The professionalism of clinical teachers in clinical education.

BACKGROUND: Professionalism has long been recognised as a core competency for clinical teachers as role models and educators. The present study aimed to evaluate the adherence to professionalism of clinical teachers from the perspectives of resident doctors and undergraduate medical students. METHODS: This is a descriptive and cross-sectional study. All learners, including undergraduate medical students and residents who were studying in the medical school and teaching hospitals affiliated with Shahid Sadoughi University, were entered into this study as evaluators (n = 311). Of these, 151 clinical teachers were assessed by the learners. The students were asked to assess the two clinical teachers with whom they had interacted during the previous month in the clinical department. The Faculty Professionalism Evaluation Questionnaire was used in this study. RESULTS: The results of the confirmatory factor analysis (CFA) confirmed the adequacy of the model. The total mean score was 1.98 (standard deviation=0.36, range = 0.96 to 2.82). In addition, the total mean score of the adherence to professionalism among clinical teachers was reported at the level of "met expectations". The results showed that the teachers' scores in the domains of "doctor-patient relationship" and "doctor-student relationship" were reported under the "met expectations" level. Their scores in the "inter-professional relationship" and "doctor-self relationship" domains were reported as "below expectations". The results showed the scores of teachers' professionalism were significantly lower from the viewpoints of residents than in the perceptions of medical students (p=0.0001). CONCLUSION: The professionalism scores of clinical teachers were evaluated as "below expectations" from the learners' perspectives.

Integrated whole transcriptome profiling revealed a convoluted circular RNA-based competing endogenous RNAs regulatory network in colorectal cancer.

Recently, it has been identified that circRNAs can act as miRNA sponge to regulate gene expression in various types of cancers, associating them with cancer initiation and progression. The present study aims to identify colorectal cancer-related circRNAs and the underpinning mechanisms of circRNA/miRNA/mRNA networks in the development and progress of Colorectal Cancer. Differentially expressed circRNAs, miRNAs, and mRNAs were identified in GEO microarray datasets using the Limma package of R. The analysis of differentially expressed circRNAs resulted in 23 upregulated and 31 downregulated circRNAs. CeRNAs networks were constructed by intersecting the results of predicted and experimentally validated databases, circbank and miRWalk, and by performing DEMs and DEGs analysis using Cytoscape. Next, functional enrichment analysis was performed for DEGs included in ceRNA networks. Followed by survival analysis, expression profile assessment using TCGA and GEO data, and ROC curve analysis we identified a ceRNA sub-networks that revealed the potential regulatory effect of hsa_circ_0001955 and hsa_circ_0071681 on survival-related genes, namely KLF4, MYC, CCNA2, RACGAP1, and CD44. Overall, we constructed a convoluted regulatory network and outlined its likely mechanisms of action in CRC, which may contribute to the development of more effective approaches for early diagnosis, prognosis, and treatment of CRC.

Evaluation of hematological parameters alterations in different waves of COVID-19 pandemic: A cross-sectional study.

BACKGROUND: The occurrence of variations in routine hematological parameters is closely associated with disease progression, the development of severe illness, and the mortality rate among COVID-19 patients. This study aimed to investigate hematological parameters in COVID-19 hospitalized patients from the 1st to the 5th waves of the current pandemic. METHODS: This cross-sectional study included a total of 1501 hospitalized patients with laboratory-confirmed COVID-19 based on WHO criteria, who were admitted to Shahid Sadoughi Hospital (SSH) in Yazd, Iran, from February 2020 to September 2021. Throughout, we encountered five COVID-19 surge waves. In each wave, we randomly selected approximately 300 patients and categorized them based on infection severity during their hospitalization, including partial recovery, full recovery, and death. Finally, hematological parameters were compared based on age, gender, pandemic waves, and outcomes using the Mann-Whitney U and Kruskal-Wallis tests. RESULTS: The mean age of patients (n = 1501) was 61.1±21.88, with 816 (54.3%) of them being men. The highest mortality in this study was related to the third wave of COVID-19 with 21.3%. There was a significant difference in all of the hematological parameters, except PDW, PLT, and RDW-CV, among pandemic waves of COVID-19 in our population. The highest rise in the levels of MCV and RDW-CV occurred in the 1st wave, in the 2nd wave for lymphocyte count, MCHC, PLT count, and RDW-SD, in the 3rd wave for WBC, RBC, neutrophil count, MCH, and PDW, and in the 4th wave for Hb, Hct, and ESR (p < 0.01). The median level of Hct, Hb, RBC, and ESR parameters were significantly higher, while the mean level of lymphocyte and were lower in men than in women (p < 0.001). Also, the mean neutrophil in deceased patients significantly was higher than in those with full recovered or partial recovery (p < 0.001). CONCLUSION: The findings of our study unveiled notable variations in hematological parameters across different pandemic waves, gender, and clinical outcomes. These findings indicate that the behavior of different strains of the COVID-19 may differ across various stages of the pandemic.

