Search Results (62)

Medicinal mushroom production utilising rural cultivation (solid state fermentation) requires approximately six months compared to culinary mushroom production (7 days). Urban cultivation (submerged liquid fermentation) can be used as a sustainable method of producing medicinal mushroom biomass. In this study, chicken patties were fortified with liquid-fermented Ganoderma lucidum flour (GLF) and Pleurotus djamor mushroom biomass flour (PDF) at concentrations of 3%, 6%, and 9%. These were compared to a negative control (0% mushroom flour chicken patty) and a commercial patty. Chicken patties fortified with 3% PDF and 9% GLF recorded the lowest cooking loss, at 5.55% and 10.3%, respectively. Mushroom chicken patties exhibited lower cooking losses and significant changes in colour and texture compared to control samples. Notably, 3% GLF chicken patty achieved the highest overall acceptability score of 6.55 followed by 9% PDF chicken patty (6.08) (p < 0.05). Biomass flour of liquid-fermented Ganoderma lucidum (ENS-GL) and Pleurotus djamor (ENS-PD) were extracted for their endopolysaccharide and analysed for their functional properties. All elemental, FT-IR, and NMR spectroscopy analyses revealed the existence of a comparable beta-glucan polymer structure, linkages, and absorptions when compared to the Laminarin standard. In addition, ENS-GL also proved to possess higher antimicrobial activities and significant antioxidant levels (DPPH-scavenging activity, ferric reduction potential and total phenolic content) compared to ENS-PD. Overall, this study revealed that sustainable liquid-fermented Ganoderma lucidum, a medicinal mushroom, outperformed Pleurotus djamor, a culinary mushroom, as a potential alternative flour for combating hunger in the future. Full article

The objective structured clinical examination (OSCE) is a well-established tool for assessing clinical skills, providing reliability, validity, and generalizability for high-stakes examinations. Des Moines University College of Osteopathic Medicine (DMU-COM) adapted the OSCE for formative assessments in undergraduate medical education, focusing on interpersonal aspects in the primary care setting. Students are graded by standardized patients and faculty observers on interpersonal skills, history/physical examination, oral case presentation, and documentation. The purpose of the study is to establish the reliability and to identify sources of variation in the DMU-COM OSCE to aid medical educators in their understanding of the accuracy of clinical skills. We examined student performance data across five OSCE domains. We assessed intra- and inter-OSCE reliability by calculating KR20 values, determined sources of variation by multivariate regression analysis, and described relationships among observed variables through factor analysis. The results indicate that the OSCE captures student performance in three dimensions with low intra-OSCE reliability but acceptable longitudinal inter-OSCE reliability. Variance analysis shows significant measurement error in rubric-graded scores but negligible error in checklist-graded portions. Physical exam scores from patients and faculty showed no correlation, indicating value in having two different observers. We conclude that a series of formative OSCEs is a valid tool for assessing clinical skills in preclinical medical students. However, the low intra-assessment reliability cautions against using a single OSCE for summative clinical skills competency assessments. Full article

This study links the traditional use of celery (Apium graveolens L.) and parsley (Petroselinum crispum L.) roots in Balkan cuisine and herbal medicine, along with the longstanding role of turmeric (Curcuma longa L.) rhizome in Ayurvedic and Asian medicinal practices, with modern technological approaches to develop a functional food formulation. A series of blend variations were evaluated for total phenolic content, antioxidant capacity, and sensory quality. The incorporation of turmeric significantly enhanced the antioxidant potential of celery–parsley mixtures. Celery–parsley–turmeric root blend (CPT6), comprising equal parts, was identified as optimal, exhibiting high total phenolic content (9.56 mg gallic acid equivalent/g), strong antioxidant activities, and a favourable sensory profile rated as “very good” (3.58 average score). CPT6 further demonstrated promising biofunctional properties, including potent α-amylase and α-glucosidase inhibition activities (72% and 80%, respectively), alongside moderate antihypertension activity (ACE) (62%) and hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibition (55%). Chemometric analyses (PCA) and machine learning modelling (ANN) confirmed the significant role of turmeric proportion in enhancing both bioactivity and consumer acceptability. This research highlights the synergy between tradition and technology in creating novel, multifunctional food ingredients suited for functional food and nutraceutical applications. Full article

