Significant P-value Research Articles

Assessment of Quality and Efficiency of Cold-Pressed Oil from Selected Oilseeds.

In this present study, an oil press was used to process 200 g each of sesame, pumpkin, flax, milk thistle, hemp and cumin oilseeds in order to evaluate the amount of oil yield, seedcake, sediments and material losses (oil and sediments). Sesame produced the highest oil yield at 30.60 ± 1.69%, followed by flax (27.73 ± 0.52%), hemp (20.31 ± 0.11%), milk thistle (14.46 ± 0.51%) and pumpkin (13.37 ± 0.35%). Cumin seeds produced the lowest oil yield at 3.46 ± 0.15%. The percentage of sediments in the oil, seedcake and material losses for sesame were 5.15 ± 0.09%, 60.99 ± 0.04% and 3.27 ± 1.56%. Sediments in the oil decreased over longer storage periods, thereby increasing the percentage oil yield. Pumpkin oil had the highest peroxide value at 18.45 ± 0.53 meq O2/kg oil, an acid value of 11.21 ± 0.24 mg KOH/g oil, free fatty acid content of 5.60 ± 0.12 mg KOH/g oil and iodine value of 14.49 ± 0.16 g l/100 g. The univariate ANOVA of the quality parameters against the oilseed type was statistically significant (p-value < 0.05), except for the iodine value, which was not statistically significant (p-value > 0.05). Future studies should analyze the temperature generation, oil recovery efficiency, percentage of residual oil in the seedcake and specific energy consumption of different oilseeds processed using small-large scale presses.

Unraveling Coronary Artery Disease vulnerability in patients with ABO gene polymorphism: A Case-Control Study in Pakistan perspective

Objectives: This study was aimed to explore the association of ABO gene variants with coronary artery disease. Methodology: This was a case-control study. Cases and controls were individuals with greater than 50% and less than 30% stenosis, respectively. One hundred thirty-eight samples were obtained, with 69 cases and 69 controls. The operator completed a proforma regarding demographics, medical history, and blood group. The bench work included blood typing, followed by blood genotyping by DNA extraction, PCR, and then Sanger's sequencing. The single nucleotide polymorphisms (SNPs) selected for the ABO gene were rs8176746 and rs8176719. Results: The results show that 68.1% of the participants were male cases, compared to 49.27% controls. The frequency of patients belonging to the old age group (60-75 years) was 65.21% in cases and 34.78% in controls. A+ was the most prevalent group in cases, with 33.33%, followed by 24.6% B+, 23.2% O+, and 4.3% AB+. Patients with Rh-ve groups were rare. On the contrary, 33.33% of patients were O+ in controls. A chi-square test showed that the A+ blood group was significantly associated with CAD, having a p-value of 0.01. Although blood genotypes did not show a significant p-value, the odds of having genotype AA was 1.35 times higher in cases compared to the controls. Conclusion: This study shows that the A+ group is significantly associated with CAD. The data obtained through Sanger’s sequencing determined the genetic variants of blood groups, but no statistically significant association was found between them and CAD.

Predicting acute aortic syndrome using aortic dissection detection risk score, D-dimer, and X-ray

ObjectiveAcute aortic syndrome (AAS) is a fatal disease with high mortality. There were previous studies using aortic dissection detection risk score (ADD-RS) and D-dimer (DD) to screen AAS. There were screening failures in previous studies, suggesting the need for a more accurate tool. This study investigated the effect of combining ADD-RS and age adjusted D-dimer (DDage-adj) with abnormal findings on chest radiographs on the diagnosis of AAS in patients admitted to emergency department (ED). MethodsThis single-center retrospective case-control study included 93 patients with AAS and 465 with chest pain (CP), diagnosis other than AAS. We attempted to compare the initial clinical presentation and laboratory examination findings. ResultsAge-adjusted DD (DDage-adj), defined as age x 0.01 mg/L in patients ≥50 years, showed sensitivity of 92.5% and specificity of 76.3% for patients with AAS (p < 0.001). Positive chest radiography findings were significant with AAS group; sensitivity was 89.2% with a specificity of 80.9% (p < 0.001). Multivariate logistic regression analysis was used; widened mediastinum, widening of aortic contour and aortic kinking indicates the probability of AAS in patients with CP (p < 0.05).ADD-RS was used to evaluate the risk of AAS. For low risk group, ADD-RS ≤1, combined use of chest radiography and DDage-adj showed meaningful result. Sensitivity and specificity were 100% and 67.1% with failure rate of 0% (p < 0.001). Multivariate logistic regression analysis were made; widening of the mediastinum (p = 0.035), widening of the aortic contour (p < 0.001) and aortic kinking (p < 0.001) showed significant p-value. Combining DDage-adj and these three chest radiography findings in ADD-RS≤1 patients resulted 0% failure rate with 67.8% specificity (p < 0.001). ConclusionsThe combination of ADD-RS, DDage-adj and chest radiography could lower the failure rate of AAS exclusion strategy. This combination strategy satisfies low failure rate (<3%) and yields relatively high specificity of 67.8%.

