Search Results (265)

Background: Simulation-based education (SBE) is increasingly integrated into medical curricula to enhance clinical reasoning, reflective practice, and experiential learning in safe educational environments. Evaluating learners’ satisfaction is essential to assess the educational impact of simulation activities. Although the Satisfaction with Simulation Experience Scale (SSE) has been internationally validated, no robust psychometric validation has been conducted among Italian medical students. This study aimed to evaluate the psychometric properties of the Italian version of the SSE (SSE-It). Methods: A cross-sectional psychometric validation study was conducted with 408 third-year medical students enrolled at a Northern Italian university after participation in a mandatory simulation internship on introductory ultrasound. Participants completed the Italian adaptation of the 18-item SSE, rated on a 5-point Likert scale and organized into three domains: Debriefing and Reflection, Clinical Reasoning, and Clinical Learning. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega coefficients. Confirmatory factor analysis (CFA) was performed to examine the factorial structure of the scale. Results: CFA supported the original three-factor structure of the SSE-ITA, showing good fit indices: χ²(132) = 410.67 (WLSMV-scaled), CFI = 0.98, TLI = 0.97, RMSEA = 0.07, and SRMR = 0.05. Internal consistency was high for the total scale (α = 0.94; ω = 0.95) and satisfactory across subscales (α ranging from 0.84 to 0.92; ω ranging from 0.86 to 0.93). Conclusions: The SSE-It demonstrated satisfactory reliability and construct validity in this task-trainer-based, introductory ultrasound simulation context, supporting its use as a reliable instrument to assess satisfaction with this type of simulation-based education among Italian medical students. Generalizability to high-fidelity, immersive simulation modalities remains to be established. Full article

Chronic inflammation and metabolic dysregulation of heart failure (HF) often result in sarcopenia. The combined effect of Mediterranean diet (MD) and omega-3 polyunsaturated fatty acids on the advanced lipidomic profile of HF patients remains poorly defined. Objective: Our objective was to analyze the specific effects of a MD plus omega-3-enriched oral nutritional supplements (MD+ONS) versus MD alone on the metabolic lipid profile of patients with HF, stratified by sarcopenia status. Methods: In this prospective, open-label, randomized controlled trial, 38 patients with HF were assigned to MD alone or MD+ONS (24 weeks). Advanced lipoprotein profiling (triglycerides, cholesterol, particle size, and concentration for VLDL, LDL, and HDL subclasses) was performed using 2D ¹H-NMR spectroscopy. Results: At baseline, NT-proBNP levels correlated positively with ω6/ω7ω9 fatty acids and IDL-TG (p < 0.05). Over 24 weeks, VLDL-C, VLDL-TG, and VLDL-P significantly decreased in the whole cohort (p < 0.001). However, stratified analysis revealed that in patients with sarcopenia, these reductions were primarily driven in the MD group (p < 0.01). Conversely, in patients without sarcopenia, the MD+ONS group showed significant reductions in VLDL-TG, VLDL-P, and VLDL-Z (p < 0.05). Regarding intermediate lipoproteins, IDL-C significantly increased in the MD group (p < 0.05) but not in the MD+ONS group. In the LDL fraction, total LDL-P and small LDL-P decreased in the MD group (p < 0.05), while medium LDL-P increased across both groups (p < 0.01). Total HDL-P decreased (p < 0.05), yet large HDL-P significantly increased in the whole cohort and the MD group (p < 0.05). No significant changes were observed in structural lipids or total fatty acid families. Conclusions: MD+ONS induces lipidomic shifts that are significantly modulated by baseline sarcopenia. The intervention appears to stabilize VLDL and IDL levels in patients with sarcopenia compared to diet alone, while promoting a more favorable VLDL reduction in individuals without sarcopenia, suggesting that early nutritional support for improving body composition is a critical determinant of the metabolic response to specific interventions in patients with HF. Full article

