Correlated Research Articles

P1195 Ecological momentary assessment of fatigue and depressive symptoms reveals significant daily variability in IBD

Abstract Background In inflammatory bowel disease (IBD), symptoms of depression and fatigue overlap to great extent, making it difficult for medical practitioners to differentiate between these symptoms and provide patients with proper treatment options. In this study, we prospectively monitored multiple factors including mood, sleep, physical and psychological wellbeing, quality of life and stress perception, and explored the effects of these factors on symptoms of depression and fatigue in IBD. Our aim was to define specific combinations of symptoms helping to better distinguish between depression and fatigue in IBD populations. Methods Sixteen patients with IBD provided daily indices of sleep duration and quality as well as ratings of depressive symptoms, fatigue, stress perception, mood and IBD-related symptoms 6 times per day for 7 consecutive days of ecological momentary assessment (EMA) monitoring. Additionally, participants were provided with a series of questionnaires, stool samples were collected, as well as ambulatory physiological monitoring was performed. Multiple linear regression analyses were computed to explore how these specific factors can predict depression and fatigue in IBD. Network analyses were applied to identify and analyse distinct patterns of statistical associations related to depression and fatigue in IBD. Results Self-reported sleep quality (pFDR = .034) and feelings of sadness (pFDR = .045) significantly predicted symptoms of depression in IBD, while fatigue could only be predicted by poor sleep quality (pFDR = .030). Network analyses revealed two distinct patterns: symptoms of depression were associated with less positive (pFDR = .024) and more negative affect (pFDR = .012), as well as stronger feelings of tiredness (pFDR = .014) in daily life. Fatigue was characterized by an inability of feeling relaxed (pFDR = .002), more severe tiredness (pFDR = .013) and exhaustion (pFDR = .022). Conclusion Our preliminary results indicate that depressive symptoms are associated with the experience of negative emotions in daily life, which could affect patients‘ motivation to engage in activities and social interactions and thus, resulting in a stronger perception of tiredness. In contrast, the manifestation of fatigue in IBD is characterised by a stronger perception of tiredness and exhaustion, but not with the experience of negative affect. Additionally to the improvement of patient’s sleep quality, treatment of depressive symptoms should focus on fostering daily activities linked to positive emotions, while relaxation techniques and regular amount of moderate exercise can be a good treatment option for fatigued patients, if these associations could be found in larger studies as well.

Association Between Cytological and Histopathological Diagnoses of Neoplastic and Non-Neoplastic Lesions in Oral Cavity from Dogs and Cats: An Observational Retrospective Study of 103 Cases

Cytology is an exam frequently used as a diagnostic technique to evaluate animal oral lesions. However, the retrospective studies published comparing cytology and histology in oral pathology are scarce. This study aimed to determining the association between diagnostic cytology and histopathology in neoplastic and non-neoplastic samples from oral cavity lesions of dogs and cats. Cytological and histological samples (n = 103) of oral lesions from 70 dogs and 33 cats collected over 12 years were compared in terms of agreement, considering the histopathology as the gold standard. Of 103 specimens, 78 were classified as neoplastic, and 25 were non-neoplastic. The sensitivity, specificity, and accuracy of cytology in neoplastic and non-neoplastic lesions were 84.6%, 96.0%, and 87.4%. Of the overall 103 cases, 75.7% (n = 78) were neoplastic and revealed an agreement that was complete in 64.1% (n = 50) and partial in 17.9% (n = 14) samples, and the remaining 17.9% (n = 14) revealed disagreement; regarding the non-neoplastic diagnoses (24.3%, n = 25) the agreement was complete in 68.0% (n = 17), partial for 20.0% (n = 5) samples, and the remaining 12.0% (n = 3) revealed disagreement. A statistical association between neoplastic cases and agreement was obtained (p < 0.0001). The high agreement verified between the cytological and histopathological diagnoses emphasizes the role of cytology as the first approach method to an oral lesion in dogs and cats.