The effect of continuing interprofessional education on improving learners' self-efficacy and attitude toward interprofessional learning and collaboration.

We aimed to assess the effect of continuing interprofessional education on collaborative self-efficacy, attitude toward the team, and interprofessional learning in workplace-based learning situations. This was a quasi-experimental study conducted in two educational hospitals. Two hundred and ten participants including nursing and medicine from general medicine, internal medicine, and emergency medicine, entered the study and were categorized in the census's intervention group (n = 97) and control group (n = 113). Continuing interprofessional education interventions included interprofessional rounds and workshops. Attitudes toward the team and interprofessional learning and collaborative self-efficacy were assessed using the Readiness for Interprofessional Learning, Attitudes Toward Health Care Teams, and Interprofessional Collaborator Assessment. Participants' attitude toward the team (p-value <.001), attitude toward interprofessional learning (p-value <.001), and interprofessional collaborative self-efficacy (p-value <.001) were significantly improved compared to participants' scores in the control group. Integrating the principles of continuing education, interprofessional education, and workplace-based learning provided an effective learning situation through interactive relationships and active collaboration of participants. The findings revealed a significant educational effect of the intervention on attitude toward interprofessional learning and the team, and a small effect on self-efficacy of interprofessional collaboration.

Comparison of the effects of etomidate, ketamine, sodium thiopental, and midazolam on the mortality of patients with COVID-19 requiring intubation.

Background: Among the medications administered for the management of COVID-19 patients, the induction drugs used for intubation have received little attention. The aim of this study was to compare the effect of induction drugs on the mortality of patients with COVID-19 requiring intubation. Methods: In this retrospective study, all patients who were admitted to Shahid Sadoughi and Shahid Rahnemoun hospitals in Yazd from February to March 2020 with definitive diagnosis of COVID-19 and needed intubation were enrolled. Patients were divided into 4 groups based on the type of drugs used in intubation, and mortality rate was assessed at the end of the first, second, fourth, and seventh days of the study. Statistical analyses were performed using SPSS 20 and P values <.05 was considered significant. Results: In this study, 76 patients were examined. Patients were divided into 4 groups, of which 21 were in etomidate group, 8 in ketamine group, 21 in sodium thiopental group, and 35 in midazolam group. Mortality rate in these 4 groups was 25%, 12.5%, 14.3%, and 14.3% (p=0.822), respectively at the end of the first day after intubation; it was 83.3%, 12.5%, 28.6%, and 25.7% (p=0.001), respectively, at the end of the second day; it was 83.3%, 12.5%, 42.9%, and 42.9% (p=0.015), respectively, until the end of the fourth day; it was 100%, 25%, 61.9%, and 65.7% (p=0.007), respectively, until the end of the seventh day. Admission to intubation time interval was 0.91±0.99, 3.12±1.95, 4.09±2.44, and 4.74±2.62 days, respectively (p<0.001). Conclusion: The results of this study suggest that the use of etomidate may be associated with higher mortality in COVID-19 patients. Further studies are needed to verify the results of this study.

Antimicrobial Peptides from Amphibian Innate Immune System as Potent Antidiabetic Agents: A Literature Review and Bioinformatics Analysis.

Antimicrobial peptides, as an important member of the innate immune system, have various biological activities in addition to antimicrobial activity. There are some AMPs with antidiabetic activity, especially those isolated from amphibians. These peptides can induce insulin release via different mechanisms based on peptide type. In this review study, we collected all reported AMPs with antidiabetic activity. We also analyze the sequence and structure of these peptides for evaluation of sequence and structure effect on their antidiabetic activity. Based on this review, the biggest peptide family with antidiabetic activity is temporins with nine antidiabetic peptides. Frogs are the most abundant source of antidiabetic peptides. Bioinformatics analysis showed that an increase of positive net charge and a decrease of hydrophobicity can improve the insulinotropic effect of peptides. Peptides with higher positive net charge and Boman index showed higher activity. Based on this review article, AMPs with antidiabetic activity, especially those isolated from amphibians, can be used as novel antidiabetic drug for type 2 diabetes disease. So, amphibians are potential sources for active peptides which merit further evaluation as novel insulin secretagogues. However, strategy for the increase of stability and positive activity as well as the decrease of negative side effects must be considered.

