Relevant Test Research Articles

Development of Electronic Objective Structured Clinical Examinations (e-OSCEs) for Prosthodontic Clinical Assessment.

Objective Structured Clinical Examinations (OSCEs) serve as a reliable assessment tool for clinical and competency evaluation. Traditional OSCEs, involving live patients, present logistical challenges and evoke student anxiety. In an effort to create a comprehensive clinical series of examinations, electronic OSCEs (e-OSCEs) were developed for assessing clinical competencies in prosthodontics at a large dental school. This manuscript aims to describe e-OSCEs as a competency assessment. The e-OSCEs were implemented for the graduating classes from 2014 to 2023, covering categories of Single-unit Crowns and Fixed Partial Dentures, Implants, Removable Partial Dentures and Complete Dentures. A digital library of clinically relevant questions was developed to simulate chairside scenarios. Competence in any area was defined as scoring a 100% where questions were taken from a pool that represented the full scope of the clinical procedure. Ten-year retrospective data indicate sustained student performance over the years, with the majority achieving competence after three e-OSCE attempts. Advantages of the e-OSCE include standardised assessments, reduced examiner bias and adaptability to external disruptions in addition to fair and relevant evaluations, cost-effectiveness and test security. Evaluation of e-OSCE outcomes allows ease of analysis for curriculum enhancement and modification. The e-OSCE method of clinical assessment offers a standardised, clinically equivalent and efficient process for assessing dental students' competencies. The assessment methodology aligns with US accreditation standards and can be easily adapted by other institutions with different grading parameters for comprehensive clinical assessments. This approach provides a feasible and effective method for assessments in dental education.

Navigating the shots: Parental willingness to immunize their children with COVID-19 vaccines in Saudi Arabia explored through a systematic review and meta-analysis.

Although COVID-19 vaccines have been recommended for children and adolescents since 2021, suboptimal vaccination uptake has been documented. No previous systematic review/meta-analysis (SRMA) investigated parents' willingness to administer COVID-19 vaccines for their children in Saudi Arabia. Accordingly, this SRMA aimed to estimate parents' willingness to immunize their children with COVID-19 vaccines in Saudi Arabia and to identify reasons and determinants influencing parents' decisions. This SRMA adhered to the PRISMA guidelines and the protocol was registered on PROSPERO (ID: CRD42023492760). An extensive systematic search was performed across electronic databases including Pub Med, Pub Med Central, ISI Web of science, Web of Science Core Collection, Medline, KCI-Korean Journal Database, ProQuest, and SciELO, to identify relevant studies published from January 1, 2020 to October 30, 2023. A random-effects model was utilized to estimate the pooled effects considering the expected variability across studies. Heterogeneity, risk of bias, publication bias and quality of studies were considered and evaluated by relevant appropriate tests to ensure robust results. Twenty-five studies with 30,844 parents were included. The overall pooled rate of parents who intended to immunize their children with COVID-19 vaccines was 48.0% (95% CI: 41.0-54.0%) with high heterogeneity (I2 = 99.42%). The main reason for parents to vaccinate children was to protect child, family and community from COVID-19. Perceived efficacy/safety of vaccines were the most significant determinants associated with parents' willingness to vaccinate children. This was the first SRMA from Saudi Arabia which emphasized the priority to focus on vaccine-related factors as main/key strategy of COVID-19 vaccines' drivers to convince parents in a logical way based on accurate cumulative and emerging scientific data about efficacy and safety of COVID-19 vaccines to optimize their uptake by children/adolescents. This SRMA can provide valuable insights for development of evidence-based policies to improve parental willingness to vaccinate children, which is crucial for controlling SARS-CoV-2 spread and promoting herd immunity in the community particularly if the virus continues to pose a major threat.

Breast ultrasound imaging systems performance evaluation using novel Contrast-Detail (C-D) and Anechoic-Target (A-T) phantoms.