Background/Objective: Low back pain (LBP) is a leading cause of disability worldwide, and patient-reported outcome measures such as the Roland–Morris Disability Questionnaire (RMDQ) are essential for assessing LBP-related disability. While the Modern Standard Arabic version of the RMDQ has demonstrated preliminary reliability, its structural validity has not been thoroughly evaluated. This study aimed to assess the structural validity of the Modern Standard Arabic RMDQ using confirmatory factor analysis (CFA). Methods: A cross-sectional study was conducted for 113 patients with LBP recruited from outpatient physical therapy clinics in Saudi Arabia. Participants completed the Modern Standard Arabic RMDQ, a 24-item instrument scored dichotomously. CFA was performed using the Weighted Least Squares Mean and Variance adjusted estimator to test a unidimensional model. Model fit was assessed using Root Mean Square Error of Approximation (RMSEA), Standardized Root Mean Square Residual (SRMR), Tucker–Lewis Index (TLI), and Comparative Fit Index (CFI). Reliability was evaluated using McDonald’s omega (ω). Results: The initial one-factor CFA model showed close to acceptable fit (RMSEA = 0.044; SRMR = 0.149; TLI = 0.94; CFI = 0.93). After accounting for significant residual correlations between item pairs (items 4 & 21; 13 & 18), model fit improved (Δχ² = 22.33; Δdf = 2; p < 0.001) (RMSEA = 0.038; SRMR = 0.145; TLI = 0.95; CFI = 0.95). Most items had significant loadings on the latent construct, except item 2. McDonald’s ω was 0.91, indicating excellent internal consistency. Conclusions: The findings of this study provide supportive evidence for the structural validity and internal consistency of the Modern Standard Arabic version of the RMDQ and suggest the presence of a dominant unidimensional structure. The Arabic RMDQ may be useful for assessing LBP-related disability in Arabic-speaking patients with LBP, although further validation studies are warranted. Full article

(1) Background: The Rational-Experiential Inventory (REI-40) is a widely used instrument for assessing individual differences in rational and experiential thinking styles based on Cognitive-Experiential Self-Theory (CEST). Despite its international prominence, no comprehensive validation existed for Brazilian Portuguese populations. (2) Methods: This study validated the REI-40 for Brazilian Portuguese through confirmatory factor analysis (CFA) estimated with a robust weighted least squares estimator (WLSMV) appropriate for ordinal items, comparison of competing structural models, internal-consistency and validity testing, and tests of measurement invariance across sex, education, and age, in a sample of 464 legal professionals from Brazil’s Advocacy-General of the Union. (3) Results: The hypothesized four-factor, 40-item model showed acceptable fit (χ²(734) = 1815.8, CFI = 0.902, TLI = 0.896, RMSEA = 0.056, SRMR = 0.080) and clearly outperformed unidimensional and two-factor alternatives. McDonald’s omega indicated good internal consistency for all subscales (ω = 0.79–0.87). Measurement invariance across sex, education, and age was supported at the configural and metric levels. Validity evidence included positive correlations between rational subscales and CRT-7 (r = 0.24–0.31) and weak or negative correlations for experiential subscales. (4) Conclusions: The Brazilian Portuguese REI-40 demonstrates adequate psychometric properties for measuring thinking styles in professional populations. Full article

