Realistic simulation case scenario as a vertical integration teaching tool for medical students: A mixed methods study.

Realistic simulation-based learning has recently become an integral part of medical education and can provide several advantages if applied effectively. This study aimed to develop and validate a realistic simulation case scenario (RSCS) as a novel teaching tool for preclinical medical students. Furthermore, we aimed to evaluate student perception of this tool as a teaching strategy, as well as to acquire an in-depth understanding of student perspectives. We employed the mixed methods approach to explore how clinical reasoning develops through a validated RSCS. This study, which included 50 third-year medical students, was conducted at the College of Medicine, Dar Al Uloom University, KSA between November 2021 and February 2022. Most of the participants (94%) were satisfied with the RSCS method and 92% of the participants reported RSCS as more effective in terms of achieving learning objectives. Many advantages of RSCS have been reported, including the provision of realistic knowledge relating to critical care management, encouraging student participation in the learning process, and enhancing interpersonal and problem-solving skills. In conclusion, RSCS is an effective and dynamic teaching approach that aids in knowledge consolidation with a significant impact on the emotions and cognitive abilities of students.

Medical students' perceptions of their educational environment in an integrated curriculum in Saudi Arabia.

OBJECTIVE: To measure medical students' perceptions of their educational environment and to determine the potential differences in those perceptions with regard to gender and the year of study. METHODS: The cross-sectional study was conducted at the College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia, in 2018-19, and comprised medical students enrolled at the college. Data was collected using the Dundee Ready Educational Environment Measure scale. Data was analysed using SPSS 22. RESULTS: Of the 262 students approached, 191(73%) responded. The total mean score was 122.49±21.50. Perception of educational environment was higher for male students and advanced-level students (p<0.05). CONCLUSIONS: The findings illustrated a healthy educational environment.

Potential Diagnostic and Prognostic Utility of miR-141, miR-181b1, and miR-23b in Breast Cancer.

miRNAs, a group of short noncoding RNAs, are key regulators of fundamental cellular processes and signaling pathways. Dysregulation of miRNA expression with known oncogenic or tumor suppressor functions has been associated with neoplastic transformation. Numerous studies have reported dysregulation of miRNA-141, miR-181b1, and miR-23b in a wide range of malignancies, including breast cancer. To the best of our knowledge, no previous study had demonstrated the expression of miR-141-3p, miR-181b1-5p, and miR-23b-3p in different histological grades and molecular subtypes of breast cancer. Here, we identified differential expression of these three miRNAs in breast cancer tissues compared with benign breast fibroadenomas. In addition, high expression levels of miR-141-3p and miR-181b1-5p are strongly associated with aggressive breast carcinomas. We also confirmed the clinical potential of using the three miRNAs individually or combined as diagnostic and prognostic markers in breast cancer. Using bioinformatics analyses, we identified 23 hub genes of these three miRNAs which are involved in key signaling pathways in breast cancer. Furthermore, the KM plotter online database analysis demonstrates the association between elevated expression of miR-141 and miR-181b and shorter overall survival of breast cancer patients. Together, our data suggest an oncogenic role of the studied miRNAs and highlight their molecular roles and potential clinical applications in breast cancer.

Coronavirus disease-19 spread in the Eastern Mediterranean Region, updates and prediction of disease progression in Kingdom of Saudi Arabia, Iran, and Pakistan.

OBJECTIVES: The present study is considered the first study that aims to estimate the spread of coronavirus disease (COVID)-19 pandemic in the Eastern Mediterranean Region and to predict the pattern of spread among Kingdom of Saudi Arabia (KSA) in comparison to Iran and Pakistan. METHODS: Data during the period from January 29, 2020, till April 14, 2020, were extracted from 76 WHO situational reports and from the Worldometer website. Numbers of populations in each country were considered during data analysis. Susceptible, infectious, recovered, and deaths (SIRD) model and smoothing spline regression model were used to predict the number of cases in each country. RESULTS: SIRD model in KSA yielded ß = 2e-0.6, γ = 0.006, and µ = 0.00038 and R0= 0.00029. It is expected that by the 1st of May 2020, that number of cumulative infected cases would rise to 16848 in KSA and to 11,825 in Pakistan while in Iran, it is expected that the number mostly will be 100485. Moreover, the basic reproduction number R0 is expected to decrease by time progression. CONCLUSION: The cumulative infected cases are expected to grow exponentially. Although R0 is expected to be decreased, the quarantine measures should be maintained or even enhanced.

Clinical Significance of Expression Changes and Promoter Methylation of PLA2R1 in Tissues of Breast Cancer Patients.

Phospholipase A2 receptor 1 (PLA2R1) expression and its role in the initiation and progression of breast cancer are an unresolved issue. PLA2R1 was found to endorse several tumor suppressive responses, including cellular senescence and apoptosis. Previous in vitro studies demonstrated that DNA hypermethylation was highly associated with the epigenetic silencing of PLA2R1 in breast cancer cell lines. Our objective was to study the level of PLA2R1 mRNA expression and the methylation of its promoter in different histological grades and molecular subtypes of breast cancer. We performed bioinformatics analyses on available human breast cancer expression datasets to assess the PLA2R1 mRNA expression. We used qRT-PCR to evaluate the PLA2R1 mRNA expression and its promoter's methylation in breast cancer tissue in comparison to breast fibroadenomas. Our results describe, for the first time, the expression of PLA2R1 and the methylation of its promoter in human breast cancer tissues. A significant downregulation of PLA2R1, together with hypermethylation of the promoter was detected in breast cancers of different histological grades and molecular subtypes when compared to benign breast tissues. PLA2R1 promoter hypermethylation was associated with aggressive subtypes of breast cancer. In conclusion, PLA2R1 promoter hypermethylation is a potentially useful diagnostic and prognostic biomarker and could serve as a possible therapeutic target in breast cancer.

Shift work and risk of skin cancer: A systematic review and meta-analysis.

Shift work with circadian disruption has been considered as a carcinogenic risk factor for skin cancer. The few prior studies that investigated the association between shift work and skin cancer have inconclusive results. Our main objective was to evaluate the associations between shift work and the risks of different types of skin cancer. We systematically searched PubMed, Web of Science, Cochrane Library, EMBASE and Science Direct until October 2018 for studies that included a relationship between shift work and skin cancer. Our search yielded 193 articles and 9 studies met the criteria for our review. The included studies involved 3,579,147 participants and 17,308 skin cancer cases. Overall, ever shift work, was associated with increased risk of melanoma (RR = 1.10, 95% CI = 1.05-1.16) and a significant decrease in the risk of BCC (RR = 0.90, 95% CI = 0.88-0.93). No association between shift work and the risk of SCC was detected. Interestingly, our dose response analysis demonstrated that the risk of melanoma cumulatively increases by 2% for every year of shift work (RR = 1.02; 95% CI = 1.00-1.03). In conclusion, shift work is associated with increased risk of melanoma and deceased risk of BCC. Further studies are needed to confirm our findings and to elucidate the related potential biological mechanisms.