Customization and its Influence on the Performance of International Courier Firms in Kenya

The primary objective of this research was to investigate the influence of customization on the performance of international courier companies operating in Kenya. The study employed a descriptive research design, utilizing the survey technique as its methodology. The research focused on operations managers, with an estimated population of 55 individuals representing various international courier firms in Kenya. To gather data, the researcher employed a census-based purposive sampling approach, targeting both primary and secondary sources. The data collection instrument of choice was the questionnaire, which had undergone a pilot test involving five local national courier companies in Kisumu. The analysis of quantitative data involved the application of both descriptive statistics, such as percentages, frequencies, averages, and standard deviation, as well as inferential statistics, including regression analysis and Pearson's correlations. Throughout the research process, ethical considerations were rigorously addressed, ensuring the integrity of the study. The findings of the study were presented through the use of tables. The research findings, as indicated by the model summary derived from simple linear regression, revealed that customization accounted for 23.8% (R2 = 0.238) of the variations observed in the performance of international courier companies in Kenya, with a statistically significant p-value of 0.001. When controlling for other factors within the model, multiple linear regression analysis demonstrated that a one-unit change in customization led to a substantial improvement of 0.397 units in the performance of these companies (β = 0.397, t = 3.489, P&lt;0.05). Consequently, the study rejected the second null hypothesis and established that customization had a noteworthy influence on the performance of international courier companies in Kenya. The research contributes to existing theory by highlighting the relevance of market segmentation in the context of the freight industry, offering a foundation for future studies in this field. Furthermore, the study recommends that management in the courier industry actively seek feedback from their clientele to gauge their satisfaction levels and identify areas for improvement. Emphasizing a market-oriented approach is suggested, as it would enable these companies to better understand the genuine needs and desires of their customers, ultimately enhancing their overall performance.

The Influence of Health Education and Prevention of Complications Program Using Wa Group on the Attitudes of Pregnant Women in the III Trimester in Preparing for Birth in the District Kuala Samboja In 2023

AKI in Indonesia is still high, mainly due to direct causes such as hemorrhage, infection, eclampsia, and others. Preparation for childbirth through P4K is necessary, but in practice, many mothers are not adequately prepared to face childbirth, thus requiring education, including through WhatsApp (WA) groups. To analyze the influence of health education from the Maternity Planning and Complications Prevention Program (P4K) using WhatsApp groups on the attitudes of third-trimester pregnant mothers regarding childbirth preparation in Kuala Samboja Village in the year 2023. This study employed a quasi-experimental design with a nonequivalent control group design. The research population consisted of 82 third-trimester pregnant mothers in Kuala Samboja Village from January to March 2023. The sampling technique used the estimation formula, resulting in a sample size of 20 participants. The measurement instruments utilized were the SAP (Scale of Attitude towards Pregnancy) and a questionnaire. Data analysis was performed using the Mann-Whitney test. The description of attitudes among third-trimester pregnant mothers before the intervention in the treatment group had a mean value of 37.10, and after the intervention, the mean value was 64.60. The description of attitudes among third-trimester pregnant mothers before the intervention in the control group had a mean value of 36.00, and after the intervention, the mean value was 53.65. There is a significant difference in attitudes among third-trimester pregnant mothers between the WA Group and the leaflet group in preparing for childbirth, with a significant p-value of 0.000. Education using WhatsApp (WA) Groups is more effective compared to leaflets because the social media platform WA is easier to use and enhances mothers' attitudes towards childbirth preparation