C-D and A-T phantoms were imaged using a range of clinical breast ultrasound systems and imaging modes. A novel sensitive imaging performance metric, the Detectability Score (DS), was proposed which encompasses the Lesion Contrast to Noise Ratio (LCNR) weighted by the lesion depth and diameter. A geometry-based theoretical model comparing LCNR measured using spherical and cylindrical phantom anechoic/lesion targets was developed to investigate the influence of slice thickness on focal lesion detectability. LCNR and DS metrics derived from phantom image measurments were capable of differentiating the imaging performance of a range of ultrasound systems and advanced imaging modes, with the -2 dB contrast lesion targets offered as the most challenging to resolve. The geometry-based theoretical model, validated against phantom measurements, demonstrated the significant influence of slice thickness on focal lesion detectability, highlighting the need for increased availability of low contrast resolution spherical target phantoms for clinically realistic performance evaluation. The performance metrics coupled with the -1 dB contrast targets provide scope for evaluating future technological improvements in ultrasound systems. Given the high dependence of breast cancer care on high quality ultrasound imaging techniques, there is a need for evaluating imaging performance using clinically relevant test objects.

COMPUTED TOMOGRAPHIC ANGIOGRAPHY DATA SET CONTAINING ABDOMINAL AORTIC SEGMENTATION

BACKGROUND: Artificial Intelligence (AI) is widely actively in radiology. The effectiveness of AI algorithms essentially depends on the availability of relevant and representative training and test datasets. Currently, such datasets are highly demanded in open access, particularly CT angiographic (CTA) studies of the abdominal aorta containing not only pathology classification but also vessel segmentation. The disadvantages of existing solutions include small sample volume, narrow specialization, and disparate data preparation methodology. AIM – Design of a CTA dataset containing abdominal aortic segmentation for cases of normal, dilatation, thrombosis, and calcinosis. METHODS: In accordance with the methodology of AI-algorithms testing, the terms of reference for datasets preparation were developed, the necessary sample volume was calculated and approval of the independent ethical committee was obtained. Previously designed original algorithm of semi-automatic segmentation of abdominal aorta on CTA-studies using open access software Slicer 3D was used. Inclusion criteria: CTA studies, or abdominal CT studies with contrast enhancement; presence of arterial phase of the scan; slice thickness not more than 3 mm. Exclusion criteria: presence of any foreign objects in the aortic lumen, aortic dissection. The algorithm was tested on patient data obtained from the Unified Radiologic Information System. Expert evaluation of the compliance of the obtained results with the formed requirements, as well as the assessment of time costs when using the developed segmentation algorithm was carried out. RESULTS: The calculated sample size was 100 CTA studies with a slice thickness ≤ 1.2 mm. Population data: the number of unique patients was 100, the proportion of female patients was 51%; the median age was 62 years ranged from 18 to 84 years. The proportion of pathologic studies was 61%, of which (including combined pathology): 60 cases contained calcification, both by 18 cases with aortic dilatation and thrombosed lumen. Different non-overlapping masks were used for each object. The dataset is presented in the public domain. The average processing time is 0.8 hours per 100 CT-images. CONCLUSION: The public dataset containing 100 CTA studies of segmented abdominal aorta for normal, dilated, thrombotic and calcified cases was created. Results are valuable for AI-algorithms design and anthropomorphic 3D-modeling.

Diagnostic Accuracy of Median Nerve Cross-Sectional Area in Suspected Amyotrophic Lateral Sclerosis.

Reduced nerve sizes obtained by nerve ultrasound (NUS) have been proposed as a potential diagnostic marker for amyotrophic lateral sclerosis (ALS). However, prospective studies evaluating patients with suspected ALS are currently lacking. We, therefore, evaluated the diagnostic accuracy of a standardized NUS protocol in a large sample of suspected ALS patients. We prospectively recruited 193 patients with suspected ALS, all of whom underwent the relevant ancillary tests. They also underwent a standardized NUS protocol, evaluating median nerve cross-sectional area (CSA) at upper arm, forearm and wrist. Additionally, we selected, retrospectively, a random sample of incident patients with multifocal motor neuropathy (MMN, n = 42). We determined diagnostic accuracy using receiver operating characteristic (ROC) analysis. Ultimately, 143/193 patients received a final diagnosis of ALS, at a median disease duration of 10 months. Fifty patients were classified as non-ALS. Diagnostic yield of NUS to distinguish between patients with and without ALS was low (highest area under the curve (AUC) at the wrist: 0.57). In contrast, abnormal nerve sizes accurately discriminated MMN from patients with ALS, with AUCs ranging from 0.65 at the wrist to 0.86 at the upper arm. Our study shows that reductions in nerve size are unlikely to have diagnostic utility during routine evaluation of suspected patients with ALS. However, when the differential diagnosis includes both ALS and MMN, median nerve size demonstrates high diagnostic accuracy.

