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Nevin Manimala Statistics

Perceptions of medical students at Najran University on the effectiveness of problem-based learning and team-based learning

BMC Med Educ. 2024 Oct 16;24(1):1150. doi: 10.1186/s12909-024-06148-w.

ABSTRACT

BACKGROUND: Team-based learning (TBL) and problem-based learning (PBL) are two effective educational approaches used in medical education for increasing knowledge acquisition, learning motivation, and collaborative and communication skills among students. Few studies have been conducted in Saudi Arabia to evaluate medical students’ perceptions of these approaches.

AIM OF THE STUDY: The present study aimed to evaluate the perceptions of current or previous preclinical students at the College of Medicine, Najran University (NU) about the effectiveness of PBL and TBL and to assess students’ perceptions regarding the strengths and limitations of both educational approaches and their preferences.

METHODS: A cross-sectional survey was conducted on 106 preclinical students at NU, Saudi Arabia. The survey questionnaire was validated by a pilot study and designed based on Kirkpatrick’s evaluation model. Descriptive statistics was used to analyze the collected data through IBM SPSS Statistics 2.0.

RESULTS: 73.6% of participants enjoyed PBL and found it motivating compared to TBL and classic lectures. PBL was reported as more effective for knowledge acquisition (50%), teamwork (62.3%), and high academic performance (58%).

CONCLUSION: It is concluded that PBL was more favored by the students regarding the learning outcomes. TBL was reported to need more individual preparation and effort and require lecturer involvement, suggesting the need for structured facilitation in this learning approach and potentially indicating the challenges associated with coordinating team-based activities.

PMID:39407260 | DOI:10.1186/s12909-024-06148-w

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Differential methylation of circulating free DNA assessed through cfMeDiP as a new tool for breast cancer diagnosis and detection of BRCA1/2 mutation

J Transl Med. 2024 Oct 15;22(1):938. doi: 10.1186/s12967-024-05734-2.

ABSTRACT

BACKGROUND: Recent studies have highlighted the importance of the cell-free DNA (cfDNA) methylation profile in detecting breast cancer (BC) and its different subtypes. We investigated whether plasma cfDNA methylation, using cell-free Methylated DNA Immunoprecipitation and High-Throughput Sequencing (cfMeDIP-seq), may be informative in characterizing breast cancer in patients with BRCA1/2 germline mutations for early cancer detection and response to therapy.

METHODS: We enrolled 23 BC patients with germline mutation of BRCA1 and BRCA2 genes, 19 healthy controls without BRCA1/2 mutation, and two healthy individuals who carried BRCA1/2 mutations. Blood samples were collected for all study subjects at the diagnosis, and plasma was isolated by centrifugation. Cell-free DNA was extracted from 1 mL of plasma, and cfMeDIP-seq was performed for each sample. Shallow whole genome sequencing was performed on the immuno-precipitated samples. Then, the differentially methylated 300-bp regions (DMRs) between 25 BRCA germline mutation carriers and 19 non-carriers were identified. DMRs were compared with tumor-specific regions from public datasets to perform an unbiased analysis. Finally, two statistical classifiers were trained based on the GLMnet and random forest model to evaluate if the identified DMRs could discriminate BRCA-positive from healthy samples.

RESULTS: We identified 7,095 hypermethylated and 212 hypomethylated regions in 25 BRCA germline mutation carriers compared to 19 controls. These regions discriminate tumors from healthy samples with high accuracy and sensitivity. We show that the circulating tumor DNA of BRCA1/2 mutant breast cancers is characterized by the hypomethylation of genes involved in DNA repair and cell cycle. We uncovered the TFs associated with these DRMs and identified that proteins of the Erythroblast Transformation Specific (ETS) family are particularly active in the hypermethylated regions. Finally, we assessed that these regions could discriminate between BRCA positives from healthy samples with an AUC of 0.95, a sensitivity of 88%, and a specificity of 94.74%.