Extended Field Radiosurgery of Spinal Metastases with MRI-Guided Adaptive Planning: A Dosimetric Study

Spinal metastases occur in ∼40% of cancer patients. Stereotactic body radiotherapy (SBRT) precisely delivers high doses of RT to enhance local control and reduce chronic pain. Eligibility for spine SBRT can depend on number of spine vertebrae involved. For example, RTOG 0631 was limited to two contiguous levels due to concerns about spinal cord (SC) tolerance when aligning to long targets in the mobile spine. The purpose of this study was to determine whether adaptive replanning on an MRI-Linear Accelerator could permit SBRT of longer spinal segments. We randomly selected ten patients treated in the abdomen on a 0.35T MRI-Linac with MRI including L2-T8. For each patient, their simulation MRI was used to generate six distinct plans starting at 2 spinal levels incrementing to 7 spinal levels. Coverage was 90% at 16 Gy to the entire vertebrae including processes and TG-101 constraints were used for SC and other nearby organs at risk (OAR). Each plan was then rigidly fused in 6-dimensions to a treatment MRI obtained on another day (non-adaptive) and evaluated. An adaptive plan was then generated for each non-adaptive plan. Target coverage between non-adaptive and adaptive techniques was compared using paired t tests. McNemar's tests were used to compare proportions of dose objective failures for OAR between sets. The target-coverage and number of patients meeting V10 Gy <0.35 and Dose max <14 Gy are shown in the table below with respective p-values. Statistically significant p-values (<0.05) were obtained for all criteria analyzed, especially above 4 vertebral body (VB) levels. This dosimetric analysis suggests that adaptive replanning using a hybrid MR/Linac platform has the potential to safely extend spine SRS beyond the currently accepted practice of 2-3 consecutive VB levels. Future directions include applying this innovative approach in a clinical trial.

Cytological Changes in Buccal Mucosa among Glue Abusers in Shendi, Sudan

Background: Glue sniffing among young people on the streets has gone completely out of control. The majority of street kids start out sniffing glue before moving on to other, more extreme narcotics. The organizations tackling the drug problem claim that because it is inexpensive and widely accessible, the majority of young people on the streets smell it. Objective: The purpose of this study was to assess how sniffing glue affected the buccal mucosal cells. Materials and Methods: This cross-sectional descriptive study was carried out at Shendi town between March 2021 and March 2022. The study involved 150 participants under the age of 25, of whom 50 were glue abusers. The remaining 50 participants served as the (control1) group, and their parameters were similar to those of the abusers', with the exception that they did not abuse glue. The final 50 participants served as the (control 2) group, and they appeared to be in good health and did not use tobacco, Glue sniffing, or another type of addiction. Buccal samples were taken from each group, strained by pap stain, and microscopically examined. A standardized face-to-face questionnaire was utilized to gather data, and the (SPSS) version (11.5) application was used to analyze the results. Results: The study revealed a significant P-value of nuclear atypia among study populations, inflammation, and infection was 0.000, the significant relationship of nuclear atypia with the duration of glue snuffing and dose of glue with P-value 0.000,0.001 respectively. Conclusions: The usage of glue caused considerable morphological alterations in mucosal cells, such as nuclear atypia and pre-nuclear hallo, as well as inflammations and infections (bacterial and viral)

Association between glycated hemoglobin and functional outcomes in patients with intracranial large artery atherosclerotic disease-related acute ischemic stroke: identifying the magic number.