Unveiling the role of mixing in [Fe(CN)6]4− defects and Na content for preparing NaxMn[Fe(CN)6]y · nH2O via microreactor

AbstractTaking advantage of strong mixing performance in oscillating feedback microreactor (OFM), the manganese hexacyanoferrates (NaxMn[Fe(CN)6]y · nH2O, MnHCFs) with low defects and high sodium content were controllably prepared. First, fluid mixing performance in OFM was investigated via dye‐tracer and Villermaux‐Dushman experiments, and the fluid mixing mechanism in OFM was investigated through CFD simulations. Then, MnHCFs were prepared using OFM at different flow rates, and the role of mixing in [Fe(CN)6]4− vacancies and sodium content during co‐precipitation synthesis of MnHCFs was discussed. The results indicate that an increase in flow rates can increase fluid chaos strength, enhancing the mass transfer process to match the extremely fast reaction rate of MnHCFs, thus preparing MnHCFs with high sodium content and low defects. Relevant electrochemical tests indicate that the MnHCF prepared at the largest throughput (180 mL/min) has the highest initial specific capacity (132 mAh/g at 15 mA/g), minimum electrochemical impedance, and fastest sodium ion transport rate.

Predictive Value of Ocular Fundus Hemorrhage for Severe Coronary Artery Disease Assessed via SYNTAX Score.

Aims/Background The relationship between retinal fundus hemorrhage and the severity of coronary artery lesions remains unclear. This study aimed to explore the incidence of fundus hemorrhage in patients at high risk of coronary heart disease (CHD) and to examine its correlation with the SYNTAX score, a tool used to assess the complexity of coronary artery disease. Methods This retrospective study consecutively enrolled patients undergoing coronary angiography (CAG) at Beijing Anzhen Hospital Hospital from June 2019 to January 2020. Bilateral non-mydriatic fundus photography was performed to detect fundus hemorrhages. The SYNTAX score was calculated to quantify the severity of coronary artery lesions, and patients were divided into two groups: a high SYNTAX score (hSS) group (≥23 points) and a low SYNTAX score (lSS) group (≤22 points). Baseline demographic and clinical data were collected, along with relevant laboratory tests. Results A total of 878 patients were included in the study, with 177 in the hSS group and 701 in the lSS group. Fundus hemorrhage was observed in 91 patients (incidence: 10.36%, 95% confidence interval (CI): 8.35%-12.38%). The incidence of fundus hemorrhage was significantly higher in the hSS group compared to the lSS group (21.47% [38/177] vs. 7.56% [53/701], p < 0.001). Multivariate logistic regression analysis identified fundus hemorrhage, body mass index (BMI), and low-density lipoprotein cholesterol (LDL-C) as independent predictors of high SYNTAX scores. Conclusion Fundus hemorrhage is significantly associated with a higher SYNTAX score and may serve as a potential predictor of severe coronary artery lesions in clinical practice.

Selection of In Vivo Relevant Dissolution Test Parameters for the Development of Cannabidiol Formulations with Enhanced Oral Bioavailability.

Background: Cannabidiol (CBD) shows interesting therapeutic properties but has yet to demonstrate its full potential in clinical trials partly due to its low solubility in physiologic media. Two different formulations of CBD (amorphous and lipid-based) have been optimized and enable an increase in bioavailability in piglets. In vivo studies are time-consuming, costly and life-threatening. Therefore, we need to develop in vitro tests that can predict what will happen in vivo. Methods: Comparisons in terms of dissolution were made especially by using different media (FaSSGF, FaSSIF, FeSSIF, HCl 0.1N with or without SLS, phosphate buffer pH 6.8 with or without SLS) and different conditions (sink or non-sink conditions). These in vitro results were confronted with in vivo results to select the most appropriate dissolution test conditions. Results: The importance of the presence of surfactants to enable solubilization of CBD was demonstrated. Neutral media enabled a relatively good prediction of the extent of absorption observed in vivo, whereas the rate of absorption was more complicated to predict. Conclusions: FeSSIF media, and FaSSIF sink media to a lesser extent, were the only compositions enabling predictions of both extent and rate, indicating that emulsification is possibly a major contributor to the in vivo availability of the drug.

The role of vitamin D in slipped capital femoral epiphysis in children and adolescents: a retrospective case-control study.

