Search Results (98)

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

Background: A detailed understanding of cardiac anatomy and physiology is crucial in cardiovascular medicine. However, traditional learning methods often fall short in addressing this complexity. Augmented reality (AR) offers a promising tool to enhance comprehension. To assess its potential integration into the Heidelberger Curriculum Medicinale (HeiCuMed), we conducted a needs assessment among medical students and lecturers at Heidelberg University Medical School. Methods: Our survey aimed to evaluate the perceived benefits of AR-based learning compared to conventional methods and to gather expectations regarding an AR course in cardiovascular medicine. Using LimeSurvey, we developed a questionnaire to assess participants’ prior AR experience, preferred learning methods, and interest in a proposed AR-based, 2 × 90-min in-person course. Results: A total of 101 students and 27 lecturers participated. Support for AR in small-group teaching was strong: 96.3% of students and 90.9% of lecturers saw value in a dedicated AR course. Both groups favored its application in anatomy, cardiac surgery, and internal medicine. Students prioritized congenital heart defects, coronary anomalies, and arrhythmias, while lecturers also emphasized invasive valve interventions. Conclusions: There is significant interest in AR-based teaching in cardiovascular education, suggesting its potential to complement and improve traditional methods in medical curricula. Further studies are needed to assess the potential benefits regarding learning outcomes. Full article

Background/Objectives: Accurately assessing the independence level of older adults using useful assessment tools is an important step toward providing them with the necessary care while preserving their dignity. These tools allow older adults to receive effective, personalized home care, which improves their quality of life. This study aimed to clarify the current prevalence of severe and complete functional dependence and associated factors among Kazakhstan’s older adults aged >60 years. Methods: This cross-sectional study was conducted in several polyclinics and geriatric service care centers in two cities of Kazakhstan from March to May 2024. Functional status was assessed by the Barthel Index. We combined the selection into two categories: total dependency and severe dependency in the category “dependent”, and moderate dependency, slight dependency, and total independence in the category “active patients”. Results: Among the 642 older people in this study, 43.3% were dependent patients, and 56.7% were active patients. The odds of severe and total functional dependence are significantly higher for frail participants (adjusted odds ratio (AOR) = 2.96, 95% confidence interval (CI) [1.70, 5.16], p < 0.001) compared to those that are not frail; eleven times higher for those at home (AOR =11.90, 95% CI [5.77, 24.55], p < 0.001) than those in nursing homes; two times higher for participants with sarcopenia (AOR =2.61, 95% CI [1.49, 4.55], p < 0.001) compared to those with no sarcopenia; and three times higher for participants with high risk of fracture (AOR =3.30, 95% CI [1.94, 5.61], p < 0.001) compared to those with low risk. The odds of having severe and total functional dependence are significantly higher for participants with low dynamometry (AOR =1.05, 95% CI [1.03, 1.07], p < 0.001) compared to those with normal dynamometry. Conclusions: Old age, low dynamometry (for men ≤ 29 kg, for women ≤ 17 kg), frailty, being at home, high risk of fracture and osteoporosis, and sarcopenia were associated with increased risk of severe and total functional dependence. Full article

Microglia, as the immune guardians of the central nervous system (CNS), have the ability to maintain neural homeostasis, respond to environmental changes, and remodel the synaptic landscape. However, persistent microglial activation can lead to chronic neuroinflammation, which can alter neuronal signaling pathways, resulting in accelerated cognitive decline. Phosphoinositol 3-kinase (PI3K) has emerged as a critical driver, connecting inflammation to neurodegeneration, serving as the nexus of numerous intracellular processes that govern microglial activation. This review focuses on the relationship between PI3K signaling and microglial activation, which might lead to cognitive impairment, inflammation, or even neurodegeneration. The review delves into the components of the PI3K signaling cascade, isoforms, and receptors of PI3K, as well as the downstream effects of PI3K signaling, including its effectors such as protein kinase B (Akt) and mammalian target of rapamycin (mTOR) and the negative regulator phosphatase and tensin homolog (PTEN). Experiments have shown that the overproduction of certain cytokines, coupled with abnormal oxidative stress, is a consequence of poor PI3K regulation, resulting in excessive synapse pruning and, consequently, impacting learning and memory functions. The review also highlights the implications of autonomously activated microglia exhibiting M1/M2 polarization driven by PI3K on hippocampal, cortical, and subcortical circuits. Conclusions from behavioral studies, electrophysiology, and neuroimaging linking cognitive performance and PI3K activity were evaluated, along with new approaches to therapy using selective inhibitors or gene editing. The review concludes by highlighting important knowledge gaps, including the specific effects of different isoforms, the risks associated with long-term pathway modulation, and the limitations of translational potential, underscoring the crucial role of PI3K in mitigating cognitive impairment driven by neuroinflammation. Full article

