associations of TyG index with CHD risk and Gensini score in OSA patients.ResultsTotally 1059 OSA patients were included, with 514 diagnosed with CHD (48.54%). Multivariable logistic regression analysis upon adjustment for age, gender, hypertension, diabetes, and smoking history revealed TyG index as a risk factor for CHD in OSA cases. CHD risk in the high-TyG index group was 1.977 fold higher versus the low-TyG index group (OR = 1.977, 95% CI 1.424-2.800, P < 0.001). In addition, TyG index had a linear relationship with CHD (P for nonlinearity = 0.0709). In moderate to severe OSA cases, the high-TyG index group had a significantly higher CHD risk (OR = 2.430, 95% CI 1.601–3.690, P < 0.001). Gensini score and TyG index (P for non-linearity = 0.0033) had a non-linear relationship, while high TyG index was a risk factor for high Gensini score.ConclusionTyG index is a risk factor for CHD in OSA cases and reflects the severity of coronary atherosclerosis. TyG, a surrogate indicator for IR evaluation, may help predict CHD in OSA cases, especially in moderate to severe OSA.

Potential cardioprotective effect of paroxetine against ventricular remodeling in an animal model of myocardial infarction: a comparative study

BackgroundPost-myocardial infarction (MI) remodeling involves various structural and functional changes, such as inflammation and fibrosis. Upregulation of G protein-coupled receptor kinase 2 (GRK2) is linked to the progression of cardiovascular diseases, including myocardial infarction. The inhibitory effects of paroxetine on GRK2 are recognized, yet its protective effect on post-MI remodeling has not been elucidated. Here, we investigated the cardioprotective effect of paroxetine in an animal model of MI, focusing on post-MI cardiac remodeling and comparing its effect to a β-blocker and an angiotensin receptor antagonist.MethodsAlbino Wistar rats were divided into five groups (control; untreated MI; and MI pre-treated with either paroxetine, metoprolol, or irbesartan). MI was induced using isoproterenol (100 mg.kg−1) on days 16 and 17. Cardioprotective effects were determined by assessing markers of cardiac injury, histopathology, inflammation, oxidative stress, and fibrosis. Statistical analysis performed using a one-way analysis of variance, followed by an appropriate post hoc test, the differences between the groups were considered significant when the (P < 0.05).ResultsParoxetine significantly attenuated cardiac injury biomarkers including serum Tn-I and CK-MB levels. In terms of cardiac remodeling, paroxetine significantly reduced the relative HW/BW index and the plasms FGF23 level. Furthermore, it modulated markers of fibrosis, inflammation, and oxidative stress.ConclusionThe current findings suggest that pre-treatment with paroxetine may exert a beneficial effect that protects against post-MI remodeling, including modulating fibrotic, inflammatory, and angiogenesis-related factors. Therefore, the current findings show the promising role of paroxetine as a cardioprotective that attenuates post-MI remodeling processes.

The associations between emotional empathy, emotional intelligence, and COVID-19-related stress among nursing students: a cross-sectional study

BackgroundThe COVID-19 pandemic has variably affected the stress levels among students. Nursing students, as the reserve force of medical resources and the successors of frontline nursing staff, warrant particular attention regarding their stress levels. This study investigates the relationship between emotional empathy, emotional intelligence, and COVID-19-related stress in nursing students and examines the masking role of emotional intelligence in this relationship.MethodsA cross-sectional study was conducted from March to June 2023 using multi-stage sampling method to recruit 1126 nursing students from a medical university. Participants completed a demographic information questionnaire, the COVID-19 Student Stress Questionnaire, the Multidimensional Emotional Empathy Scale, and the Trait Meta-Mood Scale. Data were analyzed using t-tests/ one-way ANOVA, Pearson correlations, multiple linear regression, and the PROCESS macro program to examine the relationships between emotional empathy, emotional intelligence, and COVID-19-related stress, as well as the masking role of emotional intelligence.ResultsStatistically significant differences were observed in COVID-19-related stress scores among nursing students from different residential areas (P < 0.05); Emotional empathy was significantly positively correlated with emotional intelligence and its dimensions. Emotional empathy also showed a significant positive correlation with COVID-19-related stress. Emotional intelligence and its dimensions were significantly negatively correlated with COVID-19-related stress; Emotional empathy and emotional intelligence were significant predictors of COVID-19-related stress; Emotional intelligence and its dimensions demonstrated a masking effect on the relationship between emotional empathy and COVID-19-related stress, with total effect sizes of -0.023 for emotional intelligence, -0.021 for emotional attention, -0.017 for emotional clarity, and − 0.018 for emotional repair.ConclusionEmotional empathy and emotional intelligence were significant predictors of COVID-19-related stress among nursing students. Emotional intelligence masked the impact of emotional empathy on COVID-19-related stress. Schools should implement stress management programs for nursing students that focus on enhancing emotional intelligence and moderating excessive emotional empathy. These programs are particularly crucial during public health emergencies to reduce stress levels and promote mental well-being.Clinical trial numberNot applicable.