To explore the correlation between vitamin D levels, related endocrine/metabolic factors, and the risk of slipped capital femoral epiphysis (SCFE) in children and adolescents, and to assess whether vitamin D levels are associated with SCFE severity. A retrospective case-control study was conducted from March 2014 to October 2023 in Shengjing hospital. Patients diagnosed with SCFE were categorized as the SCFE group. The control group consisted of healthy children matched by gender, age, weight, height, body mass index (BMI), and date of blood tests at a 1:2 ratio from the pediatric developmental clinic. The analysis included relevant laboratory tests such as 25-hydroxyvitamin D (25(OH)D), hemoglobin (Hb), serum alkaline phosphatase (ALP), calcium (Ca), phosphorus (P), and magnesium (Mg), etc. Univariate and multivariate conditional logistic regression analyses were conducted to identify factors associated with SCFE, with a particular focus on the correlation between 25(OH)D levels and the risk of SCFE. The study also explored whether these factors were correlated with SCFE severity, determined by measuring the slip angle and displacement on the anteroposterior pelvic or frog-leg lateral views. One hundred and twenty subjects were finally included, with 40 SCFE patients (36 males, 4 females) and 80 controls (72 males, 8 females). There were no significant differences in gender, age, weight, height, BMI, Hb, albumin (ALB), creatinine (Cr), free triiodothyronine (FT3), thyroid stimulating hormone (TSH), Ca, and P (P>0.05). Significant differences were found in 25(OH)D, ALP, free thyroxine (FT4), and Mg (P<0.05). The SCFE group had lower 25(OH)D and ALP levels but higher FT4 and Mg. Univariate analysis showed that 25(OH)D, FT4, and ALP were associated with SCFE, but multivariate analysis indicated only 25(OH)D had a significant correlation (P<0.05). 25(OH)D levels were not linked to SCFE severity (P>0.05). The results of this study indicate that a higher level of vitamin D is associated with a decreased risk of SCFE, suggesting potential benefits of vitamin D sufficiency. However, no correlation was observed between 25(OH)D levels and the severity of SCFE. Serum FT4 and ALP also seem to have some association with SCFE, but the clinical significance is unproven. Future multi-center studies in various regions are necessary to further validate the protective role of vitamin D against SCFE.

Contribution of Non-Current Assets Management on Organisation Performance

The study assessed contribution of non-current assets management on organization performance in Tanzania. The study consisted three identified independent variable that were tested towards organization performance as the dependent variable. The independent variables include company size, production catalyst and company inputs. The study was conducted using explanatory design through causality testing approach in knowledge generation. The study employed primary data since a case was selected for the inquiry to be undertaken which was the Institute of Finance Management (IFM). Primary data were obtained from the sample of 83 respondents through structured questionnaire. The gathered results were computed in SPSS software specifically version 23.0 whereas relevant statistical tests were obtained to present the findings. Descriptive statistics were used to describe the profile of the respondents with inferential analysis specifically correlation and multiple regression analysis used to describe the relationship between study variables. The results revealed that all three tested predicting variables to the dependent variable namely company size, production catalyst and company inputs are positive with significant effect statistically to the dependent variable (p&lt;0.05) which is organization performance. The implication of the results is that performance of the organizations in Tanzania through non-current assets is influenced with company size, production catalyst and company inputs. The study recommended that it is essential for non-current assets to be considered prior to the company focus or assessment towards performance respectively.

Treatment of refractory poly articular course juvenile idiopathic arthritis with tofacitinib: Extended experience from Bangladesh.

Juvenile Idiopathic arthritis (JIA) is one of the most common chronic diseases in children. It still remains a challenge to treat refractory poly-articular course JIA patients, especially in Bangladesh, where patients from low socio-economic backgrounds are unable to manage biological agents. Tofacitinib is one of the alternative options to biological agents, which can be taken orally and is cost effective. The purpose of this prospective observational study was to evaluate the efficacy of tofacitinib in the treatment of refractory poly-articular course JIA cases. This study was carried out in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU). A total number of 50 refractory polyarticular course JIA patients received JAK-2 inhibitor, tofacitinib along with other drugs according to the recommended doses. The disease activity level was measured by Juvenile Arthritis Disease Activity Score-27 (JADAS-27). All the cases were assessed at baseline, 6th, 12th and52nd week of tofacitinib therapy. The relevant statistical tests were applied for data analysis. After treating the refractory cases with tofacitinib, arthritis subsided, and laboratory parameters improved in all the cases. Overall JADAS-27 score improvement was 40.67%, 56.38% and 96% at 6th, 12th and 52nd week of follow-up respectively. It was also possible to taper the dose of steroid gradually and stopped it by 24 weeks. Tofacitinib was well tolerated with minimum side effects. Tofacitinib was effective to all the children with poly-articular course JIA. It was well tolerated and had very few tolerable adverse effects.