Relationship between School Principal’s Leadership Behavior and Teacher’s Job Satisfaction in Secondary Schools in Puntland, Somalia

This study explored the association between school principal’s leadership behaviour and teacher’s job satisfaction in secondary schools in the Puntland, Somalia. A quantitative approach with a correlational design was employed. The target population comprised 14 governmental secondary schools, and a sample of 12 schools was selected. Out of 240 teachers, 140 (70 from each region) were chosen through census and proportional stratified sampling techniques. Two questionnaires were used: a self-developed Effective Leadership Behaviour Questionnaire for principals and the Minnesota Satisfaction Questionnaire for teachers. Using descriptive and inferential statistics like Pearson’s correlation coefficient, two independent t-tests, and one-way ANOVA, the data were analysed using SPSS. The findings revealed that change-oriented leadership behaviour was the most dominant (M = 4.0, SD = .85). Overall, principals displayed a moderate level of effective leadership (M = 3.20, SD = .80), and schools showed no significant differences in this regard (F(11, 140) = 0.145, p = 0.99). Teacher’s job satisfaction was also moderate (M = 3.20, SD = 0.86), with individual variations. Teachers’ job satisfaction and principal’s leadership behavior had a weak but positive and significant connection (r = 0.196, p = 0.020). Principals were found to practice task- and change-oriented leadership more frequently than relation-oriented leadership. The study recommends that principals improve their relation-oriented leadership to enhance teachers’ job satisfaction. Implications and future research directions are discussed.

Cotton production areas are at high risk of invasion by Amrasca biguttula (Ishida) (Cicadellidae: Hemiptera): potential distribution under climate change.

The cotton jassid, Amrasca biguttula, a dangerous and polyphagous pest, has recently invaded the Middle East, Africa and South America, raising concerns about the future of cotton and other food crops including okra, eggplant and potato. However, its potential distribution remains largely unknown, posing a challenge in developing effective phytosanitary strategies. We used an ensemble model of six machine-learning algorithms including random forest, maxent, support vector machines, classification and regression tree, generalized linear model and boosted regression trees to forecast the potential distribution of A. biguttula in the present and future using presence records of the pest and bioclimatic predictors. The accuracy of these algorithms was assessed based on the area under the curve (AUC), correlation (COR), deviance and true skill statistic (TSS). All algorithms showed good performance in forecasting the distribution of A. biguttula (AUC ≥ 0.91, COR ≥ 0.72, TSS ≥ 0.77 and deviance ≤ 0.65). Mean temperature of wettest quarter, mean temperature of driest quarter and precipitation of the wettest month were the key variables that contributed to predicting A. biguttula occurrence. Projection of the model showed that cotton production areas in Asia, sub-Saharan Africa, and South America are at threat of invasion by A. biguttula under the current climatic scenario. Additionally, range expansion for A. biguttula is projected in the future in sub-Saharan Africa, South America and China, indicating a suitable ecological niche for A. biguttula to thrive. Our results provide early warning and decision-making information that can guide efforts to prevent this pest's further spread and invasion into new areas. © 2025 Society of Chemical Industry.

English Continuation Writing in China’s Senior High Schools: A Systematic Review of Empirical Research

English continuation writing has gained prominence in China’s senior high school English education as a pedagogical and assessment tool, following its incorporation into the national gaokao. This systematic review addresses the limited understanding of continuation writing by critically examining empirical studies published between 2016 and 2024, focusing on four key dimensions: (1) main focus areas and findings, (2) research designs and methodologies, (3) pedagogical approaches and their impacts, and (4) challenges and limitations faced by students and teachers. A PRISMA-based methodology was employed, reviewing 24 peer-reviewed studies retrieved from Web of Science, Scopus, and Google Scholar. Findings reveal that cognitive and affective factors, including anxiety, cognitive load, and imagination, significantly influence student engagement and writing performance. Pedagogical strategies such as multimodal composing, blended learning, and production-oriented approaches enhance accuracy, coherence, and engagement but face challenges like uneven cohesion improvement and overemphasis on non-textual elements. Quantitative correlational and quasi-experimental designs dominate the literature, while qualitative insights remain underexplored. Teachers grapple with insufficient training, heavy workloads, and resource constraints, while students face challenges like limited vocabulary knowledge, high cognitive demands, and writing anxiety. This review highlights the need for balanced, context-sensitive instructional strategies and greater institutional support. It underscores the importance of diversifying research methodologies and advocates for longitudinal and qualitative studies to deepen understanding.

The orientational structure of a model patchy particle fluid: Simulations, integral equations, density functional theory, and machine learning.