This study aimed to investigate the effect of the glycated hemoglobin A1c (HbA1c) level on the functional outcome (FOC) in patients with intracranial large artery atherosclerotic disease (ICLAD)-related acute ischemic stroke (AIS). This retrospective study enrolled patients with ICLAD-related AIS who were admitted to King Fahd University Hospital between January 2017 and September 2021. Patients were divided into two groups based on the optimal cutoff HbA1c level determined using receiver operating characteristic curve analysis-those with HbA1c ≤6.9% and those with HbA1c >6.9%. Demographic and other clinical characteristics were compared between the two groups using chi-square tests. The association between HbA1c and 90-day FOC was assessed using the chi-square test and odds ratios (ORs). Multivariate analysis was performed to adjust for confounding factors. A total of 140 patients were included in the analysis. A significant association was observed between the HbA1c level and FOC. Compared to patients with HbA1c ≤6.9%, patients with HbA1c >6.9% were more likely to have an unfavorable FOC [p = <0.001, OR = 2.05, 95% confidence interval (CI) = 1.33-3.14]. The association between HbA1c >6.9% and unfavorable FOC was sustained even after adjusting for confounding factors (p = 0.008) and atherosclerosis risk factors (p = 0.01). HbA1c >6.9% was also associated with higher ORs for in-hospital complications (p = 0.06, OR = 1.34, 95% CI = 1.02-1.77) and mortality (p = 0.07, OR = 1.42, 95% CI = 1.06-1.92) although these associations did not attain significant p-values. HbA1c >6.9% was significantly associated with unfavorable FOC in ICLAD-related AIS. However, further studies with larger sample sizes are required to verify whether HbA1c is an independent predictor of poor FOC. Nevertheless, targeting HbA1c <7% should be the goal of physicians when managing patients at high risk of ICLAD.

A CLINICAL TRIAL OF VIRTUAL REALITY IN PHYSICAL THERAPY FOR BURN PATIENTS: EFFECTS ON PAIN PERCEPTION

In clinical contexts, virtual reality (VR) has demonstrated potential as a cognitive diversion technique to alleviate discomfort among patients undergoing challenging procedures, including physical rehabilitation for burn victims. However, the extent of research investigating the effectiveness of VR in reducing pain during physical therapy for burn patients is limited. This clinical trial was conducted at Civil Hospital's burns unit in Hyderabad and involved 68 participants. Each participant underwent two 6-minute physical therapy sessions, one utilizing VR and the other without VR. After each session, participants provided feedback on their pain experience, which the treating therapist documented. Analysis of graphic rating scores revealed a significant decrease in pain levels during physical therapy with VR compared to physical therapy without VR. The average scores for pain rumination, worst pain intensity, and unpleasantness decreased from 5.99 to 3.88, 6.24 to 3.41, and 6.18 to 3.82, respectively. The paired t-test indicated a highly significant p-value of less than 0.001. The results of this study suggest that VR is a valuable tool for reducing pain during physical therapy for burn patients. Further research is necessary to explore the long-term effects of VR on pain management and its potential application in other clinical settings.

Comparison Of Naproxen And Diacerein In The Treatment Of Knee Joint Osteoarthritis

Background: Knee osteoarthritis is a common disease in older age. Pain and limitation of movement are the main symptoms of knee osteoarthritis. Many pharmacological options are available for symptomatic relief but NSAIDs are mostly prescribed. Diacerein is also prescribed for osteoarthritis but data regarding its efficacy is still controversial. Moreover, studies regarding the comparison of diacerein with NSAIDs are deficient in Pakistan.&#x0D; Objective: The objective of the study was to compare the clinical efficacy of naproxen (NSAID) with diacerein in treating knee osteoarthritis.&#x0D; Methodology: Patients fulfilling inclusion criteria were included in the study. After written informed consent 60 patients of knee osteoarthritis were included in the study. They were divided randomly into two groups. Group A (n=30) was prescribed with tablet naproxen 500mg twice daily and group B (n=30) was given capsule diacerein 50mg twice daily for 12 weeks. Baseline VAS and WOMAC scores of the patients were noted. These scores were compared with scores achieved 12 weeks after intervention. Intra-group comparison of the scores was also carried out. SPSS version 23.0 was used for statistical analysis.&#x0D; Results: WOMAC and VAS scores comparison of the two groups (A &amp; B) before intervention showed an insignificant p-value that is 0.815 for the WOMAC score and 0.509 for the VAS score. After intervention means WOMAC score i.e.10.50 ± 2.46 of group A (treated with naproxen) was better than the mean 29.62 ± 7.03 of group B (treated with diacerein) showing significant p-value (&lt; 0.001). Similarly mean VAS of group A 1.92 ± 0.58 improved more than the mean VAS of group B i.e 3.38 ± 0.75 with significant p-value (&lt; 0.001). Intra-group comparison of the groups also showed a significant p-value.&#x0D; Conclusion: Clinical efficacy of naproxen is better than diacerein in treating knee osteoarthritis.

Maternal and Perinatal Outcome in Patients With Eclampsia: A Study Done at a Tertiary Care Centre.