Investigating students’ perceptions of the medical education environment and learning autonomy in blended learning in pediatrics: a cross-sectional study

BackgroundIn the process of education reform, carrying out continuous educational environment measurement is necessary. This study aimed to evaluate the perceptions of the medical education environment and learning autonomy in blended learning in pediatrics among clinical medicine students, as well as the relationship between these two constructs.MethodsA cross-sectional study was conducted on clinical medical students from the First Clinical School of Wuhan University who had completed the blended learning courses of pediatrics. Perceptions of the medical education environment and learning autonomy were surveyed using the Dundee Ready Education Environment Measure (DREEM) and the Autonomy in Learning Rating Scale for college students (ALRS), respectively. Independent samples t-test, one-way ANOVA, correlation, and multiple linear regression analyses were conducted.ResultsA total of 487 students participated in the survey (valid response rate: 83.53%). Students’ perceptions of the current medical education environment and learning autonomy were generally positive. Among the average scoring rates of DREEM, students’ perception of teachers (SPT) > students’ perception of learning (SPL) > students’ perception of atmosphere (SPA) > students’ academic self-perceptions (SASP) > students’ social self-perception (SSSP), while learning strategies > learning motivation > self-regulation > content and environment among the average scoring rates of ALRS. Correlation analyses revealed that all subscales of the two were significantly associated with each other (P < 0.05). Regression analyses showed that SPA and SASP were significant factors for students’ learning autonomy.ConclusionClinical medicine students who experienced blended learning in pediatrics had positive perceptions of the medical education environment, and their learning autonomy was good and closely related to the perceptions of the medical education environment. In the implementation of blended learning, continuous optimization of teaching content and proactive enhancement of the medical education environment will help enhance clinical medicine students’ satisfaction with the educational environment and their learning autonomy.Clinical trial numberNot applicable.

Early Online

Background. The personal health behaviours and lifestyle habits of health professionals influence their counselling practices related to non-communicable diseases (NCDs). There is limited evidence on the prevalence of modifiable NCD risk factors among medical students in South Africa (SA). Objectives. To determine the prevalence of modifiable behavioural and metabolic NCD risk factors in first-year medical students at a SA university. Methods. This cross-sectional observational study included 256 first-year students. Participants completed five online questionnaires regarding lifestyle behaviours (physical activity, dietary habits, smoking, alcohol consumption and sleep quality). NCD-related metabolic markers including body composition, blood pressure, total cholesterol and random glucose concentrations, were measured. The prevalence of risk factors was calculated using internationally accepted criteria, and sex differences were reported using one-way ANOVA or χ2 test (p&lt;0.05). Results. The prevalence of poor sleep quality was 79.7%, followed by low-to-moderate diet quality (66.8%), low levels of physical activity (64.1%), overweight/ obesity (26.2%), current/past smoking (13.3%) and harmful use of alcohol (12.5%). Most (88.3%) participants had two or more NCD-related risk factors. The prevalence of multiple NCD risk factors differed significantly between male and female participants, with more male participants having ≥2. Conclusions. This study found that first-year medical students at a South African university have a high prevalence of lifestyle-related risk factors, specifically poor sleep quality, low levels of physical activity and low-to-moderate diet quality. Sleep hygiene, regular activity and good nutrition should be promoted, and interventions focusing on nutrition, smoking cessation and alcohol consumption could be targeted by sex.

Factors associated with tobacco use among Saudi Arabian youth: Application of the Theory of Planned Behavior.

