Soluble PILRα: A novel plasma biomarker for atrial fibrillation progression and recurrence after catheter ablation.

BACKGROUND: We aimed to identify plasma biomarkers of atrial fibrillation (AF) progression and recurrence after catheter ablation. METHODS: Using AF gene profiling data from GEO database, a weighted gene co-expression network analysis (WGCNA) was conducted to determine the most significant module and hub genes associated with AF. Subsequently, 318 consecutively admitted patients who had undergone radiofrequency catheter ablation were enrolled in this study. RESULTS: WGCNA results revealed that paired immunoglobulin-like type 2 receptor alpha (PILRA) was the only black module gene highly correlated with clinical traits. Plasma soluble PILRα (sPILRα) levels were elevated in patients with AF and significantly elevated in patients with persistent versus paroxysmal AF (4.64 ± 2.74 vs. 3.04 ± 1.56 ng/mL, p < 0.001). Elevated sPILRα level was an independent risk factor for AF progression even after adjusting for traditional factors (adjusted odds ratio: 3.06, 95 % confidence interval [CI]: 1.88-5.27, p < 0.001) and AF recurrence after catheter ablation in patients with persistent AF (adjusted hazards ratio: 4.41, 95 % CI: 1.22-15.92, p = 0.023). CONCLUSIONS: WGCNA screening of GEO microarray gene profiling data showed PILRA expression levels to be correlated with AF progression and recurrence after catheter ablation in patients with persistent AF.

Causal relationship between atrial fibrillation and leukocyte telomere length: A two sample, bidirectional Mendelian randomization study.

Background: Atrial fibrillation (AF) is an age-related disease, while telomeres play a central role in aging. But the relationship between AF and telomere length (LTL) is still controversial. This study aims to examine the potential causal association between AF and LTL by using Mendelian randomization (MR). Methods: Bidirectional two-sample MR, expression and protein quantitative trait loci (eQTL and pQTL)-based MR were performed using genetic variants from United Kingdom Biobank, FinnGen, and a meta-analysis study, which comprised nearly 1 million participants in the Atrial Fibrillation Study and 470,000 participants in the Telomere Length Study. Apart from the inverse variance weighted (IVW) approach as the main MR analysis, complementary analysis approaches and sensitivity analysis were applied. Results: The forward MR revealed a significant causal estimate for the genetically predicted AF with LTL shortening [IVW: odds ratio (OR) = 0.989, p = 0.007; eQTL-IVW: OR = 0.988, p = 0.005; pQTL-IVW: OR = 0.975, p < 0.005]. But in the reverse MR analysis, genetically predicted LTL has no significant correlation with AF (IVW: OR = 0.995, p = 0.916; eQTL-IVW: OR = 0.999, p = 0.995; pQTL-IVW: OR = 1.055, p = 0.570). The FinnGen replication data yielded similar findings. Sensitivity analysis ensured the stability of the results. Conclusion: The presence of AF leads to LTL shortening rather than the other way around. Aggressive intervention for AF may delay the telomere attrition.

Predicting Behavioral Intentions Related to Cervical Cancer Screening Using a Three-Level Model for the TPB and SCT in Nanjing, China.

: Objective: Exploring how the theory of planned behavior (TPB), social capital theory (SCT), cervical cancer knowledge (CCK), and demographic variables predict behavioral intentions (BI) related to cervical cancer screening among Chinese women. METHODS: Self-administered questionnaires were distributed to 496 women, followed by a path analysis. RESULTS: The three-level model was acceptable, χ2(26, 470) = 26.93, p > 0.05. Subjectively overcoming difficulties, support from significant others, screening necessity, and the objective promotion factor promoted BI, with effect sizes of 0.424, 0.354, 0.199, and 0.124. SCT and CCK promoted BI through TPB, with effect sizes of 0.262 and 0.208. Monthly income, education, age, and childbearing condition affected BI through TPB, SCT, and CCK, with effect sizes of 0.269, 0.105, 0.065, and -0.029. CONCLUSION: The three-level model systematically predicted behavioral intentions relating to cervical cancer screening.

The effects of flipped classrooms on undergraduate pharmaceutical marketing learning: A clustered randomized controlled study.

BACKGROUND: Recently, flipped classrooms (FCs) have gradually been used in Chinese higher education settings. However, few studies have focused on the effects of FCs on interdisciplinary curricula. The purpose of this study was to examine the impact of an FC on the engagement, performance, and perceptions of students and on teacher-student interaction in a pharmaceutical marketing course. DESIGN: A clustered randomized controlled study was conducted, with 137 junior-year pharmacy undergraduates using an FC serving as the intervention group, in contrast to students using lecture-based learning (LBL) as the control group. Flanders' interaction analysis system (FIAS) was used to measure teacher-student interaction, and questionnaires regarding attitudes toward and satisfaction with the teaching model were administered. RESULTS: The students in the FC group scored significantly higher than those in the LBL group (88.21±5.95 vs. 80.05±5.59, t = -8.08, p = 0.000) on pharmaceutical marketing. The multiple linear regression results showed that the FC model had a significant impact on student performance (ß = 8.16, p<0.0001). The percentages of teacher talk in the FC and LBL groups were 21% and 96%, respectively (χ2 = 2170.274, p = 0.000); however, the percentages of student talk in the FC and LBL groups were 75% and 2.6%, respectively (χ2 = 2012.483, p = 0.000). Compared with the LBL group, most students in the FC group held more positive attitudes toward the teaching model; the mean scores for the 8 attitude attributes in the FC group were significantly higher than those in the LBL group (p = 0.000). There were significant differences in the ratings of satisfaction with teacher-student interaction (p = 0.000), the students' learning attitude (p = 0.000), the teacher's preparatory work (p = 0.000), the teaching objective (p = 0.000), and the teaching effect (p = 0.000) between the two groups. CONCLUSION: Compared with LBL methods, implementing the FC model improved student performance, increased teacher-student interaction and generated positive student attitudes toward the experience. As an effective pedagogical model, it can also stimulate pharmacy students' learning interest and improve their self-learning abilities.