Background and Objectives: Burnout syndrome is increasingly recognized as a significant occupational hazard among forensic medicine professionals, a population exposed to intense psychological stress and complex work demands. This study aimed to assess the prevalence of burnout, job satisfaction, and unconditional self-acceptance among forensic personnel in Romania and to explore potential predictors and mediators of burnout within this context. Materials and Methods: A cross-sectional survey was conducted among 153 forensic medicine professionals from 31 counties across Romania. Participants completed a battery of standardized instruments, including the Maslach Burnout Inventory—General Survey (MBI-GS), the Job Satisfaction Survey (JSS), and the Unconditional Self-Acceptance Questionnaire (USAQ). Cut-off scores for burnout subscales were established using the 75th percentile. Data were analyzed to identify demographic, occupational, and psychological correlates of burnout. Descriptive statistics were used to summarize sample characteristics and burnout prevalence. Group comparisons were made across demographic and professional categories. A mediation model was tested to evaluate whether unconditional self-acceptance mediated the relationship between job satisfaction and burnout. We hypothesized that job satisfaction would be negatively associated with burnout symptoms and that unconditional self-acceptance would mediate this relationship, acting as a protective psychological factor. Results: Approximately a quarter of respondents met the criteria for high total burnout, emotional exhaustion, and professional inefficacy, while cynicism was present in a fifth of participants. Burnout was more prevalent among younger workers, forensic medicine residents, and those working in the capital. Job satisfaction was generally high, but lower in women, younger individuals, and residents. Nearly half of the participants reported low or very low self-acceptance. Mediation analysis revealed that unconditional self-acceptance partially mediated the relationship between job satisfaction and burnout, suggesting a protective psychological mechanism. Conclusions: This study highlights the considerable burden of burnout among forensic medicine professionals in Romania and identifies job dissatisfaction and low self-acceptance as key contributors. Findings underscore the need for targeted interventions aimed at enhancing job satisfaction and emotional resilience, particularly in vulnerable subgroups. Institutional efforts that support mental well-being, foster emotional coping, and improve organizational dynamics are essential to reduce burnout in this high-risk population. Full article

Crown ethers have gained importance in the field of medicine because of their resemblance to natural ionophores like valinomycin. With the goal of developing new pharmacologically important crown ethers, a novel series of crown ethers linked with Fusidic acid butyl ester 10a–d were synthesized and characterized by means of their ¹H NMR, ¹³C NMR DEPT-135, FT-IR, and mass spectrometry. In vitro antioxidant and α-glucosidase inhibition activities of all crown ethers along with the precursor Fusidic acid butyl ester were examined and compared to the standard butylated hydroxyanisole and acarbose, respectively. Compounds (FABE-16-crown-4) 10b and (FABE-19-crown-5) 10c showed high antioxidant potential with the IC₅₀ = 22.5 ± 0.2 μM and 32.1 ± 0.3 μM, respectively, when compared to the standard BHA (IC₅₀ = 44.2 ± 0.34 μM). To understand the binding mode of the compounds, molecular docking investigations were performed using human antioxidant protein, peroxiredoxin 5. Molecular docking studies revealed higher docking scores (−6.5 and −6.7 kcal/mol) for the highly active compounds 10c and 10b, respectively, than standard BHA (−5.3 kcal/mol). Synthesized crown ethers exhibited moderate α-glucosidase inhibition with (IC₅₀ = 23.5 ± 0.2 to 76.5 ± 0.1 μM) when compared to acarbose as standard (IC₅₀ = 5.2 ± 0.8 μM). The in silico ADMET predictions indicated that the prepared compounds obeyed (bRO5) and Veber’s rule for the acceptance as orally administered drugs and indicated that all the prepared crown ethers exhibited calculated values of drug likeness parameters in acceptable ranges that showed good potential of these molecules for further drug development investigations. Full article