Background and Objectives: The aim of this study is to categorize and combine (according to the source of biomaterial) biomarkers of frailty syndrome and identify challenges in research on these biomarkers by reviewing the current literature from the past five years. Methods: We systematically searching five electronic databases—PubMed, Scopus, Web of Science, CINAHL, and the Cochrane Library—for citations from 1 January 2019 to 1 July 2024. We conducted a qualitative data synthesis and categorized the limitations by topics and subtopics. PROSPERO—CRD: 42024491369. Results: A total of 61 papers met the criteria for inclusion in this study. These studies included a total of 56,758 participants, and 1479 unique biomarkers. We categorized biomarkers such as blood, genetic, urinary, and salivary biomarkers. Our analysis identified three major categories of challenges: challenges related to study design, unclear pathophysiological mechanisms, and biomarker-specific challenges. Conclusions: This review underscores the extensive research into biomarkers associated with frailty syndrome, such as blood, genetic, urinary, and salivary biomarkers. However, significant challenges persist, including methodological inconsistencies, biomarker measurement variability, and a limited understanding of underlying mechanisms. Full article

Objective: Eating habits established during adolescence play a crucial role in shaping both current and future health status. However, adolescents today appear to be increasingly adopting poorer dietary and lifestyle habits. This study aims to investigate eating behaviors and supplement use among adolescent students who participated in the EduALI nutrition education project. Methods: The project included first-year students from six sports-oriented scientific high schools in Florence. The students participated in six nutrition sessions, completing the International Physical Activity Questionnaire to assess physical activity performance, a questionnaire on dietary supplement use, and, to assess eating habits a Food Frequency Questionnaire (FFQ), as well as the Medi-Lite questionnaire to specifically assess adherence to the Mediterranean diet (MD). The data from the FFQ were compared with national dietary guidelines. Results: The study sample consisted of 83 students (69.9% male; average age: 13.8 ± 0.4 y). The results showed that 61.4% of participants had used supplements in the past year, most commonly mineral salts (56.6%) and vitamins (54.2%), followed by botanical products (22%), sports drinks (16%), proteins/amino acids (8%), and creatine (2%). Alarmingly, 27.7% used supplements without medical supervision. Students involved in individual sports had higher supplement consumption than those in team sports, especially creatine use. Eating habits revealed poor adherence to both the MD and Italian dietary guidelines, with deficiencies in fruits, vegetables, olive oil, fish, and legumes, and excessive intake of cheese, meat, especially red and processed meats. Conclusions: A high prevalence of supplement use among adolescents was observed, along with poor adherence to dietary guidelines and MD. These findings underscore the need for targeted, school- and sport-based interventions to enhance adolescents’ nutritional awareness and responsible supplement use. Full article

Background: During the past years, brain drain has become an international problem. A shortage of human resources in the medical field revealed its challenges during the COVID-19 pandemic. Despite the large number of medical school graduates in Egypt, the reports of the World Health Organization and the Egyptian Medical Syndicate indicate a yearly decline in the number of physicians in Egypt. The aim of this study is to determine the factors affecting Egyptian physicians’ intention to leave Egypt to work in another country. Methods: This is a cross-sectional study with a self-administered questionnaire via the snowball sampling technique that focused on Egyptian physicians who graduated from Egyptian universities and were working in Egypt. The outcome measures include the migration intentions of physicians and their satisfaction with different aspects of work, their family and housing conditions, and their demographic characteristics. Results: The questionnaire was answered by 249 Egyptian physicians, 140 of whom were living in Egypt. The findings revealed that 66.4% of the sample in Egypt were considering working abroad. Work satisfaction was the main factor affecting the decisions of physicians in Egypt; the physicians with a lower satisfaction score were 20 times more likely to leave their country. Additionally, physicians who classified themselves as having a low economic status, being younger, or who were male were more likely to leave. Conclusion: Egypt may suffer major resource losses as a result of the high degree of dissatisfaction among physicians regarding their working conditions. To realize Egypt’s Vision 2030 for health and economic progress, policymakers need to address the driving factors and take probable intervention measures to reduce the drain of our physicians. Full article