Background/Objectives: Ulcerative colitis (UC) is a chronic inflammatory bowel disease in which alterations in the gut microbiota and dietary lipid composition play a central role; this study aimed to evaluate the effects of synbiotics, omega-3 polyunsaturated fatty acids, and their combination on clinical, macroscopic, microbiological, and histopathological outcomes in dextran sodium sulfate (DSS)-induced colitis in Wistar rats. Methods: Seventy-two male Wistar rats were randomly allocated to four groups (n = 18/group) and received 5% DSS in drinking water for eight days to induce colitis. Following DSS withdrawal and histological confirmation of colitis in sentinel animals, groups were treated for 8 days as follows: DSS (control), DSS-S (synbiotics, Ecologic^® 825), DSS-Ω3 (omega-3 fatty acid-enriched diet, ProSure^®), or DSS-S&Ω3 (combined therapy). Eight rats per group were sacrificed on days 4 and 8 post-DSS. Body weight, Disease Activity Index (DAI), distal colon length, hematologic parameters, bacterial translocation to the liver and mesenteric lymph nodes, histological colitis score, and myeloperoxidase (MPO)-positive cell counts were assessed. Results: DSS induced severe colitis characterized by diarrhea, rectal bleeding, and extensive mucosal erosions. After 8 days of treatment, the DSS-S&Ω3 group showed the greatest body-weight recovery (206.1→222.9 g, p < 0.05 vs. other groups), significantly preserved distal colon length, and the largest reduction in DAI (p < 0.05). Both the DSS-S and DSS-S&Ω3 groups demonstrated reduced bacterial translocation compared with DSS. The DSS-Ω3 group demonstrated persistent MPO-positive neutrophil infiltration compared with the DSS-S and DSS-S&Ω3 groups, whereas combined therapy was associated with lower MPO-positive cell counts. Histological colitis scores were significantly improved only in the DSS-S&Ω3 group (p < 0.05). Conclusions: In this DSS colitis model, the DSS-S&Ω3 group demonstrated superior clinical and histological outcomes compared with DSS-S or DSS-Ω3 alone, supporting further evaluation of combined synbiotic and omega-3 therapy as an adjunctive approach in ulcerative colitis. Full article

Background: The Operating Room Management Attitudes Questionnaire (ORMAQ) is widely used to assess operating room (OR) staff attitudes toward patient safety and teamwork across diverse contexts. However, no validated French version currently exists, limiting its use in francophone settings. This study aimed to translate and culturally adapt the ORMAQ into French and to evaluate its psychometric properties, while also reporting OR professionals’ attitudes explored during the validation process. Methods: A cross-sectional methodological study was conducted among OR professionals, including surgeons, anesthetists, anesthesia nurses, operating room nurses, and residents. The original ORMAQ was translated into French using a standardized forward–backward translation procedure and pretested with 20 OR professionals. Content and concurrent validity were examined. Reliability was assessed through internal consistency, test–retest reproducibility, and dimension-level consistency. Construct validity was examined using both exploratory and confirmatory factor analyses (CFA). Results: The overall response rate to the survey was 76.5% (n = 303). The French ORMAQ demonstrated good internal consistency, as evidenced by both Cronbach’s alpha (α = 0.842) and McDonald’s Omega (ω = 0.98). For the individual dimensions, reliability values ranged from 0.597 to 0.891 for alpha and from 0.75 to 0.89 for Omega. Test–retest analysis showed excellent reproducibility (ICC = 0.96; 95% CI: 0.92–0.98). Factor analyses supported the eight-factor structure, with the CFA confirming good model fit and meaningful item loadings across dimensions, with standardized loadings ranging from 0.40 to 0.83. Conclusions: The French version of the ORMAQ showed satisfactory psychometric properties. It represents a robust tool for assessing safety and teamwork attitudes among OR professionals in francophone countries. Full article

Omega-6 polyunsaturated fats (ω-6 PUFAs) are vital for many physiological functions, but their impact on cardiovascular disease (CVD) risk is controversial. Eryptosis alters blood viscosity by providing a procoagulant surface and leads to anemia, which is a recognized risk factor for CVD. This study examines the toxic mechanisms of adrenic acid (ADR), an ω-6 PUFA enriched in inflammatory and oxidative conditions, in red blood cells (RBCs). Purified RBCs were prepared from healthy volunteers and treated with 10–100 μM of ADR for 24 h at 37 °C under various physiological conditions. Eryptotic markers were studied through flow cytometry including Ca²⁺ (Fluo4/AM), loss of volume (forward scatter), phosphatidylserine (PS) exposure (annexin-V-FITC), and oxidative stress (H₂DCFDA). Moreover, hemolytic markers were measured by colorimetric methods, whereas cellular morphology was visualized using a scanning electron microscope. ADR led to significant Ca²⁺ elevation, cell shrinkage and schistocyte formation, PS externalization, hemolysis, and oxidative stress. While guanosine, heparin, and NSC 23766 prevented eryptosis and hemolysis, melatonin, ATP, adenine, and L-NAME only prevented eryptosis. Conversely, mannitol and urea exacerbated eryptosis, whereas caffeine, mannitol, and urea under Ca²⁺ deprivation and membrane potential dissipation aggravated hemolysis. ADR induces erythrocyte membrane injury and eryptosis through Ca²⁺ elevation, oxidative stress, and metabolic exhaustion subject to inhibition by the Rac1 GTPase/NOS/COX pathway. Altogether, these findings present a novel mechanistic link between lipid dysregulation and RBC dysfunction which may improve dietary strategies to prevent and manage CVD. Full article

