Category: Nevin Manimala

BMC Med. 2025 Oct 2;23(1):532. doi: 10.1186/s12916-025-04311-8.

ABSTRACT

BACKGROUND: MicroRNAs (miRNAs) are short, single-stranded RNAs that function as post-transcriptional regulators of gene expression. Although circulating miRNAs have been linked to carcinogenesis, they have not yet been systematically investigated in relation to risk of colorectal cancer (CRC).

METHODS: We used Mendelian randomization (MR) and colocalization analyses to investigate the association of genetically predicted plasma miRNA concentrations (2083 miRNAs in 710 individuals) with risk of CRC (58,221 cases and 67,694 controls). For miRNAs associated with CRC risk, we also investigated their association with circulating plasma proteins (4907 proteins in 35,559 participants), bidirectionally, using MR. We performed pathway enrichment analysis (PEA) to explore downstream molecular pathways.

RESULTS: Associations of five miRNAs with CRC were found in MR and supported in colocalization analyses. Specifically, miR-146a-5p, miR-21-5p, and miR-4707-3p were positively, and miR-1908-5p and miR-6810-3p were inversely associated with CRC risk. Several protein associations were found for these miRNAs (range of proteins with P < 0.05: 78-796; 211 with FDR < 5%), and 11 pathways were identified in PEA, including regulation of Erb-B2 receptor tyrosine kinase 4 (miR-6810-3p) and insulin-like growth factor pathways (miR-1908-5p).

CONCLUSIONS: Our results support a potential implication of miR-146a-5p, miR-21-5p, miR-4707-3p, miR-1908-5p, and miR-6810-3p to CRC risk. However, their downstream effects should be elucidated before they can be utilized as preventive targets.

PMID:41039543 | DOI:10.1186/s12916-025-04311-8

BMC Vet Res. 2025 Oct 2;21(1):558. doi: 10.1186/s12917-025-05011-4.

ABSTRACT

BACKGROUND: Riding clubs face significant financial losses due to upper respiratory infections caused by Beta-hemolytic (β-hemolytic) streptococci, leading to strangles and related diseases that negatively impact the health and performance of horses. Our objective was to determine the relationship between these inflammatory cells, the presence of β-hemolytic streptococcal species, and the clinical symptoms exhibited by the horses. This study investigated the presence of β-hemolytic streptococcus in 133 tracheal lavage samples from horses exhibiting various clinical respiratory symptoms and quantified the populations of neutrophils, eosinophils, macrophages, lymphocytes, and mast cells. The horses included in this study exhibited a variety of clinical respiratory symptoms categorized into groups: (I) Horses with no apperent symptoms (Control Group), (II) Horses with only coughing, (III) Horses with only lymph node swelling, (IV) Horses with coughing and lymph node swelling, (V) Horses with all symptoms (coughing, lymph node swelling and nasal discharge). After obtaining the bacterial cultures from tracheal wash samples, additional diagnostic tests were performed to identify the suspected colonies. The cytological analysis determined the proportions of inflammatory cells, while the statistical analysis assessed the significance of differences in inflammatory cell populations and pathogen presence across the different symptom groups.

RESULTS: Among 133 horses categorized into five clinical groups, S. zooepidemicus was isolated in 18% overall, with the highest isolation rate in horses exhibiting both coughing and lymph node swelling (36%). Statistical analysis showed a significant difference in S. zooepidemicus prevalence between groups (p = 0.019), with post hoc tests confirming significance between asymptomatic horses and those with combined symptoms. Neutrophil proportions differed significantly among groups (p = 0.010), with the highest counts in symptomatic horses with both coughing and lymph node swelling. Furthermore, bacteriologically positive samples exhibited significantly higher neutrophil counts (median 83.5, IQR 76) than negatives (median 22, IQR 46, p < 0.001), suggesting an acute inflammatory response linked to infection. In contrast, macrophage, lymphocyte, and eosinophil counts showed no significant variation among groups or infection status.