Background and Objectives: Depression is a multifactorial mental health disorder involving inflammation, oxidative stress, neuroplasticity deficits, and metabolic dysfunction. Emerging research suggests that vitamin K, beyond its classical roles in coagulation and bone metabolism, may influence neurobiological processes relevant to mood regulation. This systematic review evaluates the association between vitamin K and depressive symptoms and explores potential underlying mechanisms. Materials and Methods: A systematic search was conducted across PubMed, Scopus, Cochrane Library, ScienceDirect, and Google Scholar, following PRISMA 2020 guidelines. Eligible studies included human or animal research examining associations between vitamin K status (dietary intake or serum levels) and depression-related outcomes. Fourteen studies met the inclusion criteria: eleven observational studies, one randomized controlled trial (RCT), and two preclinical animal studies. Results: Most observational studies reported an inverse association between vitamin K intake or serum levels and depressive symptoms across diverse populations. One small RCT demonstrated modest improvements in depression scores following vitamin K2 (menaquinone-7) supplementation in women with polycystic ovary syndrome. Two preclinical studies using non-depression models reported behavioral improvements and reduced oxidative stress following vitamin K2 administration. Conclusions: While preliminary findings suggest a potential role for vitamin K in pathways relevant to depression, the current evidence is limited by cross-sectional designs, lack of isoform-specific analyses, and the absence of depression-focused preclinical models. Mechanisms including inflammation reduction, oxidative stress modulation, sphingolipid regulation, and vitamin K-dependent protein signaling (e.g., GAS6 and osteocalcin) were discussed based on indirect evidence and require further investigation in depression-specific contexts. Full article

Background/Objectives: Medical students experience significant mental stress during clinical internships. This study aimed to assess the levels of uncertainty stress among medical interns, evaluate its temporal changes and associations with doctor–patient conflict and reference norm, and provide insights for stress-alleviating policies and educational initiatives. Methods: A prospective longitudinal panel study was conducted; 131 medical students preparing for clinical internships were recruited via WeChat social media groups from June 2023 to June 2024. Data were collected at three time points using an online survey on Wenjuanxing: before the internship, three months into the internship, and after the internship. Variables such as uncertainty stress, doctor–patient conflict, and reference norm were measured, and data were analyzed using GEE and the GLMM program. Results: A total of 122 students completed all three waves of the study. Uncertainty stress decreased over the internship period (W = 7.25, p < 0.05), while doctor–patient conflict increased (W = 6.65, p < 0.05). Uncertainty stress was positively associated with the reference norm from teachers (β = 0.856, p < 0.05) and doctor–patient conflict (β = 1.068, p < 0.05). Conclusions: Although uncertainty stress reduces as internships progress, doctor–patient conflict rises. A supportive learning environment, especially from teachers, is crucial for mitigating stress. Medical schools and hospitals should implement comprehensive strategies to address individual stressors and institutional factors, considering the associations between uncertainty stress, doctor–patient conflict, and reference norm. However, the study has limitations such as a small sample size and reliance on self-reported measures, indicating a need for further research. Full article

The International CCN Society has been organizing workshops and conferences for the past two decades to advance our understanding of the biology and pathophysiology of the cellular communication network (CCN) proteins. The 12th CCN Workshop broadened the scope of discussions, introducing topics like CCN-dependent and -independent signaling networks involved in brain development, cellular senescence, efferocytosis, neurobiology, and the application of DNA-fabricated origami structures. This expansion proved fruitful and should continue in future events. Fostering collaborations across various fields has created a dynamic environment for innovative ideas, driving substantial progress to tackle both basic scientific questions and clinically relevant challenges. Three standout presentations sparked significant discussions and highlighted key advancements in these areas. These include the work of Li-Jen Lee (Neurobiology and Cognitive Science Center, National Taiwan University) on the involvement of the CCN2 protein in depressive and aggressive behaviors in mice; the studies of Anna Zampetaki (King’s College London British Heart Foundation Centre, School of Cardiovascular & Metabolic Medicine and Sciences) and Brahim Chaqour (University of Pennsylvania, Perelman School of Medicine, Dept of Molecular Ophthalmology) on the metabolome and mechanosensing in iPSC-derived human blood vessel organoids and in the microvasculature of genetically modified mice, and the talk of Björn Högberg (Karolinska Institutet, Department of Medical Biochemistry and Biophysics) on the promises of DNA origami. We believe that these examples illustrate better future directions, as they offer an opportune moment to pursue initiatives that broaden the focus of the CCN Workshops and other projects like ARBIOCOM (website link included below) that support collaboration among research societies, educational institutions, and private biomedical industries, all working together to further our understanding of biosignaling and cellular communication networks for the development of new drug discovery methods and disease treatments. Full article