The epidemic of tobacco use poses one of the most severe public health challenges globally, responsible for over 8 million deaths annually according to the World Health Organization (WHO). This study investigates the factors associated with tobacco use among Saudi Arabian youth using the Theory of Planned Behavior (TPB) framework. A cross-sectional study used the 2022 Global Youth Tobacco Survey (GYTS) to assess tobacco use among 5610 Saudi students aged 13-15 years. The structured, anonymous questionnaire collected demographic data and TPB constructs (e.g. attitudes, subjective norms, perceived behavioral control, and intentions) were derived from the validated GYTS questionnaire, with items grouped and scored to represent each construct. One-way ANOVA, t-tests, and logistic regression analyses were conducted, with a significance level set at 0.05. Of the surveyed students, 5610 (80.4%) aged 13-15 years met the inclusion criteria. Tobacco use was prevalent, with 31.3% having ever used tobacco and 8.78% currently using it. Negative attitudes toward tobacco were inversely associated with usage (AOR=0.97; 95% CI: 0.970-0.974). Subjective norms, reflecting perceived social pressure, were positively associated with tobacco use (AOR=1.17; 95% CI: 1.170-1.176). Perceived behavioral control, indicating the ease of quitting or avoiding tobacco, was strongly associated with use (AOR=1.87; 95% CI: 1.848-1.888). Stronger behavioral intentions to use tobacco were also associated with a higher likelihood of use (AOR=1.24; 95% CI: 1.226-1.246). The high prevalence of tobacco use among Saudi Arabian youth, early initiation, and significant social influences highlight the need for comprehensive public health strategies. Targeted education, reduced tobacco accessibility, and programs to shift social norms and attitudes are essential. Addressing these factors can help prevent initiation and support cessation efforts among young people.

Characterising the activity, lifestyle behaviours and health outcomes of UK university students: an observational cohort study with a focus on gender and ethnicity

BackgroundHealth-related outcomes and behaviours in university students are known to be poor relative to the general population. The substantial contextual shifts related to the COVID-19 pandemic, combined with increased numbers of students from minoritised ethnicity backgrounds and presenting as trans and gender diverse (TGD), means that up-to-date information is unavailable. The primary aim of this study was therefore to characterise the current movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students and assess differences between genders and ethnic groups.MethodsAn online, self-report survey was administered across three years (2021–2023). Three independent cohorts of university students’ (n = 6,327) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders (men, women, TGD), and independent samples t-tests were used to assess differences between ethnic groups (White, Minoritised Ethnicity).Results30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥ 6 h·d− 1, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P < 0.05), with men having better mental health and engaging in healthier movement and sleeping behaviours, whereas women had more healthful dietary and drinking behaviours, and TGD students had poorer outcomes compared to cis-gender students in most domains. Differences between White and minoritised ethnicity students were present for all variables other than sedentary behaviour, diet quality, WPA and BMI (P < 0.05); students of minoritised ethnicity engaged in better movement, drinking and sleep behaviours in addition to having more positive mental health than White students.ConclusionThe findings of the current study provide an update on the landscape of UK university students’ health and health-related behaviours. Overall, health-related outcomes and behaviours are poor in this population and these data suggest that gender and ethnicity play a role in determining students’ health and health-related behaviours. Therefore, these factors should be considered when developing strategies to promote healthy living in the context of higher education.

Instrumental Colorimetric Evaluation of Combined Enamel and Dentin Composite Resins Compared to the Vita Classic Shade Guide

Accurate color determination in dental restorations is crucial for achieving aesthetically pleasing and functional results. Traditionally, color selection has been performed using visual methods, which are subject to observer variability and factors such as lighting and experience. However, the use of instrumental technologies like spectrophotometry has allowed for greater objectivity and reproducibility in color measurement. This study aims to evaluate the accuracy of color determination in composite resin restorations using spectrophotometry, comparing the results obtained with the Vita Classic shade guide. A total of 120 samples were prepared using 4 types of composite resins and 3 enamel/dentin combinations (A2, A3, and A3.5), with 0.7 mm thickness for enamel and 1.3 mm for dentin, achieving a final thickness of 2 mm. Color measurements were taken with a Vita™ Easyshade® spectrophotometer, and the results were expressed in terms of ΔE using the CIE Lab* formula. Normality (Shapiro-Wilk) and homoscedasticity (Levene) tests were applied, and one-way ANOVA was used to assess differences between resin brands and shades. The results showed that, although no statistically significant differences were found in the A2 and A3 shades between brands, the A3.5 shade exhibited significant variations, with Filtek Z350 XT® 3M Espe Solventum being the resin that showed color values closest to the ideal.