We investigate the orientational properties of a homogeneous and inhomogeneous tetrahedral four-patch fluid (Bol-Kern-Frenkel model). Using integral equations, either (i) HNC or (ii) a modified HNC scheme with a simulation input, the full orientational dependence of pair and direct correlation functions is determined. Density functionals for the inhomogeneous problem are constructed via two different methods. The first, molecular density functional theory, utilizes the full direct correlation function and an isotropic hard-sphere bridge functional. The second method, a machine learning approach, uses a decomposition of the functional into an isotropic reference part and a mean-field orientational part, where both parts are improved by machine learning techniques. A comparison with the simulation data at hard walls and around hard tracers shows a similar performance of the two functionals. Machine learning strategies are discussed to eliminate residual differences, with the goal of obtaining machine-learning enhanced functionals for the general anisotropic fluid.

The Impact of Gender Wage Differentials on Economic Growth in Kenya

Purpose: This study investigates the impact of gender wage differentials on Kenya's economic growth. Methodology: The study utilized a correlation research design and time-series data spanning 2012 to 2023. Econometric modeling was applied to evaluate the relationship, with economic growth as the dependent variable and gender wage differentials as the independent variable. Findings: Descriptive statistics revealed that the gender wage gap, measured by the gender wage gap index, exhibited significant variations over the study period, with an average index of 0.531. Regression analysis demonstrated a statistically significant negative relationship (β = -0.249, p < 0.01) between gender wage differentials and economic growth, with a moderate explanatory power (R² = 0.269). The findings suggest that persistent wage disparities undermine economic productivity by constraining female labor participation and limiting household investment in education and health. Unique contribution to theory, practice and policy: These results underline the urgency of addressing occupational segregation, pay inequity, and structural barriers through targeted economic policies, affirmative action, and enforcement by the National Gender and Equality Commission (NGEC). This study contributes to the literature on gender economics and highlights the importance of equitable wage structures in achieving sustainable development goals, particularly SDG 5 (Gender Equality) and SDG 8 (Decent Work and Economic Growth). Future research could explore sector-specific effects to refine policy interventions.

The Hormetic Potential of GDF15 in Skeletal Muscle Health and Regeneration: A Comprehensive Systematic Review.

Growth Differentiation Factor 15 (GDF15) has been described as influencing skeletal physiology. Nevertheless, no systematic appraisal of the effect of GDF15 on skeletal muscle tissues has been developed to the present day. The aim of the present work was to review the evidence on the topic. In this preregistered systematic review (https://osf.io/wa8xr), articles were retrieved from MEDLINE/PubMed, EMBASE, and WebOfScience. Inclusion criteria comprised studies on humans or animal models, assessment of peripheral or local tissue GDF15 concentrations, as well as the direct expression of GDF15 in skeletal muscle, and direct or indirect correlates of GDF15 with physical activity/ sarcopenia/trophism/ function. A total of 646 studies were retrieved, and 144 finally included. Molecular inducers or inhibitors of GDF15 in skeletal muscle tissues were described. GDF15 was reported to promote skeletal muscle health, metabolic homeostasis, and overall physical conditioning. In pathology, GDF15 seems to be correlated to the degree of muscle impairment and mitochondrial stress. GDF15 has also been described as having the potential to stratify patients based on clinical prognosis and functional outcome. A hormetic hypothesis for GDF15 on skeletal muscle was proposed. In fact, GDF15 exhibited beneficial effects when expressed at high levels facing acute stressors (i.e., "myoprotection"). Conversely, GDF15 exhibited maladaptive effects, such as chronic low-grade inflammation, when chronically expressed in pathological processes (e.g., obesity, aging). GDF15 may be a potential molecular target for disease-modifying interventions. The current review underscores the need for further research on GDF15 to elucidate its therapeutic potential across different pathological states. The study protocol, registered before data collection and analysis, can be retrieved at https://osf.io/wa8xr. It should be noted that the study deviated from the protocol after peer review, including other electronic databases beyond MEDLINE/PubMed alone.