CONCLUSIONS: Horses with coughing and lymph node swelling showed the highest prevalence of β-hemolytic streptococci. S. zooepidemicus infection was associated with increased neutrophils and decreased macrophages and lymphocytes, highlighting the role of neutrophils in inflammation. Asymptomatic horses may also carry the bacteria, indicating their role as carriers. Distinct inflammatory profiles correspond to clinical signs, underscoring the complexity of equine respiratory disease and the value of cytology and tracheal wash in diagnosis.

PMID:41039541 | DOI:10.1186/s12917-025-05011-4

BMC Med Educ. 2025 Oct 2;25(1):1315. doi: 10.1186/s12909-025-07887-0.

ABSTRACT

BACKGROUND: Evidence-based medicine (EBM) is an essential component of medical practice, combining the best available scientific evidence with clinical expertise to support high-quality patient care. There is limited information on how EBM is integrated into postgraduate medical education programs. This study investigates differences in EBM training between university and non-university hospitals and across specialties in Switzerland and Austria.

METHODS: Data were collected through annual nationwide surveys evaluating the quality in postgraduate medical education in Switzerland and Austria. A total of 13,659 residents (Switzerland: 9,683; Austria: 3,976) responded to a paper-based questionnaire, resulting in response rates of 71% for Switzerland and 44% for Austria. The questionnaire contains a five-item EBM-scale measuring different aspects of EBM training on a 6-point Likert scale. Residents also answered questions related to scientific publishing. Comparisons were made between university hospitals and other institutions within and between both countries, as well as across specialties within hospital types and countries. Descriptive statistics were reported, and differences were analyzed using the Mann-Whitney U and Chi-square test.

RESULTS: In both countries, residents at university hospitals gave overall significantly higher ratings on the EBM-scale than those at non-university hospitals, with more pronounced differences observed in Austria. Moreover, residents in university hospitals reported higher engagement in scientific activities. Specialty comparisons revealed that internal medicine received the highest EBM ratings among university hospitals. In both countries, there were no significant differences between the two specialities anaesthesia and pediatrics across university and non-university hospitals.

CONCLUSIONS: Data from residents of two countries indicate potential to improve EBM training in postgraduate medical education in non-university hospitals, and reveal differences across specialities, suggesting the need for further research to identify the factors underlying these differences across hospital types and clinical contexts.

PMID:41039536 | DOI:10.1186/s12909-025-07887-0

BMC Med Educ. 2025 Oct 2;25(1):1337. doi: 10.1186/s12909-025-07942-w.

ABSTRACT

BACKGROUND: Medical education is inherently demanding, often compromising students’ well-being, especially in conflict-affected regions. This study aims to 1) evaluate the burnout levels among medical students using the Maslach Burnout Inventory General Survey for Students (MBI-GSS), 2) assess quality of life (QoL) using the World Health Organization QoL scale (WHOQOL-BREF), and 3) identify predictors of burnout and QoL.

METHODS: A cross-sectional online survey was conducted in English between May and June 2024. The questionnaire included sociodemographic data, MBI-GSS subscales (emotional exhaustion, cynicism, and professional efficacy respectively), and WHOQOL-BREF domains (physical, psychological, social, and environmental respectively). Bivariate and multivariable analyses were performed with the subscales and domains as dependent variables. An alpha of 0.05 was considered statistically significant.

RESULTS: A total of 200 medical students participated in this study, yielding a 78% response rate. Participants reported relatively high levels of emotional exhaustion (Mean ± SD = 21.2 ± 8.1) and low levels of professional efficacy (22.6 ± 7.8). Lower exhaustion scores were observed among last-year medical students (adjusted (a)ß (95% CI) = -13.1 (-19.5; -6.8)) and those who reported exercising daily (-9.7 (-14.8; -4.5)). Higher cynicism scores were found among students experiencing financial problems (2.6 (0.2; 5)). Moreover, lower professional efficacy scores were observed among students reporting academic difficulties (-3.1 (-5.7; -0.4)) or social isolation (-3.1 (-5.9; -0.2)). Students reported the highest satisfaction in the environmental QoL domain (Mean ± SD = 64 ± 18). Social isolation and symptoms of anxiety and/or depression were significantly associated with poorer QoL across multiple domains.