Background: Unhealthy expansion of adipose tissue (AT) due to excessive dietary intake of omega-6 or overnutrition stimulates the overaccumulation of the extracellular matrix (ECM), resulting in AT metabolic dysregulation. Hypertrophic conditions, excessive adipose depots, and hypoxia stimulate the overproduction of collagenous and non-collagenous proteins, which pathophysiologically initiate the pro-fibrotic signaling pathway associated with fibrosis progression, resulting in atherosclerosis and cardiovascular diseases. Methods: We aimed to investigate adipocyte plasticity in response to a varying ratio of omega-3 (ω3) to omega-6 (ω6) supplementation during the chemically induced adipogenic differentiation of human mesenchymal stem cells. Additionally, changes in lipid accumulation, adipocyte hypertrophy and hyperplasia, active lipid metabolites, and inflammatory cytokine profiles were evaluated. Furthermore, conditioned media from adipocytes treated with different ω3/ω6 ratios were applied to platelets to assess inflammatory responses through prostaglandin and thromboxane measurements. Results: A 1:3 ratio of ω3/ω6 (20:60 µM) significantly reduced lipid accumulation, promoted brown-like adipocyte morphology, and decreased apoptosis and reactive oxygen species (ROS) generation, as confirmed via FACS analysis. Transcriptional control of adipose tissue expansion was confirmed by the downregulation of LIPIN1 and COL1A1 mRNA expression and p-prostaglandin12-R protein levels in a 1:3 ratio when compared with 1:1, 1:2, 1:4, or 2:6 ratios of ω3/ω6. Notably, a 1:3 ratio of fatty-acid-treated adipocyte-conditioned media-treated platelets significantly reduced platelet activation and aggregation, as evidenced by lower p-thromboxane A2 protein levels. Conclusions: Supplementation with a 1:3 (20:60 µM) ω3/ω6 ratio favored the development of lean adipocytes, evidenced by the decreased lipid storage achieved by mitochondrial thermogenesis, which attenuated minimal adipocyte expansion and metabolic inflammation. Full article

Background: Adolescent insomnia is a public health concern associated with affective disturbances, poor academic performance, and cardiometabolic risk. In Peru, nighttime screen use, psychosocial stressors, and social inequalities intensify its impact; however, brief, validated screening instruments remain limited. Objective: To translate, culturally adapt, and evaluate the psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in Peruvian adolescents, examining its internal structure, reliability, and invariance across sex. Methods: An instrumental study was conducted with 300 students aged 13 to 17 years (M = 15.02; SD = 1.07). Descriptive statistics were calculated, and confirmatory factor analysis (CFA) was performed using a robust estimator. Reliability was assessed through Cronbach’s alpha (α), McDonald’s omega (ω), and average variance extracted (AVE). Factorial invariance by sex was examined at the configural, metric, scalar, and strict levels. Results: The unidimensional model demonstrated adequate fit (χ² = 44.55, df = 18, p < 0.001; CFI = 0.97; TLI = 0.95; RMSEA = 0.07; SRMR = 0.04), with factor loadings ranging from 0.47 to 0.76, high internal consistency (α = 0.86; ω = 0.81), and AVE = 0.51. Although the two-factor model showed acceptable global fit indices, it revealed insufficient AVE in one factor (AVE = 0.40) and a high inter-factor correlation (r = 0.93), suggesting a lack of discriminant validity. Factorial invariance across sex was supported at all evaluated levels. Conclusions: The Spanish version of the YSIS demonstrates a unidimensional structure, adequate internal consistency, and factorial invariance across sex, supporting its use as a brief screening tool in clinical and school settings, as well as in epidemiological studies among Peruvian and Latin American adolescents. Full article