Microplastics versus natural mineral particles. How to create and test them while maintaining environmental relevance

Whether microplastics cause different effects than inert natural particles, and how to create relevant testing materials, are key questions in microplastics research. We prepared Environmentally Relevant Microplastic (ERMP) and Mineral Microparticle (ERMS) mixtures with similar levels of polydispersity and tested their 28-day chronic effects on the reproduction and growth of L. variegatus at two different organic matter (OM) contents (average and enriched). Additionally L. variegatus was exposed to ERMP and ERMS to study the particle egestion for 14 days. We observed no differences in growth or reproduction between ERMP and ERMS at particle concentrations of up to 10% (v/v). In contrast, organisms exposed to enriched OM content increased their growth with 30% and increased reproduction with 20%. For ERMP with an enriched OM content, reproduction was reduced with an effect threshold EC50 of 13.68 ± 5.54% (v/v). After 14 days of exposure to 5% ERMP, the egestion of faecal pellets was higher compared to exposure to 5% ERMS, suggesting that in order to acquire the same amount of nutrition, L. variegatus is spending more energy. With this study, we demonstrate that refinements in the manufacturing of environmentally diverse particle mixtures can contribute to a more realistic testing of particle effects.

Responses of an In Vitro Coculture Alveolar Model for the Prediction of Respiratory Sensitizers (ALIsens®) Following Exposure to Skin Sensitizers and Non-Sensitizers.

In recent years, a global increase in allergy incidence following chemical exposure has been observed. While the process of skin sensitization is well characterized through the adverse outcome pathway (AOP) framework, the immunological mechanisms underlying respiratory sensitization remain less well understood. Respiratory sensitizers are classified as substances of very high concern (SVHC) under the European Union (EU) regulation for the registration, evaluation, authorization and restriction of chemicals (REACH), emphasizing the importance of evaluating respiratory tract sensitization as a critical hazard. However, the existing new approach methodologies (NAMs) for the identification of skin sensitizers lack the capacity to differentiate between skin and respiratory sensitizers. Thus, it is imperative to develop physiologically relevant test systems specifically tailored to assess respiratory sensitizers. This study aimed to evaluate the efficacy of ALIsens®, a three-dimensional (3D) in vitro alveolar model designed for the identification of respiratory sensitizers and to determine its ability to correctly identify sensitizers. In this study, we used a range of skin sensitizers and non-sensitizers to define the optimal exposure dose, identify biomarkers, and establish tentative thresholds for correct sensitizer classification. The results demonstrate that ALIsens® is a promising in vitro complex model that could successfully discriminate respiratory sensitizers from skin sensitizers and non-sensitizers. Furthermore, the thymic stromal lymphopoietin receptor (TSLPr) cell surface marker was confirmed as a reliable biomarker for predicting respiratory sensitization hazards.

Capital Market Liberalization and Manufacturing Firm Innovation: Evidence from the Shanghai-Shenzhen-Hong Kong Stock Connect

An active and open capital market plays a crucial role in guiding the allocation of financial resources and supporting innovation in manufacturing enterprises. This study examines the issue from the perspective of market macrostructure, utilizing data from listed manufacturing enterprises spanning from 2010 to 2022 as samples. By constructing a multi-period difference-in-differences model, it verifies that the opening-up of the capital market, represented by the Shanghai-Shenzhen-Hong Kong Stock Connect, promotes innovation in manufacturing enterprises. This conclusion remains valid after passing relevant robustness tests. Heterogeneity analysis reveals that this promotional effect is more pronounced in non-state-owned enterprises, manufacturing enterprises with relatively low information transparency, and those with higher institutional ownership. Mechanism analysis shows that the opening-up of the capital market fosters innovation in manufacturing enterprises by enhancing investment efficiency, alleviating financing constraints, and improving the information environment of enterprises. The research findings indicate that the opening-up of the capital market plays a significant role in promoting innovation in manufacturing enterprises and achieving high-quality economic development, providing theoretical support for further deepening capital market reforms and expanding capital market openness.