A major aspect of transition of care is the patient handover, during which miscommunication can significantly cause medical error and harm in patient care. Few medical schools in the U.S. offer formalized instructions on patient handovers, with most medical students learning from interns and residents through unstructured teaching. The aim of this study was to assess the effectiveness of a patient handover curriculum we developed for fourth-year medical students to increase their confidence and skills. Graduating fourth-year medical students (N = 98) enrolled in a two-week Transition to Residency (TTR) course attended an interactive session on patient handovers. During this session, students were presented with the I-PASS (illness severity, patient summary, action items, situation awareness and contingency planning, synthesis by receiver) mnemonic, went over case vignettes, and practiced giving and receiving handovers with a partner using the I-PASS template. At the end of TTR, students participated in an OSCE (Objective Structured Clinical Exam) activity that consisted of two standardized patient cases on blood transfusion and informed consent. Overall, our students did well with including important information in their Patient Summary (P: Case Scenario 1 Mean Score 56%; Case Scenario 2 Mean Score: 68%) and Action List (A: Case Scenario 2 Mean Score; 78%; Case Scenario 2 Mean Score: 87%) in their simulated patient case scenario. Pre-and-post survey results also indicated a significant improvement on student level of confidence (agreed or strongly agreed) in giving a patient handover (Pre: 53.1%; Post: 93.6%, p < 0.001), in receiving a patient handover (Pre: 58.2%; Post: 92.5%, p < 0.001), and in knowing what pertinent information to include in a patient handover (Pre: 62.2%; Post: 89.4%, p < 0.001). This study underscores the importance of systematic and repeated patient handover education throughout medical school training. Full article

Background: Globally, approximately 65% of adolescents undergoing antiretroviral therapy (ART) adhered to their treatment, whereas only 55% achieved viral suppression in 2023. The low rate of viral suppression is concerning, as elevated viral loads are associated with a heightened risk of opportunistic infections, progression to advanced HIV disease, increased mortality, and greater HIV transmission rates. We conducted this scoping review to identify the facilitators and barriers to ART adherence among adolescents and young adults (AYAs) in sub-Saharan Africa (SSA). Methods: We conducted this scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist. We searched for peer-reviewed articles published in English from 2014 to 2024 across the SCOPUS, ScienceDirect, PubMed, Africa Journals Online, and Google Scholar databases. Two reviewers independently selected the articles and extracted the data. We used NVivo to develop codes and categories of facilitators and barriers. Results: We used 30 articles reporting on studies conducted in 13 countries in this review. The total number of participants in the studies was 12,250. Sixteen articles reported on qualitative studies, nine on quantitative studies, and five on mixed-methods studies. This scoping review identified various personal (14 articles), interpersonal and social (15 articles), healthcare system-related (9 articles), medication-related (7 articles), and economic (2 articles) factors that facilitate ART adherence among AYAs. Additionally, the scoping review also identified various personal (28 articles), interpersonal and social (13 articles), healthcare system-related (14 articles), medication-related (20 articles), school- or work-related (6 articles), and economic (14 articles) factors that hinder ART adherence among AYAs. Conclusions: Enhancing ART adherence in AYAs requires multiple strategies, including the reduction of internalized stigma, implementation of community awareness campaigns, harm reduction approaches for AYAs who misuse substances, comprehensive education on HIV, and the provision of support from school staff and leadership, alongside the adoption of differentiated service delivery (DSD), which encompasses home-based ART delivery, refills at private pharmacies, community ART distribution centers, and patient-led community ART refill groups, as well as multi-month dispensing practices. Full article