The concept of blended education, which refers to the intensive integration of digital resources into the teaching process and its mixed online and on-site delivery, combining as much as possible the advantages of both methods in an optimal way, is becoming increasingly popular among teaching tools. There is no universal recipe for designing a successful blended course; the success of such courses is measured entirely through their degree of acceptance among students, defined by their emotional motivation to learn and the obtained practical results. Our study aimed to evaluate the motivational persistence degree (MPS) of medical students in connection with the students’ acceptance of different didactic tools involved in blended-learning approaches. Materials and Method: We investigated a sample comprising 523 students in Dental Medicine or General Medicine, belonging to all years of study, from four main Universities in Romania; we classified them according to their motivational persistence profile (using k-means data clustering) and we comparatively investigated the main relevant features of students in each cluster—gender, age group, opinions about the general usefulness of multimedia resources in the learning process, and their degree of acceptance of specific types of instructional materials involved in blended learning. Results: We found that the students who mostly enjoy the traditional learning style have average motivational persistence skills; they are perseverant and competitive, but they are not so good at planning their daily tasks. They enjoy external directions, set by teachers. The students who most enjoy PowerPoint presentations and those who enjoy instructional videos show similar behavior, both belonging to the cluster with the highest MPS score. They have the best motivational persistence skills amongst all categories; they are particularly excellent at planning and fulfilling daily tasks, as well as following their goals in the long term. The students who mostly enjoy online documentary sources belong also to a cluster with above average MPS score; they excel in fulfilling daily tasks, but exhibit weaker performance in recalling unachieved goals. These results are similar to those already reported in the literature; the strength of our study is in that it provides much more specific evaluations oriented to the motivational persistence degree, which is highly significant in the case of medical students, because it is a measure of their commitment in fulfilling certain tasks. Conclusions: Our results have the potential to highlight reasons for academic success or failure according to a student’ s profile, and will prove helpful in selecting the most appropriate didactic tools. Full article

This work aims to evaluate students’ opinions on the materials normally used in anatomy practical classes (fixed and plastinated) compared to 3D anatomical prints. For this purpose, students of anatomy enrolled in the Degree in Veterinary Medicine from the University of Murcia filled out a satisfaction survey about both kinds of material. The students rated the fixed material with a satisfaction percentage close to 100% and the plastinated material with a percentage higher than 75%. Regarding the 3D prints, the percentage obtained was consistently higher than 50% except for two issues: the identification of the vascular structures of the dolphin’s head and the usefulness for surgery of the viscera and vascular structures of the cat, both of which scored less than 50%. This could be related to the lesser knowledge of dolphins of the veterinary students as well as the complexity of these structures. However, the other questions, such as usefulness for learning and exam preparation, the quality of the anatomical piece, the identification of the feline spleen and kidneys, etc. obtained a satisfaction percentage between 58 and 90.40%. This reflects the good acceptance by students of the 3D prints and may allow for a reduction in the number of cadavers used. Full article