Evaluation of combined workflows for multimodal mass spectrometry imaging of elements and lipids from the same tissue section

The wide range of mass spectrometry imaging (MSI) technologies enables the spatial distributions of many analyte classes to be investigated. However, as each approach is best suited to certain analytes, combinations of different MSI techniques are increasingly being explored to obtain more chemical information from a sample. In many cases, performing a sequential analysis of the same tissue section is ideal to enable a direct correlation of multimodal data. In this work, we explored different workflows that allow sequential lipid and elemental imaging on the same tissue section using atmospheric pressure laser desorption/ionisation-plasma post-ionisation-MSI (AP-MALDI-PPI-MSI) and laser ablation-inductively coupled plasma-MSI (LA-ICP-MSI), respectively. It is found that performing lipid imaging first using matrix-coated samples, followed by elemental imaging on matrix-coated samples, provides high-quality MSI datasets for both lipids and elements, with the resulting distributions being similar to those obtained when each is performed in isolation. The effect of matrix removal prior to elemental imaging, and of performing elemental imaging first were also investigated but found to generally yield lower quality elemental imaging data but comparable lipid imaging data. Finally, we used the ability to acquire both elemental and lipid imaging data from the same section to investigate the spatial correlations between different lipids (including ceramides, phosphatidylethanolamine, and hexosylceramides) and elements within mouse brain tissue.Graphical

Analysis of Nocturia Determinants Using a Novel Portable Urine-Measuring Device.

To investigate the relationship between nocturia and values measured using a novel multifunctional portable urine-measuring device. Thirty-five older men with nocturia and/or high-normal or high blood pressure were enrolled to record measurements on one full day (24 h) and two nights using the portable device during urination. Participants used a semi-conical cup with a small hole equipped with a conductivity sensor, temperature sensor, and timer to measure urine volume, salt content, urine temperature, and urination speed. Two participants were excluded owing to oliguria. The mean age of 33 participants was 75.2 ± 7.4 years (range: 55-85 years). The mean nocturnal urination frequency, including the first urination after waking, was 2.1 ± 0.6 times. Simple correlation analysis revealed that nocturnal urine frequency significantly increased with nocturnal urine volume (r = 0.65, p < 0.001) and salt content (r = 0.57, p < 0.001) but not with 24-h urine volume and salt content. Furthermore, the frequency significantly decreased with nocturnal urine temperature (r = -0.37, p < 0.05). No significant relationship was observed between morning blood pressure and nocturnal urination frequency. A high correlation was observed between nighttime urine volume and salt content (r = 0.73, p < 0.001). Nocturnal urine volume, salt content, and urine temperature are significantly correlated with nocturia. The portable urine-measuring device could guide nocturia reduction through facilitation of the reduction of nocturnal urine volume and salt content, in addition to urine temperature monitoring.

Factors correlated with demoralization among cancer patients: A systematic review and meta-analysis.

Demoralization isa common psychological problem in cancer patients. The purpose of this study is to systematically evaluate the correlated factors of demoralization among cancer patients. We also summarized the available evidence, effect estimates, and the strength of statistical associations between demoralization and its associated factors. We systematically searched PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, PsycINFO, and 2 electronic databases to identify studies published up to October 2023 with data on the correlates of demoralization. Two researchers independently reviewed references, extracted data, and assessed data quality. Meta-analysis was performed using R4.1.1 software. Thirty-eight studies were included in this meta-analysis. For the most studied sociodemographic correlates, demoralization was negatively correlated with income (z = -0.29, 95% CI: -0.51, -0.02), education (z = - 0.11, 95% CI: - 0.16, -0.05), and age (z = -0.45, 95%CI: -0.75, -0.01). For the most studied clinical correlates, demoralization was positively correlated with symptom burden (z = 0.37, 95% CI: 0.22, 0.50) and negatively correlated with quality of life (z = -0.40, 95% CI: -0.54, -0.24). For the most studied psychosocial correlates, demoralization was negatively correlated with social support (z = -0.39, 95% CI: -0.51, -0.26) and positively correlated with anxiety (z = 0.65, 95% CI: 0.56, 0.73), depression (z = 0.61, 95% CI: 0.54, 0.67), and suicidal ideation (z = 0.48, 95% CI: 0.34, 0.60). Demoralization showed either positive or negative associations with sociodemographic, clinical, and psychological variables. More research is needed to explore the underlying mechanisms to develop effective interventions. This review provides information on the factors associated with demoralization in cancer patients, which can be used to inform strategies for clinical care providers.