White-backed and Ash-grey cows yielded an average of 6212 kg and 6078 kg of milk per year, with 4.25–4.28% fat and 3.37–3.40% protein, while Holsteins averaged 10,694 kg with 4.47% fat and 3.45% protein. The study aimed to analyse the fatty acid (FA) profile of milk from two local cow breeds, compare them with that of Holstein cows, and evaluate the influence of lactation number, productivity indicators and milk colour. The study was carried out with White-backed (n = 40), Ash-grey (n = 49), and Holstein (n = 51) cows. Based on lactation number, cows were divided into two groups. Composite milk samples from all quarters of each cow were collected. Two additional milk samples were taken: 1st to assess milk colour and the second to determine the fatty acids profile. Productivity data of cows were provided from the Livestock Information System. Statistical analysis included calculating means and standard deviations or standard errors of the mean. One-way and two-way ANOVA (breed and lactation) were used, and Duncan’s test was applied to compare mean values between groups. White-backed cows contained greater proportions of C17:0, C17:1, C18:3 ω3, and C20:0 (p < 0.05), as well as higher total omega-3 and polyunsaturated fatty acid (PUFA) contents. Parity did not have a significant effect on productivity indicators, but parity influenced the FA profile. Milk from 1st-lactation Ash-grey cows showed higher levels of PUFA and omega-6 fatty acids (p < 0.05). Milk from Ash-grey cows has more favourable visual attributes, indicating improved suitability for dairy processing, where colour uniformity is important for technological quality. Full article

Background: The Child and Adolescent Eating Disorder Examination Questionnaire (ChEDE-Q) is a widely used self-report screening instrument for assessing eating disorder psychopathology in young people. Evidence on the psychometric properties of the Polish-language version remains limited. This pilot study evaluated the internal consistency, dimensional structure, and BMI-related convergent validity of the Polish ChE-DE-Q in a regional youth sample. Methods: A cross-sectional design was used, including 200 participants aged 10–18 years. Item characteristics and data quality were examined. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega. Dimensional structure was evaluated with exploratory factor analysis (EFA) based on a polychoric correlation matrix and confirmatory factor analysis (CFA) comparing one-factor, four-factor, and bifactor models. Convergent validity was examined using Spearman’s rank correlations with BMI and linear regression analyses with BMI z-scores. Results: The global score showed high internal consistency (α = 0.898; ω = 0.900). Subscale reliability ranged from acceptable to high. EFA supported a multidimensional solution. In CFA, the bifactor model showed the best fit among the tested alternatives (CFI = 0.742; TLI = 0.681; RMSEA = 0.122; SRMR = 0.084), but none of the tested models achieved fully satisfactory absolute fit. The global score correlated positively with BMI (rho = 0.282; p < 0.001) and was significantly associated with BMI z-score in regression analysis (B = 0.334; p < 0.001). Conclusions: The Polish ChEDE-Q global score demonstrated strong internal consistency and preliminary BMI-related convergent validity. The findings provide initial support for a general factor and for using the global score in screening-oriented research; however, the pilot character of the study and the suboptimal absolute fit indices indicate that further validation in larger and more heterogeneous samples is required. Full article

This study aimed to translate, culturally adapt, and validate the Arabic version of the 6-Item Lubben Social Network Scale (LSNS-6). The LSNS-6 was translated, culturally adapted, and administered, alongside the Medical Outcomes Study Social Support Survey (MOS-SSS), to 327 Arabic-speaking adults aged 60 years and older. Internal consistency was examined using Cronbach’s alpha and McDonald’s omega. Confirmatory factor analysis (CFA) tested the hypothesized two-factor structure (Family and Friends), and measurement invariance was evaluated across key sociodemographic and lifestyle variables. Convergent validity was assessed through correlations with MOS-SSS domains. Item response theory (IRT) analyses examined item discrimination and threshold parameters. Latent class analysis (LCA) explored whether the LSNS-6 could identify subgroups with distinct patterns of social connectedness and perceived support. The Arabic LSNS-6 demonstrated good internal consistency (α = 0.83; ω = 0.84) and supported the expected two-factor structure with satisfactory model fit (CFI = 0.963; TLI = 0.931; SRMR = 0.03). Convergent validity was evidenced by moderate correlations with overall perceived social support (r = 0.51). IRT analyses indicated strong discrimination for most items, and LCA identified four distinct latent classes. Overall, the Arabic LSNS-6 is a reliable and valid tool for assessing social isolation among older Arabic-speaking adults. Full article