Background/Objectives: While speckle-tracking echocardiography (STE) is increasingly gaining acceptance in the medical community, establishing normal pediatric values and interpreting data derived from software provided by various vendors can pose significant challenges. This review aims to present an updated compilation of nomograms pertinent to speckle-tracking echocardiography. Methods: A review of research using three medical engine searches (National Library of Medicine, Science Direct, and Cochrane Library) for Medical Subject Headings (MeSH) and the free text terms “echocardiography”, “STE”, “normal values”, and ”children” was performed and refined by adding the keywords “nomograms”, “z-scores”, and “healthy children”. Results: A total of twenty-five studies were selected for the final analysis. Our research indicated that current nomograms provide adequate coverage of most strain parameters; however, those pertaining to the right ventricle and the atria are less numerous than those for the left ventricle. A noted trend suggests a decrease in strain values with advancing age and increasing body surface area; nevertheless, the relationships observed were weak and nonlinear. The absence of robust correlations between strain values and age and body size parameters hindered the generation of a Z-score possessing sufficient statistical power. Consequently, normal values are primarily represented as mean values accompanied by standard deviation. A comparative analysis of vendors demonstrated good agreement between different versions of the same platform for Philips (except for QLAB 5) and, similarly, between General Electric (GE) and TomTec. The limited data available regarding the comparison between GE and Philips revealed significant findings that warrant further investigation of differences. Conclusions: A comprehensive review and an updated list of current pediatric nomograms for STE measurements have been presented. This may serve as a valuable guide for accurately interpreting STE in pediatric patients with congenital and acquired heart disease. Full article

Background/Objectives: Randomized controlled trials (RCTs) are needed to evaluate the impact of food is medicine (FIM) programs, such as medically tailored groceries (MTGs) to treat hypertension among diverse populations. Partnerships between academic centers’ student-run organizations (SROs) and community-based organizations (CBOs) offer critical safety nets for historically underserved groups, positioning these organizations to effectively undertake FIM programs among populations disproportionately affected by hypertension. We conducted an unblinded pilot RCT whose objectives were to assess the feasibility and acceptability of an SRO-coordinated, CBO-partnered MTGs intervention targeting blood pressure (BP) and food insecurity (FI) in underserved groups. Methods: Adult Black/African American and Hispanic/Latinx patients in Durham, North Carolina, where essential hypertension and FI were randomized (parallel arm, computerized 1:1 ratio) to 12 weeks of home-delivered, hypertension-focused MTGs plus in-person nutrition education sessions with compensation (intervention) versus data collection sessions with compensation (control). We offered transportation, childcare, and home visits to facilitate session attendance. The primary outcomes were the eligibility, enrollment, and retention rates (feasibility), and the survey feedback from the participants and CBO partners (acceptability). The secondary outcomes included the changes in the mean BP and median FI score with associated 95% confidence intervals. Results: Medical record screening identified 1577 eligible participants. Of the 94 reached to confirm eligibility, 77 met the enrollment criteria, and 50 were randomized (82% post-screen eligibility, 65% enrollment). A conventional content analysis of 15 participant surveys and CBO partner feedback affirmed the acceptability, noting intervention components that enhanced the retention (e.g., home delivery, transportation support, home visits). Pre–post analyses of secondary outcomes for 13/25 intervention and 15/25 control participants completing ≥2 sessions ≥2 months apart were performed. The intervention was associated with an average change in systolic BP of −14.2 mmHg (−27.5, −4.5) versus −3.5 mmHg (−11.7, 5.9) in the control group. The FI scores improved by −2 (−2.2, −0.5) in the intervention group and −1 (−1.3, −0.2) in the control group. No adverse events were reported. Conclusions: SRO-CBO partnerships could be feasible and acceptable avenues for conducting FIM trials among underserved populations. This multi-component FIM approach enhanced the study equity by addressing the participants’ disease-related social needs and warrants expansion into a powered RCT. Full article

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants’ knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic’s risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures. Full article