CONCLUSIONS: Our study emphasizes the importance of tumor cell-derived DNA methylation in BC, reporting a different methylation profile between patients carrying mutations in BRCA1, BRCA2, and wild-type controls. Our minimally invasive approach could allow early cancer diagnosis, assessment of minimal residual disease, and monitoring of response to therapy.

PMID:39407254 | DOI:10.1186/s12967-024-05734-2

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Efficacy of proinflamatory cytokines in the clinical and radiograpic outcomes of different primary molar pulpotomy agents: a comperative randomised study featuring a novel biomarker for pulpal diagnosis

BMC Oral Health. 2024 Oct 15;24(1):1227. doi: 10.1186/s12903-024-04972-6.

ABSTRACT

BACKGROUND: While the effect of biomaterials covering the pulp tissue is considered in the success of pulpotomy treatment, the level of pulpal inflammation is still very important for treatment success. The aim of this study was to compare IL-6 and IL-8 levels, known as good indicators of pulpal inflammation, with a new biomarker, presepsin, and to evaluate the impact of biomarker levels along with the pulp capping agents used in the treatment on the one-year success of pulpotomy treatment.

METHODS: The study included 120 primary second molar teeth with pulpotomy indications from 75 children. To determine the pulpal inflammation status, pulpal bleeding samples were taken during treatment, and the levels of IL-6, IL-8, and presepsin were measured. During the pulpotomy treatment, MTA, NeoMTA™, and Biodentine™, and ZOE were randomly applied to groups of thirty teeth each. Patients were monitored for a period of 12 months post-treatment.

RESULTS: IL-8, IL-6, and presepsin levels were significantly higher in teeth with pathology (p < 0.001). Biomarker levels were found to be higher in the NeoMTA and Biodentine groups, but this did not result in a statistically significant difference. (p > 0.05) Following pulpotomy treatment, the most successful material groups in order were MTA, ZOE, NeoMTA™, and Biodentine™.

CONCLUSION: Presepsin may be a usable indicator in predicting the level of inflammation. At the end of the one-year follow-up of pulpotomy treatment, more pathology was observed in the NeoMTA and Biodentine groups, where biomarker levels were higher, while no pathology was found in the MTA group, where biomarker levels were lower.

TRIAL REGISTRATION: NCT06398327/ 20,240,503.

PMID:39407247 | DOI:10.1186/s12903-024-04972-6

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Comparative clinical efficacy of “Figure-8” Banding and double-row anchor suture-bridge fixation in arthroscopic management of tibial intercondylar eminence avulsion fractures

J Orthop Surg Res. 2024 Oct 16;19(1):663. doi: 10.1186/s13018-024-05111-1.

ABSTRACT

OBJECTIVE: The objective of this study is to assess and compare the clinical efficacy of “Figure-8” banding and double-row anchor suture-bridge fixation techniques in the arthroscopic management of tibial intercondylar eminence avulsion fractures.

METHOD: A retrospective analysis was conducted on the medical records of 42 patients who underwent arthroscopic surgery for tibial intercondylar eminence fractures at our institution from June 2017 to June 2022. This cohort included 20 cases treated with “Figure-8” banding and 22 cases managed using double-row anchor suture-bridge fixation. Comparative assessments were made regarding operative duration, duration of fracture consolidation, postoperative knee joint range of motion, joint stability as assessed by the Lachman test, Lysholm score, and International Knee Documentation Committee (IKDC) functional score for both treatment groups.

RESULTS: The mean follow-up duration was 13.8 months. The analysis indicated that the double-row anchor suture-bridge group had a significantly longer operative duration compared to the “Figure-8” banding group (p < 0.05). Postoperative computed tomography (CT) scans confirmed successful reduction in both groups, with fracture consolidation achieved within an average of three months. Both groups showed significant improvements in postoperative knee range of motion, joint stability, and functional scores compared to preoperative measurements (p < 0.05). During the initial two-month post-surgery, the double-row anchor suture-bridge group demonstrated superior knee joint range of motion and functional scores compared to the “Figure-8” banding group (p < 0.05); however, these differences were not statistically significant beyond three months post-surgery (p > 0.05). By the one-year postoperative mark, joint stability outcomes were comparable between the two treatment groups (p > 0.05).