Background One of the leading causes contributing to morbidity and mortality globally is attributed to eclampsia. Hence, it is vital to comprehensively review each female having eclampsia and to evaluate the factors that govern the outcomes in females with eclampsia. Aim To decode the fetal and maternal outcomes in subjects having eclampsia and to evaluate various factors that govern the outcomes. Methods This retrospective cohort and epidemiological study commenced at the Department of Obstetrics and Gynaecology,Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, in January 2016 till April 2017, and included females that either developed eclampsia in hospital stay duration or presented with pre-existing eclampsia. In included females, various fetal and maternal parameters were assessed along with the outcome of pregnancy. The institutional data records and the database were also used to determine the prevalence and incidence of eclampsia. Baseline maternal parameters were recorded from the already-existing institute data. These included the gestational age (in years), socioeconomic status, educational attainment, parity, gravidity, and the number of weeks of gestation present at the time of delivery. Antenatal care data assessed were blood pressure recordings, any proteinuria documented in the data, and the number of antenatal visits by the subjects. Statistical analysis was performed to assess both parameters. Results In the current investigation, there were 0.34% eclampsia cases among females visiting the institution for deliveries. Incidences of stillbirth were seen in 19.04% and 8% of study participants, respectively. We found 9.52% (n=4) of female infants to have perished from eclampsia. Preterm births, a delayed start to the treatment, and insufficient care were all linked to poor foetal and mother outcomes. The longer the period between the beginning of a fit and delivery, the greater the likelihood of unfavourable results.Seizure onset before or after birth, parity, or subject age had no impact on mother or foetal health.The p-value for statistical significance was kept at 0.05. Conclusion Most of the research participant women, had intrapartum eclampsia, postpartum eclampsia, and antepartum eclampsia, based on the time of the convulsions in relation to the labor. It was highlighted that there was no conclusive evidence linking the date of the fit's beginning to unfavourable results or an elevated risk of complications. Neonatal mortality and stillbirth were observed with vaginal delivery in eclampsia cases. Outcomes in eclampsia can be improved byearly treatment initiation, timely and appropriate referral, early disease recognition, and appropriate antenatal care.

Analysis of Zinc and Stromal Immunity in Disuse Osteoporosis: Mendelian Randomization and Transcriptomic Analysis.

Disuse osteoporosis is known to be primarily caused by a lack of exercise. However, the causal relationships between zinc and immunity and disuse osteoporosis remain unknown. This study investigated these relationships and their potential mechanisms. This study was an integrative study combining genome-wide association studies and transcriptomics. Two-sample Mendelian randomization analysis (MR) was used to analyze the causal relationships between exposures (zinc, immunity, physical activity) and the outcome (osteoporosis) with the aid of single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs). Four models, MR-Egger, inverse variance weighted, weighted median and MR-Pleiotrophy RESidual Sum and Outlier (MRPRESSO), were used to calculate odds ratio values. Sensitivity and heterogeneity analyses were also performed using MRPRESSO and MR-Egger methods. The mRNA transcriptomic analysis was subsequently conducted. Zinc metabolism scores were acquired through single-sample Gene Set Enrichment Analysis algorithms. Stromal scores were obtained using the R Package "estimate" algorithms. Important Kyoto Encyclopedia of Genes and Genomes and Gene Ontology pathways were also derived through gene set variation analysis. Cytoscape software helped construct the transcription factor (TF)-mRNA-microRNA (miRNA) network. Virtual screening and molecular docking were performed. Polymerase chain reaction validation was also carried out in vivo. Causal relationships were demonstrated between zinc and exercise (95% confidence interval [CI] = 1.30-2.95, p = 0.001), exercise and immunity (95% CI = 0.36-0.80, p = 0.002), exercise and osteoporosis (95% CI = 0.97-0.99, p = 0.0007), and immunity disorder and osteoporosis (95% CI = 1.30-2.03, p = 0.00002). One hundred and seventy-nine mRNAs in important modules were screened. Combining the differential expressional genes (DEGs) and the Boruta selection, six DEGs were screened (AHNAK, CSF2, ADAMTS12, SRA1, RUNX2, and SLC39A14). TF HOXC10 and miRNA hsa-miR-204 were predicted. Then, the TF-mRNA-miRNA network was successfully constructed. RUNX2 and SLC39A14 were identified as hub mRNAs in the TF-mRNA-miRNA network. Eventually, the novel small drug C6O4NH5 was designed according to the pharmacophore structure of SLC39A14. The docking energy for the novel drug was -5.83 kcal/mol. SLC39A14 and RUNX2 were downregulated (of statistical significance p-value < 0.05) in our animal experiment. This study revealed that zinc had a protective causal relationship with disuse osteoporosis by promoting exercise and immunity. SLC39A14 and RUNX2 mRNA participated in this zinc-related mechanism.

