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Scientific Reports May 2024Tuberculosis (TB), caused by Mycobacterium tuberculosis, ranks among the top causes of global human mortality, as reported by the World Health Organization's 2022 TB...
Tuberculosis (TB), caused by Mycobacterium tuberculosis, ranks among the top causes of global human mortality, as reported by the World Health Organization's 2022 TB report. The prevalence of M. tuberculosis strains that are multiple and extensive-drug resistant represents a significant barrier to TB eradication. Fortunately, having many completely sequenced M. tuberculosis genomes available has made it possible to investigate the species pangenome, conduct a pan-phylogenetic investigation, and find potential new drug targets. The 442 complete genome dataset was used to estimate the pangenome of M. tuberculosis. This study involved phylogenomic classification and in-depth analyses. Sequential filters were applied to the conserved core genome containing 2754 proteins. These filters assessed non-human homology, virulence, essentiality, physiochemical properties, and pathway analysis. Through these intensive filtering approaches, promising broad-spectrum therapeutic targets were identified. These targets were docked with FDA-approved compounds readily available on the ZINC database. Selected highly ranked ligands with inhibitory potential include dihydroergotamine and abiraterone acetate. The effectiveness of the ligands has been supported by molecular dynamics simulation of the ligand-protein complexes, instilling optimism that the identified lead compounds may serve as a robust basis for the development of safe and efficient drugs for TB treatment, subject to further lead optimization and subsequent experimental validation.
Topics: Mycobacterium tuberculosis; Antitubercular Agents; Humans; Drug Design; Tuberculosis; Proteomics; Genome, Bacterial; Bacterial Proteins; Phylogeny; Molecular Docking Simulation; Molecular Dynamics Simulation; Genomics
PubMed: 38740859
DOI: 10.1038/s41598-024-61752-6 -
PLoS Neglected Tropical Diseases May 2024Prognosis of Chronic Chagasic Cardiomyopathy (CCC) patients depends on functional and clinical factors. Bradyarrhythmia requiring pacemaker is a common complication.... (Observational Study)
Observational Study
BACKGROUND
Prognosis of Chronic Chagasic Cardiomyopathy (CCC) patients depends on functional and clinical factors. Bradyarrhythmia requiring pacemaker is a common complication. Prognosis of these patients is poorly studied, and mortality risk factors are unknown. We aimed to identify predictors of death and to define a risk score for mortality in a large cohort of CCC patients with pacemaker.
METHODS
It was an observational, unicentric and prospective study. The endpoint was all-cause mortality. Cox regression was used to identify predictors of death and to define a risk score. Bootstrapping method was used to internal score validation.
RESULTS
We included 555 patients and after a mean follow-up of 3.7±1.5 years, 100 (18%) deaths occurred. Predictors of death were: right ventricular dysfunction (HR [hazard ratio] 2.24; 95%CI 1.41-3.53; P = 0.001); heart failure class III or IV (HR 2.16; 95% confidence interval [95%CI] 1.16-4.00; P = 0.014); renal disease (HR 2.14; 95%CI 1.24-3.68; P = 0.006); left ventricular end-systolic diameter > 44mm (HR 1.97; 95%CI 1.26-3.05; P = 0.003); atrial fibrillation (HR 1.94; 95%CI 1.25-2.99; P = 0.003) and cardiomegaly on X-ray (HR 1.87; 95%CI 1.10-3.17; P = 0.020). The score identified patients with: low (0-20 points), intermediate (21-30 points) and high risk (>31points). The optimism-corrected C-statistic of the predictive model was 0.751 (95% CI 0.696-0.806). Internal validation with bootstrapping revealed a calibration slope of 0.946 (95% CI 0.920-0.961), reflecting a small degree of over-optimism and C-statistic of 0.746 (95% CI 0.692-0.785).
CONCLUSIONS
This study identified predictors of mortality in CCC patients with pacemaker defining a simple, validated and specific risk score.
Topics: Humans; Male; Female; Chagas Cardiomyopathy; Middle Aged; Prospective Studies; Pacemaker, Artificial; Aged; Risk Factors; Prognosis; Risk Assessment; Adult
PubMed: 38723058
DOI: 10.1371/journal.pntd.0012114 -
Heliyon May 2024Considering the need to gain a deeper understanding of the protective factors associated with coping with food insecurity, specifically in times of severe prolonged...