CONCLUSION: Both “Figure-8” banding and double-row anchor suture-bridge fixation techniques in the arthroscopic management of tibial intercondylar eminence avulsion fractures can achieve precise reduction and stable fixation. In addition, the figure-8 suture group has the characteristics of shorter surgery time and less cost. Notably, early postoperative knee function appears to be superior with double-row anchor suture-bridge fixation compared to “Figure-8” banding.

PMID:39407246 | DOI:10.1186/s13018-024-05111-1

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Nevin Manimala Statistics

Review of MrsFreqPhase methods: methods designed to estimate statistically malaria parasite multiplicity of infection, relatedness, frequency and phase

Malar J. 2024 Oct 15;23(1):308. doi: 10.1186/s12936-024-05119-2.

ABSTRACT

Malaria parasites are haploid within humans, but infections often contain genetically distinct groups of clonal parasites. When the per-infection number of genetically distinct clones (i.e., the multiplicity of infection, MOI) exceeds one, and per-infection genetic data are generated in bulk, important information are obfuscated. For example, the MOI, the phases of the haploid genotypes of genetically distinct clones (i.e., how the alleles concatenate into sequences), and their frequencies. This complicates many downstream analyses, including relatedness estimation. MOIs, parasite sequences, their frequencies, and degrees of relatedness are used ubiquitously in malaria studies: for example, to monitor anti-malarial drug resistance and to track changes in transmission. In this article, MrsFreqPhase methods designed to estimate statistically malaria parasite MOI, relatedness, frequency and phase are reviewed. An overview, a historical account of the literature, and a statistical description of contemporary software is provided for each method class. The article ends with a look towards future method development, needed to make best use of new data types generated by cutting-edge malaria studies reliant on MrsFreqPhase methods.

PMID:39407242 | DOI:10.1186/s12936-024-05119-2

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Associations between an open-response situational judgment test and performance on OSCEs and fieldwork: implications for admissions decisions and matriculant diversity in an occupational therapy program

BMC Med Educ. 2024 Oct 15;24(1):1146. doi: 10.1186/s12909-024-06071-0.

ABSTRACT

BACKGROUND: Casper, an online open-response situational judgement test that assesses social intelligence and professionalism [1], is used in admissions to health professions programs.

METHOD: This study (1) explored the incremental validity of Casper over grade point average (GPA) for predicting student performance on objective structured clinical examinations (OSCEs) and fieldwork placements within an occupational therapy program, (2) examined optimal weighting of Casper in GPA in admissions decisions using non-linear optimization and regression tree analysis to find the weights associated with the highest average competency scores, and (3) investigated whether Casper could be used to impact the diversity of a cohort selected for admission to the program.

RESULTS: Multiple regression analysis results indicate that Casper improves the prediction of OSCE and fieldwork performance over and above GPA (change in Adj. R2 = 3.2%). Non-linear optimization and regression tree analysis indicate the optimal weights of GPA and Casper for predicting performance across fieldwork placements are 0.16 and 0.84, respectively. Furthermore, the findings suggest that students with a slightly lower GPA (e.g., 3.5-3.6) could be successful in the program as assessed by fieldwork, which is considered to be the strongest indicator of success as an entry-level clinician. In terms of diversity, no statistically significant differences were found between those actually admitted and those who would have been admitted using Casper.

CONCLUSION: These results constitute preliminary validity evidence supporting the integration of Casper into applicant selection in an occupational therapy graduate program.

PMID:39407220 | DOI:10.1186/s12909-024-06071-0

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Elemental analysis and micromorphological patterns of tooth/restoration interface of three ion-releasing class V restorations

BMC Oral Health. 2024 Oct 15;24(1):1221. doi: 10.1186/s12903-024-04944-w.