Influence of the presence of dental implants on the accuracy and difficulty level of diagnosis of furcation involvement in molars: An in vitro CBCT study.

The aim of this study was to investigate the possible interference of image artifacts (IA) generated by dental implants in the evaluation of furcation involvement (FI) in molars. Tomographic scans of first molars (1M) were performed in dry skulls in the absence and presence of titanium (TI) and zirconia (ZI) dental implants. FI grades were simulated in the alveoli of the 1Ms. Diagnostic accuracy of FI and level of difficulty were verified. Chi-squared test and logistic regression analysis were used. There was no difference in the diagnostic accuracy of FI between the arches (p = .117). The highest diagnostic accuracy value for the implant variable was found in the absence of implants (88.3%) and the lowest in the presence of two ZI implants (66.7%). The highest diagnostic accuracy value for FI was observed in grade 0 (G0). There was no significant difference between the arches regarding the evaluators' perception of difficulty (p > .05). Assessments were considered difficult in 12.7% of the TI implants and in 29% of the ZI implants. Regarding the number of dental implants, assessments were considered difficult in 24.4% cases including one implant and 17.4% cases including two implants. The logistic regression model showed a significant p-value only for one and two ZI implants (p = .0061 and p = .0096, respectively). The presence of dental implants in the region adjacent to the area of investigation of FI decreased the diagnostic accuracy while increasing the perception of difficulty by the examiners, especially in cases with ZI implants.

Brain-Derived Neurotrophic Factor Levels in Cannabis Use Disorders - A Systematic Review and Meta-Analysis.

The prevalence of cannabis use disordershas become a noteworthy global public health issue.Understanding the neurobiological factors associated with cannabis use disorder (CUD) is crucial for creating effective interventions. One such factor, the brain-derived neurotrophic factor (BDNF), has been linked to the onset and persistence of addictive behaviors. This systematic review aims to summarize the existing literature on BDNF levels in individuals with CUD to provide a comprehensive overview of the current evidence. A systematic search was conducted using electronic databases (PubMed, Scopus) for relevant studies. The search approach yielded a total of 785 articles, with 559 located in the PubMed database and 226 in Scopus. Studies reporting BDNF levels in individuals with CUD compared to healthy controls were included in this study. Ultimately, eight articles were included in this systematic review. The primary emphasis of these studies was on individuals who were cannabis users or had a dependency on cannabis. There is considerable variation in the estimated effect size among included studies due to heterogeneity; hence, a random effect model was used for meta-analysis. The findings of our study suggest that the effect size of BDNF levels was 0.25 with 95% CI (-0.55; 1.05) in cannabis users, which was not statistically significant (p-value=0.54). Therefore, it is important to interpret the results withcaution, and additional research is warranted to investigate the potential factors contributing to this heterogeneity.

Unlocking the Potential of the CA2, CA7, and ITM2C Gene Signatures for the Early Detection of Colorectal Cancer: A Comprehensive Analysis of RNA-Seq Data by Utilizing Machine Learning Algorithms.

Colorectal cancer affects the colon or rectum and is a common global health issue, with 1.1 million new cases occurring yearly. The study aimed to identify gene signatures for the early detection of CRC using machine learning (ML) algorithms utilizing gene expression data. The TCGA-CRC and GSE50760 datasets were pre-processed and subjected to feature selection using the LASSO method in combination with five ML algorithms: Adaboost, Random Forest (RF), Logistic Regression (LR), Gaussian Naive Bayes (GNB), and Support Vector Machine (SVM). The important features were further analyzed for gene expression, correlation, and survival analyses. Validation of the external dataset GSE142279 was also performed. The RF model had the best classification accuracy for both datasets. A feature selection process resulted in the identification of 12 candidate genes, which were subsequently reduced to 3 (CA2, CA7, and ITM2C) through gene expression and correlation analyses. These three genes achieved 100% accuracy in an external dataset. The AUC values for these genes were 99.24%, 100%, and 99.5%, respectively. The survival analysis showed a significant logrank p-value of 0.044 for the final gene signatures. The analysis of tumor immunocyte infiltration showed a weak correlation with the expression of the gene signatures. CA2, CA7, and ITM2C can serve as gene signatures for the early detection of CRC and may provide valuable information for prognostic and therapeutic decision making. Further research is needed to fully understand the potential of these genes in the context of CRC.