The Mediating Role of Depersonalization on the Relationship Between Sleep and Psychological Well-Being in an Online Adult Community Sample

ABSTRACT Poor sleep quality has been linked to both poor psychological and physical well-being. Mood and anxiety levels are affected by poor quality sleep, and the relationship between these variables appears to be mediated by a tendency to depersonalize or not. This study examines these relationships in 112 Adults (Female = 82, Male = 30), via an online study. The Pittsburgh Sleep Quality Index, Patient Health Questionnaire4, Cambridge Depersonalization Scale-9, and Patient Health Questionnaire-15 were administered using the Gorilla platform. The following variables were analyzed using correlation statistics, and mediation analyses: sleep quality, anxiety, depression, somatic pain, and depersonalization. Poor sleep quality was associated with higher levels of all psychological variables. As predicted, depersonalization mediated the relationship between sleep quality and anxiety, depression and somatic concerns. The findings indicate that sleep quality and the mediating effect of depersonalization have a significant impact on psychological well-being in adults.

The Correlation of Learning Motivation and Conventional Learning Methods with Civic Education Learning Outcomes

This study examines the relationship between learning Motivation and conventional teaching methods on students' learning outcomes in Civic Education. The research employed a quantitative approach with a correlational design. Data were collected through questionnaires designed to measure learning motivation, applying conventional teaching methods, and students' learning outcomes. Data analysis was conducted using simple linear regression and correlation analysis. The results revealed a significant positive relationship between learning Motivation and students' learning outcomes and a significant relationship between conventional teaching methods and students' outcomes. Learning Motivation enhances student engagement, enthusiasm, and overall learning quality. Meanwhile, while effective, conventional teaching methods can be further enhanced by integrating interactive approaches such as group discussions or visual media. The implications of this study highlight the need for teachers to design teaching strategies that are relevant to students' needs and capable of continuously motivating them. A combination of strong learning motivation and optimal implementation of conventional teaching methods is believed to effectively support students' academic success. Therefore, these factors should primarily focus on developing school learning strategies for better outcomes.

Factors Affecting Numeracy Skills

This study aimed to determine what factors affect the numeracy skills of the Grade 1-3 students. This study used a descriptive correlational quantitative research design, which examines the relationships between factors affecting numeracy skills and the level of numeracy skills of students. The research instrument used was a survey questionnaire containing two parts: the summative test for the level of numeracy skills and the survey questionnaire for the factors. The respondents of this study were 38 Grade 1-3 students of Canloterio Elementary School during School Year 2023-2024.

Proinflammatory cytokine genes and their polymorphic variants: clinical and laboratory profiles in the Federal Firefighting Service employees of the EMERCOM of Russia

Relevance. Genetic determinants of multifactorial diseases are critical for assessing the risk of genetic diseases and their prevention, especially among the workforce exposed to industry-related dangerous and aggressive occupational factors. Firefighters perform combat service duties in extremely unfavorable industrial environments associated with occupational diseases. Respiratory diseases are among the pathologies with highest incidence rates in firefighters. In addition to environmental factors, the development of these diseases (especially bronchial asthma and chronic obstructive pulmonary disease) is largely driven by impaired immune system – one of the three critical regulatory systems involved in pathogenetic mechanisms of various diseases, including inflammatory diseases. Polymorphic gene variants of inflammatory mediators – in particular cytokine genes and their receptors – mediate the immune system activity and can impact its functionality, susceptibility, or resistance to disease development.The objective is to analyze how interleukin 1β, 4, 6, 13, TNF and interleukin 6 receptor genes, as well as their polymorphic variants are associated with respiratory diseases and changes in the biomarker profiles showing immune response intensity in the employees of the Federal Firefighting Service of the EMERCOM of Russia. Methodology. Molecular genetic profiling and immunology tests were performed in 70 employees of the Federal Firefighting Service of the EMERCOM of Russia to analyze proinflammatory cytokine genes and their polymorphic variants. Real-timePCR was used to analyze the interleukin 1β, 4, 6, 13, TNF and interleukin-6 receptor genes and their polymorphic variants. Immunological examination evaluated the blood monocyte subpopulations and relative count of type 2 T-helper cells; flowcytometry and immunochemiluminescence assays were used to evaluate immune response biomarkers in peripheral blood and total immunoglobulin E (IgE) respectively.Results and discussion. The analysis provides evidence that minor alleles of most polymorphic cytokine genes are associated with a proinflammatory phenotype, which is especially apparent for genotypes comprising several minor alleles. Allele A at rs1 800 629 polymorphic TNF gene exposed a direct correlation with respiratory diseases, as well as with increased monocyte differentiation. Allele T of IL4 rs2243250 gene and allele A of IL1β rs16944 gene were associated with increased proinflammatory monocyte count. Elevated count of type 2 T-helper mediators of humoral response, especially of allergicorigin, was observed in individuals with C/C IL6 rs1 800 795 and G/G IL1β rs16944 genotype.Conclusion. The obtained results suggest that evaluation of cytokine gene polymorphic variants is a promising strategy to predict the risk of respiratory diseases in firefighters. Prompt assessment of genetic predisposition to a proinflammatory phenotype paves the way towards prevention and early detection of inflammatory diseases in this cohort of workers.