CONCLUSION: Burnout and reduced quality of life emerged as relevant concerns among medical students. Addressing these issues requires targeted institutional support and national investment in student mental health infrastructure, particularly in conflict-affected and economically strained regions.

PMID:41039528 | DOI:10.1186/s12909-025-07942-w

BMC Med Educ. 2025 Oct 2;25(1):1301. doi: 10.1186/s12909-025-07920-2.

ABSTRACT

BACKGROUND: Academic institutions play an important role not only in increasing the health workforce, but also ensuring faculty are equipped to meet the rising demand on trainees to enter the workforce. Located in Kigali, Rwanda, Africa Health Sciences University (AHSU) is a newly established institution training the next generation of health professionals across medicine, nursing, midwifery, and other health domains. This study explores faculty and staff perceptions of their current skills in teaching and research and identifies ways to further strengthen faculty development initiatives.

METHODS: This cross-sectional, survey-based study was conducted from August 11 to September 30, 2024, across AHSU’s three main residency clinical teaching sites. Participants included doctors, nurses, midwives, and administrators involved in educational activities. Data was collected via an anonymous questionnaire, with sections on participant demographics, job profile allocations, teaching and research skills, and faculty development preferences. Data was analyzed via descriptive statistics. Mean scores and standard deviations were calculated across Likert scale questions to evaluate central tendencies and participant response variability. The Kruskal-Wallis test was also employed for associations, with a statistical significance of p < 0.05.

FINDINGS: 230 participants completed the survey, including nurses and midwives (62.61%), medical doctors (31.74%), and administration (5.65%). Teaching skills were perceived to be stronger overall than research skills, with an average of 3.46 and 2.95 out of 4 respectively. Improving teaching and scholarship, and personal interest were the most cited motivations to engaging in faculty development programs. The perceived importance of faculty development showed significant associations with role, highest level of education, and faculty rank.

CONCLUSION: Strengthening faculty development in clinical academic settings has the potential to improve the overall academic environment across health sciences universities and their teaching sites. Health sciences universities should consider ways to recognize, develop, and support both their clinical and non-clinical staff engaged in academic activities. This can be done through institutional support systems, improved academic recognition frameworks, and the promotion of innovative teaching and learning methods.

PMID:41039527 | DOI:10.1186/s12909-025-07920-2

BMC Med Educ. 2025 Oct 2;25(1):1336. doi: 10.1186/s12909-025-07939-5.

ABSTRACT

INTRODUCTION: Generational change is impacting medical education and driving the adaptation and reform of teaching and clinical practice to successfully educate the next generation of physicians. Aim of the study was to establish undergraduates’ needs by analyzing the strengths and weaknesses of their soft skills from the start of medicine school. METHOD: We conducted a cross-sectional study to evaluate the personalities and soft skills of first-, third-, and sixth-year undergraduates in medical school. Of the eligible participants (N = 333), 127 of them (38.1%) were evaluated for their soft skills. The assessment was based on psychological and behavioral assessments.

RESULTS: Results showed the strong need of the young to understand themselves and know how to improve their personal growth during academic study. Mediation statistical analyses showed significant direct and indirect effects of the factors (year level in medical school) and mediators (conscientiousness/extroversion and openness) on the soft skills indexes. Conscientiousness was a predictive factor for all soft skills examined: self-determination (β = 0.54), resilience (β = 0.48), empathy (β = 0.36), assertiveness (β = 0.24), social support (β = 0.18), and teamwork (β = 0.30). Openness was correlated and predictive for empathy (β = 0.19). The model of the multilayered construct of medical competence represents a fruitful framework and using the lens of Self-Determination theory, medical undergraduates could be engaged and buffered against the stressors of patient care. DISCUSSION: In this scenario, the interaction with medical leaders is relevant, clinical trainers and medical undergraduates should model the professional learning; escalated clinical skills should build advanced knowledge in medicine.