The Risk and Prevalence of COVID-19 Infection in Colorectal Cancer Patients: a Systematic Review and Meta-analysis.

BACKGROUND: Patients with cancer might be at an increased risk of infection with COVID-19 and a more severe disease course. However, different tumor types have differing susceptibility to the infection and COVID-19 phenotypes. Thus, the risk and prevalence of COVID-19 is not uniform across the different tumor types. Here, we performed a meta-analysis to estimate the risk and prevalence of COVID-19 infection in colorectal cancer (CRC) patients. METHODS: A comprehensive literature search was performed up to July 25, 2020, thorough PubMed, Web of Science, Scopus, Google Scholar, CNKI, CBM, China Science, Wan Fang, and SciELO databases. The risk of COVID-19 infection in CRC patients was performed based on the odds ratios (ORs) and 95% confidence interval (95% CI). RESULTS: A total of six studies with 204 different cancer patients with COVID-19 and 92 CRC infected patients with COVID-19 were selected. Our results showed that the prevalence of COVID-19 infection in CRC patients was 45.1% in the global population. The pooled data showed that there is no a significant risk of infection with COVID-19 in CRC patients in the global population (OR = 0.261, 95% CI 0.099-0.533, p = 0.082). However, when subgroup analysis was performed based on country of origin, we found a significant correlation in Chinese CRC patients (OR = 0.221, 95% CI 0.146-0.319, p ≤ 0.001). CONCLUSIONS: This study results revealed that Chinese CRC patients harbored a higher risk of COVID-19 infection. However, more multicenter, larger sample sizes and high-quality studies are required to verify this meta-analysis result.

Association Between the hOGG1 1245C>G (rs1052133) Polymorphism and Susceptibility to Colorectal Cancer: a Meta-analysis Based on 7010 Cases and 10,674 Controls.

BACKGROUND: The 1245C>G (rs1052133) polymorphism of human 8-oxoguanine DNA glycosylase 1 (hOGG1) gene has been indicated to be correlated with colorectal (CRC) susceptibility, but studies have yielded conflicting results. Thus, the present meta-analysis was performed to derive a more precise estimation between hOGG1 1245C>G polymorphism and CRC risk. METHODS: Data were collected from several electronic databases such as PubMed, EMBASE, and Google Scholar databases, with the last search up to September 01, 2020. Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to assess the strength of the association. RESULTS: A total of 24 case-control studies with 7010 CRC cases and 10,674 controls were selected. Pooled data showed that the hOGG1 1245C>G polymorphism was significantly associated with CRC risk under three genetic models, i.e., homozygote (GG vs. CC: OR = 1.229, 95% CI 1.031-1.465, p = 0.022); heterozygote (GC vs. CC: OR = 1.142, 95% CI 1.008-1.294, p = 0.037); and dominant (GG+GC vs. CC: OR = 1.162, 95% CI 1.034-1.304, p = 0.011). When stratified analysis by ethnicity, a significant association of the hOGG1 1245C>G polymorphism with risk of CRC was found in the Caucasians, but not in Asians. Moreover, there were significant associations between hOGG1 1245C>G polymorphism and CRC by PCR-RFLP and hospital-based subgroups. CONCLUSIONS: Inconsistent with the previous meta-analysis, these meta-analysis results revealed that the hOGG1 1245C>G polymorphism might be associated with an increased risk of CRC, especially in Caucasians.

Cumulative Evidence for Association Between IL-8 -251T>A and IL-18 -607C>A Polymorphisms and Colorectal Cancer Susceptibility: a Systematic Review and Meta-analysis.