Assessment of Barriers to Knowledge Sharing Among Medical Students in Riyadh, Saudi Arabia.

Background Knowledge sharing is a process by which information is exchanged between peers, colleagues, or, at a higher level, between institutions and organizations. This study aimed to assess the barriers to knowledge sharing among medical students at private and public-sector medical colleges in Riyadh, Saudi Arabia. Methodology An online questionnaire was used to collect data from four medical colleges. Students were selected by non-probability convenience sampling. The English-language questionnaire included 12 questions related to knowledge sharing based on a Likert scale of one to five, with one denoting strongly disagreeing and five strongly agreeing. Out of the 520 questionnaires, 497 (96%) were received and analyzed using SPSS version 23 (IBM Corp., Armonk, NY, USA). Results A total of 497 respondents completed our questionnaire. Most were males (67.8%). Our results revealed that statements such as "afraid to provide the wrong information," "people only share with those who share with them," and "too busy/lack of time" were the most perceived barriers to knowledge sharing (mean = 3.95, 3.61, and 3.60, respectively). Furthermore, female opinions on statements such as "lack of relationship," "afraid to provide the wrong information," "do not know what to share," and "shyness to provide own opinions" were more dominant than male opinions. This difference was found to be statistically significant (p-values = 0.007, 0.020, 0.002, and 0.009, respectively). Conclusions Our study indicated that barriers such as "afraid to provide the wrong information" and "people only share with those who share with them" are important barriers that hinder the process of knowledge sharing. Moreover, most students agreed that "too busy/lack of time" and "lack of relationship" are barriers to knowledge sharing. In addition, statements such as "lack of relationship," "afraid to provide the wrong information," "do not know what to share," and "shyness to provide own opinions" were acknowledged as barriers by female students more than male students. There is a need in the curriculum to structure various types of activities that inspire and promote knowledge exchange among students. Further research is needed to validate our findings.

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation.

This study aimed to assess the performance of a tongue-positioning device in interfractional tongue position reproducibility by cone-beam computed tomography (CBCT). Fifty-two patients treated with radiation therapy (RT) while using a tongue positioning device were included in the study. All patients were treated with 28 or 30 fractions using the volumetric modulated arc therapy technique. CBCT images were acquired at the 1st, 7th, 11th, 15th, 19th, 23th, and 27th fractions. Tongues on planning computed tomography (pCT) and CBCT images were contoured in the treatment planning system. Geometric differences in the tongue between pCT and CBCT were assessed by the Dice similarity coefficient (DSC) and averaged Hausdorff distance (AHD). Two-dimensional in vivo measurements using radiochromic films were performed in 13 patients once a week during sessions. The planned dose distributions were compared with the measured dose distributions using gamma analysis with criteria of 3%/3 mm. In all patients, the mean DSC at the 1st fraction (pCT versus 1st CBCT) was 0.80 while the mean DSC at the 27th fraction (pCT versus 27th CBCT) was 0.77 with statistical significance (p-value = 0.015). There was no statistically significant difference in DSC between the 1st fraction and any other fraction, except for the 27th fraction. There was statistically significant difference in AHD between the 1st fraction and the 19th, 23th, and 27th fractions (p-value < 0.05). In vivo measurements showed an average gamma passing rate of 90.54%. There was no significant difference between measurements at the 1st week and those at other weeks. The tongue geometry during RT was compared between pCT and CBCT. In conclusion, the novel tongue-positioning device was found to minimize interfractional variations in position and shape of the tongue.

Effects of Teriparatide Treatment on Bone Mineral Density in Patients With Osteoporosis: A Short-Term Dose-Response Study.