PMID:41039516 | DOI:10.1186/s12909-025-07939-5

BMC Med Educ. 2025 Oct 2;25(1):1334. doi: 10.1186/s12909-025-07906-0.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had severely disrupted the education system in a variety of settings, particularly medical and dental teaching institutes. Restricting the teaching system to virtual mode and the treatment aspect to emergency-only care was of great challenge, in order to prevent the spread of COVID-19. During the pandemic, distance learning had become necessary to ensure that education continues.

OBJECTIVE: The present study aimed to analyse dental students’ perceptions of the transition of education from traditional to distance learning.

METHODS: This was a cross-sectional study consisting of a 25-statement online questionnaire, which was validated (Item- Content Validity Index (I-CVI: 0.87-0.89), reliability confirmed (Cronbach’s alpha = 0.82). The questionnaire was anonymously administered to students studying dentistry at the Manipal Academy of Higher Education, Manipal, India. The data collected were analysed statistically.

RESULTS: A total of 713 out of 800 undergraduate dental students participated in the survey, resulting in an 89.12% response rate. Approximately 74% students did not feel that it was easier to concentrate in online classes than in offline lectures, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. Almost three-fourths of the students (73.9%) felt that lockdowns and distance education severely affected the quality of their dental education. Most of the students (86.4%) felt that a lack of patient exposure would affect their future dental practice. With respect to learning preferences, the majority of the students preferred a combination of traditional methods and online learning.

CONCLUSION: The COVID-19 pandemic taught not only the use of technology in education but also future learning strategies. In today’s technologically adept world, e-learning is a convenient and effective method for teaching undergraduate dental students. Dental education is evolving consistently to accommodate rapid changes in the education system. However, it should be used as an auxiliary approach in the clinical setting since it cannot replace the conventional face-to-face approach.

PMID:41039511 | DOI:10.1186/s12909-025-07906-0

Head Face Med. 2025 Oct 2;21(1):65. doi: 10.1186/s13005-025-00539-0.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of endoscopic navigation-guided 3D printing combined with absorbable materials for individualized minimally invasive reconstruction of orbital blowout fractures, comparing outcomes to preformed titanium mesh controls to validate clinical value in achieving anatomical reduction, improving visual function, and reducing complications.

METHODS: This retrospective study enrolled 87 patients receiving absorbable implants (Trial Group) and 19 patients treated with preformed titanium mesh (Control Group). Preoperative CT scans were processed using Mimics 21.0 and Geomagic Studio 12.0 for 3D reconstruction, generating patient-specific guides and 3D-printed orbital models based on mirror-imaged healthy orbits. In the Trial Group, absorbable plates were thermo-molded using surgical guides and implanted; controls underwent titanium mesh trimming followed by screw fixation. Statistical analyses employed SPSS 26.0 with Python-automated covariate control: propensity score weighting (PSW) balanced baseline covariates (gender, age, fracture extent; SMD < 0.1 confirmed balance). Longitudinal continuous data (exophthalmos difference, logMAR BCVA) were analyzed via generalized estimating equations (GEE) modeling time-group interactions, while ordinal outcomes (diplopia severity, ocular motility restriction) used weighted ordinal logistic regression to compute marginal effects. All analyses controlled for timepoint interactions with statistical significance defined at α = 0.05.

RESULTS: The absorbable material group demonstrated superior diplopia resolution (residual rate: 9.2% vs. 31.6%, P = 0.018) with significant long-term recovery interaction (β = 1.59, P = 0.039). Both groups showed significant time-dependent improvements in ocular motility and exophthalmos (P < 0.001), though intergroup differences were non-significant. Trial group BCVA improved an additional 42% at 6 months (interaction β = 0.05, P = 0.028). No implant-related complications (infection/displacement) occurred in the absorbable group.