As a crop with significant medicinal value and nutritional components, the market demand for bitter melon continues to grow. The diversity of bitter melon shapes has a direct impact on its market acceptance and consumer preferences, making precise identification of bitter melon germplasm resources crucial for breeding work. To address the limitations of time-consuming and less accurate traditional manual identification methods, there is a need to enhance the automation and intelligence of bitter melon phenotype detection. This study developed a bitter melon phenotype detection model named CSW-YOLO. By incorporating the ConvNeXt V2 module to replace the backbone network of YOLOv8, the model’s focus on critical target features is enhanced. Additionally, the SimAM attention mechanism was introduced to compute attention weights for neurons without increasing the parameter count, further enhancing the model’s recognition accuracy. Finally, WIoUv3 was introduced as the bounding box loss function to improve the model’s convergence speed and positioning capabilities. The model was trained and tested on a bitter melon image dataset, achieving a precision of 94.6%, a recall of 80.6%, a mAP50 of 96.7%, and an F1 score of 87.04%. These results represent improvements of 8.5%, 0.4%, 11.1%, and 4% in precision, recall, mAP50, and F1 score, respectively, over the original YOLOv8 model. Furthermore, the effectiveness of the improvements was validated through heatmap analysis and ablation experiments, demonstrating that the CSW-YOLO model can more accurately focus on target features, reduce false detection rates, and enhance generalization capabilities. Comparative tests with various mainstream deep learning models also proved the superior performance of CSW-YOLO in bitter melon phenotype detection tasks. This research provides an accurate and reliable method for bitter melon phenotype identification and also offers technical support for the visual detection technologies of other agricultural products. Full article

Background/Objectives: Medicine acceptability is crucial for paediatric drug development, yet its assessment remains challenging due to the multifaceted nature of sensory attributes like taste, smell, and mouthfeel. Traditional methods of acceptability evaluation often involve complex questionnaires and lack standardisation, leading to difficulties in a comparative analysis across studies. This study aimed to develop a simplified, standardised approach for assessing medicine acceptability introducing the Net Promoter Score (NPS) framework to derive a Medicine Acceptability Score (MAS). Methods: A retrospective analysis was conducted using taste assessment data from nine paediatric formulations across four studies. The MAS was calculated by identifying an optimal range for categorising participant responses, which encapsulated diverse sensory attributes into a single metric. Validation was performed across various age groups and different formulations to test the reliability and discriminatory power of MAS. Results: The MAS effectively discriminated between acceptable and unacceptable formulations, providing a practical tool for formulation development. Conclusions: The MAS offers a novel, standardised metric for evaluating paediatric medicine acceptability, addressing key limitations of traditional methods. Future studies are recommended to refine the MAS model through the establishment of benchmark scores for chronic and acute medications, thereby standardising acceptability assessment of medicines across the pharmaceutical industry. Full article

Background/Objectives: This retrospective study evaluated the effectiveness of a two-year online mindfulness program (five biweekly sessions) combined with a smartphone application for healthcare workers (HCWs) in Korean medicine (KM) institutions. Methods: Twenty-three participants, including KM University students, KM doctors, and nurses, completed a 9-week online mindfulness program in 2023 or 2024. The pre- and post-intervention surveys assessed subjective health status (SHS), knowledge of mind–body modalities (MBMs), hwa-byung (HB) symptoms, emotional labor (EL), burnout, and program satisfaction. Results: Participants showed significant improvements in SHS (p = 0.008) and MBM knowledge (p = 0.035). HB personality scores decreased significantly (p = 0.027), while the reduction in HB symptoms approached statistical significance (p = 0.052). The frequency of interactions among job-focused EL increased (p = 0.003). The subgroup analysis revealed significant reductions in HB personality traits (p = 0.017) and symptoms (p = 0.006) among practicing KM doctors and nurses. No significant changes were observed in burnout levels. Participants reported high satisfaction (median 8.00 [IQR 8.0–9.0]) and willingness to recommend the program (median 5.00 [IQR 4.0–5.0]). Conclusions: Analysis of the 2-year results suggests that the online mindfulness program effectively improved SHS, MBM knowledge, and HB-related symptoms among HCWs in KM institutions, particularly among practicing professionals. High satisfaction rates indicated the acceptability of the program. Future research should use larger sample sizes and randomized controlled designs to further validate these findings and explore long-term outcomes. This intervention shows promise as a tool to promote mental health in Korean healthcare settings. Full article