Osteoporosis is a chronic bone disease that develops with a decrease in bone mineral density (BMD) along with bone mass. An essential measure in the prevention of osteoporosis is the achievement of normal peak bone mass.Teriparatide (TPTD) functions as an osteoanabolic agent, exerting a dual influence on bone remodeling by modulating both osteogenesis and osteoclastogenesis. Bone mass is determined by dual-energy x-ray absorptiometry (DEXA) quantitative CT scan and has outstanding precision (within 1% to 2%) and has the ability to show the effectiveness of drug intervention. To assess the effectiveness of TPTD treatment on BMD in osteoporosis patients. The study is a retrospective, observational, multi-centerstudy of 378 osteoporosis patients who were treated with 20 µg of subcutaneous TPTD every day for six months. DEXA scores of the hip joints of patients were measured both before and after TPTD treatment. TheDEXA scores of the total population pre and post-treatment were -2.75+0.58 and -2.15+0.95 respectively, with a p-value of <0.001, which is statistically significant. In women the pre and post-treatment scores were -2.728+0.52 and -2.276+0.49, with a significant p-value of <0.001 whereas in males, the scores were -2.756+0.72 and -2.108+1.29 respectively, with a significant p-value of <0.05. The six-month treatment with TPTD significantly improved DEXA scores in osteoporosis patients. DEXA score's precision and sensitivity in quantifying impact contribute to effective osteoporosis management, guiding treatment strategies for better outcomes in the Indian population. Further research is warranted to see the long-term effect of TPTD.

Versatility and outcomes of lateral arm free flap in head and neck reconstruction: a retrospective case series study of our experiences and innovations

ObjectivesThe Lateral Arm Free Flap (LAFF) offers advantageous features like variable thickness and minimal hair growth. LAFF is primarily used in orofacial and pharyngeal reconstructions, with limited reports on tracheal/esophageal applications. Also, the psychological prognosis and quality of life in patients with LAFF reconstruction are lacking. MethodsThis retrospective case series presents outcomes of LAFF reconstruction for head and neck surgical defects which included 19 patients. The disease type, location of reconstruction, TNM staging, tumor size, chemoradiation status, anxiety, depression, quality of life and detailed perioperative information of the LAFF reconstruction surgery were presented in a descriptive pattern. Subgroup analysis was conducted using Mann–Whitney U and Pearson r test. ResultsAll 19 patients (100%) had a viable flap after surgery with 5 (26.3%) of them developed flap-related complication. Patients with oropharyngeal reconstruction were more likely to have lower anxiety and depression score and higher quality of life than those with below-oropharyngeal reconstruction. However, no significant p-value was generated in any subgroup comparison or correlation test. And the application of LAFF in esophageal and tracheal reconstruction was proved to be successful. ConclusionsThe lateral arm free flap exhibits remarkable versatility and multifunctionality, providing advantageous outcomes in head and neck reconstruction. Level of evidenceLevel 4 according to OCEBM.

Hearing Screening in High-Risk Neonates Using Distortion Product Oto-Acoustic Emission.

The prevalence of hearing loss is 0.09-2.3% in low risk neonates, and 0.3-14.1% in the high-risk population. The treatment requires early identification by neonatal hearing screening and early rehabilitation. OAE (oto-acoustic emission) and ABR (Auditory Brain Response) are the two objective tests used to evaluate hearing loss in neonates. OAE tests the biological response of the cochlea to auditory stimuli. ABR tests the auditory pathway. The aim is to estimate hearing loss in high-risk neonates using the Distortion Product Oto- acoustic emission (DP OAE) and to correlate the associated high-risk factors. This was a cross-sectional study conducted between March 2021 to September 2022. Newborns satisfying the inclusion criteria were included in the study. DP- OAE is performed to screen for hearing loss within 48h of birth. Infants failing the first screening test are then examined for treatable causes and then repeated at 2 weeks. Newborns who fail the second DP-OAE are subjected to ABR for confirmation of hearing loss. A total of 100 high risk neonates underwent hearing screen using DP-OAE. Most common risk factors seen in our study are prematurity (22%), Low birth weight (< 2.5kg) (20%), Neonatal Hyperbilirubinemia (17%), Maternal risk factors (GDM) (14%). Most neonates with prematurity failed the hearing test with significant p-value of 0.05. DP- OAE test can be successfully implemented as newborn hearing screening method, for early detection of hearing impairment to achieve the high quality standard of screening programs.