Nazarbayev University School of Medicine selected the University of Pittsburgh School of Medicine to guide their curricular development. University of Pittsburgh faculty members teaching in the medical school were asked to help develop the curriculum in Nazarbayev. Some were asked to travel to Nazarbayev University to provide mentoring. Realizing that this would be a new activity, we wanted to investigate the perceived motivations, rewards, and barriers to participation. We conducted open-ended interviews of University of Pittsburgh faculty members, who were asked to participate in a project about motivations for accepting or rejecting the offer. We asked those accepting about the benefits and negatives. Nineteen faculty members agreed to 30 min interviews, which were digitally recorded and transcribed. All interviews were coded. Participating faculty members felt that reviewing their courses improved them. Most noted increased altruism and felt improved as educators. Some felt angst in providing their curricula. Several felt that traveling was challenging, but video conferencing technologies facilitated communication. Interviewees desired tangible rewards. This study highlights faculty perceptions of international curricular development. Faculty members felt that rewards included an improved native curriculum and personal and professional enrichment. Time constraints and distance were the main challenges and the primary reason others declined. The faculty perceived multiple benefits from this curricular development and collaboration. More transparency regarding expectations and the degree of assistance Nazarbayev University needed may have assuaged these fears. Full article

Objective: General practice (GP) plays an important role in the healthcare of human populations, and Chinese medical schools have paid attention to using education to improve the GP ability of medical students. However, there are still a lack of evaluating tools focusing on the general practice ability of clinical undergraduate students in China. To the best of our knowledge, this is one of the first studies aimed at constructing a scale of the general practice ability of medical undergraduates (GPA-MU) and understanding the current situation and factors influencing the general practice ability of the undergraduate clinical medical students in China. Methods: This study included two steps: the scale development and the empirical study. The items of the GPA-MU scales were developed from a literature review, in-depth individual interviews, Delphi expert consultation, and a pilot test. For the empirical study, a sample of 318 medical undergraduates was recruited. Item analysis, content validity, exploratory and confirmatory factor analysis, convergent and discriminant validity, and internal consistency reliability were conducted to examine the properties of the GPA-MU, and single and multi-factor analysis were used to explore the related factors of the GPA-MU. Results: Finally, the GPA-MU consisted of 3 first grade indexes, 12 second grade indexes, and 43 third grade indexes, with good reliability and validity, which could be used to assess the level of general practice ability of clinical undergraduate students. According to the cross-sectional study, the general practice ability score of clinical undergraduate students in Hunan Province was 83.75 ± 14.97, indicating the low general practice ability of clinical undergraduate students. The region, knowledge, duration of practice, and salary package had an obvious effect on the general practice ability of clinical undergraduate students. Further targeted intervention strategies in China are needed to strength the general practice ability of students. Full article

Background/Objectives: The repetitive overhead throwing of baseball stresses the posterior shoulder, including the rotator cuff and capsule, causing stiffness, tissue thickening, and dysfunction. Previous studies on collegiate baseball players have linked these changes to glenohumeral internal rotation deficits, pain, and injuries. However, these studies primarily used acoustic radiation force impulse-based shear wave elastography (SWE), which has limitations, including tissue heating and lack of portability. The acute effects of pitching on infraspinatus (ISP) muscle elasticity in high school pitchers remain unclear. Therefore, this study aimed to evaluate the acute impact of pitching on ISP muscle elasticity in high school baseball pitchers using continuous SWE (C-SWE), which is a safer and more portable method. The relationship between ISP muscle elasticity and pitching load was also examined. Methods: ISP muscle shear wave velocity (SWV), shoulder range of motion, and strength were evaluated in high school baseball pitchers. The participants were categorized into pitching and non-pitching groups based on whether they pitched with full effort on the day of their medical checkup. C-SWE was used to assess ISP muscle elasticity. Results: The pitching group had considerably higher ISP muscle SWV on the dominant side than the non-pitching group (p = 0.008). A significant positive correlation was observed between pitch and ISP muscle SWV (r = 0.467, p = 0.003). Conclusions: Repetitive pitching acutely increases ISP muscle stiffness in high school pitchers, contributing to posterior shoulder tightness. C-SWE is a safe and practical method for assessing tissue elasticity and developing injury prevention strategies. Full article