Considering the need to gain a deeper understanding of the protective factors associated with coping with food insecurity, specifically in times of severe prolonged stress, the current longitudinal study seeks to examine the role of optimism in the relationship between food insecurity and adverse mental health outcomes during the COVID-19 pandemic. A three-wave longitudinal study involving 1921 Israeli adults was performed during the COVID-19 pandemic. Participants completed questionnaires assessing food insecurity, anxiety, depression, optimism, and socio-demographic characteristics. To explore the relationship between food insecurity and symptoms of anxiety and depression, as well as the moderating role of optimism in this relationship, we employed a set of panel regression models with individual fixed effects. Our results indicate that the degree and change in food insecurity over time were positively associated with both anxiety and depression symptoms, whereas the degree and change in optimism were negatively correlated. Optimism was found to moderate the association between food insecurity and anxiety symptoms over time, but not the association between food insecurity and depression symptoms. A subgroup analysis revealed that optimism moderated the relationship between food insecurity and anxiety and depression for women, but not for men; for married/coupled individuals but not for singles; for non-parents with regard to anxiety, and for parents with regard to depression. Our results highlight the need to practice and enhance optimism in times of great despair, uncertainty, and hardship, especially in situations of food insecurity where tangible change may take time.
PubMed: 38720755
DOI: 10.1016/j.heliyon.2024.e30385 -
BMC Medical Education May 2024The current applications of artificial intelligence (AI) in medicine continue to attract the attention of medical students. This study aimed to identify undergraduate...
BACKGROUND
The current applications of artificial intelligence (AI) in medicine continue to attract the attention of medical students. This study aimed to identify undergraduate medical students' attitudes toward AI in medicine, explore present AI-related training opportunities, investigate the need for AI inclusion in medical curricula, and determine preferred methods for teaching AI curricula.
METHODS
This study uses a mixed-method cross-sectional design, including a quantitative study and a qualitative study, targeting Palestinian undergraduate medical students in the academic year 2022-2023. In the quantitative part, we recruited a convenience sample of undergraduate medical students from universities in Palestine from June 15, 2022, to May 30, 2023. We collected data by using an online, well-structured, and self-administered questionnaire with 49 items. In the qualitative part, 15 undergraduate medical students were interviewed by trained researchers. Descriptive statistics and an inductive content analysis approach were used to analyze quantitative and qualitative data, respectively.
RESULTS
From a total of 371 invitations sent, 362 responses were received (response rate = 97.5%), and 349 were included in the analysis. The mean age of participants was 20.38 ± 1.97, with 40.11% (140) in their second year of medical school. Most participants (268, 76.79%) did not receive formal education on AI before or during medical study. About two-thirds of students strongly agreed or agreed that AI would become common in the future (67.9%, 237) and would revolutionize medical fields (68.7%, 240). Participants stated that they had not previously acquired training in the use of AI in medicine during formal medical education (260, 74.5%), confirming a dire need to include AI training in medical curricula (247, 70.8%). Most participants (264, 75.7%) think that learning opportunities for AI in medicine have not been adequate; therefore, it is very important to study more about employing AI in medicine (228, 65.3%). Male students (3.15 ± 0.87) had higher perception scores than female students (2.81 ± 0.86) (p < 0.001). The main themes that resulted from the qualitative analysis of the interview questions were an absence of AI learning opportunities, the necessity of including AI in medical curricula, optimism towards the future of AI in medicine, and expected challenges related to AI in medical fields.
CONCLUSION
Medical students lack access to educational opportunities for AI in medicine; therefore, AI should be included in formal medical curricula in Palestine.
Topics: Humans; Artificial Intelligence; Students, Medical; Cross-Sectional Studies; Male; Female; Education, Medical, Undergraduate; Young Adult; Curriculum; Surveys and Questionnaires; Middle East; Arabs; Attitude of Health Personnel; Adult; Qualitative Research
PubMed: 38714993
DOI: 10.1186/s12909-024-05465-4 -
Scientific Reports May 2024When updating beliefs, humans tend to integrate more desirable information than undesirable information. In stable environments (low uncertainty and high...