CONCLUSION: Endoscopic navigation-guided 3D printing with absorbable materials enables precise, individualized orbital reconstruction, significantly improving diplopia and visual acuity with superior safety, strongly supporting clinical adoption.

PMID:41039504 | DOI:10.1186/s13005-025-00539-0

Genome Med. 2025 Oct 2;17(1):108. doi: 10.1186/s13073-025-01552-3.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by diverse presentations and a strong genetic component. Environmental factors, such as prematurity, have also been linked to increased liability for ASD, though the interaction between genetic predisposition and prematurity remains unclear. This study aims to investigate the impact of genetic liability and preterm birth on ASD conditions.

METHODS: We analyzed phenotype and genetic data from two large ASD cohorts, the Simons Foundation Powering Autism Research for Knowledge (SPARK) and Simons Simplex Collection (SSC), encompassing 78,559 individuals for phenotype analysis, 12,519 individuals with genome sequencing data, and 8104 individuals with exome sequencing data. Statistical significance of differences in clinical measures was evaluated between individuals with different ASD and preterm status. We assessed the rare variants burden using generalized estimating equations (GEE) models and polygenic load using the ASD-associated polygenic risk score (PRS). Furthermore, we developed a machine learning model to predict ASD in preterm children using phenotype and genetic features available at birth.

RESULTS: Individuals with both preterm birth and ASD exhibit more severe phenotypic outcomes despite similar levels of genetic liability for ASD across the term and preterm groups. Notably, preterm-ASD individuals showed an elevated rate of de novo variants identified in exome sequencing (GEE model, p = 0.005) in comparison to non-ASD-preterm group. Additionally, a GEE model showed that a higher ASD PRS, preterm birth, and male sex were positively associated with a higher predicted probability for ASD in SPARK, reaching a probability close to 90%. Lastly, we developed a machine learning model using phenotype and genetic features available at birth with limited predictive power (AUROC = 0.65).

CONCLUSIONS: Preterm birth may exacerbate multimorbidity present in ASD, which was not due to ASD-associated genetic variants. However, increased ASD-associated rare variants may elevate the likelihood of a preterm child being diagnosed with ASD. Additionally, a polygenic load of ASD-associated variants had an additive role with preterm birth in the predicted probability for ASD, especially for boys. Future integration of genetic and phenotypic data in larger preterm or population-based cohorts will be crucial for advancing early ASD identification in preterm subgroup.

PMID:41039503 | DOI:10.1186/s13073-025-01552-3

BMC Med Educ. 2025 Oct 2;25(1):1300. doi: 10.1186/s12909-025-07911-3.

ABSTRACT

BACKGROUND: Simulation-based learning (SBL) is a structured educational method that enables learners to practice clinical, technical, and decision-making skills in a safe, immersive, and controlled environment. It has become a cornerstone of modern medical education.

OBJECTIVE: This study aimed to assess the effect of SBL on the academic performance of medical students at the pediatrics end of the clerkship examination.

METHODS: We analyzed the academic performance of 2,251 fifth-year medical students over 12 academic years, from September 2012 to June 2024, at the end of the pediatric clerkship. The period includes six years before and six years after the integration of simulation-based learning into the pediatric curriculum.

RESULTS: The performance of the students in the three components of the end of the clerkship examination, written, clinical, and continuous assessment, after the utilization of SBL was much better than their performance in the era before the SBL. The difference was statistically significant (p < 0.001).

CONCLUSION: The study highlights the positive impact of incorporating SBL into pediatric education for medical students in Bahrain. These findings support the wider integration of simulation as a teaching strategy across various clinical specialties in medicine and other sciences worldwide. They also highlight its potential to progressively complement and, in some cases, partially replace traditional classroom-based instruction.

PMID:41039502 | DOI:10.1186/s12909-025-07911-3