Ovarian Fetiform Teratoma in 38 Years Nulliparous Woman: A Case Report.

Fetiform teratoma, another name for homunculus, is a rare form of mature teratoma that is highly differentiated and has parts that resemble a malformed fetus. We reported a case of ovarian Fetiform teratoma in a 38 years old nulliparous woman presented with right side abdominal distention of 10 years duration. An ultrasound revealed a heterogeneous pelvic cystic mass that ranged in appearance from fully hyperechoic to fully hypoechoic, suggesting mature cystic teratoma. The patient underwent laparotomy. Histopathology of Cystectomy specimen was found to be compatible with Fetiform teratoma. It is important to distinguish this highly differentiated benign neoplasm with potential somatic malignant transformation from Fetus in fetu and ectopic pregnancy. To establish the diagnosis, a thorough clinicopathologic examination, laboratory tests for pregnancy and relevant cytogenetic tests for Zygosity should be performed.

Application of Fish Embryo Assay Using Zebrafish and Oryzias latipes for Toxicity Testing and Deriving Water Quality Criteria

To protect aquatic organisms in ecosystems, each country and continental union has established guidelines for deriving the water quality standards (WQS) of specific substances. These guidelines mandate the use of acute and chronic toxicity data for fish, which are high-trophic-level organisms. However, due to increasing concerns about animal welfare and experimental ethics, there is a growing need for alternative methods to determine substance toxicity in fish. Fish toxicity tests using early life stages, such as embryos or larvae, have been utilized as alternative methods for adult fish toxicity assays. This review of the WQS guidelines and relevant test protocols confirmed the classification of acute and chronic toxicity in fish assays using different developmental stages. Fish toxicity data derived from exposure periods longer than one week using embryonic- or larval-stage organisms can be considered as indicative of chronic toxicity. There is a high correlation between fish embryo toxicity and adult effects, suggesting that fish embryo toxicity tests with appropriate exposure durations could replace adult fish toxicity tests, addressing experimental animal ethics concerns.

A Dynamic Trapdoor Redactable Blockchain Schemes

The permanent storage of blockchain data exposes certain security risks in practical applications, necessitating the ability to edit data in specific scenarios. The chameleon hash function, as a trapdoor one-way hash function, has emerged as a key technology for achieving redactable blockchains. However, existing redactable blockchain schemes based on chameleon hash function face security vulnerabilities related to trapdoor misuse and leakage. This paper proposes a dynamic trapdoor redactable blockchain schemes, utilizing a dynamic trapdoor chameleon hash (DTCH) that allows for the dynamic update of trapdoors while overcoming the inherent immutability of blockchain, thus reducing the risk of malicious nodes retaining the trapdoor long-term. The proposed scheme employs controllable randomness, where the trapdoor key automatically updates after a certain period or upon use. In this scenario, authorized nodes cannot successfully find hash collisions with old keys, effectively revoking their authorization. Consequently, only users with valid trapdoor keys can modify the data on the chain. Relevant security tests and experimental results indicate that the proposed scheme offers advantages in security and maintains good efficiency at various stages, achieving higher security guarantees with minimal computational cost. Received: 27 September 2024 | Revised: 5 November 2024 | Accepted: 4 December 2024 Conflicts of Interest The authors declare that they have no conflicts of interest to this work. Data Availability Statement Data sharing is not applicable to this article as no new data were created or analyzed in this study. Author Contribution Statement Shuqiao Li: Conceptualization, Methodology, Software, Validation, Formal analysis, Formal analysis, Resources, Data curation, Writing – original draft, Writing – review &amp; editing, Visualization, Supervision, Project administration. Xiaoming Hu: Conceptualization, Methodology, Resources, Writing – original draft, Writing – review &amp; editing, Visualization, Supervision, Project administration. Yan Liu: Formal analysis, Formal analysis, Resources, Writing – review &amp; editing, Visualization, Supervision. Shuangjie Bai: Validation, Formal analysis, Writing – review &amp; editing, Visualization.