ABSTRACT

OBJECTIVES: To evaluate and compare the ion-releasing capability of three different restorative systems at the restoration/tooth interface elemental analysis using energy-dispersive X-ray technique. Additionally, micromorphological patterns of the restoration/tooth interfaces was investigated.

MATERIALS AND METHODS: Eighteen freshly extracted sound human premolars were collected for the study. The premolars were randomly assigned into 3 groups (n = 6) based on the type of restorative materials used: Giomer (Beautifill II), ion-releasing composite (Activa Presto), and RMGI (Riva Light Cure). Half of the specimens in each group were tested after 24 h (the “immediate group”), while the remaining half were tested after 6 months of storage in deionized water (the “delayed group”). Standardized box-shaped cavities along the cervical area of teeth crowns and restored them with the assigned restorative material following manufacturers’ instructions. The specimens were sectioned buccolingually into 2 halves. One half of each specimen was subjected to elemental analysis using energy-dispersive X-ray technique (EDX), while the remaining half was sputter coated and underwent micromorphological analysis of the restoration/tooth interface using a scanning electron microscope (SEM). The collected data from elemental analysis test were tabulated and subjected to statistical analysis.

RESULTS: The two-way ANOVA test showed significant differences in both phosphorus and calcium levels among the tested restorative systems (p < 0.05). In the immediate subgroup, RMGI recorded the highest phosphorus level (0.1527), followed by the ion-releasing composite (0.1172), while Giomer exhibited the least levels (0.0326) (p < 0.05). The ion-releasing composite group had the highest calcium level (0.2797), followed by RMGI (0.248), and Giomer (0.2385) respectively (p < 0.05). In the delayed subgroups, Giomer recorded the highest phosphorus level (0.1526), followed by the ion-releasing composite (0.1058), and RMGI group (0.0466) respectively (p < 0.05). RMGI had the highest calcium level (0.2801), followed by the ion-releasing composite (0.2659), and Giomer had the lowest level (0.1792) (p < 0.05). The micromorphological analysis of the restoration/tooth interfaces showed good adaptation between the composite and tooth substrate in different restorative groups.

CONCLUSIONS: The ion-releasing capability of the three restorative systems appears to be comparable. The rate of mineral release and diffusion is affected by time and composition.

PMID:39407219 | DOI:10.1186/s12903-024-04944-w

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Common pitfalls in drug target Mendelian randomization and how to avoid them

BMC Med. 2024 Oct 15;22(1):473. doi: 10.1186/s12916-024-03700-9.

ABSTRACT

BACKGROUND: Drug target Mendelian randomization describes the use of genetic variants as instrumental variables for studying the effects of pharmacological agents. The paradigm can be used to inform on all aspects of drug development and has become increasingly popular over the last decade, particularly given the time- and cost-efficiency with which it can be performed even before commencing clinical studies.

MAIN BODY: In this review, we describe the recent emergence of drug target Mendelian randomization, its common pitfalls, how best to address them, as well as potential future directions. Throughout, we offer advice based on our experiences on how to approach these types of studies, which we hope will be useful for both practitioners and those translating the findings from such work.

CONCLUSIONS: Drug target Mendelian randomization is nuanced and requires a combination of biological, statistical, genetic, epidemiological, clinical, and pharmaceutical expertise to be utilized to its full potential. Unfortunately, these skillsets are relatively infrequently combined in any given study.

PMID:39407214 | DOI:10.1186/s12916-024-03700-9

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Patient and family aftercare enhance interactions between Helicopter Emergency Medicine Services and former patients and families

BMC Health Serv Res. 2024 Oct 16;24(1):1238. doi: 10.1186/s12913-024-11720-7.

ABSTRACT

BACKGROUND: Helicopter Emergency Medical Services (HEMS) in the United Kingdom (UK) deliver enhanced care to high-acuity, critically ill and injured patients. To enable patients to meet the HEMS team who treated them, many services within the UK have developed or are in the process of developing a Patient and Family Aftercare Service (PFAS). This study aims to evaluate whether the introduction of PFAS mitigates anxiety associated with patient aftercare visits.