Takotsubo Cardiomyopathy After Subarachnoid Hemorrhage: Who Is At Risk?

Takotsubo Cardiomyopathy (TCM) is a rare but well recognized complication of subarachnoid hemorrhage associated with increased morbidity and poor clinical outcomes. There is a scarcity of literature describing the prevalence and risk factors associated with this complication. The aim of this study was to identify patients who are at risk of developing TCM in non-traumatic subarachnoid hemorrhage. The 2016 to 2021 National Inpatient Sample (NIS) was used to identify adult inpatients with a primary diagnosis of non-traumatic subarachnoid hemorrhage. Univariate and multivariable analyses adjusting for patient demographics, comorbidity status, and hemorrhage etiology were used to characterize statistical associations with disease-related complications. Patients with TCM were further divided into those with "good" or "poor" functional outcomes and compared. A total of 42 141 patients were identified as having a subarachnoid hemorrhage from 2016 to 2021. Of these patients 486 patients (1.2%) were found to have TCM. TCM was associated with increased length of stay (19.15 ± 17.8 days vs 11.72 ± 14.4, P < .001), increased total costs ($451 502.59 ± 443 777.9 vs $242 327.92 ± 338 862.3, P < .001), increased number of days from admission to first procedure (1.74 ± 4.5 vs 1.94 ± 5.0, P < .001), and increased mortality (31.7% vs 22.8%, P < .001). After controlling for confounding factors, independent risk factors for TCM in patients with non-traumatic subarachnoid hemorrhage included: Female (Odds Ratio [OR]: 3.11, 95% Confidence Interval [CI]: 2.50-3.89, P < .001), Congestive Heart Failure (OR:4.60, CI:3.70-5.71, P < .001), and Fluid and Electrolyte Disorders (OR: 2.52, CI: 2.05-3.11, P < .001). Patients with good functional outcomes were found to have younger age (54.85 years ± 14.0 vs 58.14 ± 14.7, P < .001), decreased length of stay (17.11 ± 16.9 vs 19.83 ± 18.1, P < .001), decreased total charge ($370 245.94 ± 517 702.8 vs $477 366.55 ± 417 122.4, P < .001), and decreased mortality (P < .001) compared to those with poor functional outcomes. TCM after subarachnoid hemorrhage is associated with increased mortality, length of stay, total cost, number of procedures in patients, and number of days to first procedure. Neurosurgeons and Neurocritical care medical professionals should be aware of the comorbidities and factors associated with increased TCM after subarachnoid hemorrhage in order to improve patient outcomes.

The (un)known crosstalk between metabolism and mechanotransduction: Implications for metabolic syndrome (MetS)-associated neurological complications.

Metabolic syndrome (MetS) has been associated with disruptions in tissue mechanical homeostasis and inflammatory and metabolic derangements. However, the direct correlation between metabolic alterations and changes in tissue stiffness, and whether they could play a role as upstream initiators of disease pathology remains to be investigated. This emerging concept has yet to be put into clinical practice as many questions concerning the interplay between extracellular matrix mechanical properties and regulation of metabolic pathways remain unsolved. This review will highlight key foundational studies examining mutual regulation of cell metabolism and mechanotransduction, and opening questions lying ahead for better understanding MetS pathophysiology.

Intolerance of uncertainty, aging, and anxiety and mental health concerns: A scoping review and meta-analysis.

Although intolerance of uncertainty (IU) is associated with negative outcomes, studies focusing on older adults are still emerging. Specifically, the relationship between IU and psychological health in this population remains unclear. Moreover, no review has focused on understanding the unique contributions of IU and aging to anxiety and mental health in older adults. This scoping review and meta-analysis addressed this gap and provided a comprehensive understanding of the relationship between IU, aging, and mental health. Among 45 studies reviewed, 37 were included in the meta-analysis using mixed effect analysis to examine the relationship between IU and age across adulthood. The remaining eight studies, along with seven selected from the meta-analysis, were included in the scoping review to evaluate the relationship between IU, anxiety, and mental health. Among these, 12 studies focused on late adulthood, two on overall adulthood, and one included both late and overall adulthood. Results of the meta-analysis revealed an overall significant age difference in IU throughout adulthood. Moreover, results of the scoping review indicated a direct correlation between IU and anxiety, and other psychological issues in elderly. These findings provide insights for future research and interventions aimed at reducing IU and improving mental health among older adults.