Urban mobility plays a key role in territorial equity, access to services, and population well-being, as unfavorable mobility experiences are associated with stress and physical and mental deterioration. However, in Latin American and border cities, validated instruments for comprehensively assessing these experiences remain scarce. This study aimed to design and evaluate the psychometric properties of the Urban Mobility Experiences Scale [UMES]. A cross-sectional study was conducted with 423 adults from Nogales, Sonora, Mexico, selected through convenience sampling. The initial UMES consisted of 24 items distributed across five conceptual dimensions. Content validity was assessed by nine experts using Aiken’s V coefficient, while construct validity was examined through exploratory factor analysis with principal axis factoring and PROMAX rotation. Data adequacy was verified using the Kaiser–Meyer–Olkin index and Bartlett’s test of sphericity. Internal consistency was estimated using McDonald’s Omega. All items demonstrated adequate content validity (V ≥ 0.80). Five factors were identified, explaining 53.6% of the total variance, with factor loadings above 0.40. Reliability was acceptable across all dimensions (ω ≥ 0.70), and overall internal consistency was high (ω = 0.912). The UMES is a valid and reliable instrument for assessing urban mobility experiences in intermediate and border cities and may inform evidence-based policies promoting equity, sustainability, and urban well-being. Full article

Background/Objectives: Circulating inflammatory cytokines and tissue sensitivity are both elevated following heat stress-induced intrauterine growth restriction (IUGR). Cytokines disrupt myoblast function and muscle growth, and thus we hypothesized that suppressing inflammatory tone in IUGR-born lambs by supplementing anti-inflammatory nutraceuticals would improve early postnatal growth. Methods: IUGR lambs produced by maternal heat stress were supplemented daily with 42 mg/kg oral omega-3 polyunsaturated fatty acid (ω-3 PUFA) Ca²⁺ salts or placebo from birth to 28 days of age. Results: By day 28, the 21% lighter bodyweights for IUGR lambs were fully resolved by ω-3 PUFA due to the complete recovery of average daily gain. Subcutaneous fat deposition and visceral organ growth were modestly diminished in IUGR-born lambs, but skeletal muscle mass was more markedly restricted. This coincided with 63% less muscle AdipoR2 but 27% greater circulating adiponectin. ω-3 PUFA reduced or eliminated deficits in subcutaneous fat, visceral organs, and five of the six individual muscles assessed, which corresponded with rescue of myoblast populations and AdipoR2 content. In turn, asymmetric growth restriction was resolved at one month of age. Conclusions: These findings show that targeting heightened inflammatory tone during the neonatal period in IUGR-born offspring can recover early growth in skeletal muscle and other soft tissues. Full article

DNA and RNA, by focusing on their unique molecular properties, have transcended their role as carriers of genetic information in life and pioneered new application fields such as molecular robotics and molecular computing. However, as these technologies advance, the limitations inherent in natural nucleic acids and their ecosystems are increasingly becoming apparent as barriers to further application. To overcome these constraints, efforts to create artificial nucleic acids using chemical synthesis are underway and are now reaching a new stage of development. This paper proposes a concept of ultimate nucleic acid, “Omega Nucleic Acids ($\mathsf{\Omega }$NA),” as a thought experiment. We discuss the specifications required for this molecule, its implementable functions and approaches, and the construction of an ecosystem centered around $\mathsf{\Omega }$NA. By working backward from the characteristics of known natural and artificial nucleic acids, while envisioning next-generation artificial systems and applications in extreme environments, we aim to explore new approaches to nucleic acid chemistry and provide guidelines for constructing innovative artificial molecular systems. Full article