When updating beliefs, humans tend to integrate more desirable information than undesirable information. In stable environments (low uncertainty and high predictability), this asymmetry favors motivation towards action and perceived self-efficacy. However, in changing environments (high uncertainty and low predictability), this process can lead to risk underestimation and increase unwanted costs. Here, we examine how people (n = 388) integrate threatening information during an abrupt environmental change (mandatory quarantine during the COVID-19 pandemic). Given that anxiety levels are associated with the magnitude of the updating belief asymmetry; we explore its relationship during this particular context. We report a significant reduction in asymmetrical belief updating during a large environmental change as individuals integrated desirable and undesirable information to the same extent. Moreover, this result was supported by computational modeling of the belief update task. However, we found that the reduction in asymmetrical belief updating was not homogeneous among people with different levels of Trait-anxiety. Individuals with higher levels of Trait-anxiety maintained a valence-dependent updating, as it occurs in stable environments. On the other hand, updating behavior was not associated with acute anxiety (State-Anxiety), health concerns (Health-Anxiety), or having positive expectations (Trait-Optimism). These results suggest that highly uncertain environments can generate adaptive changes in information integration. At the same time, it reveals the vulnerabilities of individuals with higher levels of anxiety to adapt the way they learn.
Topics: Humans; COVID-19; Female; Male; Adult; Anxiety; Uncertainty; SARS-CoV-2; Middle Aged; Motivation; Young Adult; Quarantine; Pandemics; Adolescent
PubMed: 38714776
DOI: 10.1038/s41598-024-61207-y -
PeerJ 2024Watching a magic trick is a unique experience in which seemingly impossible events appear possible but without any suspension of disbelief. Unfortunately, relatively...
Watching a magic trick is a unique experience in which seemingly impossible events appear possible but without any suspension of disbelief. Unfortunately, relatively little work has examined the psychological impact of this fascinating experience. In the current study, participants first completed a measure of the degree to which they disliked magic (Loathing of Legerdemain Scale: LOLS) and then watched a video that either contained a series of magic tricks (magic video) or carefully matched non-magic tricks (control video). Participants then rated the degree to which they experienced positive epistemic emotions (Epistemically Related Emotion Scale: ERES), their belief about impossible events being possible in the future (Modal Judgment Task: MJT), general optimism (State Optimism Measure: SOM) and subjective wellbeing (Satisfaction With Life Scale: SWLS). Compared to participants who watched the control video, those who saw the magic video reported more positive epistemic emotions on the ERES. There were no significant differences on the MJT, SOM and SWLS. Participants' LOLS scores were negatively correlated with the ERES, SOM and SWLS, suggesting that those who like magic are more likely to experience positive epistemic emotions, have higher levels of general optimism, and express greater satisfaction with their lives. These findings are discussed within the context of short-term and long-term exposure to magic, along with recommendations for future work.
Topics: Humans; Female; Male; Optimism; Emotions; Adult; Young Adult; Personal Satisfaction; Adolescent
PubMed: 38708358
DOI: 10.7717/peerj.17308 -
Brain, Behavior, & Immunity - Health Jul 2024This study analyzes, in nurses, the influence of openness to experience and hardiness (assessed at baseline and one year after the COVID-19 pandemic respectively) on the...
AIMS AND OBJECTIVES
This study analyzes, in nurses, the influence of openness to experience and hardiness (assessed at baseline and one year after the COVID-19 pandemic respectively) on the development of optimism (assessed two years after the COVID-19 pandemic). Concerns about self-contagion were included as a moderating variable, given their relevance as a risk factor.
BACKGROUND
Nurses have been among the healthcare professionals most affected by the COVID-19 pandemic. Most previous studies have focused on the variables contributing to psychological symptoms, whilst the attention given to the variables adding to the well-being of these professionals has been much scarcer.
DESIGN
A prospective study was carried out.
METHODS
This study was carried out using three data collection periods: Period 1 (From May to June 2020), Period 2 (From January 2021 to April 2021), and Period 3 (From April 2022 to July 2022), with the participation of 151 Spanish nurses, using online self-reporting questionnaires. The study followed the STROBE statement.
RESULTS
The results showed that the proposed model was statistically significant. There was a positive effect of openness to experience (year 2020) on hardiness assessed one year later (year 2021). Similarly, hardiness had a positive effect on optimism assessed another year on (year 2022).
CONCLUSIONS
Concerns about self-contagion behaved as a moderator in the relationship between openness to experience and hardiness (the relationship between openness and hardiness was statistically significant when contagion concern was higher). Relevance to clinical practice: In-depth understanding of the psychological processes that trigger psychological strengths (i.e. optimism) as a result of adverse situations (i.e. COVID-19 pandemic) is essential in promoting the mental health of healthcare professionals. Interventions targeting resilient personality traits and cognitive flexibility are key to this goal. No Patient or Public Contribution: The participants contributed exclusively to the collection of the sample.
