Evolving Mental Health Dynamics among Medical Students amid COVID-19: A Comparative Analysis of Stress, Depression, and Alcohol Use among Medical Students.

Background and Objectives: The ongoing COVID-19 pandemic has posed an array of new challenges for medical students worldwide. Amidst academic rigors, students are confronted with unique stressors, potentially affecting their mental health and substance use. This study aimed to investigate the multifaceted effects of depression, alcohol use, and stress on medical students and discern how these factors have been amplified by the pandemic's circumstances, and to identify predictors of mental distress during the COVID-19 pandemic period. Materials and Methods: Two online anonymous and cross-sectional surveys were conducted at the University of Medicine and Pharmacy "Iuliu Hatieganu" in Romania among medical students in 2018 and in 2022. Data were gathered via online questionnaires distributed through closed student groups on social media platforms, with a total of 1061 participants, to investigate stress, depression, alcohol and drug use, and the impact of the pandemic and online education on mental health, maintaining anonymity and ethical approval. The Medical Student Stress Questionnaire (MSSQ) was employed to measure different aspects of stress, the Beck Depression Inventory (BDI) provided insights into the participants' depressive symptoms, and for the assessment of alcohol consumption habits, the Alcohol Use Disorders Identification Test (AUDIT) was utilized. Results: Our findings showed a significant decrease in mean depression scores (13.81 vs. 11.56, with p < 0.001) from 2018 to 2022. In 2018, students scored significantly higher in the overall stress-related domains. Additionally, being female, facing financial constraints, and being in pre-clinical years emerged as predictors of heightened academic-related stress and depressive symptoms. Students who had experienced the loss of a family member due to COVID-19 exhibited a statistically significant rise in their average BDI score and current anxiety levels. Conclusions: The pandemic, despite introducing new stressors, may have indirectly fostered an increased focus on students' mental health, leading to more refined support mechanisms. Specialized interventions, taking into account gender and financial problems, are needed to address the multifaceted challenges faced by medical students. Our study highlights the ongoing need to nurture both the academic and emotional strength of future medical practitioners.

The Role of miRNAs in Dexmedetomidine's Neuroprotective Effects against Brain Disorders.

There are limited neuroprotective strategies for various central nervous system conditions in which fast and sustained management is essential. Neuroprotection-based therapeutics have become an intensively researched topic in the neuroscience field, with multiple novel promising agents, from natural products to mesenchymal stem cells, homing peptides, and nanoparticles-mediated agents, all aiming to significantly provide neuroprotection in experimental and clinical studies. Dexmedetomidine (DEX), an α2 agonist commonly used as an anesthetic adjuvant for sedation and as an opioid-sparing medication, stands out in this context due to its well-established neuroprotective effects. Emerging evidence from preclinical and clinical studies suggested that DEX could be used to protect against cerebral ischemia, traumatic brain injury (TBI), spinal cord injury, neurodegenerative diseases, and postoperative cognitive disorders. MicroRNAs (miRNAs) regulate gene expression at a post-transcriptional level, inhibiting the translation of mRNA into functional proteins. In vivo and in vitro studies deciphered brain-related miRNAs and dysregulated miRNA profiles after several brain disorders, including TBI, ischemic stroke, Alzheimer's disease, and multiple sclerosis, providing emerging new perspectives in neuroprotective therapy by modulating these miRNAs. Experimental studies revealed that some of the neuroprotective effects of DEX are mediated by various miRNAs, counteracting multiple mechanisms in several disease models, such as lipopolysaccharides induced neuroinflammation, ß-amyloid induced dysfunction, brain ischemic-reperfusion injury, and anesthesia-induced neurotoxicity models. This review aims to outline the neuroprotective mechanisms of DEX in brain disorders by modulating miRNAs. We address the neuroprotective effects of DEX by targeting miRNAs in modulating ischemic brain injury, ameliorating the neurotoxicity of anesthetics, reducing postoperative cognitive dysfunction, and improving the effects of neurodegenerative diseases.

The Effect of Vitamin D Supplementation on the Length of Hospitalisation, Intensive Care Unit Admission, and Mortality in COVID-19-A Systematic Review and Meta-Analysis.

The coronavirus disease 2019 (COVID-19) pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has become a global health crisis and pushed researchers and physicians to discover possible treatments to improve the outcome of their patients. Vitamin D, known for its role in immune system function, has been hypothesized to play a role in COVID-19 treatment. A systematic review and meta-analysis were conducted to evaluate the efficacy of vitamin D supplementation in COVID-19, focusing on length of hospital stay (LOS), admission to the intensive care unit (ICU), and mortality. Thirteen randomized controlled trials (RCTs) were included, and the meta-analysis revealed that high-dose vitamin D supplementation showed potential benefits in reducing the length of hospital stay and ICU admission rates for patients with COVID-19. However, the overall effect on mortality did not reach statistical significance. While this systematic review suggests the potential benefits of high-dose vitamin D supplementation in reducing hospital stays and ICU admission in COVID-19 patients, caution is warranted due to the high heterogeneity and limitations of the included studies. Further large-scale randomized controlled trials with consistent study characteristics are needed to provide more robust evidence regarding the therapeutic benefits of vitamin D supplementation in COVID-19 outcomes.