METHODS: A service evaluation of anxiety in HEMS team members before and after patient aftercare visits were conducted. The study was carried out between 1 September 2023, and 31 October 2023, and patient visits were undertaken between March 2022 and July 2023. An electronic survey was distributed to the respondents who provided informed consent for participation. The survey comprised the validated generalised anxiety disorder anxiety scale (GAD-7) and five additional contextualised statements developed through the wider PFAS. Anonymised data were collected using REDCap, a secure electronic database and was analysed in R programming. Free-text comments were reported by content analysis, placed into themes, and discussed with a narrative to complement the quantitative analysis.

RESULTS: Of the 33 recipients, 25 completed the questionnaire. Between the pre- and post-aftercare visits, a statistically significant difference was found between scores for GAD-7 (0.004, p < 0.05) and contextualised statements (0.001, p < 0.05). In addition, six broad themes were identified through content analysis. These include the emotional impact of patient interaction, coping strategies and structural changes in the aftercare system, challenges in patient and family expectations, anxieties relating to operational commitments, memory and recall of the incident, and a positive impact on personal growth.

CONCLUSION: Anxiety related to patient aftercare visits was reduced when measured before and after the patient visits. Following this service evaluation, we can hypothesise that within pre-hospital care, PFAS plays an important structural role. Future research should focus on affirming the correct tool to measure anxiety in multi-disciplinary teams and prospectively evaluating these methods collaboratively across multiple pre-hospital services.

PMID:39407209 | DOI:10.1186/s12913-024-11720-7

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Bruxism awareness and self-assessment in dental clinical students: a questionnaire-based study

BMC Oral Health. 2024 Oct 15;24(1):1223. doi: 10.1186/s12903-024-04997-x.

ABSTRACT

BACKGROUND: Bruxism is a recurrent parafunctional habit characterized by clenching or grinding teeth and/or jaw contractions. It is quite common among dental students and is associated with psychosocial factors such as stress and anxiety. This study aimed to compare bruxism awareness and self-assessment among clinical students with and without bruxism.

METHODS: This study included systemically healthy individuals aged 18 to 27 years. Intraoral and extraoral examinations were performed on 128 4th- and 5th-grade dental students with (64) and without bruxism (64), 4th and 5th-grade dental students at Bolu Abant İzzet Baysal University who met the inclusion criteria. The diagnosis of bruxism was based on the 2018 International Consensus and data collected through a validated 33-item questionnaire covering general information and bruxism awareness. The questionnaire included multiple-choice questions on bruxism types, risk factors, symptoms, and impact on periodontal tissues. Statistical analyses were performed via IBM SPSS Statistics, and p < 0.05 was considered statistically significant.

RESULTS: Clenching and teeth grinding during sleep, tooth wear, muscle fatigue, pain in the temples, jaw pain, joint trismus, neck pain, and jaw joint pain and clenching while awake were significantly different in bruxism patients (p < 0.05). There was no significant difference between the two groups in terms of bruxism type, symptoms, treatment methods, periodontal tissues, occlusal trauma, diagnostic methods, or the relationship between lifestyle and bruxism (p > 0.05). While 71.9% of those diagnosed with bruxism stated that they had bruxism, 68.8% of those who were not diagnosed stated that they did not have bruxism.

CONCLUSION: Although dental students are aware of bruxism, their understanding of its multifactorial nature and treatment options needs improvement. Increasing this knowledge could reduce the prevalence of bruxism among dental students and improve patient care.

CLINICAL TRIAL REGISTRATION: The clinical trial was retrospectively registered on ClinicalTrials.gov under the identifier NCT06583044, with a registration date of 03/09/2024. https://register.

CLINICALTRIALS: gov/prs/beta/studies/S000EUYA00000023/recordSummary .

PMID:39407206 | DOI:10.1186/s12903-024-04997-x