PURPOSE: The correlation of IL-8 and IL-18 gene polymorphisms with colorectal cancer (CRC) was investigated by previous studies, though the results remained conflicting. Thus, the meta-analysis was performed to investigate the association of IL-8 -251T>A and IL-18 -607C>A polymorphisms with CRC risk. METHODS: A comprehensive search of the PubMed, Web of Science, CNKI, SciELO, and Wanfang databases was performed up to February 20, 2020. The strength of the associations was calculated with odds ratios (ORs) and their corresponding 95% of confidence intervals (CIs). RESULTS: A total of 16 case-control studies including 13 studies with 3908 cases and 5005 controls on IL-8 -251T>A polymorphism and three studies with 396 cases and 560 controls on IL-18 -607C>A polymorphism were selected. Pooled data revealed that the IL-8 -251T>A and IL-18 -607C>A polymorphisms were not significantly associated with an increased risk of CRC in global population. When stratified by ethnicity, source of controls, sample size, and Hardy-Weinberg equilibrium (HWE), there were still no significant association between IL-8 -251T>A polymorphism and risk of CRC. CONCLUSIONS: Our results revealed that the IL-8 -251T>A and IL-18 -607C>A polymorphisms were not associated with an increased susceptibility to CRC. We strongly call for further studies with larger sample sizes and different ethnicities to confirm our findings.

Association of XPC Polymorphisms with Cutaneous Malignant Melanoma Risk: Evidence from a Meta-Analysis.

BACKGROUND: A number of studies have reported that the xeroderma pigmentosum complementation group C (XPC) polymorphisms are associated with cutaneous malignant melanoma (CMM) susceptibility. But the results of those studies were inconsistent. Here, we performed a study to obtain a more conclusive result on the association of XPC polymorphisms with risk of CMM. METHODS: The XPC Lys939Gln and Ala499Val polymorphisms were genotyped in 150 CMM cases and 150 controls by PCR-RFLP assay. Subsequently, all published relevant studies were identified through a comprehensive literature search in PubMed, Web of Science, and CNKI databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the strength of correlation. RESULTS: There was no significant association between XPC Lys939Gln and Ala499Val polymorphisms and CMM risk in our population. A total of 15 case-control studies including ten studies with 5,990 cases and 7,697 controls on XPC Lys939Gln and five studies with 3,139 cases and 3,721 controls on XPC Ala499Val polymorphism were selected. Pooled data revealed that XPC Lys939Gln (C vs. A: OR = 1.108, 95% CI 1.008- 1.217; P = 0.033) and Ala499Val (C vs. A: OR = 0.918, 95% CI 0.850-0.992; p = 0.031; CC+CA vs. AA: OR = 0.904, 95% CI 0.819-0.997; p = 0.043) polymorphisms were significantly associated with an increased risk of CMM. Moreover, stratified analyses by ethnicity revealed that the XPC Ala499Val and Lys939Gln polymorphisms were significantly associated with risk of CMM in Caucasians and mixed populations, respectively. CONCLUSIONS: This meta-analysis result suggested that XPC Lys939Gln and Ala499Val polymorphisms were significantly associated with risk of CMM.

Association of IL-12B rs3212227 and IL-6 rs1800795 Polymorphisms with Susceptibility to Cervical Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND: Primary studies have shown that the IL-12B rs3212227 and IL-6 rs1800795 polymorphisms are associated with an increased risk of cervical cancer. However, conflicting results warrant a meta-analysis to obtain more precise estimates. METHODS: A comprehensive literate search on PubMed, Web of Science, Scopus, CNKI, and SciELO was performed to collect all eligible studies up to November 10, 2019. The pooled odds ratios (OR) and 95% confidence intervals (CI) were used to calculate the risk. This meta-analysis was carried out by utilizing CMA software. RESULTS: A total of eleven case-control studies including four studies on IL-12B rs3212227 and seven studies on IL-6 rs1800795 were selected. Pooled ORs revealed that the IL-6 rs1800795 polymorphism was significantly associated with an increased risk of cervical cancer (C vs. G: OR = 1.294, 95% CI 1.071-1.564, p= 0.007; CC vs. GG: OR = 1.633, 95% CI 1.059-2.520, p= 0.027; CC+CG vs. GG: OR = 1.312, 95% CI 1.048-1.643, p= 0.018; and CC vs. CG+GG: OR = 1.592, 95% CI 1.268-1.999, p≤0.001), but not IL-12B rs3212227 polymorphism. Stratified analysis by ethnicity revealed that both IL-12B rs3212227 and IL-6 rs1800795 polymorphisms were associated with risk of cervical cancer in Asian women. CONCLUSIONS: Our pooled data revealed that the IL-12B rs3212227 and IL-6 rs1800795 polymorphisms may be used to identify individuals at high risk of cervical cancer in Asian women.
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