PubMed: 38706572
DOI: 10.1016/j.bbih.2024.100782 -
BMC Medical Education May 2024People with substance use disorder (SUD) deal with stigmatization in various areas of life, including healthcare system. In this study, we investigated the attitudes of...
INTRODUCTION
People with substance use disorder (SUD) deal with stigmatization in various areas of life, including healthcare system. In this study, we investigated the attitudes of final-year medical students towards SUD people and attempted to understand their influence.
METHODS
We conducted a two-stage cluster analysis (hierarchical ascending classification followed by K-means clustering) based on the "beSAAS". We administrated this 23-item questionnaire to 923 final-year medical students in Belgium (response rate = 71,1%). Sociodemographic characteristics were compared between the clusters.
RESULTS
Four clusters of students with specific characteristics were identified in this study. The first, "The Inclusives" (including 27,9% of respondents) had the least negative attitudes; they wanted to specialize mainly in psychiatry and gynecology. The second, "The Centrists" (23,6%) consisted mainly of male students. They had many private and professional experiences with substance use and considered themselves less healthy than others did. Most wanted to specialize in pediatrics and general practice. Their attitudes were slightly negative towards people with SUD. The third, "The Moralists" (27,6%), were mainly older, from non-European countries, had the least experience with substance use (or contact mainly in hospitals), had the less high mother's level of education and reported excellent health. They were heading toward other specialties. They had the most stereotypes and moralism, and less treatment optimism. The fourth, "The Specialist care-oriented" (20,8%), were the most in favor of specialized treatment. This group had a higher proportion of Belgian, females, and students who had specific contact with this population. They especially intended to specialize in internal medicine.
CONCLUSION
This study revealed 4 profiles of medical students with different attitudes towards SUD people. "The Moralists", including more than a quarter of the respondents, were characterized by strong stereotypes and moralism and little treatment optimism. These clusters could contribute to the design of a learner-centered program aimed at addressing stigma within the main curriculum.
Topics: Humans; Students, Medical; Male; Female; Substance-Related Disorders; Attitude of Health Personnel; Belgium; Cluster Analysis; Adult; Surveys and Questionnaires; Young Adult; Education, Medical, Undergraduate
PubMed: 38702647
DOI: 10.1186/s12909-024-05380-8 -
Antimicrobial Stewardship & Healthcare... 2024Many factors have been associated with the risk of toxigenic diarrhea (TCdD). This study derived and internally validated a multivariate model for estimating the risk...
BACKGROUND
Many factors have been associated with the risk of toxigenic diarrhea (TCdD). This study derived and internally validated a multivariate model for estimating the risk of TCdD in patients with diarrhea using readily available clinical factors.
METHODS
A random sample of 3,050 symptomatic emergency department or hospitalized patients undergoing testing for toxigenic at a single teaching hospital between 2014 and 2018 was created. Unformed stool samples positive for both glutamate dehydrogenase antigen by enzyme immunoassay and gene by polymerase chain reaction were classified as TCdD positive. The TCdD Model was created using logistic regression and was modified to the TCdD Risk Score to facilitate its use.
RESULTS
8.1% of patients were TCdD positive. TCdD risk increased with abdominal pain (adjusted odds ratio 1.3; 95% CI, 1.0-1.8), previous diarrhea (2.5, 1.1-6.1), and prior antibiotic exposure, especially when sampled in the emergency department (4.2, 2.5-7.0) versus the hospital (1.7, 1.3-2.3). TCdD risk also increased when testing occurred earlier during the hospitalization encounter, when age and white cell count increased concurrently, and with decreased eosinophil count. In internal validation, the TCdD Model had moderate discrimination (optimism-corrected C-statistic 0.65, 0.62-0.68) and good calibration (optimism-corrected Integrated Calibration Index [ICI] 0.017, 0.001-0.022). Performance decreased slightly for the TCdD Risk Score (C-statistic 0.63, 0.62-0.63; ICI 0.038, 0.004-0.038).
CONCLUSIONS
TCdD risk can be predicted using readily available clinical risk factors with modest accuracy.
PubMed: 38698945
DOI: 10.1017/ash.2024.58