Design, Implementation, and Evaluation of Anesthesia Students’ Clinical Competency Based on the Virtual Objective Structured Clinical Examination

Background: The objective structured clinical examination (OSCE) is an appropriate method for assessing clinical competency among students in universities worldwide. With nowadays technological advances, there is a growing interest in virtual OSCEs (VOSCEs). Objectives: The present study aimed to design, implement, and evaluate a VOSCE for assessing anesthesia students’ clinical competency. Methods: This quasi-experiment study was conducted in six phases: (1) Defining the exam’s specifications and design, (2) determining validity and reliability, (3) setting up and conducting a pilot VOSCE, (4) familiarizing students with the VOSCE, (5) administering the exam, and (6) evaluating and providing feedback. Seventy-five senior anesthesia students from Abadan University of Medical Sciences were selected by census and participated in this study between 2021 and 2023. The scores of virtual and in-person OSCEs were compared, and the correlation between the two exams was investigated. At the end of each semester, students participated in a survey related to the VOSCE. The exam results and survey data were presented at the faculty’s educational development office meetings, and suggestions for amending and eliminating shortcomings were considered in the following semester. Data were analyzed using SPSS 20 by calculating means, standard deviations, and Pearson’s correlation. Results: The students’ mean scores in the virtual and in-person OSCEs were 17.68 and 16.75, respectively. No significant difference was observed between the scores of the two exams. The total score of the VOSCE had a direct and significant correlation with the in-person OSCE (r = 0.861, P &lt; 0.001), and this correlation was also observed in all stations of both exams (P &lt; 0.05). Student surveys indicated that the VOSCE fostered a sense of empowerment, self-confidence, and enhanced learning, causing students to express strong agreement with its continuation in the future. Conclusions: The VOSCE can be an appropriate substitute for or an integral part of the in-person OSCE. It is recommended that educational planners and instructors develop this exam as a new assessment method. Given advances in technology and the requirement for improving the quality of virtual exams, professors need to be empowered in the field of modern electronic assessment methods.

From one size fits all to a tailored approach: integrating precision medicine into medical education

BackgroundAs precision medicine gains momentum, the traditional - One Size Fits All - approach to disease prevention and treatment is becoming less reliable. Medical education must prioritize equipping physicians with the knowledge to apply precision medicine effectively. The present study aimed to investigate the knowledge, attitudes, and perceived barriers to precision medicine among medical students, interns, and physicians in Jordan.Materials and methodsAn analytical cross-sectional study, using an online validated and reliable questionnaire to collect data, was conducted. The knowledge, attitudes, and perceptions related to precision medicine were assessed and explored for statistical associations. The strength of each association was further presented by calculating the Cramér’s phi (φc).ResultsParticipants in the present study were 607 individuals, 55.5% were males. 29.6% of participants had low knowledge scores (marks between − 12 and 0). The strongest association was reported between knowledge score and primary care setting followed by age (φc = 0.27 and 0.29, respectively). Physicians at the Ministry of Health had the highest odds of a high knowledge score (OR = 5.3, 95% CI 2.7–10.2, P < 0.001). Most respondents (79.1%) would consider using genome-guided prescribing tools developed by researchers, with only (15.8%) deeming these tools clinically useless. Nevertheless, almost 78% of participants expressed concern regarding patient anxiety with test results. Students showed better perception than physicians (p = < 0.001), but Physicians were more confident to implement precision medicine (P = < 0.0001). Most participants (87.1%) considered expanding their knowledge in precision medicine. Physicians cited limited accessibility as the main barrier to adopt precision medicine (92.9%), while high cost was the primary obstacle reported by students (80.2%).ConclusionMedical students and Physicians share a positive attitude toward implementing Precision Medicine, but barriers must be overcome for successful implementation. Integrating precision medicine and genome-based technologies into medical education is necessary for its successful application in clinical practice.