The integration of deep learning into radiology has the potential to enhance diagnostic processes, yet its acceptance in clinical practice remains limited due to various challenges. This study aimed to develop and evaluate a fine-tuned large language model (LLM), based on Llama 3-8B, to automate the generation of accurate and concise conclusions in magnetic resonance imaging (MRI) and computed tomography (CT) radiology reports, thereby assisting radiologists and improving reporting efficiency. A dataset comprising 15,000 radiology reports was collected from the University of Medicine and Pharmacy of Craiova’s Imaging Center, covering a diverse range of MRI and CT examinations made by four experienced radiologists. The Llama 3-8B model was fine-tuned using transfer-learning techniques, incorporating parameter quantization to 4-bit precision and low-rank adaptation (LoRA) with a rank of 16 to optimize computational efficiency on consumer-grade GPUs. The model was trained over five epochs using an NVIDIA RTX 3090 GPU, with intermediary checkpoints saved for monitoring. Performance was evaluated quantitatively using Bidirectional Encoder Representations from Transformers Score (BERTScore), Recall-Oriented Understudy for Gisting Evaluation (ROUGE), Bilingual Evaluation Understudy (BLEU), and Metric for Evaluation of Translation with Explicit Ordering (METEOR) metrics on a held-out test set. Additionally, a qualitative assessment was conducted, involving 13 independent radiologists who participated in a Turing-like test and provided ratings for the AI-generated conclusions. The fine-tuned model demonstrated strong quantitative performance, achieving a BERTScore F1 of 0.8054, a ROUGE-1 F1 of 0.4998, a ROUGE-L F1 of 0.4628, and a METEOR score of 0.4282. In the human evaluation, the artificial intelligence (AI)-generated conclusions were preferred over human-written ones in approximately 21.8% of cases, indicating that the model’s outputs were competitive with those of experienced radiologists. The average rating of the AI-generated conclusions was 3.65 out of 5, reflecting a generally favorable assessment. Notably, the model maintained its consistency across various types of reports and demonstrated the ability to generalize to unseen data. The fine-tuned Llama 3-8B model effectively generates accurate and coherent conclusions for MRI and CT radiology reports. By automating the conclusion-writing process, this approach can assist radiologists in reducing their workload and enhancing report consistency, potentially addressing some barriers to the adoption of deep learning in clinical practice. The positive evaluations from independent radiologists underscore the model’s potential utility. While the model demonstrated strong performance, limitations such as dataset bias, limited sample diversity, a lack of clinical judgment, and the need for large computational resources require further refinement and real-world validation. Future work should explore the integration of such models into clinical workflows, address ethical and legal considerations, and extend this approach to generate complete radiology reports. Full article

Background/Objectives: With the advent of the field of pediatric emergency medicine, studies on the differences in treatment patterns between pediatricians and emergency medicine (EM) physicians in various pediatric conditions have been accumulating. This study aimed to compare croup (acute laryngotracheobronchitis) management patterns between pediatricians and EM physicians to enhance pediatric emergency care and inform the training of future specialists. Methods: A retrospective review of medical records was conducted for 1676 previously healthy children diagnosed with croup who visited a single pediatric emergency department (PED) of a tertiary university-affiliated hospital in South Korea, from March 2019 to February 2023. Patient characteristics, management patterns, and the impact of physician specialty on emergency care were analyzed. Results: EM physicians used injected dexamethasone monotherapy in 30.54% of the cases, more frequently than the 3.57% among pediatricians. In contrast, pediatricians used a combination of nebulized epinephrine and dexamethasone in 88.29% of the cases, compared with 67.71% for EM physicians. The appropriate use of nebulized epinephrine based on the Westley Croup Score was significantly higher in the EM physician group (77.64% vs. 57.89%, p < 0.001). Pediatricians also prescribed oral antibiotics and corticosteroids more frequently (25.13% vs. 3.13% and 81.54% vs. 22.69%, respectively; p < 0.001 for both). Despite these differences, there were no significant disparities in PED length of stay or 48 h revisit rates. Conclusions: EM physicians adhered more closely to currently accepted management algorithms for croup management. These findings underscore the need for standardized, evidence-based pediatric emergency care and provide valuable insights for training programs in this field. Full article