Simulating atherosclerotic plaque mechanics using polyvinyl alcohol (PVA) cryogel artery phantoms, ultrasound imaging and inverse finite element analysis

The clinical decision to establish if a patient with carotid disease should undergo surgical intervention is primarily based on the percent stenosis. Whilst this applies for high-grade stenosed vessels (>70%), it falls short for other cases. Due to the heterogeneity of plaque tissue, probing the mechanics of the tissue would likely provide further insights into why some plaques are more prone to rupture. Mechanical characterization of such tissue is nontrivial, however, due to the difficulties in collecting fresh, intact plaque tissue and using physiologically relevant mechanical testing of such material. The use of polyvinyl alcohol (PVA) cryogel is thus highly convenient because of its acoustic properties and tunable mechanical properties.Methods.The aim of this study is to demonstrate the potential of PVA phantoms to simulate atherosclerotic features. In addition, a testing and simulation framework is developed for full PVA vessel material characterization using ring tensile testing and inflation testing combined with non-invasive ultrasound imaging and computational modeling.Results.Strain stiffening behavior was observed in PVA through ring tensile tests, particularly at high (n= 6) freeze-thaw cycles (FTCs). Inflation testing of bi-layered phantoms featuring lipid pool inclusions demonstrated high strains at shoulder regions. The application of an inverse finite element framework successfully recovered boundaries and determined the shear moduli for the PVA wall to lie within the range 27-53 kPa.Conclusion.The imaging-modeling framework presented facilitates the use and characterization of arterial mimicking phantoms to further explore plaque rupture. It also shows translational potential for non-invasive mechanical characterization of atherosclerotic plaques to improve the identification of clinically relevant metrics of plaque vulnerability.

Health professionals contacting patients' relatives directly about genetic risk (with patient consent): current clinical practice and perspectives.

Genetic testing can provide risk information to individuals and their blood relatives. Cascade testing uptake by at-risk relatives is <50%, with suboptimal family communication a key barrier to risk notification. The practice of health professionals (HPs) directly contacting relatives (with patient consent) to assist with risk notification has significant international support, but little is known about the practices and views of HPs in Australia. We surveyed Australian clinical genetics and laboratory services (public and private) which offer genetic testing of relevance to relatives, about current practices and views. Of 104 services invited, 78 responded to our online survey (75.0% response rate; clinical n = 59/81; laboratory n = 19/23). Most clinical services (83.3%) agreed it would be beneficial to contact at-risk relatives directly. However, the majority (80.4%) do not routinely contact relatives directly, with inadequate resources (80.0%) and privacy concerns (62.2%) cited as primary reasons. If direct contact methods were used, most clinical services (65.4%) prefer a letter which includes specific information about the genetic condition. Most clinical (86.5%) and laboratory (88.2%) services saw benefit in the development of a national clinical guideline for HPs regarding direct contact. This study confirms that most clinical genetics services would see benefits to being able to assist patients by contacting relatives directly about their potential genetic risk. Our findings highlight the need for a national clinical guideline clarifying HPs' legal and privacy obligations, and provide an opportunity for clinical services to reconsider their allocation of resources to prioritise assisting patients with risk notification.

Students perceptions &amp; motivation for ‘Basic Pranic Healing workshop’ and its impact on the well-being of medical students

Pranic Healing (PH) is an ancient energy healing method focusing on the body's energy fields. The study explores its potential positive impact on the well-being of medical students. Existing research supports the transformative effects of PH on molecular structures and overall well-being. Spiritual well-being has been linked to mental health, and the study aims to evaluate the connection between Basic Pranic Healing workshops and students' mental health in a stressful medical school environment.This retrospective observational pilot study recruited 50 medical students through purposive sampling. Participants from Dr. Baba Saheb Ambedkar Medical College, Delhi, India, completed pre and post-workshop questionnaires, assessing knowledge, attitude, interest, motivation, and impact on well-being. Data were analyzed using SPSS, employing descriptive statistics and relevant tests.45 interested students participated, with a mean age of 20.78±2.09, 68.8% female. Significant improvements were observed in pre and post-workshop scores for knowledge (p = 0.00), interest (p = 0.00), and confidence (p = 0.00). Beliefs shifted positively with a final favorable perception . Participants reported a positive impact on various life domains with 56% practicing learned techniques weekly. Efficacy in healing (73.4%) and self-healing (84.4%) was notable The Basic Pranic Healing workshop effectively enhanced participants' knowledge, interest, confidence, beliefs, and overall perceptions. Positive impacts on various life domains and high success rates in healing demonstrate the practical relevance of Pranic Healing in promoting well-being. Findings support the integration of holistic healing practices in healthcare training and personal development programs.